Category: Osteoporosis

Echos: The no-radiation method to determine bone density and quality

Echolights Scan

How many times have you gone to get your bone density tested? If you have done it even once, you know that the procedure involves radiation. Although many clinicians remind us that the radiation levels for many tests are low, I do know that women across the world are less accepting of continued use of radiation for diagnostics than we used to be. As I thought more about a radiation-free diagnostic, it became clear to me that preventative care usually begins with a personal experience that motivates an individual. If a 30-year-old person can get the data on their personal bone health when they are theoretically at their peak bone density, it seems to me that we would have an opportunity to intervene with healthy lifestyle choices and prevent a lot of problems down the line. In my mind, radiation-free means that people could stay abreast of their bone health throughout their life.

About the Echolights Scan

I first read about the EchoS in October 2020, when Echolight S.P.A. opened an office in the US. Initially, I was curious about this radiation-free technology that determines bone density and quality for personal interest. I wanted to know about my own bone quality, but I did not want to submit myself to more radiation. A lot of women I work with feel the same way. I was impressed by the clinical data from Europe where the device was first used in a clinical setting in 2015. The FDA approved the Echolight in 2018. Let’s delve into what this new technology really is.

How Does REMS Technology Measure Bone Density?

Echolight Medical developed the first clinically available method for the direct non-ionizing (radiation-free) measurement of lumbar and femoral bone mineral density (BMD). The device, EchoS, utilizes proprietary R.E.M.S. (Radiofrequency Echographic Multi Spectrometry) technology to scan the lumbar vertebrae and proximal femur. The EchoS rapidly generates a medical report that includes BMD, T-score, and Z-score. In addition, the system automatically assesses the quality of bone micro architecture, independent of BMD, and provides a five-year probability of a major osteoporosis fracture. For me, it’s a huge win to be able to monitor my osteoporosis more closely, with more frequent EchoS scans. I would like for my granddaughter and other women to be able to get a scan long before menopause to give them the data they need to spur their own preventative activities in regards to osteopenia and osteoporosis.

What Is the Fragility (Quality) Score?

The fragility score measures the quality (fragility) of the bone’s microarchitecture. Echolight’s proprietary score ranges from 1-100. The range is normal at 1 and fragile at 100, respectively. One could have a low bone mineral density, but having a lower fragility score would indicate a stronger microarchitecture (quality) of the bone. The spectral model created frail and non-frail data from real patients over 10 years. Here’s an analogy to help you understand the two parameters: A stool made of wood is less dense than a stool made of steel. Let’s say the steel stool has uneven legs, while the wooden stool is reinforced with struts and bands (quality architecture). One would likely sit on the wooden stool rather than the steel stool given the choice.

My REMS Scan Experience

I recently recorded a video podcast with Vicki Baldwin, RT(R), RDMS, RVT. Vicki is a clinical Sales Specialist who performs demonstration exams, and she provided us with an Echolight Scanning device. Vicki performed a bone and spine scan for four people on our podcast day. Flose was our first patient. She is a 28-year-old who is very health conscious. She had two fractures in her tibia in her teens and has been concerned about her bone density, but for obvious reasons, a DEXA did not make sense because of her age. Amalia is a 39-year-old mom with an 18-month-old baby. She was very sick during her pregnancy and had a difficult time with nutrition and exercise. She was concerned about her bone density but did not want to receive the DEXA due to radiation concerns. Virginia is a middle-aged woman who is very fit and active and quite petite. She was curious about her small stature and active life and what it means for bone density. Finally, I was scanned at 62.5 years. I have moved from osteopenia to osteoporosis again. Although the change was disappointing, I was encouraged by the fact that my bone quality is very good. As you all are familiar with the color coding that comes with many diagnoses, I had numbers in the red for density and numbers in the green for quality. I will be looking at all the reasons that may exist beyond aging for this change, but I will not be changing my activity level. My weightlifting keeps my muscles and balance strong, and we know that NOT falling is half the battle. When I have fallen on the tennis court, I bounce right back up, so I know that my bone quality is holding me in good stead right now. The great news is that I CAN monitor my bone density and quality more often now because we have a non-radiation method for getting information on our bones.

