4 Supplements That Build Strong Bones
by Krista Russ
April 5, 2023
With so many people living in the northern hemisphere, where even in March, clouds tend to block out much of the sunlight needed to produce enough Vitamin D, it’s a perfect time to bring up the topic of bone health. Perhaps, you have heard Vitamin D referred to as the “sunshine vitamin”. This is because we produce it in response to sunlight. It’s one of many crucial nutrients necessary for bone health, but there are many more.
As we age, our bones naturally thin and weaken. This is known as osteopenia. Over time, it can lead to a more severe bone disease–osteoporosis, putting us at greater risk for fractures as we age. And make no mistake, fractures are no benign thing. A treated hip fracture has a staggering 21% mortality rate after a year and a 70% mortality rate if the fracture isn’t repaired within a year (per verywellhealth.com [1]).
Keeping our bones strong as we age is essential for good health overall. Our bones support the structure of our entire bodies and also produce stem cells that eventually turn into red blood cells, immune cells, platelets and other important cells (per cancer.gov [2]) .
Nutrition and physical activity can profoundly influence bone health, as well as supplementation with the right bone-supporting nutrients and compounds. In this blog, we will explore five of those exciting compounds.
To find a doctor near you, simply search the Bio-Identical Hormone Therapy (BHRT) Provider Directory.
Vitamin D
In addition to being a fat-soluble vitamin, Vitamin D is technically a hormone in its active form. Whether Vitamin D is derived from the food we eat or sunlight, all Vitamin D is eventually converted by the skin, kidneys, and liver into a hormone called calcitriol (per the Endocrine Society [3]).
Calcitriol helps to maintain normal levels of two key minerals that make up our bones: calcium and phosphorus. It is also needed for the absorption of both minerals. Vitamin D even supports healthy muscles, which is important for the prevention of falls and fractures.
But how do we make vitamin D from sunlight, you might wonder? It all happens when a molecule derived from cholesterol converts into Vitamin D through our skin’s exposure to ultraviolet sun rays (per the Endocrine Society [3]). This initial form of vitamin D undergoes additional chemical changes in the liver followed by the kidneys, to become the active hormone calcitriol.
Unfortunately, food sources of Vitamin D are fairly limited but include things like fortified milk and dairy products, eggs, beef liver, and cold-water fish like tuna, sardines, and salmon.
Vitamin K
While Vitamin K is perhaps best known for its role in blood clotting, it also plays an important role in bone health. We get it in one of two forms: phylloquinone (Vitamin K1) and menaquinone (Vitamin K2) (per Harvard TH Chan [4]). The former is found in dark leafy vegetables like greens, spinach, broccoli, and kale. Menaquinones are actually produced by bacteria living in our intestines when they ferment the fiber we eat. We can also obtain them from certain foods like natto (fermented soybeans) as well as smaller amounts in meat, eggs, and cheese.
Both forms help to build proteins needed for blood clotting and healthy bones. For example, prothrombin is an important blood-clotting protein that requires Vitamin K to create. Osteocalcin is a protein needed to generate healthy bone tissues and also requires Vitamin K to produce.
Several studies support that higher intakes of Vitamin K are associated with a reduced incidence of hip fractures, while lower blood levels of Vitamin K are associated with poorer bone density.
Strontium
Strontium is a lesser-known mineral that can also support bone health. Most of the strontium in nature is derived from seawater or soil, but it also occurs in small amounts in foods like seafood, whole milk, poultry, wheat bran, and root vegetables like carrots and onions (per Web MD [5]).
It works in a similar fashion to calcium, helping the body synthesize new bone and slowing the breakdown of older bone tissue. Strontium is also believed to activate genes that can increase osteoblast (bone cell) growth and replication. It even helps these important bone cells live longer and has been used for several bone-related conditions like tooth sensitivity, osteoarthritis, and osteoporosis. Finally, it reduces pain from metastatic bone cancer when given as an intravenous prescription called strontium-89 chloride.
Ipriflavone (IP)
Ipriflavone is a compound derived from soy that is synthesized in a laboratory and is even available as a prescription in some countries (per Web MD [6]). Because it is created in a laboratory, it can only be obtained from supplements or prescriptions–not food–but IP is derived from naturally occurring plant compounds called isoflavones [7], which can be obtained from soy products like edamame and tofu. IP is a more isolated and concentrated form, however, rendering it more effective, but isoflavones show some benefit for bone health too.
IP is often used to treat bone diseases like osteoporosis and Paget’s disease and works by blocking a process that can induce bone loss called bone resorption (per Web MD [6]).
