Let’s talk about HEALTHY BONES! Strong and healthy bones are essential to healthy aging. We all want to be able to run, jump, lift, and summersault into our 70s, 80s, 90s and beyond.
These are the top ways to protect and improve your bone density:
1) Vitamin D3 with K2. Let’s get your vitamin D level tested and optimized to a target range of 60-80 ng/mL. Most of my patients seem to need vitamin D3 5000 IU with K2 daily to maintain this level. Vitamin K2 is an essential vitamin that helps the calcium enter your bones and keeps the calcium away from your coronary arteries. Vitamin D3 and K2 are fat soluble, so always take with food for optimal absorption.
2) Calcium and Magnesium. Are you getting enough calcium from your diet? Did you know that leafy greens are an incredibly rich source of calcium? Kale, chard, spinach, dandelion greens, and collard greens are all calcium powerhouses.
We also supplement calcium 500 mg once or twice a day (depending on your bone density). Did you know calcium works synergistically with magnesium? That’s why I always recommend calcium with magnesium at bedtime. Make sure your calcium and magnesium are highly absorbable forms (avoid calcium carbonate and magnesium oxide which are poorly absorbed). In my practice, we love Reacted Calcium, and Reacted Magnesium.
There are a slew of other minerals that are good for bones including boron, copper, manganese, selenium, zinc. That’s why I recommend a complete multivitamin to all my patients to cover all of these minerals. For those with osteopenia or osteoperosis, we often use ProBono — which is is designed with convenient AM and PM packets with all the minerals (including calcium, magnesium, boron, strontium, K2) at target dose to rebuild strong bones.
3) Healthy Gut. Did you know you absorb all these vitamins and minerals from your gut? If you have gut inflammation, it may be affecting how you absorb your vitamins and nutrients. A recent review article showed that H. pylori infection in the stomach increases your risk of osteoperosis. Low stomach acid or insufficient pancreatic enzymes can contribute to low bone density. Did you know you convert vitamin K1 (found in leafy greens) to vitamin K2 by the bacteria in your gut? Having a healthy gut microbiome can influence your vitamin levels! Ever thought your probiotic may be helping your bones? We can evaluate the health of your gut microbiome through a comprehensive stool test.
4) Hormones! Estrogen is good for the bones. Young women who are ovulating regularly will have better estrogen levels for their bones. Women who are not having regular periods (anovulatory cycles) due to anorexia, PCOS, or extreme athletic training are at risk of lower bone density. Women also start losing bone faster after menopause due to the drop in estrogen levels. If you are having symptoms of menopause like hot flashes it may be worth considering bio-identical estrogen replacement for your bone health as well.
Thyroid hormones also influence bone metabolism. The thyroid is the “Goldilocks” hormone where the dosing has to be just right within a target range. Over-treating the thyroid (suppressing the TSH) is not recommended as it can promote osteoperosis.
Chronic high cortisol levels (bad stress hormone from your adrenals) from chronic stress can also weaken your bones.
5) Avoid BONE SABATEURS! An acidic diet is bad for the bone. Keep your diet more alkaline by eating vegetables/ fruits at every meal. Avoid processed foods. Carbonated sodas contain phosphoric acid which will cause calcium loss through the kidneys. Pure carbonated water does not have phosphoric acid and is fine.
Excess sugar, alcohol, and caffeine are also bad for bone health. Smoking (Cadmium exposure) is bad for bone density.
Certain medications should not be taken long term due to their negative impact on bone health. This includes acid-suppressive medications like proton-pump inhibitors (like Prilosec), and steroids (like prednisone). That’s why it’s best to figure out root causes of heartburn so you don’t have to take an acid-suppressive medication long term.
Environmental pollution and toxins like lead, pesticides, mercury, glyphosate, and cadmium are also bad for bones.
6) Dynamic weight-bearing exercises. You want to do exercises that have some impact — like brisk walking, hiking, aerobics, dancing, or stair climbing. This helps with bone density in the hips and spine. Any weight training against gravity helps bone density. Light weights and resistance bands are a great addition to common exercises like squats and lunges to help stimulate bone growth. I recommend meeting with a trainer or physical therapist to learn more exercises to implement into your daily routine. I’ve seen women with significant improvement in their DEXA bone density scores after consistent weight training.
7) Inflammation. If you do have low bone density (osteopenia or osteoporosis), inflammation can definitely affect your risk of fracture. Eating an anti-inflammatory diet high in vegetables will definitely improve the metabolic health of your bones.
Rajsree Nambudripad, MD