The 11th Percentile

My mom told me to get my bone density checked. I did. And when the results came back, I understood exactly why she said it.

The 11th percentile. That is where my bone density landed. In this episode I am sharing what the DEXA scan actually found, why it probably did not start with perimenopause, and what I am doing about it right now.

We are talking about the vitamin D piece nobody told me about, the thread that goes all the way back to college, and the connection between RED-S and bone health that I am still piecing together. I am also giving you the most current update I have, one month on HRT, second iron infusion, and what I am actually noticing and not noticing yet.

This one is still unfolding. I am sharing it anyway.

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"I decided to stop performing and start telling the truth."

Transcript

A Comment That Stings

Jama Pantel 0:00

My podcast episodes drop on Tuesday. Last Tuesday morning, someone I've known for almost thirteen years looked at me and asked if I was pregnant. I laughed and said no, I'm a forty-eight year old perimenopausal woman. Sorry, I'm not still skinny anymore. And then I went and changed my outfit, and then I went around and asked basically anyone I knew if I looked pregnant. One person even told me I looked hot, which made me laugh, and honestly, that person saved my day a little bit. But some of my people offered to trip her if she got close again. You know who you are, and I love you for it. I have never been asked this before in my life. I have always been a small person, and that comment from someone who knows me on the same day I was telling all of you about gaining fifteen pounds hit differently than I expected. I thought I was doing a good job getting dressed that morning. I ended up spending most of the time I was away in shorts and a t-shirt because nothing else felt safe. When you have always been able to show up professionally and suddenly nothing fits the way it should, that's its own kind of hard, and I'm still sitting with it.

Why I’m Talking Bone Density

Jama Pantel 1:16

Hey y'all, it's your podcast Bestie Jama again. Today I want to keep going with this health story I've been sharing because there is one more piece I haven't told you about yet, and honestly, it might be the most important one. I don't know. They all are and they all tie. I don't know. This is the episode about bone density, about what the DEXA scan actually found, what it means, and what I'm doing about it. I am recording this on july sixth, the day before the july seventh drop. I got my second iron infusion this morning. I've been on HRT for about a month now. I am going to give you the most current update I have right now because I think that is the only way to tell this story honestly.

DEXA Results And Mixed Emotions

Jama Pantel 2:03

My mom was the one who told me to get my bone density checked earlier this year as we were sitting around the dining room table. Nothing dramatic and not a big story attached, just to mention the kind of thing a mom says, and you file away somewhere. Of course, she has been dealing with her own bone density issues since her cancer, and she wanted me to know. Hers has gotten serious enough that she gets injections every six months now. I did not think much of it at the time. I was active, I'd been running for decades, I figured I was fine. But I got it checked anyways, and when the results came back, I understood exactly why she said it. Eleventh percentile Shock was the first thing, then fear, then that voice in your head that starts asking what you did wrong, how you could have done better, where you missed something. All of it came at once. And underneath all of it, this wave of gratitude from my mom that I still cannot fully put into words. She told me to get it checked, and I did, and now I know. Here's the part of it that makes my brain do a little something funny though. That same DEXA scan that gave me that eleventh percentile number also told me that the lean muscle mass in my legs is close to the ninetieth percentile. The same body. Eleven percentile bone density overall, ninetieth percentile lean muscle in my legs. Decades of running built something extraordinary in my legs, while my bones were quietly struggling underneath. The engine was strong, the foundation needed work. This is not a simple story, and it is not nothing either. My body has been doing remarkable things for a very long time, even when it was not getting everything

Clues Going Back To College

Jama Pantel 3:58

it needed, as I found out recently. So here's where the story gets more complicated than I expected, because this is not a perimenopause story. When I started pulling on this thread of low bone density, it went all the way back to college. I was a sub five minute miler back then, I was working incredibly hard, pounding the pavement at the level I do not even attempt anymore. I was under a hundred pounds at the time. I was also late starting my period and it wasn't consistent back then. There were B deficiencies that showed up back then too, and I ended up with multiple stress fractures in both of my legs at the same time. Nobody connected any of those dots at the time. I did not have the language for it, it was just stress fractures. Take it easy. Come back when you feel better. And I did, and I kept running, and life kept moving forward, although not competitively running anymore. I slowed way down and I'm still slow today. But looking back now with everything I know, I have to wonder, was my body always a little off? Was the thread running through my whole life without anyone ever pulling on it? I've been going to the same doctor since my early twenties, y'all. I do not know the answer to that yet. My doctors are going to test for B deficiencies going forward, so maybe more pieces will fall into place eventually. But for now, I'm just sitting with the possibility that some of this goes back much further than I even realized.

