About 80% of osteoporosis cases affect women. Mostly postmenopausal women.
It has been estimated that women lose about one-third of the mineral density in their hip bones by the time they reach the age of 80 [1]. Some factors contributing to osteoporosis are genetic, while others can be caused by nutrition and lifestyle choices.
So, can you rebuild bone density? It is possible, yes. If you’re wondering how to increase bone density naturally, read on to learn what the clinical research indicates.
While this information is geared towards pre-, peri-, and postmenopausal women because of their high risk for osteoporosis, the information on how to rebuild bone density is relevant to everyone (…with the exception of paraben-free progesterone cream). Osteoporosis in men does occur, regularly, and men can rebuild bone density too.
First, a little about HEALTHY BONES
Our bones get entirely too little attention for how important they are to our mobility, comfort, and functionality. In addition to being the basis of structural support, they act as a mineral storage solution.
All cells use minerals for signaling, as gatekeepers for what comes in and out, and as building blocks for other molecules. What happens when there aren’t enough of each of these minerals in the diet? Bones break down a little bit at a time to release calcium, phosphorus, potassium, and magnesium into the bloodstream to meet the body’s needs. This system works wonderfully, as long as the bone’s minerals are soon replaced. When these minerals are plentiful in the diet, new bone is built.
When we live for a long time with a mineral-insufficient diet, however, it can take a very serious toll on our health. When bone is breaking down faster than it is being built, it leads to low bone mass, low bone density, and eventually a condition known as osteoporosis.
What is osteoporosis?
Osteoporosis is a disease caused by the breakdown of bones taking place faster than the building of new bone. Osteoporotic bones are so weak and brittle that a minor bump or even a strong cough can cause a fracture. There are unlikely to be any symptoms that may warn you of early bone loss before osteoporosis sets in, but your doctor can measure your bone mineral density. Once your bones have been weakened to the point of osteoporosis, you may notice you have lost height, experience back pain from weakened or fractured vertebrae, develop a hunched-over posture, or break bones more easily than expected.
Who is at risk? Why does osteoporosis affect more women?
Women generally have smaller skeletons than men when they reach maturity, meaning smaller, thinner bones with less total mineral mass. There is just less to lose before the bones become brittle. This also means that women with smaller frames are at a higher risk than women of taller, larger stature.
There are other factors that make certain women more susceptible than others. These factors include age/hormonal status, race, family history, and diet/lifestyle.
Hormones: Progesterone, Estrogen, and osteoporosis
Approximately one in every two women over the age of 50 will break a bone due to osteoporosis [1].
The close relationship between estrogen and osteoporosis has been understood since the 1940s [2]. Estrogen is the main female reproductive hormone and is also credited as the most important for the maintenance of a functional bone matrix (the structural portion of bone). Less studied, but still significant is the synergistic effect between estrogen and progesterone on bone metabolism [2]. We now know that while estrogen’s effect is to slow bone resorption (breakdown), progesterone’s effect is to signal bone remodeling (rebuilding) [2].
As women reach menopause their estrogen production drops significantly below baseline, a change that is often preceded by a drop in progesterone [2]. The cells responsible for balancing bone remodeling and breakdown are no longer receiving the hormonal signals they have been accustomed to, and so behave accordingly. While breakdown continues, bone remodeling begins to slow, even before menopause has officially (or noticeably) begun [3].
Race
Of all the women in the US, Caucasian and Asian women are at the highest risk of osteoporosis [1]. About 50% are likely to develop low bone mass and about 20% will be diagnosed with osteoporosis [1].
Latinx women and African-American women are statistically less likely to develop osteoporosis. although it is possible these figures are related to fewer People of Color seeking treatment or being treated for these conditions [1].
Age/Family History
There is not a specific age at which all women reach menopause, so the decline in bone density also ranges significantly. Menopause is an appropriate time to start monitoring your bone density and mass with a physician if you have not yet been analyzed. This is especially important if you went through early menopause, have broken a hip or wrist bone, or have a family member with osteoporosis (or low bone mineral density/mass) [4].
