photo of the effects of osteoporosis

Osteoporosis – Beyond Calcium Supplementation


Osteoporosis is a serious disease that affects the strength of the bones, called bone density. Osteoporosis is considered one of the most predominant bone density diseases in Western society.

Who is at risk?

Rates of low bone density are found most commonly found in postmenopausal women, specifically Asian American women. However, it should be known that osteoporosis is not strictly a female disorder. Males over 70 are also at a high risk of decreased bone density. Other risk factors for osteoporosis include early menopause, long-term use of certain medications, alcohol abuse, smoking history, sedentary lifestyle and low body weight.


Osteoporosis is diagnosed through a bone density scan, called a DEXA scan. This is a fancy term for a type of x-ray that can assess the density of specific bones to gauge fracture risk. The scan will deem bone density normal, osteopenic or osteoporotic. Normal bone density is considered the appropriate bone density. Osteopenia is the term for bone that is loosing some density, however, is not significant enough to be classified as osteoporosis. To reach osteoporosis means you have a significant amount of bone loss. The spine and hips are the typical locations for osteopenia and osteoporosis to be found.

Skeleton Physiology 101

The skeleton is continually breaking down and rebuilding. This balance is critical for strong bones. It is said the entire skeleton is regenerated ever 7-10 years! This makes it important to provide the essential nutrients needed to make bone strong and less likely to fracture, or break.

The breakdown and building up of bone is contingent on parathyroid hormone, the hormone that is secreted from the parthyroid glands. There are 4 parathyroid glands located on the back of the thyroid that function to balance the amount of calcium circulation in the blood. If there is too little, bone is broken down, if there is too much, bone is built up. Evaluating that the parathyroid glands are managing calcium balance is essential in preventing and treating osteoporosis.

Cortical and Trabecular Bone

The skeleton is made of cortical bone and trabecular bone. Trabecular bone is located inside the bone where the bone marrow is stored. The protective hard outside of the bone is the cortical bone. The bones that make the spinal column are 90% trabecular and 10% cortical, making them an easy target for compression fracture, when the spine begins to compress onto itself. The hip is made up of about 50% trabecular and cortical. The bones of the arms and legs are about 90% cortical and 10% trabecular. Fracture is much less likely to occur in a limb comparatively.

Osteoporosis and Fracture Risk

Hormonal Influences

Estrogen encourages bone to mineralize, or strengthen. In postmenopausal women, estrogen levels decrease which affects bone density as the breakdown of bone is less inhibited. This does not mean estrogen replacement therapy is a requirement to keep bone healthy. Looking at other hormones than lead to estrogen formation including testosterone and DHEA, both hormones are needed to maintain muscle mass as females but also bone density.

Stomach acid

Many bone mineral supportive nutrients including calcium, magnesium and zinc are all dependent on stomach acid for absorption. This puts individuals who are on stomach acid suppressing medications at a higher risk of osteoporosis.


Genetic influences as to when bone mass will be at peak mineralization are a large predicting factor in the development of osteoporosis. Females with a mother who experienced a fracture due to osteoporosis are at a 30% greater risk of developing osteoporosis.

Medication Use

Individuals who are on long-term medications including proton pump inhibitors (stomach acid blockers), steroids or immunosuppressive drug therapy have an increased risk of developing osteoporosis.

Other predicting factors

Smoking and alcohol use has been linked to a decrease in bone density. Studies show that women who smoke or consume more than 7 ounces of alcoholic beverage a week reduce their bone density and increase the risk of fracture.

Weight Bearing Exercise

Sedentary behavior, lack of movement and exercise, increases the risk of osteoporosis exponentially. Bones need weight bearing movements to maintain their strength. Consider walking, stair climbing, aerobics or weight training to maintain bone strength. Consult your physician as to what type of exercise would be appropriate for you.


Nutrients including calcium, magnesium, vitamin D, zinc, boron and vitamin K2 work synergistically to build bone strength. Each nutrient plays an essential role in the structure and strength of the skeletal system, therefore, making the practice of only supplementing calcium for bone health a thing of the past. When it comes to supplementing amounts of nutrients, it is recommended you have an individualized plan based on your risk. Consult your physician as to the amount of nutrients needed to keep your bones healthy.

Maintaining your skeletal system is essential for quality of life and longevity. Osteoporosis is much easier to prevent than to treat once it has become severe. This makes assessing your risk, considering bone density analysis and establishing a plan for bone health essential.

Dr. Ashley Burkman is a board certified licensed naturopathic physician at Connecticut Natural Health Specialists, LLC in Manchester, CT. She is in network with most insurance companies and is now taking new patients. For appointments, please call (860) 533-0179.

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