Natural Ways to Enhance Bone Strength: Hormones, Diet, Exercise and Targeted Supplements

Bones are much more than the rigid structures that make up our skeleton; they are dynamic, living tissues that constantly undergo remodeling and adaptation. Bones affect our structure, immune system, blood cell production, and are a great indicator of overall health. This dynamic process of bone health regulation is largely handled by hormones, which play crucial roles in maintaining bone health and strength. While many are familiar with the roles of calcium and vitamin D in bone health, the impact of various hormones is often less discussed but equally important. This post should help to provide insight and additional context for an often overlooked part of bone health. Sure calcium and vitamin D are great, but there are many other factors that influence bone metabolism.

Understanding Bone Remodeling

Before delving into the specific hormones, and how to strengthen bone health, it’s important to understand the process of bone remodeling. Bone remodeling is a continuous process where old bone tissue is broken down by cells called osteoclasts and new bone tissue is formed by cells called osteoblasts. This process is essential for repairing micro-damage to bones, maintaining calcium homeostasis, and adapting to mechanical stress.

The balance between bone resorption (breakdown) and bone formation is tightly regulated by various factors, including hormones, physical activity, vitamin and mineral intake, rest, and more. When this balance is disrupted, it can lead to bone disorders such as osteoporosis, where bones become weak and brittle.

Sclerostin: The Bone Brake

Sclerostin is a protein that is primarily produced by osteocytes, the most abundant cells in bone tissue. It acts as an inhibitor of bone formation by antagonizing the Wnt signaling pathway (if you really want to nerd out on weird chemical signals in the body the links in this post were made for you), which is crucial for the activation of osteoblasts. In simpler terms, sclerostin serves as a “brake” on bone formation.

In healthy individuals, sclerostin helps to maintain a balance between bone resorption and formation. However, when sclerostin levels are too high, it can lead to reduced bone formation and, eventually, bone loss. This is seen in conditions like sclerosteosis and van Buchem disease, where mutations lead to the absence or reduction of sclerostin, resulting in excessive bone formation and increased bone mass.

The pharmaceutical industry has taken interest in sclerostin due to its potential as a therapeutic target for osteoporosis. Sclerostin inhibitors, such as romosozumab, have been developed to block the activity of sclerostin, thereby promoting bone formation and increasing bone density. Unfortunately, side effects of romosozumab are common, and can run the gambit from join pains and headaches to difficulty breathing, chest pain, seizures, and more which makes many patients hesitant to go down that route.

Lipocalin-2 (LCN-2): Beyond Bone Density

Lipocalin-2 (LCN-2), also known as neutrophil gelatinase-associated lipocalin (NGAL), is another hormone that has recently garnered attention for its role in bone metabolism. LCN-2 is produced by various tissues, including the bone, and has been shown to influence bone homeostasis.

Recent studies suggest that LCN-2 plays a role in regulating bone resorption. It appears to have a dual function: while it promotes osteoclast differentiation (which would typically increase bone resorption), it also inhibits bone resorption by acting on osteoblasts and the bone microenvironment. This complex interaction means that LCN-2’s role in bone health is still not fully understood, but it is clear that it plays a significant role in maintaining bone density and strength.

Interestingly, LCN-2 is also involved in energy metabolism and has been linked to obesity and insulin resistance, both of which are risk factors for osteoporosis. Essentially, it appears that this hormone is secreted to try and protect your bones from the inflammatory effects of of other metabolic diseases. Alternatively, it appears that LCN-2 has the opposite effect for many metastatic cancers, and often elevates as cancer spreads.

Osteocalcin: The Bone-Building Hormone

Osteocalcin is a hormone that is exclusively produced by osteoblasts and plays a pivotal role in bone mineralization. It is often referred to as a marker of bone formation, as its levels correlate with the rate of bone turnover.

One of the key functions of osteocalcin is to bind calcium ions and incorporate them into the bone matrix, contributing to bone mineralization and strength. Additionally, osteocalcin has been found to have endocrine functions, influencing energy metabolism, glucose regulation, and even fertility.

Research has shown that osteocalcin can increase insulin sensitivity and secretion, making it an important player in the cross-talk between bone and energy metabolism. This connection highlights the systemic nature of bone health, where hormonal signals from bone can impact overall metabolic health. In conditions where bone formation is impaired, such as osteoporosis, diabetes, insulin resistance, and obesity osteocalcin levels are often reduced.

Hormonal Interplay: A Delicate Balance

The hormones discussed above—sclerostin, LCN-2, and osteocalcin—are just a few examples of the complex hormonal network that regulates bone health. Other hormones, such as parathyroid hormone (PTH), estrogen, testosterone, and growth hormone, also play critical roles in bone metabolism.

For example, estrogen is well-known for its protective effects on bone, particularly in postmenopausal women, where a decrease in estrogen levels leads to increased bone resorption and a higher risk of osteoporosis. Testosterone similarly supports bone density, particularly in men, and its decline with age is associated with reduced bone strength. Certain herbs and nutritional combinations can be beneficial for both men and women in order to support hormonal balance with these vital sex hormones. Additionally, parathyroid hormone (PTH) has a dual role in bone metabolism. In a continuous manner, it increases bone resorption by stimulating osteoclast activity, which helps maintain calcium levels in the blood. However, when administered as a treatment, PTH can stimulate bone formation more than resorption, making it a possible therapy for osteoporosis when other conservative options have not been as effective.

