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Top Natural Ways to Reverse Bone Loss

Article at-a-glance:

  • Osteoporosis weakens bones and increases your risk for fractures and death.
  • Advancing age, medications and diseases can cause osteoporosis, so it’s important to understand what you can do to protect yourself.
  • Fortunately, natural approaches can build stronger bones and reduce fracture risk, even when osteoporosis is caused by medications.

by Dr. John Neustadt

Your body is constantly breaking down old, worn-out bone and creating new bone. This natural balance is required to build strong, healthy bones. However, when the bone breaks down faster than it’s created, bone mineral density (BMD) declines, bones become weaker, and fracture risk increases. 

Osteopenia (pre-osteoporosis) and osteoporosis are diagnosed using a dual-energy x-ray absorptiometry (DEXA) scan that detects your BMD. Repeating BMD tests every 18-24 months can show if the disease is getting worse or improving. The 2018 US Preventative Services Task Force (USPSTF) guidelines for osteoporosis screening recommend BMD testing for all postmenopausal women 65 years and older. Men and women who are younger than that but are at increased risk for osteoporosis should also get screened.1

However, newer research may eventually result in changes to the screening recommendations to have all men and women screened at earlier ages. A 2019 study in the Journal of the American Osteopathic Association evaluated nearly 200 men and women ages 35-50 and found that one-quarter of them had osteopenia in the hip, showing that meaningful bone loss is occurring much earlier than previously believed.2

The biggest danger with osteoporosis is breaking a bone. Globally the disease causes an estimated 9 million fractures each year.3 A 10% loss of BMD can double a person’s risk of spinal fractures and increase the risk of hip fractures by 250%.4 

When we’re younger, fractures rarely cause dangerous complications. But as we age, they become a lot more dangerous. If you have osteoporosis and break a hip, there’s a 20% chance that you’ll die within a year and your risk for being hospitalized is increased for five years after the fracture.5 As if that weren’t bad enough, a study published in the Journal of the American Medical Association determined that your risk for dying is elevated for five years after a vertebral fracture and for 10 years after a hip fracture compared to people who didn’t break a bone.6 

Fortunately, there are proven integrative strategies that increase bone mass and reduce the risk of falls and fractures. 

Rethink Medications

Reversing osteoporosis means identifying and eliminating things that may be causing or exacerbating the disease. Many medications reduce bone density, create osteoporosis, and increase fracture risk. A couple of the more common ones are prednisone and acid-blocking medications. 

Alarmingly, oral prednisone is taken for six months or longer has been found to increase fractures up to 200%. For each 10 mg increase in dosage, there is a 62% increase in risk for bone fracture.7 Prednisone is frequently prescribed for autoimmune diseases and irritable bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn’s disease (CD). 

Speak to your doctor to see if there may be an alternative to taking prednisone. You can also seek out the opinion of a healthcare provider trained in integrative medicine. They might offer complementary or alternative approaches to treat the underlying causes of your illness and allow you to wean off the prednisone. 

Acid-blocking medications, which include Prilosec, Protonix, and Aciphex, were never approved by the FDA for longer than two weeks of use, but many people take these medications for far longer than that without realizing the consequences. For each year someone takes these medications, their risk of hip fractures increases. One study published in the Journal of the American Medical Association concluded that after four years, acid-blockers increase the risk of hip fractures by nearly 60%.8 

Antidepressants, thyroid hormone replacement, contraception, and cancer chemotherapy are also known to lower bone density. To learn more, read my blog, Are Medications Causing Your Osteoporosis?  

Exercise

Decades of research documents the positive effect exercise has on bone mass. Weight-bearing builds BMD. This type of exercise forces the muscles and bones to work against gravity, making both stronger. While the effects of weight-bearing exercises on the bone can be detected after about four to six months, consistency and persistence are important since the effects are greater when you keep working out for a year.9 One European study evaluated the impact one year of a combined weight-bearing training program had on BMD in women ages 66-87 years. The exercise regimen improved hip bone BMD by 8.4%.10

Diet

One food or nutrient alone cannot reverse or prevent osteoporosis. Instead, your overall dietary pattern is what’s important. A healthy overall way of eating ensures sure you’re getting all the nutrients you need to build bone (it takes far more than just calcium). 

