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In May 2023 I posted this on Facebook and it never made it on to the blog so here goes …. osteoporosis and two of my favorite self-help books by R. Keith McCormick DC:

Earlier this week I read this book, The Whole-Body Approach to Osteoporosis: How to Improve Bone Strength and Reduce Your Fracture Risk by R. Keith McCormick DC, and wow, I’m very impressed and learned a ton.

It actually consolidates and builds on what I learned from him at the in-depth and excellent interviews with him on the Osteoporosis Summit, hosted by my friend and colleague, Margie Bissinger, MS, PT, CHC (thanks Margie! – I’ve ordered his newest book too).

I really love how Dr. McCormicks walks us through him being a detective with clients (the cases are excellent). And his information and interpretation on advanced bone health tests (like CTX, P1NP), other basic blood work (CRP, homocysteine, fibrinogen, vitamin D etc.) and functional testing (celiac/gluten sensitivity labs) he does is invaluable.

I’m curious to see what updates he’s made (if any) in his newest book, Great Bones: Taking Control of Your Osteoporosis. Does he now prefer MK-4 to MK-7 (forms of vitamin K), if he addresses the tricky calcium-oxalate issues (I’m trying to figure this one out too) and if he also discusses Trabecular Bone Score (TBS) which can be included in the DXA.

I do like that he discusses prevention too – for younger women and men! He was in his 40s when he started to have osteoporotic fractures.

I’m in my early 60s and don’t have osteopenia or osteoporosis but I want to be proactive and do comprehensive testing. I do have concerns due to my dietary oxalate issues and calcium homeostasis as a result of this.

Read about both books below and more on my own osteoporosis story (yes, I do have osteoporosis after all!) and probable root causes.

The Whole-Body Approach to Osteoporosis

Here is the official blurb for this book:

No pill will cure you of osteoporosis. While medication can sometimes help, it won’t fully address the underlying causes of your osteoporosis or osteopenia. To restore bone health, you’ll need a targeted program combining the best bone-building strategies from traditional and holistic medicine. The Whole-Body Approach to Osteoporosis distills these complex strategies into a whole-body plan you can begin today to dramatically improve your bone strength and overall vitality.

This comprehensive guide includes information on:

- What to eat for stronger bones
- Choosing bone-building supplements and osteoporosis medications
- Foods and medications that may be contributing to bone loss
- Signs and symptoms that can help you monitor your bone health
- How lab tests can help you personalize your plan

It was published in 2009, and I found it to be eye-opening and a wonderful introduction to the comprehensive functional medicine, nutritional and lifestyle approach that needs to be considered when addressing bone health. It’s written for the layperson but is meaty enough for practitioners new to the mechanisms of bone building and bone breakdown, osteoporosis medication and the impacts of environmental toxins.

As I mentioned above, his information and interpretation on advanced bone health tests (like CTX, P1NP), and other labs that are important for bone health (CRP, homocysteine, fibrinogen, vitamin D etc.) is invaluable. He also covers the basics that I cover in my book/work – like eating real food, digestive health and celiac/gluten sensitivity.

It comes highly recommended and you can find it in bookstores and on Amazon here (my Amazon link).

Great Bones: Taking Control of Your Osteoporosis

Here is the official blurb for this book:

Dr. McCormick knows what potential dangers lurk for women and men who don’t understand the life cycle of bone, who don’t realize the role nutrition plays in bone health, who don’t know what can happen to bone even when they think they’re doing “everything right.”

In his mission to help readers — women and men, athletes and nonathletes, primary care physicians and specialists — Dr. McCormick explains not just the fundamentals of osteoporosis but also the pathophysiology of bone loss and what it takes to regain skeletal health.

If you’re a patient suffering from bone loss, Dr. McCormick helps you take control of your osteoporosis; if you’re a doctor, he lays out the most up-to date science so you can best serve your patients. Great Bones is a book everyone can use to achieve better skeletal health well into their 70s, 80s, and beyond.

This one was published in 2023 and is a hefty 714 pages (vs 200 pages for his first book). This book takes everything in his first book to the next level. And while it is more geared to practitioners it is easy enough to follow for the health-savvy layperson.

Every time I pick it up to search for something I learn so much more. Here are a few eye-opening gems:

Test CTX early morning and avoid biotin and collagen for 48 hours beforehand (I also heard him say this on the osteoporosis summits)
“Butyric acid can increase bone formation by lowering osteoclastic formation” (bone break down) “and stimulating the deposition of calcium into the collagen matrix”
“High concentration of lead are found in the cement lines – where mineralized bone meets non-mineralized collagen and where zinc concentration is highest” (and more information on how lead adversely affects our bones)
“Post-menopausal women excrete eight times more urinary zinc than women with normal bone density”

With regards to my questions I had before getting this book – he does use both forms of vitamin K (MK-4 and MK-7) and he also discusses Trabecular Bone Score (TBS) which is an add-on for the DXA and a good indicator of bone texture and quality.

