case_images: PMC11825221_01
case_images: Bone mineral density after conventional intervention from November 2019 to October 2021. Dual-energy X-ray absorptiometry (DXA) scans showed no change in the baseline lumbar spine T-score of -1.0 (a) and only a non-significant improvement in the femoral neck T-score to -1.2 (1.9% improvement, within the error range of the machine) from -1.3 (b) after two years of conventional interventions.
case_images: cureus-0017-00000077435-i01.jpg
case_images: PMC11825221_01_cureus-0017-00000077435-i01.jpg
case_images: FIG1
case_images: D3, and maintaining a dietary calcium intake of 650-720 mg per day through the consumption of 5-7 servings/week of cottage cheese, salmon, sardines, and Greek yogurt. Despite these collective interventions, a follow-up DXA scan conducted after two years at age 49 in 2021 showed virtually no change in BMD at the lumbar spine (Figure 1a) and no meaningful femoral neck measurement improvement (T-score of -1.2, 1.9% improvement that was within the expected coefficient of variation for the DXA scanner; Figure 1b), indicating that the initial treatment approach had effectively stabilized the patient's bone density but had not led to significant improvements.
case_images: Bone mineral density after novel combinatorial interventions from May 2022 to April 2024. Following two years of using rapamycin, with periodic additions of nutraceuticals (vitamin K2), hormones (oral progesterone), and a geroprotector (low-dose naltrexone), DXA scans showed a 15.9% improvement in baseline lumbar spine T-score of 0.3 (a) and a slight, non-significant improvement in the femoral neck T-score to -1.1 (3.9% improvement) from -1.3 (b).
case_images: cureus-0017-00000077435-i02.jpg
case_images: PMC11825221_01_cureus-0017-00000077435-i02.jpg
case_images: FIG2
case_images: T-score of -1.1, or 3.9%; Figure 2b). This is consistent with non-diagnostic whole-body BMD DXA measurements obtained throughout the PEARL trial, showing improvements from a T-score of 0.5 at the start of the trial to 0.7 at the end (Table 1). These findings represent an unexpected and substantial improvement in the patient's bone health, which was particularly notable given the typical challenges in achieving significant BMD increases in patients with osteopenia, especially post-menopausal women.