A plant-based, alkaline diet that emphasizes whole foods and lean proteins can help. This is essentially the Mediterranean Diet. It’s based on the traditional eating pattern of people from the Mediterranean Sea basin in countries such as Greece, Italy, coastal Spain, and Southern France. 

This way of eating is in stark contrast to the Standard American diet, which is high in acidic foods and contains lots of fried foods, red meat, processed foods, salt, and refined grains. Unfortunately, the Standard American Diet creates chronic disease. There is evidence that this way of eating contributes to osteoporosis and muscle loss.11

In contrast, the Mediterranean Diet is low in red meat and high in vegetables, fruit, legumes, nuts, whole grains, olive oil, and lean proteins like seafood and chicken. A study that included 177 men and women aged 65 years or older found that people who followed a predominantly Mediterranean Diet were the least likely to fracture a bone when compared to other common dietary patterns.12 

A 2016 meta-analysis found that following a Mediterranean eating pattern reduced the risk of hip fracture by 21%.13 And a case-control study of 290 middle-aged women (45–65 years), some with and some without an osteoporosis diagnosis, found that women who strongly adhered to the Mediterranean Diet had a lower risk of bone fracture. When the researchers documented the foods these women were eating, legumes and wine were observed to be protective against fractures, whereas diets that included butter and red meat put people at a higher risk.14

A Mediterranean Diet is essentially a high alkaline diet (the opposite of acidic). Researchers have proposed that an alkaline diet should be included in treatment strategies to reverse osteoporosis.15 

Dietary Supplements

Several nutrients given as dietary supplements have been shown to stop and reverse bone loss and, more importantly, decrease osteoporosis fracture risk. 

Calcium and vitamin D are the nutrients most people associate with osteoporosis. The FDA has approved both calcium and vitamin D to reduce osteoporosis risk. Research has shown that calcium alone does not protect against fractures but can when supplemented with vitamin D. One study tracked the fracture risk of more than 2,500 people whose average age was 73 years old. Supplementing with 400 IU vitamin D3 and 1,000 mg calcium daily reduced fracture risk by 16%.16 

While two types of vitamin K2 (MK4 and MK7) can also improve bone density, however, only MK4 has been shown to reduce fractures, and only at the dose of 45 mg/day. MK4 also has been cited as a potential strategy for helping people with osteoporosis caused by prednisone and diseases. 

Clinical trials show that 45 mg per day of MK4 can reduce fracture by nearly 60%17,18 and preventing bone loss and/or fractures caused by:

  • corticosteroids (eg, prednisone, dexamethasone, prednisolone)19,20,21,22
  • anorexia nervosa23
  • cirrhosis of the liver24
  • menopause (postmenopausal osteoporosis)25,26,27,28,29
  • decreased mobility (disuse) from stroke30
  • primary biliary cirrhosis31
  • leuprolide treatment (used to treat endometriosis, uterine fibroids, prostate cancer)32

To promote bone health and help grow stronger bones, Osteo-K and Osteo-K Minis deliver 45 mg per day of MK4, plus vitamin D and calcium.

Published studies have followed more than 7,000 volunteers for up to six years without any dangerous side effects from taking 45 mg and higher of MK4 daily MK4 is safe at 45 mg/day and even at higher amounts. Published research has documented the safety in humans of 135 mg/day of MK4, and 250 mg/kg body weight per day in rats.33,34 These studies concluded that MK4 does not increase the risk of blood clots. To put the animal dose in perspective. If a typical adult is 150 pounds, that would be the same as giving a human more than 17,000 mg MK4, which is nearly 380 times more per day than the 45 mg/day used in the published clinical trials. 