Studies support that it can help prevent bone loss in postmenopausal women who have osteoporosis and might even decrease the bone pain caused by osteoporosis. When taken in conjunction with the hormone estradiol, it may even prevent osteoporosis and increase bone density by amplifying the bone-building effects of estrogen on bone tissue.
Other Bone Supporting Compounds: The Role of Hormones
Vitamin D is one hormone important to bone health, but there are five more your body also makes. These natural compounds all support bone health but tend to decline with age. Fortunately, you can safely replace them by working with a provider who specializes in Bioidentical Hormone Replacement Therapy (BHRT) and has the expertise to safely and effectively prescribe these five hormones, such as an APIM-trained provider.
Estradiol
Estradiol is a female sex hormone that is also produced in smaller amounts in men and is crucial for proper bone growth and development. It is considered the most potent of three types of estrogens: estradiol, estrone, and estriol. As the ovaries begin to fail at menopause, estradiol levels drop precipitously (per The Endocrine Society [8]). Since estrogen is crucial to reducing bone breakdown, bone loss accelerates dramatically at the onset of menopause. Over time, these lower estradiol levels can lead to osteoporosis.
Testosterone
Like estradiol, testosterone increases bone density and is one reason why men tend to have lower rates of osteoporosis and bone fractures as they age (per Healthline [9]). Testosterone helps to build a heavier skeleton, which is more resistant to the decline in bone density that occurs in both sexes with age. Testosterone supplementation also increases estradiol availability through a chemical process by which some testosterone is converted into bone-healthy estradiol, further complementing its bone-building benefits. Because men lose testosterone with age during andropause, they are also at increased risk for osteoporosis due to testosterone deficiency compounded by estradiol deficiency (per a 2000 study [10]).
DHEA
Dehydroepiandrosterone (DHEA) is a hormone that your adrenal glands naturally produce. DHEA helps to make other hormones like testosterone and estradiol. Levels typically peak in early adulthood and then slowly fall with age (per Mayo Clinic [11]). DHEA’s ability to convert into either estradiol or testosterone gives it numerous bone-building benefits. In fact a 2020 review [12] stated, “Studies demonstrate a significant association between DHEA and increased bone mineral density, likely due to DHEA’s ability to increase osteoblast activity and insulin like growth factor 1 (IGF-1) expression.”
Thyroid Hormone
Thyroid hormone is produced in the thyroid gland at the base of the neck and is important for many aspects of metabolism ranging from growth to temperature regulation to metabolic rate to sexual function. As with most other hormones, levels tend to decline with age. Many people, both older and younger, have problems either producing enough thyroid hormone or converting it to its most active form. Even people with seemingly sufficient levels of the active form of the hormone (called T3) may experience a cellular resistance to the hormone, rendering it inefficient in the standard amount the body creates.
Thyroid hormone plays a vital role in the hardening of bones, known as ossification, and is essential for proper skeletal development, bone growth, bone mass maintenance, and the healing of fractures (per a 2013 article [13]). In fact, a lack of thyroid hormone in children will arrest bone growth altogether.
Human Growth Hormone (HGH/GH)
Last but not least, Human Growth Hormone (aka HGH or GH) is a hormone produced by a small, pea-sized gland called the pituitary gland located in the brain that allows children to grow and maintains body and bone structure in adults (per Cleveland Clinic [14]).
According to a 2003 review [15], “GH directly and through IGF-I stimulates osteoblast proliferation and activity, promoting bone formation…The absence of GH results in a reduced rate of bone remodeling and a gradual loss of bone mineral density.”
How Do I Get The Most From These Supplements?
Remember to always speak with a healthcare provider before taking any supplements to ensure they are appropriate for you and don’t interact with any drugs you are taking. While you should follow the supplement’s instructions for general dosage guidelines, for a more customized dosage and guidance on the best form (i.e- pill, powder, liquid, etc.) for your personal health goals, we encourage you to Ffind an APIM | WLM Trained Provider today. An APIM provider can also help if you are considering the addition of hormones to support your bone health, which becomes especially important with increasing age.
The effectiveness of a supplement is largely based on its dosage and form, which can only be determined by seeing a provider who understands this in relation to your personal health needs and goals. For instance, some forms of supplements are more bioavailable in the body than others, so this step can help you avoid wasting time and money on forms that may be less effective for you. Also, not all brands are created equally. Some brands may offer a higher quality supplement with superior absorption over another brand. Testimonials, reviews, and research into the supplement company or compounding pharmacy’s reputation and practices can all provide invaluable insight into the quality of their products. For example, do they perform any third party or quality control testing to verify their ingredients are biologically active? Are they GMP certified, or do they hold other certifications that could indicate their products are of a high quality? These are all important factors to consider as a consumer.
