July 26, 2017

Healthy Bones: Why Calcium Alone Just Doesn’t Cut It

Photo by Susanne Schwarz on Unsplash

Written By: Nicole Crane, B.S. NTP

Peel back the layers of skin and muscle and imagine your bones. You are likely thinking of something very rigid and static that does not change once you reach adulthood. Despite being a hard substance, our bones are very much alive, growing and changing throughout our lives. This means that if we nourish our bones correctly, we can keep them healthy for our entire lifetime. There is a lot more to bone health than just getting enough calcium. In fact, taking calcium alone may even be problematic, as calcium needs several nutrients to direct it to the bones. Without these nutrients, calcium may get laid down in our arteries, kidneys and other organs and can eventually cause damage.

In 2011, the per capita consumption of milk alone was 174.1 pounds (or 2,785 ounces) and 603 pounds of all dairy products i , yet there are still millions of people who have low bone density. The National Osteoporosis Foundation reported in 2014 that 10.2 million Americans have osteoporosis (brittle bone disease) and another 43.4 million Americans have osteopenia (low bone density, a precursor to osteoporosis)ii . Two million bone breaks and fractures are also attributed to osteoporosis, yet more often than not, osteoporosis is never tested for or even considered.iii Clearly, there are other factors involved besides getting enough calcium. In fact, there are nearly 25 nutrients that make up our bones and are needed for proper mineralization of our bones!

What proteins and minerals make up our bones?

Our bones are made of a protein-mineral matrix. We essentially have two types of bones; 75% makes up the hard exterior and protects bone from trauma and 25% of softer tissue on the inside of bone, which includes bone marrow and allows bones to withstand pressure without breaking. The minerals make our bones hard and strong. Our bones contain calcium, potassium, manganese, magnesium, silica, iron, zinc, selenium, boron, phosphorus, sulfur, chromium, and many more. The proteins include collagen and osteocalcin, which gives our bones flexibility and allows them to bend without breaking. It is collagen which allows us to twist our bodies and sustain falls without experiencing a bone fracture. This softer tissue is more metabolically active and has a higher turnover rate. There are a few factors that affect the health of our inner bones, like low estrogen levels in both women and men, steroid use and immobilization. Similarly, a very sedentary lifestyle can lead to loss of this type of bone.

The Breakdown of Bone As We Age

Our bones are constantly being broken down and built back up, so the body can remove old frail bone cells and replace them with new strong ones. This is a normal process the body must do to repair for the microdamage of daily life. When you stub your toe or hit your elbow, your body needs a way to repair that tissue. The osteoclasts break down bone and prevent old bone cells from accumulating. They make proteins and enzymes which dissolve the bone tissue. While this may sound like a negative factor, the osteoclasts are important. Without them, old, weak and worn out bone cells would not be removed and replaced with new, strong bone tissue. The osteoblasts are the other key to bone health, helping the body lay down new bone tissue. Their main job is to lay down the protein matrix and attract calcium compounds to it. When we are children, new bone is added faster than old bone is removed. Women reach 85% of their bone mass by age 18. Men reach 85% of their bone mass by age 20. Good nutrition and mineral intake during this stage of life is so important for healthy bones later in life. We reach our peak bone mass at around age 30. After this age, old bone is removed faster than new bone can be laid down. At this point, it is key to maintain the bones you have because the time where it is very easy to build new bones has ended. While it is still possible to build new bones, it is just not nearly as efficient for the body as it was when you were young. It is normal to lose some bone as we age, but good nutrition and a healthy lifestyle can prevent damaging rates of bone tissue loss.

There are several major factors to consider when it comes to what breaks down our bones and may interfere with bone health.

Smoking reduces the body’s ability to absorb calcium and has chemicals which damage bone cells and inhibit new bone growth.
Consuming a diet based in processed foods including refined sugars, flours and salts, fried foods, or hydrogenated oils, can promote inflammation in the body and force the osteoclasts (the bone breakers) into overdrive.
Caffeine, alcohol and salt have diuretic properties that can lead to calcium loss through urination.iv These factors can allow lots of calcium to be drained right out of the body.
Medications like corticosteroids increase bone breakdown and inhibit the cells that rebuild bone and, at the same time, reduce the body’s ability to absorb calcium. Antacids also decrease stomach acid production and keep the body from properly absorbing minerals.
For the same reason, digestive diseases like Crohn’s or Celiac disease also damages bone health because the body is unable to absorb the nutrients it needs. We need digestive enzymes and strong stomach acid to properly breakdown and absorb minerals and metabolize all nutrients properly.
Stress can be a huge factor often overlooked in bone health. Cortisol release due to stress increases bone breakdown and floods the bloodstream with calcium while suppressing the hormones involved in bone rebuilding. A very high stress day can result in a net loss of as much as 900 mg of calcium.vi Consider herbs like ashwaganda, passion flower or lemon balm to curb levels of cortisol and other stress hormones for both body and mind.