Strontium is a mineral that can increase bone density and reduce fractures, but you may want to think twice before taking it. The only form of strontium that has been tested in clinical trials is strontium ranelate (SR), and some trials have shown that taking 500-2000 mg per day of SR can decrease vertebral fractures by 23% to 49%, as well as increase bone mineral density. Strontium ranelate is not available in the US. Additionally, strontium is heavier than calcium and can give false BMD test results, making them inaccurate.35

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References

1Curry SJ, Krist AH, et al. Screening for Osteoporosis to Prevent Fractures: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(24):2521-2531. [Article]

2Bass MA, Sharma A, Nahar VK, et al. Bone Mineral Density Among Men and Women Aged 35 to 50 Years. J Am Osteopath Assoc. 2019;119(6):357-363. [Article]

3Facts and Statistics. International Osteoporosis Foundation. Accessed April 25, 2020. [Web Page]

4Klotzbuecher, Carolyn M., Ross, Philip D., Landsman, Pamela B., et al. Patients with Prior Fractures Have an Increased Risk of Future Fractures: A Summary of the Literature and Statistical Synthesis. Journal of Bone and Mineral Research. Apr. 2000; 15(4):721–739. [Article]

5Leibson CL, Tosteson AN, Gabriel SE, Ransom JE, Melton LJ. Mortality, disability, and nursing home use for persons with and without hip fracture: a population based study. J Am Geriatr Soc. 2002;50:1644-1650. [Article]

6Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR. Mortality Risk Associated With Low-Trauma Osteoporotic Fracture and Subsequent Fracture in Men and Women. JAMA. 2009;301(5):513-521. [Article]

7Van, Staa TP, Leufkens, HGM, Abenhaim, L, et. al. Use of oral corticosteroids and risk of fractures. J Bone Miner Res. Jun. 2000; 15(6):993-1000. [Article]

8Yang, YX, Lewis, JD, Epstein S, Metz, DC. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA. Dec. 2006; 296(24):2947-2953. [Article]

9Gomez-Cabello, A., Ara, I, Gonzalez-Agüero, A., et al. Effects of Training on Bone Mass in Older Adults: A Systematic Review. Sports Med. Apr. 2012; 42(4):301-25. [Article]

10Englund U, Littbrand H, Sondell A, et al. A 1-year combined weight-bearing training program is beneficial for bone mineral density and neuromuscular function in older women. Osteoporosis International. Jan. 2005; 16(9):1117-1123. [Article]

11Schwalfenberg, Gerry K. The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health? Journal of Environmental and Public Health. Oct. 2011; 2012: 727630. [Article]

12Colica, Carmela, Maza, Elisa, Ferro, Yvelise, et al. Dietary Patterns and Fractures risk in the elderly. Frontiers in Endocrinology. Dec. 2017; 8(322). [Article]

13Malmir, Hanieh, Saneei, Parvane, Larijani, Bagher, et al. Adherence to Mediterranean diet in relation to bone mineral density and risk of fracture: a systematic review and meta-analysis of observational studies. European Journal of Nutrition. Jun. 2017; 57: 2147–2160. [Article]

14Palomeras-Vilches, Anna, Viñals-Mayolas, Eva, Bou-Mias, Concepcio, et al. Nutrients. Oct. 2019; 11(10): 2508. [Article]

15Sebastian, Anthony, Frassetto, Lynda A. A neglected requirement for optimizing treatment of age-related osteoporosis: Replenishing the skeleton’s base reservoir with net base-producing diets. Medical Hypotheses. Jun. 2016; 91:103–108. [Article]

16Larsen ER, Mosekilde L, Foldspang A. Vitamin D and Calcium Supplementation Prevents Osteoporotic Fractures in Elderly Community Dwelling Residents: A Pragmatic Population- Based 3-Year Intervention Study. Journal of Bone and Mineral Research. Mar. 2004; 19(3):370-378. [Article]

17Shiraki Y, Aoki C, Miura M. Vitamin K2 (Menatetrenone) Effectively Prevents Fractures and Sustains Lumbar Bone Mineral Density in Osteoporosis. Journal of Bone and Mineral Research. 2000;15(3):515-522. [Article]

18Jiang Y, Zhang Z-L, Zhang Z-L, et al. Menatetrenone versus alfacalcidol in the treatment of Chinese postmenopausal women with osteoporosis: a multicenter, randomized, double-blinded, double-dummy, positive drug-controlled clinical trial. Clinical interventions in aging. 2014;9:121-127. [Article]

19Sasaki N, Kusano E, Takahashi H, et al. Vitamin K2 inhibits glucocorticoid-induced bone loss partly by preventing the reduction of osteoprotegerin (OPG). Journal of bone and mineral metabolism. 2005;23(1):41-47. [Article]

