Ep. 118 Comprehensive Bone Health: Diet, Hormones, & Preventative Care with Dr. Pooja Luthra

Osteoporosis may present after menopause, but prevention starts decades earlier. In this episode of BackTable Women’s Health, Dr. Carla Gunn, guest host and OBGYN, interviews Dr. Pooja Luthra, an endocrinologist at UConn Health, about osteopenia, osteoporosis, and practical strategies for lifelong bone health. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction03:28 - Why Bone Health Matters Early05:23 - Bone as a Vital Sign08:02 - Amenorrhea and Early Screening09:51 - Calcium, Vitamin D, and Protein15:11 - Menopause Bone Biology Explained21:58 - Metabolic Diseases and Bone Risk25:58 - Early Screening Red Flags27:53 - Hormone Therapy Bone Benefits30:59 - Reading DEXA Scores33:42 - FRAX Scores35:09 - Modern Treatment Sequencing38:02 - Bisphosphonates Mechanism and Concerns41:16 - Secondary Labs and Referrals44:23 - Closing Thoughts --- More about this episode Dr. Luthra explains how peak bone mass is largely established by early adulthood, followed by accelerated loss during the perimenopausal/menopausal transition due to estrogen decline, inflammatory cytokines, altered calcium absorption, and increased bone resorption. She reviews prevention strategies, including adequate calcium, vitamin D, and protein intake, resistance training, and avoiding smoking and excess alcohol use. The discussion also covers high-risk conditions that can negatively impact bone health, including amenorrhea, premature ovarian insufficiency, hyperthyroidism, diabetes, and chronic kidney disease, along with considerations for earlier screening in these patients. Dr. Luthra walks through DEXA interpretation, including T-scores, Z-scores, trabecular bone score (TBS), and FRAX assessment. She closes the conversation by outlining treatment sequencing with anabolic agents before antiresorptives, bisphosphonate safety, alternative therapies, and secondary osteoporosis workup labs. --- Resources FRAX Tool:https://www.fraxplus.org/calculation-tool --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women’s health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app