What’s in It for Us All

First, I know this may sound like a promotion for Echolight, but I have no financial stake in the company or the product or a medical or spa establishment that owns a machine. I do not own a machine either. I simply see a huge public health education opportunity that should not be ignored. The benefit of a non-radiation method to assess bone quality and density means that young women will be able to have the data to make decisions regarding their bone health long before they are in osteopenia or osteoporosis. It also means that women in our age group, that is, over 60, will be able to monitor their bone density and quality far more frequently. The fact that many established medical practices have invested in DEXA scanners may mean that acceptance of the REMS technology will be slow. I truly believe that as consumers we need to ask for technology that can provide us with bone density and quality information quickly and safely. Are you concerned about osteoporosis? Have you done a bone density scan? How often do you undergo a DEXA? If you could, would you rather do a radiation-free scan? What do you think about this new REMS technology?

Let’s Have a Conversation!


Starting with gut health after my Osteoporosis diagnosis

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Like so many women, I received my Osteoporosis diagnosis over the phone and it was a huge shock. It was so much to take in!   Being a fitness professional, I felt embarrassed and devastated.

My doctor immediately offered me medication, which I declined because I wanted to do some research first. Sure enough, once I looked into it, I knew that I didn’t want to take medication.

From what I studied, I knew I wanted to take a two-pronged approach to my osteoporosis diagnosis: focusing on exercise and nutrition. 

I looked at my alignment so that I could see why the exercise that I had been doing wasn’t working. Then I approached nutrition in a similar way—although my diet was healthy, I was still having digestive troubles. My sister advised me to begin with an elimination diet, which helps you find out which foods you are sensitive to.

Finding out that you are unable to eat certain foods is hard. It’s a big adjustment and can be very disappointing. But when you realise how much better you feel…no more headaches, lethargy, digestive problems…it is so worth it!

So I suggest you start by really getting to know your gut health. Try an elimination diet and then you will be working from a position of strength.

Here are some resources on elimination diets that I found helpful:


I tried a 30-day elimination diet—that was enough for me! I thought the signs were pretty clear.  I’ve eliminated a lot of foods and I’ve learned to not to miss them. An interesting thing is that there are people who say that for instance they crave sugar.   But it’s actually your gut bacteria that crave the sugar. Once your gut bacteria is cleared of sugar,  you will no longer crave it. It’s not good bacteria, and it uses sugar for its energy. It will die off and it will be cleared when you get rid of the sugar. There are herbs and probiotics you can take to support this process.

So, yes, I still eat fruit! But I’ve vastly eliminated all the sources of refined sugar. Not to say that I don’t have some dark chocolate. In fact, I have a little bit of dark chocolate every day. 

After I cleaned up my gut by altering my diet, I decided to start with probiotics.

Rather than going the route of reading all of the various suggestions on probiotics that you can buy, I decided I was going to make my own! I bought bottles and I started making my own kombucha; it’s really easy to make. You can find the instructions and the recipes online, and you can even buy a scoby, the little kombucha starter online.  I love the recipes and tips on this website.  I am not an affiliate, I just like the site.  

Then my husband decided to make sauerkraut! It’s also full of probiotics. So, again, it’s super simple, it’s just a lot of chopping. Or you can even purchase bags of pre-chopped cabbage. My husband used a darker cabbage and ginger to get just the right flavor.

Now I feel great about what’s going on in my gut!

The next step was to start looking at how to get the nutrients that I need, through diet.

The facebook group Osteoporosis Natural Remedies was a big help with food and supplements.  

I highly recommend that you do not take anyone’s word for it when it comes to what you should and should not supplement. I made my own decisions based on getting advice, being pointed in a direction, and then reading the research myself.  It is only after all that work, that I chose my supplements.  For example, I do not take calcium. After reading the most current research, I decided to get my calcium from food.  It is interesting to note that a 2019 Harvard Medical School Newsletter outlines why the 1200mg RDa for post menopausal women is likely too high.  

If there’s anything I’d like to impart to you, it’s to take your time and do your research. I know the fear is real but you do have time, you do not have to rush.

When you are comfortable with the gut and nutrient side of things, then you may want to think about a fitness approach. Exercising with weights is a recommended and proven natural approach to bone growth promotion that makes sense for many women. Many of us need to address our core strategies before we embark on a progressive loading weightlifting experience.  Additionally, many of us are interested in core strength and mobility for the lifestyle benefits they provide.

