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The Importance of Bone Health

December 2010

By Nicholas Perricone, MD


Over the years, heavy emphasis has been placed on calcium and bone health, especially for women, even though men also experience bone loss, albeit at about half the rate of women.

Functional bone health encompasses much more than skeletal strength alone. A healthy skeleton does more than just lower our fracture risk. It is intimately involved with our health as an endocrine organ.

As such, it performs many important functions, including the production of red blood cells, immune cells (white blood cells), platelets, various growth factors, and cytokines, any of various protein molecules secreted by immune system cells that serve to regulate the immune system. Bone health also exerts an endocrine influence on the regulation of sugar homeostasis (the state of equilibrium or balance), fat storage, energy metabolism, and more.

If you really wish to be Forever Young, or at least as healthy and youthful as possible, we need to place a great deal of emphasis on maintaining healthy bone mass during each decade of life.

Bone-Building Nutrition: Calcium Is Not a Solo Act

All of the research to date demonstrates that the best result achieved by any calcium supplement is to slow the rate of bone loss—not increase healthy bone density, as is the popular notion. This is a serious misconception that I am now going to remedy.

A review of the scientific literature reveals that a wide range of supplemental nutrients, in addition to calcium, can contribute to the maintenance or increasing of BMD. Nowhere is this clearer than in the recent research on the additional health benefits of calcium, vitamin D, and other bone-building nutrients. Although calcium accounts for only about 2 percent of body weight, it is essential to many life sustaining processes that go beyond the building and preservation of bone strength. It is intimately involved in the transmission of electrical impulses that control muscles and the regulation of heartbeats. Prior to the mid-thirties, the body extracts calcium from dietary sources and stores it in bones until it is released and absorbed through the gastrointestinal tract. As we age, this process appears to become less and less efficient. The body now needs more calcium than can be provided by the intake of commonly consumed foods and more than the bones can store. This results in a progressive decline in bone health with increased risk of fracture.


As the fourth most abundant mineral in the body, magnesium is essential to our good health. Approximately half of our total body magnesium is found in our bones, and the other half is distributed throughout the cells of our body tissues and organs. This essential mineral is needed for more than three hundred biochemical reactions in the body. It helps maintain normal muscle and nerve function, keeps the heart rhythm steady, supports a healthy immune system, and keeps the bones strong. Only 1 percent of magnesium is found in our blood, but the body works very hard to keep the blood levels of magnesium constant. Magnesium also helps regulate blood sugar levels, promotes normal blood pressure, and is known to be involved in energy metabolism and protein synthesis. Magnesium also plays a role in preventing and managing hypertension, cardiovascular disease, and diabetes.

The Adverse Effects of Disease and Medications on Bone Health

A wide range of common diseases are known to decrease bone health, including insulin-dependent diabetes, rheumatoid arthritis, inflammatory bowel disease (IBD), celiac disease, anorexia nervosa/bulimia, COPD, endometriosis, hemophilia, hemochromatosis, stroke, multiple sclerosis, Parkinson’s disease, spinal cord injuries, long-term immobilization, renal disease, endocrine disorders (including suppressive doses of thyroid hormones), Addison’s disease, Cushing’s syndrome, sarcoidosis, organ transplants, liver disease (including hepatitis and alcoholic cirrhosis), bariatric surgery, and more. A number of these disorders are either caused or contributed to by declining bone health. So it appears that there is a vicious circle working here, and one in need of a powerful cease-and-desist order.

It is very disturbing that a number of popular medications being used to treat many of these disorders also contribute to bone loss. A significant body of research has found that a wide variety of medications are associated with reduced bone health in people of all ages. The list includes glucocorticoids and related immunosuppressants, antidiabetic drugs, lithium, Depo-Provera and other contraceptives, cyclooxygenase inhibitors, proton pump inhibitors (pharmaceutical antacids), total parenteral nutrition (this means not administered via the alimentary canal), aromatase inhibitors (letrozole, exemestane, anastrozole), gonadotropin-releasing hormone agonists (Lupron, Lupron Depot, LH‑RH agonists, leuprolide), immunosuppressants, anticonvulsants (phenobarbital, phenytoin), cytotoxic drugs, and selective serotonin reuptake inhibitors (SSRIs), which lead to the issue of stress and depression. The stress hormone cortisol inhibits the cells that form bone. Excess cortisol also causes many other negative effects, including the storage of abdominal fat.