Building Up The Strength of Bones

Luckily, there are many things you can do to build up your bones. Nutrition is where it all starts. Given the right vitamins and minerals, the body can be put into a state where the bones have the optimal potential to regenerate. These nutrients play a critical role in activating the bone building osteoblasts and making sure the osteoclasts that break down bone are functioning normally.

- Magnesium is a nutrient with hundreds of essential roles in the body. It acts as a cofactor (activator) of 325 different enzymes and plays a critical role in energy production, stress responses, nerve and muscle function and much more.vii Magnesium influences calcium and other mineral metabolism in bone, reducing bone turnover and promoting new bone formation.viii Magnesium is required to transport calcium into the bones and for the formation of normal calcium crystals in bone tissue.ix Magnesium is also stored as part of the protein-mineral matrix, up to 60% of the magnesium in the body is found in the bones. It is involved in over 320 different enzymatic processes in the body, yet most people (75%–85%) are deficient in magnesium. Men over 30 need 420mg per day and women over 30 need 320mg.
- Vitamin D aids in the absorption of calcium from the intestines, reducing the need for the parathyroid to break down bone. Vitamin D also makes sure that calcium ends up in the bones, preventing it from being deposited in areas it does not belong, like the arteries, kidneys and gallbladder. This vital nutrient also regulates the production of osteocalcin, one of the core bone building proteins. Vitamin D also supports muscle strength and can reduce the risk of falls. Research shows that older people who have the lowest levels of vitamin D also have the highest long term risk of a bone fracture.x
- Bones are made by laying down a base of collagen and other proteins, which are then filled in with mineral crystals like calcium, magnesium and phosphorus. This action is directly driven by the presence of enough Vitamin K. Osteocalcin, which cannot become sticky with a lack of Vitamin K, may be a major factor in bone breaks and fractures. Another protein called matrix GLA protein (MGP) is also Vitamin K dependent. It has been found in several different structural tissues, like bone, cartilage and other soft tissues including blood vessels. The calcium-binding protein can also be found in the heart, lungs and kidneys. MGP plays several roles in the normal development and growth of bone tissue. Proper regulation of MPG will ensure that calcium and other minerals end up in the bones and teeth xii .

IMPORTANT NOTE: Due to the effect of Vitamin K and K-rich foods on those taking prescription blood thinners like Coumadin (Warfarin), supplemental K should be avoided and individuals should speak to their health practitioner about the proper intake of Vitamin K rich foods.

- Calcium is the most important nutrient for the bones, and it is often one of the hardest minerals to absorb. Approximately 99% of the calcium in our body is found in the bones, with the remaining 1% in blood to maintain essential life supporting functions like the beating of the heart, relaxation and constriction of blood vessels, nerve signaling, muscle contraction and other essential life supporting functions. Calcium ions are also required to stabilize and activate a number of proteins and enzymes, including several vitamin K dependent proteins.xvi Many people either do not consume enough calcium, or consume poorly absorbed forms. The type of calcium used in supplementation must be well utilized by the body; They are easily ionized, or given an electrical charge, almost always completely broken down, have virtually no toxicity, and increase the absorption of not just calcium but all minerals. These include forms like hydroxyapatite and citrate. It is important to keep calcium away from certain minerals like iron and strontium, as they can bind together and prevent the absorption of each other.

- Strontium is a mineral that is more dense than calcium and shares a number of its bone functions. Most strontium (about 90%) is found in bone. This mineral gives strength to bone, draws calcium to the bone and encourages minerals to be deposited in bone. The more bone building activity that takes place, the greater the uptake of strontium into the bones. Strontium enhances the activity of the osteoblasts, the bone builder cells, while reducing the activity of the osteoclasts, which break down bone. Studies show that post-menopausal women who supplemented with strontium over a period of 10 years had significant continuous increases in bone density, 34% on average. The reductions for vertebral and nonvertebral fractures were 35% and 38%, respectively and strontium was shown to be safe and well tolerated in the long term xvii .

- A good multivitamin is the foundation of health in general, but it is also an excellent way to get many of the nutrients that help build and maintain our bones.
- Vitamin C is another critical vitamin for bone health. This diverse nutrient is essential for the production of collagen, the most abundant protein in the bone. Just like in skin and joints, collagen provides flexibility to the bone. This gives us the ability to fall without breaking a bone. Taking collagen powder directly also has vast benefits for supporting healthy, strong and flexible bones. Vitamin C also suppresses osteoclast cells which break down bone and helps the osteoblast cells which build bone to mature. Lots of people are beginning to find new ways to support healthy joints and flexibility.

It’s never too late or too early to build healthy bones. Be sure to think beyond calcium – you want to be sure you are at least increasing your magnesium, vitamin D and vitamin K levels. If you need therapeutic bone support, consider adding strontium, collagen powder or silica. With the right nutrition and lifestyle factors, the body will take the steps to heal itself, without medications. Our bones are dependent on good nutrition.