20Yonemura K, Fukasawa H, Fujigaki Y, Hishida A. Protective effect of vitamins K2 and D3 on prednisolone-induced loss of bone mineral density in the lumbar spine. Am J Kidney Dis. 2004;43(1):53-60. [Article]

21Yonemura K, Kimura M, Miyaji T, Hishida A. Short-term effect of vitamin K administration on prednisolone-induced loss of bone mineral density in patients with chronic glomerulonephritis. Calcified tissue international. 2000;66(2):123-128. [Article]

22Inoue T, Sugiyama T, Matsubara T, Kawai S, Furukawa S. Inverse correlation between the changes of lumbar bone mineral density and serum undercarboxylated osteocalcin after vitamin K2 (menatetrenone) treatment in children treated with glucocorticoid and alfacalcidol. Endocrine journal. 2001;48(1):11-18. [Article]

23Iketani T, Kiriike N, Murray, et al. Effect of menatetrenone (vitamin K2) treatment on bone loss in patients with anorexia nervosa. Psychiatry Res. 2003;117(3):259-269. [Article]

24Shiomi S, Nishiguchi S, Kubo S. Vitamin K2 (menatetrenone) for bone loss in patients with cirrhosis of the liver. The American Journal of Gastroenterology. 2002;97(4):978-981. [Article]

25Iwamoto I, Kosha S, Noguchi S-i. A longitudinal study of the effect of vitamin K2 on bone mineral density in postmenopausal women a comparative study with vitamin D3 and estrogen-progestin therapy. Maturitas. 1999;31(2):161-164. [Article]

26Shiraki M, Shiraki Y, Aoki C, Miura M. Vitamin K2 (Menatetrenone) Effectively Prevents Fractures and Sustains Lumbar Bone Mineral Density in Osteoporosis. Journal of Bone and Mineral Research. 2000;15(3):515-522. [Article]

27Ushiroyama T, Ikeda A, Ueki M. Effect of continuous combined therapy with vitamin K2 and vitamin D3 on bone mineral density and coagulofibrinolysis function in postmenopausal women. Maturitas. 2002;41(3):211-221. [Article]

28Purwosunu Y, Muharram, Rachman IA, Reksoprodjo S, Sekizawa A. Vitamin K2 treatment for postmenopausal osteoporosis in Indonesia. J Obstet Gynaecol Res. 2006;32(2):230-234. [Article]

29Iwamoto J, Takeda T, Ichimura S. Effect of combined administration of vitamin D3 and vitamin K2 on bone mineral density of the lumbar spine in postmenopausal women with osteoporosis. J Orthop Sci. 2000;5(6):546-551. [Article]

30Sato Y, Honda Y, Kuno H, Oizumi K. Menatetrenone ameliorates osteopenia in disuse-affected limbs of vitamin D- and K-deficient stroke patients. Bone. 1998;23(3):291-296. [Article]

31Nishiguchi S, Shimoi S, Kurooka H. Randomized pilot trial of vitamin K2 for bone loss in patients with primary biliary cirrhosis. Journal of Hepatology. 2001;35(4):543-545. [Article]

32Somekawa Y, Chigughi M, Harada M, Ishibashi T. Use of vitamin K2 (menatetrenone) and 1,25-dihydroxyvitamin D3 in the prevention of bone loss induced by leuprolide. J Clin Endocrinol Metab. 1999;84(8):2700-2704. [Article]

33Ushiroyama T, Ikeda A, Ueki M. Effect of continuous combined therapy with vitamin K2 and vitamin D3 on bone mineral density and coagulofibrinolysis function in postmenopausal women. Maturitas. 2002;41(3):211-221. [Article]

34Asakura H, Myou S, Ontachi Y. Vitamin K administration to elderly patients with osteoporosis induces no hemostatic activation, even in those with suspected vitamin K deficiency. Osteoporos Int. 2001;12(12):996-1000. [Article]

35Meunier, PJ, Slosman, DO, Delmas, PD, et al. Strontium ranelate: dose-dependent effects in established postmenopausal vertebral osteoporosis–a 2-year randomized placebo-controlled trial. J Clin Endocrinol Metab. May 2002; 87(5):2060-2066. [Article]

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