Unfortunately he doesn’t address the tricky calcium-oxalate issues that I’m trying to figure out, other than a very brief mention on one page.

I’m eagerly waiting for a kindle version to come out so I can more easily search for advanced topics. My index is full of my scribbles as I find some topics buried within other topics, like some of the TBS information.

This book is also highly recommended and you can find it on Amazon here (my Amazon link).

My osteoporosis story (some of it anyway)

When I posted about these books in May 2023, I was planning to be proactive and do comprehensive testing to get a good baseline in my early 60s. After reading these books and two others, I had my first DXA in July that included a TBS and testing of my left forearm. I was shocked to find out I have osteoporosis, despite the fact I have exercised my entire life – running (road and trails), playing tennis and then squash, rock-climbing, doing weights to train for climbing, backpacking with heavy packs, mountain biking, skiing and wind-surfing.

Because of this I’m really passionate about getting the message out about testing early (for women and men) and being informed and proactive. Dr. McCormick suggests women do their first DXA at 50 and men at 55 (and earlier if they’ve had a fracture).

Given my many possible root causes, I now wonder if I should have tested myself at 40 years of age? As I mentioned above, my dietary oxalate issues and the disruption of calcium homeostasis is likely a major factor. I’ve added these as contributing factors too: my long-term gut issues (since childhood), gluten sensitivity, SIBO, my history and propensity for anxiety and panic attacks, my past exposure to toxic lead (in my 20s I worked in an oil refinery and was exposed to jet fuel at a small airport), the fact that I have pyroluria (the zinc and vitamin B6 connections – I’ll be publishing a blog post on this and osteoporosis) and my liver/bile issues (which play into the oxalate issues).

Dr. McCormick says this at the start of Great Bones … “you need to understand the causes” and I do so now I can work on all of this. I love that he also says: “In this book what you will find is hope – within realistic physiological limitations – that you can improve your bone health.”

Dr. Kim Millman’s healthier bones course

With these books and other reading I’m doing, I now have the knowledge and tools. I’ve seen some improvements in the last year and I’m ready to jump in and do further testing and additional adjustments to actually reverse my bone loss.

But I need more so I’ve just signed up to do Dr. Kim Millman, MD’s online Restore & Rebuild: 100 Days to Healthier Bones program. Dr. Millman was also a speaker on Margie’s osteoporosis summit and if you are also looking for support and expert guidance via an online program, this one is a no-brainer. There is also an opportunity to ask your questions. It’s really short notice and if you can’t make this cohort, I’ll share my feedback in case you make the 2025 class.

Dr. Millman shared this in one of her interviews with Margie: “I think that the most important thing to understand is that it is possible to reverse bone loss and drastically reduce your risk of fractures naturally. And in my 15 years of evaluating and treating the root causes of bone loss, my patients do not break bones, and they don’t feel fragile anymore. Their fear fades. They don’t feel vulnerable, and they return to living their most active lives and doing the things they love.”

Hearing this gives me even more hope and I’m excited!

And in case you’re wondering, I’m still glad I’ve read both these books and have them to refer back to again and again. Both are heavily referenced too and I love to look at the research.

Wrapping up and your feedback

Now I’d love to hear from you – do you have osteoporosis and have you read either of these books and have any gems to share?

Do you have another favorite book on bone health?

Have you done Dr. Millman’s program?

What age were you diagnosed with osteopenia or osteoporosis and were you surprised?

Have you been able to reverse your bone loss and drastically reduce your risk of fractures naturally?

What root causes do you feel play a role for you?

If you’re a practitioner working with clients/patients with osteopenia or osteoporosis I’d love your insights

Feel free to share and ask your questions below.

If you have gluten sensitivity or celiac disease and/or dietary oxalate issues (pain, anxiety, insomnia, restless legs, hearing loss, eye issues, unresolved thyroid issues, bladder issues and more) and yet really miss the occasional muffin this Gingerbread Coconut Muffins recipe is a delicious gluten-free and low oxalate option. I see way too many so-called healthy gluten-free recipes using almond flour. This is concerning given that almonds are high in oxalates. Keep in mind that wheat is also high oxalate.

I’m finding dietary oxalate issues to be underappreciated especially in menopausal women when symptoms can show up and be more severe. If you’re new to the dietary oxalate issues you can read more below.

I have also found that using almond flour and other nut flours in baking affects your zinc/copper balance, increasing copper and hence causing more anxiety and even panic attacks.

If you don’t have dietary oxalate issues, you can certainly enjoy this recipe too. But watch the overindulging and binge-eating (more on that and using amino acids below).

