By Schuyler Corrigan

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May 6, 2024

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At Richmond Natural Medicine, we work with women actively managing osteoporosis symptoms. Women with prevention on their minds want to implement habits to reduce the risk factors of developing bone loss later in life. Bone health is a significant factor as we age, and maintaining a diet, lifestyle, and exercise routine that supports our bones is something we can work on as early as our twenties. However, osteoporosis and women’s health are always on the radar of your naturopathic doctor. We can offer guidance and support in helping manage both the symptoms and contributing factors.

Bone Health Through the Years

Throughout our lives, we are continually breaking down and creating new bones. Bone is a connective tissue built up by osteoblast cells, which exude calcium phosphate. On the other hand, osteoclasts continually break down bone so that it is constantly renewed. The bones we were born with are not the same throughout our lives. As our bones develop and grow, there is much more osteoblast activity (meaning we’re making new bones more quickly than breaking them down). Approximately 6-12% of the adult skeleton is replaced yearly through osteoblast activity.

Over time, the balance shifts so that there is similar activity between the osteoblasts and osteoclasts until age 35, when skeletal mass peaks. Typically, there is more osteoclast activity after age forty, leading to more bone breakdown and less bone creation. This is a natural process. However, osteoporosis can occur quickly when this increase in osteoclast activity is combined with a deficiency in essential vitamins and minerals and hormonal changes. Some individuals are at a higher risk of developing osteoporosis due to epigenetics. 

Bones rely on calcium as their main mineral source. Most of this calcium should be obtained through our diet. Vitamin D is essential in calcium absorption, and most people are commonly deficient in vitamin D. Thus, making calcium absorption sub-optimal. Appropriate or balanced estrogen, testosterone, and DHEA levels are also essential for calcium absorption because they are often decreased in post-menopausal women. Our digestion also matters because it is challenging for the body to make new bones if we cannot appropriately digest and assimilate calcium or vitamin D. Other minerals and nutrients, such as silica, boron, and magnesium, also contribute to healthy bone formation. Without these nutrients and our ability to utilize them, our bone health can be suboptimal.

Symptoms of Osteoporosis

• The sudden onset of back pain could be a compression fracture, which occurs when there is a general weakness in the bones caused by osteoporosis.
• Incremental back pain
• Easily fractured or broken bones, especially in the wrists, hips, and spine
• Stooped posture
• Gradual loss of height
• Hip discomfort 

Daily Support for Osteoporosis Prevention

Nutrition

Our daily diet plays a significant role in our bone health as we age, and those lacking calcium, particularly from high-quality dairy sources or leafy greens, may be at risk for developing osteoporosis. Certain drugs, such as acid blockers, can impact digestion by preventing us from breaking down core nutrients and converting them into bone. It is crucial to remember that digestion and absorption are key to bone health. For this reason, people with certain chronic diseases that impact their digestion may be at a higher risk of osteoporosis. Even certain thyroid issues, such as hyperthyroidism, inflammatory bowel disease, or celiac disease, can inhibit the body’s calcium absorption. Alcohol use and smoking contribute to increased risk over time.

 

Overall, working with a nutritionist or naturopathic doctor who emphasizes nutrition starting in your twenties or thirties can be hugely beneficial in preventing osteoporosis as we age. A good goal is a whole-food diet with colorful antioxidants, plenty of fiber, adequate hydration, substantial-quality protein sources, and omega-3-rich fatty acids. Eating in a receptive and low-stress state can assist with absorbing nutrients and minerals.

 

Supplementation

Generally, people with osteoporosis lack calcium, vitamin D, and sometimes other vitamins, including B12 or folate. It is important to consult your care team to assess your needs before taking various supplements. Supplementation may be helpful in addition to examining your hormone levels, overall digestive function, and current diet. 

 

Lifestyle

From a naturopathic perspective, multiple inputs throughout our daily lives contribute to our overall health. Three substantial contributors to developing osteoporosis later in life include genetics, daily diet, and activity levels in mid-life and post-menopause. But when we look at our daily habits for the decades leading up to perimenopause (when women’s hormones go through a significant period of change), we pay attention to how much our sleep habits, immune health, stress levels, and environment can contribute to the progression of disease or severity of hormone-related symptoms. Your naturopathic doctor will keep all of this in mind even when younger and seeking care. Especially for older women presenting with hormonal or osteoporosis-related symptoms. 

 

Exercise

Bones anchor muscle activity. The amount of osteoblast activity is roughly proportionate to the amount of physical exertion. Thus, weight-bearing exercise, walking, swimming, resistance training, and yoga are often encouraged for long-term bone health. Appropriate exercise also contributes to hormonal balance and can assist with keeping tissues healthier. However, each person is an individual and responds differently to certain exercises. 

 

Depending on the severity of osteoporosis, moderate exercise and weight-bearing training may be appropriate, whereas daily walks with light weights may be more advantageous for others. Again, depending on the progression or severity of osteoporosis, working with specialists, including physical therapists or personal trainers, can assist in identifying your body’s strengths and limitations. In some cases, resistance or weight training has been shown to slow the progression of bone loss. This begins at about 1% every year after age 40. This helps to keep bones strong and even enhances bone and muscle mass over time. Maintaining a healthy and strong muscle mass will also contribute to strong bones. 

 

Care Team

If osteoporosis is a future or current concern for you, consider working with a specialized endocrinologist. This will allow for annual blood work, hormone testing, and bone markers to track your bone health or the progression of any current bone issues. They can also educate you on any other underlying health conditions that may be causing or contributing to symptoms of osteoporosis. As well as continually monitor changes in bone density. 

 

Naturopathic Approach to Osteoporosis

Your naturopathic doctor will look at the entire presentation of symptoms of your bone health. Including your hormone levels, diet, exercise, stress, possible chronic diseases, and family history. They may also request your vitamin, mineral, and hormone levels to be assessed. Although bone loss takes time to reverse, there are many opportunities to support your bone health and keep it from worsening over time. 

Support for osteoporosis and women’s health takes time since we turn over bone slowly and thus rebuild bone slowly. Our goal is to create an improved structure of your body that is stronger to take on the demands of life in the coming years. Although multiple people may have the same diagnosis of osteoporosis, the naturopathic protocol will likely be slightly different for each person because our epigenetics and lifestyles are so diverse.

Helpful Resources

Wake Forest Osteoporosis Center

How Naturopathic Medicine Can Help with Women’s Health

Effect of Estrogen on Calcium Absorption and Serum Vitamin D Metabolites in Postmenopausal Osteoporosis