Vitamin D Myth And Bone Basics

Jama Pantel 5:42

My PA even explained something recently to me I had genuinely never been told before. Darker skin plus Texas sun does not equal enough vitamin D. I had always assumed I was fine. I spend time outside. I live and run in Austin, Texas, y'all. I figured the sun was handling it all for me. It was not. Melanin reduces the skin's ability to produce vitamin D from sun exposure, and without enough vitamin D, your body cannot absorb calcium properly. Your bones have been trying to build on a compromised foundation, and I had never taken vitamin D before, not once in my life. I did not know I needed to. Layering everything else, the red S piece from last week, underfueling my body relative to everything I was asking it to do, is directly connected to bone health. The stress fractures in college that never got a real explanation, just a statement of fact. Decades of high mileage on a body that was probably not getting everything it needed. Perimenopause, of course, accelerating bone loss because that is exactly what estrogen decline does. It was not one thing, it was everything accumulated over a very long period of time, and my body held it together and kept compensating for as long as it possibly could, until it couldn't anymore.

The Action Plan For Stronger Bones

Jama Pantel 7:18

And I am not sitting with this, that is not who I am. I like to take action. So I was told I needed to take vitamin D for the rest of my life, taken with calcium so it actually absorbs omega 3s with D and K built in because I do not eat seafood and my levels showed it. I found a brand that combines all of it, so I'm not taking ten separate things, more resistance work, box jumps, lunge jumps, sprinter intervals, all the things. Not full speed workouts just yet, the way a competitive runner trains, but the kind of impact that signals your bones they need to be strong, because that is how bone density builds. You have to give your skeleton a reason. I have been slowing down the running, more intentional miles, more walking, even though walking does not hit the same for me, and I am very impatient about it. I'm also on HRT, like I said, and estrogen plays a direct role in protecting bone density. I have been on it for a month now. Here's what I will say about that. The daily aching in my bones and joints that I had been living with is mostly gone. I did notice it again this morning for the first time in a couple weeks, but before that it had just quietly stopped, and dare I say, I felt normal. I didn't even realize it was gone until

HRT Relief And Iron Updates

Jama Pantel 8:45

I sat and thought about it. And that is something. I follow up with my HRT specialist in a couple more weeks and I'll share more eventually on that. As for the iron, I got my second infusion this morning, like I said. It went smoothly, a little shorter than the first time because I didn't have the hour wait period to see how my body would react to it. It reacted well, in case you're wondering. I follow up with my hematologist in September to see where my levels actually sit. So I generally do not know what is happening in my ferritin right now. I won't know until September probably. And I am learning to be okay with not knowing everything immediately. Which is its own kind of work for me. I'm not really okay with it, but I have to be, right? So I have spent several episodes now sharing this investigation with you on my health, the four year mystery in episode six of this season, the blood work findings, what it did to my running identity, and the weight gain that I finally explained last week, and now this. I thought I was healthy my whole life, and maybe I was, mostly, but maybe I was always a little off and nobody caught it, including myself. My body did an extraordinary job of regulating and compensating and keeping everything together for so long. And I guess that's not failure. That's actually kind of incredible when you stop and think about it. But it also means I was running on something less than I deserved for a very long time, without even knowing it. I have more questions than answers still, I say that a lot. The B deficiency testing is still ahead, and I'm still processing the bone density piece and trying to figure that part out, and probably will be for a while. The weight is still not moving the way I want it to. However, the scale has stopped going up, if that matters. It doesn't, I want it to move down. I still have days where nothing fits and I feel like a hot mess most days,

What I Know Now And What’s Next

Jama Pantel 10:55

and someone asked me last week if I was pregnant on the same day my episode about gaining weight went live. That's just my life right now, and I'm choosing to laugh about it. Mostly, because what else can you do? But here is what I know. I have more information now than I ever had before. I have sort of a plan. I am still looking for a new primary care doctor, so if you know anyone in the ATX, let me know. I have more providers now who are actually looking at my full picture, and I know things about my body at forty eight that I did not know at twenty eight or thirty eight or eighteen. That knowledge is worth something. It's worth everything, actually. So if you're a woman in perimetopause and nobody has talked to you about your bones yet, ask. Ask specifically. Get the DEXA scan. Find out where you are before you were dealing with something that has been building for decades without you knowing like I am. Your mom might be the one who tells you to get it checked in. Listen to her, or listen to me because I'm telling you now. I will bring you updates on all of this as I have them, the iron levels, the HRT follow ups, all the things. What changes and what does not. I'm still right smack in the middle of it, and I'm not going anywhere. And I will keep telling you the truth about what this looks like as it unfolds because I really don't think enough people are talking about it. But that's all I've got for now. Until next week, bye for now, y'all.