Gingerbread Coconut Muffins (a low oxalate recipe)

Ingredients

6 eggs
1/3 cup melted butter
1/4 teaspoon salt
1/2 cup molasses
1/2 cup coconut sugar
2-3 teaspoons ginger powder (or liquid ginger extract)
3/4 cup sifted coconut flour
1 tablespoon ground flax seeds

Method

Melt the butter over low heat and add the coconut sugar and molasses. Once it’s cooled add the eggs and mix well. Stir in the coconut flour, salt, ground flax seeds and ginger powder.

Spoon the mixture into two greased mini muffin pans. Bake at 400 degrees F/ 205 degrees C for 12 – 14 minutes. The muffins will rise nicely and will start to turn dark brown. Remove and cool on a cooking rack. Makes 24 mini muffins.

Eat warm or when cooled. Serve with butter and/or cream and/or coconut butter. For a little added sweetness a small amount of raw honey can be spread on a muffin too.

My adaptation from a gingerbread cookies recipe

I adapted this recipe from a Gingerbread Cookies recipe in Cooking with Coconut Flour by Bruce Fife ND. I pretty much always do this when I cook – adapt recipes to my needs and likes – and always reduce the sugar. In this instance, I halved the sugar and used coconut sugar instead.

I also increased the ginger because I love all things ginger. I upped it from 1 teaspoon ground ginger to 2 teaspoons and will actually try 3 teaspoons next time I make them. Ginger can be an issue if you have oxalate issues so you’d want to see how much you can tolerate – so far so good for me. If you do have issues with ground ginger you could always use a liquid ginger extract which is low oxalate.

I omitted the cinnamon and cloves to emphasize the ginger taste. I also added ground flax seeds for added fiber.

I decided to cook them in mini muffin pans instead of making cookies on a baking tray but you could always try this option. Use the same temperature and cooking time per the original recipe.

The blackstrap molasses makes them so flavorful too and takes me back to my childhood. Molasses is nutrient dense too, providing calcium, magnesium, potassium, manganese, iron, vitamin B6, and selenium. Just be sure to use molasses made from sugar cane and not sugar beets (which are high in oxalates).

They were surprisingly soft and moist and eating them with butter and/or cream made them even more delicious. I always like to include some healthy fats. If dairy isn’t tolerated, coconut cream could be substituted. I suspect coconut oil could be substituted for the melted butter but have not tried this yet.

Here is Cooking with Coconut Flour by Bruce Fife ND. You can find it on Amazon here (my link). I’ve baked a number of recipes from this book and I’m impressed. I really appreciate that it’s all coconut flour recipes with no almond flour or other gluten-free flours used.

If you do battle with sugar cravings and binge eating – use amino acids

It’s ideal to keep baked goods – especially the ones shown on the cover of this book – to a minimum. But for an occasional treat this recipe book is excellent.

If you do battle with sugar cravings and binge eating, don’t forget how useful the amino acids are for stopping your cravings with no willpower and no feelings of deprivation. You can learn more about this here: The individual amino acids glutamine, GABA, tryptophan (or 5-HTP), DPA and tyrosine are powerful for eliminating sugar cravings, often within 5 minutes.

I discuss cravings/emotional eating and how to use amino acids in my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood and End Cravings. More here. I also cover how low blood sugar can lead to both anxiety and cravings and how to prevent this by use glutamine and eating for blood sugar stability.

If you’re new to dietary oxalates as a possible health issue

This blog post is a helpful one to start with if you’re new to dietary oxalates and the issues they can cause: Oxalate crystal disease, dietary oxalates and pain: the research & questions

These are the common medium-oxalate and high-oxalate foods that many folks have problems with: nuts, nut-butters and nut-flour (especially baking with almond flour and something to watch when eating Paleo or GAPS), wheat, chocolate, kiwi fruit (very high – see the raphides image on the above blog), star fruit (also very high), beets, potatoes, sweet potatoes, legumes, raspberries, spinach and soy.

In the above blog post, I share an overview of oxalates, my pain issues with dietary oxalates (severe foot pain and eye pain), and deeper dive into the condition called oxalate crystal disease (with some of my insights and questions).

The big take-aways are that calcium oxalate crystals are sharp and can cause far reaching harm beyond pain – such as unresolved anxiety, thyroid issues, neurological symptoms, eye issues, hearing loss, bladder issues, headaches, fatigue, insomnia, restless legs, autism symptoms and more. You can have issues with dietary oxalates and not have kidney disease/kidney stones, although there is very little research supporting the latter.

You may find these oxalate blogs helpful too:

What dietary oxalates issues have you experienced and has a low oxalate diet helped you?

If you have dietary oxalates issues can you handle ginger?

Do let us know if you make this recipe and enjoy it.

Feel free to share a favorite recipe of something you’ve adapted to be low or even medium oxalate.

If you have questions and feedback please share them here too.

Osteoporosis: two of my favorite self-help books by R. Keith McCormick DC (and some of my own story)