Though estrogen was what I recommended first, Daphne was opposed to taking HRT. When she was 55 and a few years into menopause, she had a bone density screening that showed she had moderate to severe bone loss. She had been taking medication to control her thyroid for many years, which probably accelerated her bone loss well before her body’s estrogen levels dropped off and she had her last period. Daphne had also struggled with anxiety and depression, and although there are no double-blind, placebo-controlled studies proving a direct link between those conditions and bone density, I believe continual stress of any kind—especially something as severe as chronic emotional disruption—is hard on your bones. There are plenty of gold-standard studies demonstrating a crucial connection between the health of your mind and your body generally, and I see no reason why your skeleton would be exempt.

The good news for Daphne was that a simple lab test that assesses fracture risk and rate of progression of bone loss—independent of current bone density — was smack in the middle of the normal range. With a reasonably low risk of fracture and a reasonably slow rate of loss, then, she had a chance to improve her general health along the lines of the program outlined later in this book, and find out if that would help her bones sufficiently, before she reached a crisis point. She decided to take alendronate to make sure her situation wouldn’t deteriorate’ and she showed excellent improvement very quickly. So Daphne was able to remain committed to helping herself without using supplemental hormones.

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