The Hidden Impact of Undereating: Bone Health and Hormones | With Dr. Nicky Keay

In this episode, Talia is joined by Dr Nicky Keay to explore the often overlooked consequences of under-eating and over-exercise on hormones and bone health.Together, they unpack how low energy availability can disrupt the menstrual cycle, reduce estrogen and impact bone health. They also discuss DEXA scans, osteoporosis, HRT and REDS.What You’ll Learn:The hormonal consequences of under-fuelling and over-exercisingThe link between amenorrhoea, low oestrogen, and bone healthThe difference between osteopenia and osteoporosisThe latest guidance around HRT for functional hypothalamic amenorrhoeaBlood tests that may be useful when assessing REDS and bone healthResources & Links:Dr Nicola Keay’s website: www.nickykeayfitness.com Dr Nicola Keay on social media: @drnikkikeay Personal Energy Availability Questionnaire (PEAQ): https://mypeaq.streamlit.app/ Books by Dr Nicola Keay:Hormones, Health and Human PotentialMyths of MenopauseAbout our guest:Nicky is a medical doctor specialising in exercise endocrinology. Nicky’s clinical endocrine work provides personalised approach for hormone health, offering health advisory appointments, with a focus for those experiencing relative energy deficiency in sport (REDs) and women experiencing perimenopause and menopause. Based on her research into REDs, Nicky developed the free online personal availability questionnaire (PEAQ). Nicky is medical advisor to Scottish Ballet and offers talks on a variety of hormone topics at international conferences for organisations and groups. Nicky is the author of “Hormones, Health and Human Potential” and editor of “Myths of Menopause”. Episode Timestamps:00:00 – Introduction00:32 – How under-eating and over-exercise affect hormones02:57 – Why periods may stop when the body is conserving energy05:30 – What DEXA scans can and cannot tell us08:38 – Understanding osteopenia, osteoporosis, Z-scores and T-scores27:45 – Can osteoporosis be improved?37:34 – What HRT is and when it may be indicated42:22 – Why the oral contraceptive pill is not bone-protective in FHA52:28 – Helpful blood markers for REDs and bone health56:08 – Why vitamin D matters more than “normal range” aloneConnect with Talia:Talia’s Instagram: @tcnutritionFood Is Food Instagram: @foodisfoodpodWebsite & Mailing List: www.taliacechele.com Clinic Enquiries: https://www.taliacecchele.com/contact Support the Podcast:If this episode resonated with you, you can support Food is Food by:Following or subscribing to the podcastLeaving a 5* reviewSharing this episode with someone who might find it helpfulDisclaimer:This podcast is for educational and supportive purposes only and is not a substitute for individual medical or dietetic advice.