Nutritional Deficiencies
As low dietary calcium intake can contribute to the development of osteoporosis [1]. Vitamin D is also necessary for the absorption of calcium and phosphorus, so both men and women who are vitamin D deficient have an increased risk of bone resorption and diminishing bone mineral density [5].
Vitamin D is made in the body in response to bare skin’s exposure to sunlight. Skin cells with more pigment need more time in sunlight to make a healthful level of vitamin D. As we age, we are more likely to spend less time in the sun. People with darker skin and those who live in cold climates with fewer sunlight hours may need to be especially conscious of their vitamin D levels.
What do my bone density test results mean?
Bone density test results are delivered as a Z-score and a T-score. A T-score compares your bone density to what is normal in a healthy 30-year-old adult (the age at which bone density peaks). T-scores can be objectively used to help diagnose osteoporosis in men over 50 and postmenopausal women.
A Z-score compares your bone density to what is normal for someone your own age. If your Z-score is above -2.0 (ex. +0.5, -0.5, or -1.5), your bone density is considered within the ranges of normal according to the International Society for Clinical Densitometry (ISCD) [1].
If your Z-score is -2.0 or lower (ex. -2.1, -2.3, or -2.5), your bone density is lower than the normal range. This does not mean an automatic osteoporosis diagnosis, however. Your doctor may examine your lifestyle, family history, and other health conditions for possible reasons for bone loss other than osteoporosis before giving you a diagnosis. On the flip side, you can still be diagnosed with osteoporosis if your Z-score is normal, but you’ve broken one or more bones from a minor injury.
Can you rebuild bone density?
Although some of the risk factors are unchangeable, there are measures that can be taken to protect the health of our bones and even rebuild lost bone density. Unfortunately — or fortunately depending on your tolerance for lactose– drinking more milk is not the answer.
Nutrition for rebuilding bone density
Obviously, getting enough calcium and vitamin D is at the top of the list. If you know you aren’t getting much calcium from your diet or spending much time in the sun, ask a trusted healthcare professional about the dose of supplemental calcium and vitamin D you should be taking to mitigate those risk factors.
Generally, calcium intake should be 1,200-2000 milligrams per day for women over 50 and men over 70. All adults ages 51 to 70 should get a minimum of 600 international units (IU) a day of vitamin D and 800 IU a day after age 70, although up to 4000 IU of vitamin D per day is safe for most people [4].
However, calcium and vitamin D alone are often not enough. It has been well studied and yet highly underpublicized that other trace minerals have a significant impact on bone density as well.
Rebuild® and Rebuild® Plus Formulas from Metabolic Maintenance®
In 1994, a study was published showing that postmenopausal women (average age = 66) who took calcium supplements with trace elements increased their bone density over the study’s duration [6]. Those who took only calcium supplements (without trace minerals) or only trace minerals (without calcium) lost bone density over the study’s duration [6].
These findings have been repeated and supported by more and more data over the years. Boron, selenium, iron, zinc, and copper all have a positive impact on bone metabolism [7]. Conversely, exposure to cadmium, lead, and chromium has been shown to have a negative impact on bone health [8].
Milk, both raw and pasteurized, has been shown to contain all of these negative impact elements, but not necessarily all of the positive impact elements [9]. While dairy products are a commonly promoted source of calcium, it is estimated that two-thirds of the global population cannot digest dairy products effectively or comfortably [10]. Due to these facts, and others, milk, and dairy products are not the best answer to stronger bones.
Based on this expansive research, Metabolic Maintenance® collaborated with expert physicians to develop Rebuild® and Rebuild® Plus Bone Health Support supplements. The one-a-day Rebuild® formula delivers research-based doses of calcium and trace minerals along with bone-supportive vitamins D, K-1, and K-2 to protect and rebuild lost bone density. Rebuild® Plus contains a more potent dose of vitamin D, for those who need it.