To reap the most benefits from these bone-healthy nutrients and hormones, you must understand how they work, conditions they help, how to increase their levels, and other important considerations. Fortunately, you’ll gain all of this important insight and more by downloading our comprehensive guide on bone health:
Sources:
Basaraba S, Hassan M. Hip Fracture Dangers and Mortality Rates: Elevated Risk of Death for Years After a Broken Hip. Verywell Health. Updated January 29, 2023. Accessed February 6, 2023. https://www.verywellhealth.com/how-dangerous-is-a-broken-hip-when-youre-older-2223520#:~:text=According%20to%20a%202019%20study,year%20mortality%20is%20about%2070%25
Bone marrow. National Cancer Institute. Accessed February 6, 2023. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/bone-marrow
Endocrine-related Organs and Hormones. Endocrine Society. Updated Janaury 24, 2022. Accessed February 6, 2023. https://www.endocrine.org/patient-engagement/endocrine-library/hormones-and-endocrine-function/endocrine-related-organs-and-hormones#:~:text=Vitamin%20D%20is%20a%20hormone,D%20levels%20in%20the%20blood.
Vitamin K. Harvard T.H. Chan School of Public Health. Accessed February 6, 2023. https://www.hsph.harvard.edu/nutritionsource/vitamin-k/
Dunkin MA, Felson S. Strontium for Osteoporosis. Web MD. Medically reviewed on December 04, 2022. Accessed February 6, 2023. https://www.webmd.com/osteoporosis/guide/strontium-treatment-osteoporosis#:~:text=Strontium%20is%20similar%20to%20calcium,absorb%20strontium%20as%20they%20should
Ipriflavone – Uses, Side Effects, and More. Web MD. Accessed February 6, 2023. https://www.webmd.com/vitamins/ai/ingredientmono-310/ipriflavone
Harahap IA, Suliburska J. An overview of dietary isoflavones on bone health: The association between calcium bioavailability and gut microbiota modulation. J Materials Today proceedings. Volume 63, Supplement 1, 2022, Pages S368-S372. https://doi.org/10.1016/j.matpr.2022.03.549 https://www.sciencedirect.com/science/article/pii/S2214785322019009#:~:text=Isoflavones%20promote%20bone%20health%20by%20regulating%20calcium%20absorption%2C%20gut%20microbiota,during%20the%20calcium%20uptake%20process.
Menopause and Bone Loss. Endocrine Society. Updated on January 24, 2022. Accessed February 6, 2023. https://www.endocrine.org/patient-engagement/endocrine-library/menopause-and-bone-loss#:~:text=Since%20estrogen%20helps%20prevent%20bones,seen%20in%20women%20experiencing%20menopause
Yetman D, Bernstein A. Is There a Link Between Testosterone Levels and Osteoporosis? Healthline. August 17, 2022. Accessed February 6, 2023. https://www.healthline.com/health/testosterone-and-osteoporosis#testosterone-and-bone-health
Carlsen CG, Soerensen TH, Eriksen EF. Prevalence of low serum estradiol levels in male osteoporosis. J Osteoporos Int. 2000;11(8):697-701. doi: 10.1007/s001980070068. PMID: 11095173.
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Mayo Clinic Staff. DHEA. Mayo Clinic. February 12, 2021. Accessed February 6, 2023. https://www.mayoclinic.org/drugs-supplements-dhea/art-20364199
Kirby DJ, Buchalter DB, Anil U, Leucht P. DHEA in bone: the role in osteoporosis and fracture healing. J Arch Osteoporos. 2020 Jun 5;15(1):84. doi: 10.1007/s11657-020-00755-y. PMID: 32504237. https://pubmed.ncbi.nlm.nih.gov/32504237/#:~:text=Studies%20demonstrate%20a%20significant%20association,(IGF%2D1)%20expression.
Kim, HY., Mohan, S. Role and Mechanisms of Actions of Thyroid Hormone on the Skeletal Development. J Bone Res 1, 146–161 (2013). https://doi.org/10.4248/BR201302004 https://www.nature.com/articles/boneres201311#:~:text=Thyroid%20hormone%20(TH)%20plays%20an,efficient%20fracture%20healing%20(1).
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Olney RC. Regulation of bone mass by growth hormone. J Med Pediatr Oncol. 2003 Sep;41(3):228-34. doi: 10.1002/mpo.10342. PMID: 12868124. https://pubmed.ncbi.nlm.nih.gov/12868124/#:~:text=GH%20directly%20and%20through%20IGF,net%20effect%20of%20bone%20accumulation.