10 Things You Need To Know About Bone Density

Bone density | Hataitai Osteopaths | Wellington Osteopath

Are you concerned about your bone density? What you need to know.

1. Fizzy drinks contain phosphoric acid, which interferes with the body’s ability to absorb calcium and can lead to osteoporosis, cavities, and bone softening. Phosphoric acid also interacts with stomach acid, slowing digestion and blocking nutrient absorption.

2. Vitamin K is a fat soluble vitamin that is important for blood clotting and that contributes to a healthy heart, bones and immune system.

There are several different forms, mainly K1 and K2 -

  • Vitamin K1– (or phylloquinone) is natural form found in greens and nettle that is used by the liver for proper blood clotting.

  • Vitamin K2– (or menaquinone) is a more absorbable form of Vitamin K found in certain fermented foods and supplements is used by soft tissues and is helpful for bones, heart tissue and controls proper utilisation of calcium.

  • Vitamin K3– (or menadione) is a synthetic form of Vitamin K. This is typically the one injected into infants at birth.

Estimates are that over half of the adult population is deficient in Vitamin K. While the effects of Vitamin K deficiency can show up in more serious problems like cardiovascular disease, bone loss and tooth decay, it can also manifest in smaller symptoms like easy bruising, heavy periods, or nosebleeds.

Those with digestive problems or with a history of antibiotic use are the most at risk for these problems.

How I Take Vitamin K2

Since there are no known side effects from K2 consumption, even at high levels, I take 180 mcg (two 90mcg capsules) per day on most days (consuming a small amount of Natto would also work). I also consume Fermented Cod Liver Oil Daily, which is a natural source of K2 (and other fat soluble vitamins). 

Some experts recommend as much as 500mcg per day, but I would only consume high levels like this under the guidance of a practitioner to make sure that cofactors (D3, calcium and magnesium) maintained proper levels as well. Of course, since K2 is a fat soluble vitamin, it is important to check with a doctor before taking, especially at high doses if pregnant or nursing. I also recommend this book for learning more about Vitamin K supplementation and safety.


Food Sources of Vitamin K1

  • Kale

  • Dried Basil

  • Spring Onions/Scallions

  • Broccoli

  • Brussels Sprouts

  • Asparagus

  • Cabbage

  • Cucumbers

  • Prunes

  • Most greens

Food sources of K2

  • Natto – fermented soybeans -you can make this yourself (best source)

  • Grass fed butter (raw)

  • Grass fed cheese (raw)

  • Egg Yolks

  • Chicken livers

  • Grass fed Beef

  • Chicken


3. Vitamin D3

Vitamin D regulates mineral concentration in the blood (including calcium). When we are exposed to ultraviolet-B light from the sun or artificial sources, our bodies create vitamin D3, or cholecalciferol photochemically in our skin. Food sources like fatty fish, eggs, and meat also provide D3.

How to Get Enough Vitamin D

  • Spend a safe amount of time in the sun, but optimize your diet and lifestyle to prevent burning and get out of the sun before skin has a chance to burn.

  • Use a cover-up or a safe sunscreen for long sun exposure.

  • Deficiency of magnesium can inhibit vitamin D function, so make sure you get that too!

  • Getting blood levels of vitamin D tested in NZ is difficult and expensive – however in the UK the NHS has recommended Vit D supplementation as many studies have shown low levels in most of the population.

  • If necessary, use a vitamin D supplement. You need about 10-20 micrograms (400–800 IU) per day of vitamin D intake with a safe upper safe limit of 100mcg (4000 iu per day) for healthy bones; 90% comes from the action of sunlight on our skin and 10% from diet (such as oily fish). People who rarely expose their skin to sunlight or have a restricted diet need vitamin D supplements. The NHS recommends that breast-fed babies up to one year old and all children aged one to four should have a daily supplement, while children over five and adults should consider one in the winter months.

4. Magnesium

Magnesium is vital for hundreds of functions within the human body and especially so for bone health. Many of us are deficient in this master mineral . There are several different ways to get Magnesium - In powder form or tablet form - work up slowly to full dose to ensure against diarrhea. This will be available at our practice soon. Ionic liquid form can be added to food and drinks and dose can be worked up slowly, or transdermal form by using Magnesium oil applied to the skin (this is my favorite method). Topical application is often the most effective option for those with a damaged digestive tract or severe deficiency. This is available at our practice in cream form.

