A quarter of American women and about 5 percent of men over age 64 have osteoporosis, which is weak, brittle bones that increase their risk of fracture. In fact, each year 300,000 people are hospitalized for a broken hip, and osteoporosis is often the culprit.
Yet, while some bone loss is inevitable as we get older, osteoporosis is not a normal part of aging. There is a lot you can do to enhance bone health—and the earlier you start, the better.
Healthy Habits = Stronger Bones
For starters, you have to adopt a healthy lifestyle. At a minimum, a bone-strengthening program should include:
- Weight-bearing exercise
- A healthy diet with adequate protein and lots of plant foods
- Smoking cessation
- Avoidance of excessive alcohol
- Supplemental calcium
These standard recommendations are great, and I heartily endorse them. However, calcium is not the only nutrient involved in bone growth, repair, and maintenance.
If you are concerned about your bones—and if you’re in your 60s or older or have other risk factors for bone loss, you should be—I suggest a more advanced supplement regimen. Let’s take a look at other minerals and vitamins that play a role in bone health.
Calcium Deserves Top Billing
Everyone knows about calcium supplements, but do you really know why calcium is vital to bone health? First, calcium makes your bones hard and rigid. It does that by combining with phosphorus to form hydroxyapatite crystals, which gives bones their stiffness and durability.
Second, if you don’t get enough calcium from diet or supplements, it is leached from your bones, which contain 99 percent of all calcium stores in your body—it’s your “calcium bank.” Your body needs calcium for multiple life-sustaining functions, and when your blood levels run low calcium is “withdrawn” from your bones. If you don’t make up for these withdrawals with calcium deposits, your bones will suffer.
Getting enough calcium is particularly important during childhood and adolescence, pregnancy and lactation, and later in life when bone loss accelerates. It is possible to get enough calcium from dairy and other dietary sources, but I suggest covering your bases with 1,000–1,200 mg of supplemental calcium daily.
Vitamin D for Calcium Absorption
Although vitamin D was all but ignored 30 years ago, it is now one of the most actively researched nutrients—and much of the research is on vitamin D and bone health.
Because it is required for the absorption of calcium in the gut, vitamin D deficiency and bone loss go hand in hand. Without enough vitamin D, calcium is not properly absorbed—and without proper absorption, once again calcium is “withdrawn” from your bones. This leads to lower bone density, along with other problems like rickets and osteomalacia (softening of the bones).
Multiple studies demonstrate the benefits of supplemental vitamin D for protecting against bone loss and increasing bone density. Most of them also included supplemental calcium, so I recommend taking them together.
What’s the best vitamin D dose? The best dose is whatever it takes to keep your vitamin D blood level in the optimal range of 50–80 ng/mL. Depending on where you live, your sun exposure, age, skin color, and other factors, this may require between 2,000–10,000 IU of supplemental vitamin D3 per day.
Vitamin K & Bone Formation
We used to think of vitamin K only as the “clotting vitamin.” Now we know this group of fat-soluble vitamins (primarily K1 and K2) are key players in several important proteins. One vitamin K-dependent protein is osteocalcin, which is produced in bone cells and helps bind calcium to the bone matrix. Low vitamin K status is associated with reduced bone density and increased risk of fracture.
A form of vitamin K2 called MK-7 has been of particular interest to researchers as a potential therapy for slowing bone loss. Studies have demonstrated that when postmenopausal women, who are at increased risk of bone loss, took this supplement, they had improvements in bone mineral density. Vitamin K2 (MK-7) 100–200 mg per day is a good addition to an advanced supplement program for bone health.
Boron for Bones
Boron may not receive as much attention as these other vitamins and minerals, but it is also critical for bone health. In addition to enhancing the absorption and/or metabolism of calcium, vitamin D, and magnesium, boron also positively affects the activity of hormones, particularly estrogen and testosterone, that promote bone building.
Deficiencies have adverse effects on bone growth and regeneration, and supplementing with boron has been shown to reduce calcium and magnesium loss. A reasonable daily dose of boron for bone health is 5 mg or 222 mg of calcium fructoborate (FruiteX-B), a form that mimics natural boron found in fruits and vegetables.
Don’t Forget a Daily Multivitamin
Last but certainly not least, it’s important to take a good daily multivitamin supplement. Make sure it includes robust levels of these nutrients:
- Magnesium: In addition to bone-building benefits of its own, magnesium is required for vitamin D metabolism. Because most Americans don’t get enough magnesium, supplementation is critical. I suggest taking 400–500 mg per day.
- Vitamin C: Best known as an antioxidant, vitamin C is also required for the production of collagen, the structural protein that forms the matrix where calcium and other minerals are deposited in your bones. Aim for 500 mg twice a day.
- B-complex vitamins: A high homocysteine level is a risk factor for low bone mineral density. Folic acid and vitamins B6 and B12 help keep homocysteine levels in check. The suggested daily dose of vitamin B12 for bone health is 150 mcg, B6 75 mg, and folic acid 800 mcg (1,330 mcg DFE).
- Other vitamins & minerals: Although the precise role of other vitamins and trace minerals in bone growth is less clear, they are important for all aspects of health. Look for a comprehensive multivitamin that contains the gamut of nutrients in above-RDA doses.
Get Serious About Bone Health
Even the best bone-strengthening program cannot claim to reverse severe osteoporosis. However, the combination of weight-bearing exercise, attention to diet, and an advanced nutritional supplement program has proven benefits for slowing bone loss and reducing the risk of fracture. And that’s a goal worth striving for.