While stress and excess stress-induced depression have been shown to cause loss of bone mass, antidepressant medications have been shown to cause even further significant bone loss. This is another issue of special importance to women going through menopause, who experience a greater rate of depression and its related disorders and who are prime candidates for such medications. This could be a situation where the “cure” is worse than the disease. Another recent study suggests that diabetics who are being treated with thiazolidinedione, an antidiabetic drug, provided “further evidence of a possible association between long-term use of thiazolidinediones and fractures, particularly of the hip and wrist, in patients with diabetes mellitus.”

Magnesium Deficiency: We Are All at Risk

If your digestive system or kidney function is compromised, it can significantly influence magnesium status because magnesium is absorbed by the intestines and then transported through the blood to cells and tissues.

The bioavailability of magnesium is reasonable, with one-third to one-half of dietary magnesium being absorbed into your body. Gastrointestinal disorders that impair absorption, like Crohn’s disease, can limit the body’s ability to absorb magnesium.

It is interesting to note that healthy kidneys limit the urinary excretion of magnesium to compensate for low dietary intake.

However, some medications cause excessive loss of magnesium in urine as a side effect. Also, poorly controlled diabetes and alcohol abuse cause the body to lose excessive amounts of magnesium.

What Is the Best Way to Get Extra Magnesium?

You can do so by eating a variety of whole grains, legumes, and vegetables (especially dark green, leafy vegetables containing chlorophyll) to increase your dietary magnesium intake. Fish such as halibut is an excellent source, as are spinach, black beans, and pumpkin and squash seeds.

A more balanced approach is to take magnesium with your calcium supplement, as the two minerals work together in several ways to maintain balance. If you have low blood levels of magnesium, it is important that you have the cause, severity, and consequences evaluated by your doctor. If you have kidney disease, you may not be able to excrete excess magnesium and should not consume magnesium supplements unless they are prescribed by a physician.

Thanks to its calming effects on the nervous system, magnesium can help ease anxiety, relax muscles, promote stress relief, decrease levels of the stress hormone cortisol, and promote a good night’s sleep.

Vitamin D

Vitamin D is a fat-soluble vitamin that functions as an important hormone. Vitamin D communicates to the intestines to increase the absorption of calcium by as much as 80 percent. Vitamin D is also well known for maintaining normal calcium levels. These are just a few of the extremely important functions of this essential nutrient.

In addition, other important minerals and nutrients that assist in building bone density are choline-stabilized orthosilicic acid, boron and the omega-3 essential fatty acids.

Studies show that choline-stabilized orthosilicic acid (ch-OSA™), improves the bone health benefits of both calcium and vitamin D. Ch-OSA helps build and maintain bone by regulating bone mineralization, helping to trigger the deposition of calcium and phosphate, reducing the number of osteoclasts (bone destroying cells) and increasing the number of osteoblasts (bone building cells).   

Scientific data on boron clearly shows its essential role in maintaining bones and joints in an optimal physiological state. The omega-3s offer many benefits including protection against bone loss.

Vitamin D Supplements

There are many health benefits of vitamin D, and a vitamin D supplement may be a strategy to ensure adequate levels. But what vitamin D supplement is best?

Since a large body of science shows that vitamin D works closely with calcium and magnesium, it is best to take vitamin D in combination with calcium and magnesium to maintain a proper balance. Recent literature shows that most calcium supplements have too little vitamin D to be effective. And some of them use synthetic vitamin D2. A much better form is natural vitamin D3, which stays in your system longer and with greater effect.

I want to drive home the message that you must do everything naturally possible to enhance bone health and make it your most important health priority, especially if you are nearing menopause. For all of you who have a decade or more to go before menopause, now is the time to ensure that your bones are receiving optimal nutrition to protect them now and in the future. If you are a mother with daughters, even better, as you can start them on the road to improved bone and immune health, which will provide them with a strong, healthy body.

Almost every system of the body benefits from improved bone health. In fact, improving bone health at any age seems to be an important factor in our ability to slow the clock of aging. It is not too far a stretch to say that healthy bones are the foundation of the fountain of youth—because you can’t have one without the other.

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.