5. You don’t need calcium supplements.

A healthy, balanced diet should provide the recommended 700 millgrams a day of calcium that you need to make new bone as old bone is replaced. There is no good evidence that calcium supplements are needed if you are at low risk of osteoporosis. There has been some concern that taking extra calcium may lead to harmful deposits around the heart, increasing the risk of heart attack. The consensus is that dietary sources are preferable to supplements, except if you can’t get enough calcium from your diet because you have a condition such as Crohn’s disease that prevents adequate absorption of dietary calcium. 

6. Walk quickly for 10 minutes, three times a day

Weight-bearing exercise (walking, running) helps to keep bones strong. Ideally, you need a mix of “feet on the ground” activity and muscle resistance such as weights, press-ups and swimming. No one knows precisely how much exercise is needed; the NHS says adults aged 19 to 64 should do at least 150 minutes of moderate-intensity aerobic activity every week. Three 10-minute periods of fast walking every day is a good target. There is little evidence that exercise prevents fractures once you have weak bones (called osteopenia if it is mild and osteoporosis if more severe), but people who keep active into old age are less likely to fall – and if you don’t fall, you are less likely to break a bone.

7. Don’t smoke – especially when you are young

Smoking has an impact on bone-building cells, especially in people younger than 30, who are still accumulating bone. Smokers are at increased risk of osteoporosis and fractures and stopping smoking is likely to improve bone strength. It is a complicated association: smokers may also be thinner than the healthy weight range; if you fall but have no padding, you are more likely to fracture a bone. After the menopause, women make some oestrogen – which keeps bones strong – in their fat layer. Once your ovaries stop producing oestrogen, you can’t make much of it if you don’t have any fat.

8. Don’t get too thin

No one is saying that it helps to be overweight; you need to be able to keep moving, of course, and the heavier you are, the more force will land on your bones if you fall. But small-framed, low-weight people have less total bone mass. As a result, losing even small amounts of weight may result in bones that break easily.

9. HRT can help some women

Women are four times more likely than men to get osteoporosis, since their levels of oestrogen fall after the menopause. Hormone replacement therapy can help maintain strong bones and prevent fragility fractures (fractures that occur on minimal force). But note once you have osteoporosis, though, it is not very effective.

10. Don’t trip up

The main risk of having thin bones is fragility fractures. Elderly people who fall and break a hip may never regain their independence. Vertebral fractures may be silent initially, but tend to recur and can become multiple and extremely painful and disabling. One of the most useful things you can do for a frail relative or friend is check their home for potential hazards such as loose carpet. Occupational therapy assessment, to fit hand rails to steps and baths, can be accessed via local authority websites or a GP referral.

11. Know your risk

You are at increased risk of osteoporosis if you are elderly, female, underweight or immobile; if you have had previous fractures; and if you smoke, drink a lot of alcohol (more than 30 units a week) or take steroids for a condition such as rheumatoid arthritis. You can do your own risk assessment (there is a useful risk calculator on the University of Sheffield’s website). In some cases, a bone density scan is useful. This can be arranged by your GP, but the scan needs to be taken in context of your overall risk. If you are at high risk, you will probably be advised to have treatment to build up your bones, even if the scan is normal.

12. Probiotics

Last week an important new research study came out in the press supporting the use of probiotics in reducing bone loss. Supplementation with the probiotic Lactobacillus reuteri could lead to a paradigm shift in the prevention of osteoporosis. Previous studies in rodents have suggested that treatment with specific bacterial strains can improve bone density (1,2,3).

Sources : The Guardian and Wellness Mama

1.Britton RA, Irwin R, Quach D et al. Probiotic L. reuteri treatment prevents bone loss in a menopausal ovariectomized mouse model. J Cell Physiol 2014; 229: 1822–30. Wiley Online LibraryCASPubMedWeb of Science®Google Scholar

2 Collins FL, Irwin R, Bierhalter H et al. Lactobacillus reuteri 6475 Increases Bone Density in Intact Females Only under an Inflammatory Setting. PLoS ONE 2016; 11: e0153180. CrossrefPubMedWeb of Science®Google Scholar

3.Hsu E, Pacifici R. From osteoimmunology to osteomicrobiology: how the microbiota and the immune system regulate bone. Calcif Tissue Int 2017; 102: 512–21. CrossrefPubMedWeb of Science®Google Scholar