Can Supplements Support Better Bone Health?

As we age, we lose bone density. So, it’s important to take care of your bone health as early as possible. It’ll make sure those bones remain strong for years to come. But at what point should you consider supplements and vitamins for an extra boost? And who benefits most from supplements?

Rheumatologist Linda Mileti, MD, explains the answer to these questions and why any changes to your eating habits should be brought to your doctor’s attention.

Bone health supplements and vitamins

Bones hold our bodies together. They provide the framework for everything we do. But when it comes to supplements, you can sometimes have too much of a good thing.

“More is not always better,” stresses Dr. Mileti. “Studies have shown when you have too much calcium, it can get deposited into the coronary arteries, which can lead to a buildup of plaque and increase your risk of a heart attack.”

This is just one reason why Dr. Mileti strongly urges people interested in bone health supplements to talk with their healthcare providers first. Providers can tailor their recommendations to a person’s health needs.

In most cases, Dr. Mileti routinely recommends calcium and vitamin D supplementation for people with:

• Osteoporosis, especially women who’ve completed menopause and older men
• Limited sun exposure
• Diagnosed vitamin or mineral deficiencies
• Malabsorption issues caused by conditions like Crohn’s disease

That said, you can usually get most of the nutrients you need just by eating nutritious foods. Dr. Mileti breaks down which nutrients are most helpful for bone health and where to find them.

Vitamin D

Out of all the nutrients for bone health, Dr. Mileti says vitamin D is one of the most important. That’s because without it, our bodies can’t absorb calcium. And without calcium, we end up with permanent loss of bone density, resulting in conditions like osteoporosis and an increase in fractures and broken bones.

“You have to be careful, though, because too much vitamin D can start to raise your blood calcium levels,” warns Dr. Mileti. “I usually check vitamin D levels first, but for most people, I recommend about 1,000 IUs to 2,000 IUs. If they’re low, I may give them more.”

Dr. Mileti assures that, in most cases, you can get your daily dosage of vitamin D from sun exposure and vitamin D-fortified foods. But if you’re not getting enough from those sources, your healthcare provider may recommend a safe, daily allowance for vitamin D supplements that works best for you.

Calcium and phosphorus

Calcium and phosphorus are essential for bone health. Together, they help mineralize (or strengthen) our bones. But you also need calcium for other functions, too, like building and supporting muscle mass, nerves and different body systems.

“If you don’t get enough calcium in your diet, your body will do what it needs to do to keep your blood calcium normal,” explains Dr. Mileti. “Your body will pull the calcium it needs from your bones, causing them to become brittle.”

For women who’ve completed menopause and have osteoporosis, Dr. Mileti tends to recommend 1,200 mg a day. For older men with osteoporosis, she recommends 1,000 mg a day. But again, these recommendations may change based on a variety of factors.

Phosphorus can also be dangerous for people with kidney issues, so it’s always important to keep your doctor informed about what you’re taking and what you’re interested in. Recommendations will vary on a case-by-case basis.

Magnesium

Magnesium stimulates bone-building cells. It also helps with vitamin D absorption. For this reason, healthcare providers may suggest combining vitamin D supplements with magnesium supplements, but only if you’re deficient.

“Most people aren’t going to be magnesium deficient if they’re eating a balanced diet,” Dr. Mileti states.

Other supplements for people with deficiencies

Calcium, vitamin D and magnesium are the only regularly recommended supplements Dr. Mileti turns to when bone health is a concern. Occasionally, others might be recommended if someone has a specific deficiency. Some examples include:

• Vitamin C: This helps with the formation of bone-building cells and collagen. But Dr. Mileti doesn’t recommend vitamin C if you’re eating a balanced diet.
• Vitamin E: This is an antioxidant that can decrease inflammation, which leads to bone breakdown. “Vitamin E deficiency is rare,” Dr. Mileti says. “It’s in lots of cooking oils, nuts, seeds, fish and vegetables.”
• Vitamin K: Someone with conditions like Crohn’s disease or ulcerative colitis may have absorption issues. This could lead to a deficiency in vitamin K, which helps prevent low bone density and calcium buildup in blood vessels.
• B Vitamins: “If you’re deficient in B vitamins, you can start to have more bone breakdown as opposed to bone formation,” Dr. Mileti asserts. “But supplementing B vitamins in addition to a healthy diet has not been shown to prevent fractures, because most people get enough of this nutrient from food.”
• Zinc: This mineral also helps with collagen production, with women needing 8 mg a day and men needing about 11 mg a day under current recommendations. “There are so many sources of zinc,” Dr. Mileti notes. “So, it would be pretty uncommon to have a zinc deficiency.”
• Protein: There’s usually no need to supplement protein, either, advises Dr. Mileti. Although it’s the building block for skeletal muscle, there are abundant sources.

Some people claim copper, potassium, silicon and boron are also helpful for bone health, but there’s not enough research to suggest their benefits (if any). For this reason, Dr. Mileti suggests avoiding these supplements unless your healthcare provider says otherwise.

Final note

If you’re concerned about your bone health, really hone in on improving your nutrition. It’s better (and safer) to get your nutrients from whole foods instead of supplements. “Being sedentary has adverse effects on bones, too, so sometimes it even helps to incorporate exercises that get you on your feet,” Dr. Mileti highlights.

She also recommends testing for bone density if:

• You’re 65 or older
• You’ve completed menopause
• You have other risk factors like a history of rheumatoid arthritis, long-term corticosteroid use, liver disease, smoking or osteoporotic fractures (breaking a bone after a fall from standing height)

If you’re considering a supplement or looking for recommendations, your healthcare provider will guide you through that process.

“We’re here to help anyone who’s worried about their bone health,” Dr. Mileti emphasizes.