I’ve developed a system for finding core stability and strength while improving whole body mobility that is not a chore, but a fun journey of discovery.  This process lives as a community online in the Short & Sweet with Sarah Membership. We open the membership four times a year. If you’re interested, you can read more about it here!


How I Reversed My Osteoporosis

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Sarah Purcell – From Reversed Osteoporosis – Bone Density Improvement

Three years ago, I received a bone density scan result that indicated my femoral neck bone density was in the Osteoporosis zone

My T score was -2.8. Although my spinal density number was better, it was still -1.7.  Bottom line: I was very  concerned. I am post menopausal and petite as well as fair skinned and small boned. These are many of the risk factors associated with developing Osteoporosis.  I was aware of my risk and thought I was doing positive things to protect myself.  Supplements and a high level of physical activity were my tools. I practiced Pilates or Yoga and walked Daily.  But, this activity was clearly not enough.

The advice I received from my Gynecologist involved taking drugs and assuring me that I could not build bone without them. I had certified in Pilates for Osteoporosis 4 years prior to my diagnosis and through that education, I had some basic knowledge about the chemistry of bone drugs.  I knew enough to confidently reject the bone drugs as a choice for me personally. The side effects alone were troublesome and the long term outlook is a complex situation depending on the drug one takes.

Additionally, I was aware of natural bone building strategies.

Studies have shown that muscles and bones are a connected system.  Strengthening your muscles with external load (weights) creates force that sends signals to the bones to build more bone as an adaptation to the force. In addition, the load is site specific. Thus, one must load at the hip, the spine, the wrist and so on to protect all these areas. There is a direct dose relationship with using load.  This means that even a little weight has some benefits (there are studies to support this.)  Heavy weight and more than once a week would create even more benefit!

An interesting and often overlooked component is that rest is required for the body to build bone. Sleep is crucial

It’s also important to know that AGE is not a barrier.  A woman can build bone at any age.

Let’s get back to the issue of a pharmaceutical solution.  If your doctor finds your bone health situation so serious that she wants you to take a very powerful drug, then your situation is serious enough to warrant a full medical workup to determine if there is an underlying medical reason for your bone loss. You may not need to build bone with drugs; there may be a separate medical issue affecting your bones. Make sure you have ruled out the medical possibilities.

After I was diagnosed, I researched natural ways to enhance the bone making process. I created a plan that my GP and I were satisfied with. We reviewed my nutrient intake and added supplementation of key elements that I needed to support bone formation. Contrary to popular belief, it takes more than calcium and vitamin D. I changed my diet to emphasize more alkaline foods (more veggies and sweet potatoes.)

Finally, I purchased a weighted vest for my daily walks.

Ideally, the goal is to wear 10% of your body weight in your vest.  I started small and built up to my goal weight. I was a good candidate for walking with a weighted vest because I am not highly kyphotic in my thoracic spine, I do not have fractures in my spine, and I do not have a history of any spine-related dysfunctions. I diligently followed a new, heartier routine for two years. You can find the weighted vest I used down below.

Two years after that diagnosis my General Practitioner ordered a second bone scan.  The results showed that I was now out of osteoporosis in my hip and I had edged my way towards getting out of osteopenia in my lumbar spine.  My femoral neck score went from -2.8 to -2.3, which is osteopenia.  My lumbar spine went from -1.7 to -1.5. I was thrilled with the positive change.

While I was walking my way to stronger bones, I was also researching weight lifting for bone health.  

As I stated previously, bone responds when you put load (weight) on it. I created a weight lifting program that I adapted from the Australian LIFTMOR study where men and women with Osteoporosis improved their bone mineral density scores with a heavy lifting program.  The study showed that heavy weight lifting can be safe for women with Osteoporosis.  

The LIFTMOR study was a  heavy resistance program with  30-minute sessions of high-intensity resistance training at 80–85% of the “1 rep max” weight — that being the weight they could only lift only once with maximum effort. The exercises included deadlift, overhead press, and back squat along with jumping chin-ups with drop landings. The study began with a month of training in form with low weight.

I built on this programming and created a progressive loading schedule for myself three times a week.  I began with light weight and skilled supervision to teach proper form.  Progressive load is the best way to create bone strength, so I would follow that process for my own program.

I will be having another bone scan and I am excited to share those results when they are in!

Below you’ll find all of my bone building steps.  

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