Bone Density: Questions for the Experts (x-post on general forum)

Edited because the first post was way too long.  Sorry!

Hi!  Does anyone understand the physical process and "normal progression" of bone density changes? What would you think and do about the DXA bone density test results I explain below?  I welcome anyone's thoughts who wants to weigh in on these questions.

Today I had my physician-scheduled DXA scan, related to my annual physical, looking at bone density in my lower back and hips as markers toward Osteoporosis. This was helpful because I could compare the results to last year's similar DXA scan for trends. 

Some of you will remember that a month ago, I had a DEXA scan looking at whole body muscle/fat/etc, that was by a private fitness based company; today's test was a medical test done at my physician's clinic.  Same kind of machine, but a more focused look at bone density.

Today's results concerned me because they show what seems to me like quite a drop in density.  I am still well within the normal range, but am concerned about the trend.

I have been very diligent with my calcium supplements since surgery.  I have always taken Calcium Citrate.  Although I do not drink milk, I do eat a lot of cheese and greek yogurt. I also take my multivitamins regularly. I am 52 years old, and I think I am in peri-menopause.  Having had a hysterectomy, I don't have periods anymore, but I still have my ovaries.

Questions:

What might explain the change in density?  I definitely would not want to see such a drop every year. 

Is a change in bone density possibly related to peri-menopause?

Does bariatric surgery affect the bone density mechanism, in ways beyond calcium absorption?

Are there things in my diet that might be affecting calcium absorption?  Are there other things in my life or diet that might be affecting bone density mechanism besides the calcium?  (e.g., stress and cortisol?  Lack of nutrients from natural vegetable/fruit sources?)

What can I do to reduce this bone density drop?

Sounds like the second test was a better study than the first one. Menopause can cause a decrease in bone density, that is why it is recommended older women take calcium. Bariatric surgery not only affects calcium absorption, but also vit D, and magnesium absorption. Both help with calcium absorption.  Here is a webpage that may help answer some of your questions:                                                                         http://www.emedicinehealth.com/osteoporosis_and_calcium/arti cle_em.htm

To address your last question: how much calcium citrate are you taking daily? You could possibly need a larger dose. Have you had your PTH level done? A high level will indicate that your body is robbing from your bones to keep your serum calcium level in normal range. Your body keeps the serum level normal because your muscles (including heart) need it to function. What is your vitamin D level? It also needs to be on the high end of normal to help with calcium absorption. Magnesium glycinate and vit K2 (MK7) also help with calcium absorption. 

I hope this helps you.

PS  I had a revision to a distal bypass 4 months ago and had to switch my calcium citrate to Jarrows Bone Up due to severe constipation that caused a painful anal fissure. This type of calcium is not binding and cost me 4x more a month than citrate. My diet and supplement regimen is very similar to the DS.

I was on calcium citrate 4 times a day, and it still wasn't enough. I switched to the Patch multi and extra calcium/D3, and numbers got much, much better. You might want to think about trying it.

Thank you for this advice!  I have not tried the patch, but I think this might be a good reason to.

Thank you so much for replying to this post--especially since it has been a while since I posted it.  You have given me some really great information to look at.

I just had my blood work done again last week (since 6 mos ago).  My doctor (PCP) called me and told me "everything looks great," and I know that is not the whole story.  I should be able to pick up the actual numbers this week and look at them more closely. 

Thank you also for the link.  It looks like a very thorough treatment, and I look forward to reading it when the crazy election is not absorbing all our attention.