Paraben-free progesterone cream and bone density
If you are pre-or perimenopausal and still have normal estrogen cycles, a bioidentical progesterone cream like Metabolic Maintenance®’s paraben-free Natural Progeste Cream may help to balance bone-supportive hormonal signals [2]. Among its many benefits, progesterone can have a positive effect on the abundance of osteoblasts (the cells responsible for building new bone) [2].
There is evidence to suggest that progesterone may also support postmenopausal women with osteoporosis when paired with antiresorptive therapy [2]. Talk to your doctor if this sounds like a good fit for your individual health status.
Exercise for rebuilding bone density
Although usually associated with muscle building, exercise can help you build strong bones and slow bone loss too [4]. Try to include strength training, weight-bearing, and balance exercises in your routine in order to care for your whole skeleton. Strength training (lifting weights, even light ones) helps to support the bones of your upper body, while weight-bearing exercises (hiking, running, skiing, and many team sports) support your lower back and legs. Balance activities like yoga or tai chi can help you to practice stability and lessen the risk of a fall.
It has also been demonstrated that underweight and overweight bodies are at greater risk of osteoporotic injury [4]. Adding exercise to a healthy diet is a great way to help maintain appropriate body weight for your frame.
A healthy lifestyle for rebuilding bone density
Exercise is not only important to build strength, but it is also important to ward off weakening due to a sedentary lifestyle. People who spend too much time sitting are more likely to develop osteoporosis [4].
Last, but not least, just say “no” to smoking and drinking. Excessive alcohol use increases your risk of developing osteoporosis [4]. While smoking tobacco has not yet been tied to osteoporosis directly, it does contribute to the weakening of bones, and so is likely a factor in bone loss and osteoporosis [4].
References
- NOF. “What Women Need to Know”. National Osteoporosis Foundation. Accessed May 28, 2020. https://www.nof.org/preventing-fractures/general-facts/what-women-need-to-know/
- Seifert-Klauss, Vanadin, and Jerilynn C. Prior. “Progesterone and bone: actions promoting bone health in women.” Journal of osteoporosis 2010 (2010).
- Mikihito Hayashi, Tomoki Nakashima, Noriko Yoshimura, Kazuo Okamoto, Sakae Tanaka, Hiroshi Takayanagi. Autoregulation of Osteocyte Sema3A Orchestrates Estrogen Action and Counteracts Bone Aging. Cell Metabolism, 2019; 29 (3): 627 DOI: 10.1016/j.cmet.2018.12.021
- Mayo Clinic. “Osteoporosis”. Mayo Foundation for Medical Education and Research (MFMER). Accessed May 29, 2020. https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968
- Pop, G. D., et al. “Estimation of 25 (OH) D levels required for maintaining a normal bone turnover in healthy aging men.” Acta Endocrinologica (Buc) 3.1 (2007): 31-43.
- Strause, Linda, et al. “Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals.” The Journal of nutrition 124.7 (1994): 1060-1064.
- Gaffney-Stomberg, Erin. “The impact of trace minerals on bone metabolism.” Biological trace element research 188.1 (2019): 26-34.
- Zofkova, I., M. Davis, and J. Blahos. “Trace elements have beneficial, as well as detrimental effects on bone homeostasis.” Physiological research 66.3 (2017): 391.
- Lopez, Anthony, W. F. Collins, and H. L. Williams. “Essential elements, cadmium, and lead in raw and pasteurized cow and goat milk.” Journal of Dairy Science 68.8 (1985): 1878-1886.
- Storhaug, Christian Løvold, Svein Kjetil Fosse, and Lars T. Fadnes. “Country, regional, and global estimates for lactose malabsorption in adults: a systematic review and meta-analysis.” The Lancet Gastroenterology & Hepatology 2.10 (2017): 738-746.