Supporting Bone Health Naturally: Diet, Sleep, Exercise, and Supplements

As functional medicine practitioners, we understand the importance of a holistic approach to health, and bone health is no exception. While hormones like sclerostin, lipocalin-2 (LCN-2), and osteocalcin play critical roles in bone metabolism, their balance can be significantly influenced by lifestyle factors such as diet, sleep, and exercise. Additionally, specific herbs and supplements can further support these processes, ensuring optimal bone health and strength.

The Role of Diet: Lower Carb, Higher Protein

A lower carbohydrate, higher protein diet is often recommended in functional medicine for its broad benefits, including its positive impact on bone health. Protein is crucial for maintaining and building bone tissue, as it provides the necessary building blocks for collagen, a primary component of the bone matrix. Adequate protein intake has been shown to support the production of osteocalcin, which is essential for bone mineralization. As a very generalized rule, when attempting to increase protein intake in order to support hormonal and bone health, a good starting point would be 70%-100% of your target weight in grams of protein per day. For example, if an individual wanted to weigh 150 lbs, they would attempt to consume 105g (70%) to 150g (100%) of protein per day. It may sound like a lot, but it is a great foundation to supporting the bone matrix in the body.

Moreover, reducing carbohydrate intake helps to stabilize blood sugar levels, which can indirectly benefit bone health. High blood sugar and insulin resistance have been associated with increased bone resorption and reduced bone formation. By maintaining balanced blood sugar levels, you can reduce the risk of metabolic conditions like diabetes that are linked to poor bone health.

The Importance of Quality Sleep for Bone Health

Good quality sleep is another essential factor in maintaining hormonal balance, including the hormones that regulate bone health. Sleep is the time when the body undergoes repair and regeneration, processes that are crucial for bone remodeling. During deep sleep, growth hormone (GH) is secreted, which plays a key role in bone growth and maintenance. The sleep and bone density connection is in it’s infancy. Early research indicates that when women sleep less than 5 hours per night, they have a lower bone density than those that sleep at least 7. Inadequate sleep, on the other hand, can lead to elevated cortisol levels, which promote bone resorption by increasing osteoclast activity. Chronic sleep deprivation has also been linked to lower levels of osteocalcin and higher levels of sclerostin, both of which can negatively impact bone density. Prioritizing sleep hygiene and ensuring 7-9 hours of restorative sleep each night is vital for supporting bone health.

Resistance Training Exercise

Resistance training is one of the most effective exercises for improving bone density and strength. Weight-bearing activities stimulate osteoblasts to build new bone tissue, directly counteracting the effects of hormones like sclerostin that inhibit bone formation.

Regular resistance training also helps in the production of growth hormone and testosterone, both of which are anabolic hormones that support bone formation. Additionally, exercise has been shown to increase levels of osteocalcin, which, as discussed, is crucial for bone mineralization. Incorporating weightlifting, resistance bands, or bodyweight exercises into your routine can significantly enhance bone strength and overall hormonal balance. Our preferred recommendation for hormonal balance AND bone health is weight training. Yes, you will lift heavy things, no you will not look like Arnold Schwarzenegger if you start lifting heavy things…

Herbs and Supplements for Bone Health

In addition to lifestyle interventions, certain herbs and supplements can further support the hormonal regulation of bone health. Supreme Nutrition and Standard Process offer high-quality products that can be integrated into a bone health regimen, and we frequently recommend combinations of these products with patients as part of the supportive role we play in their life. In the office setting, having completed a comprehensive medical history, physical exam, and reviewed labs and other diagnostic exams, we may recommend a combination of the following (or possibly others depending on what all is involved):

Supreme Nutrition:

• Cissus Supreme (Cissus Quadrangularis): Known for its bone-healing properties, Cissus Quadrangularis is an herb that supports bone density and accelerates the healing of fractures. It has been shown to enhance osteoblast activity and reduce the effects of sclerostin, promoting bone formation.
• Reishi Supreme (Ganoderma lucidum): This adaptogenic mushroom helps modulate the immune system and reduce inflammation, both of which are beneficial for bone health. Reishi may also support the hormonal balance that is critical for maintaining bone density.

Standard Process:

• Calcifood: A whole-food supplement that provides essential calcium and phosphorus from bone meal powder. Calcifood supports the mineralization process of bones, complementing the action of osteocalcin.
• Ostrophin PMG: This product is designed to support the health of bone tissue through a proprietary blend of minerals and nutrients. It may help maintain bone density by providing the necessary cofactors for bone metabolism.
• Catalyn: A broad-spectrum multivitamin that includes essential vitamins and minerals, such as vitamin D and magnesium, which are crucial for bone health. Vitamin D helps regulate calcium absorption, while magnesium is necessary for activating vitamin D and supporting overall bone structure.
• Bone Health Pack: This combination product includes 4 separate products into a single package [Calcifood (3 waffers), Cataplex D (1 tablet), Cruciferous Complete (1 capsule), Ostrophin PMG (2 tablets)]. This combination product attempts to cover all of the bases for bone health from supporting estrogen hormonal balance to supporting mineralization and vitamin D utilization.

Conclusion: The Future of Bone Health Research

Understanding the hormonal regulation of bone health opens up new possibilities for the prevention and treatment of bone-related disorders. As research continues to uncover the roles of various hormones in bone metabolism, new therapeutic targets are likely to emerge.

The interplay between these hormones underscores the complexity of bone health and the importance of a holistic approach to maintaining strong bones. This includes not only focusing on calcium and vitamin D but also considering the broader hormonal environment that influences bone metabolism.

By focusing on a lower carb, higher protein diet, prioritizing good quality sleep, and incorporating resistance training into your routine, you can support the balance of hormones that regulate bone health. Additionally, targeted herbs and supplements based on your specific metabolic needs can further enhance these natural processes, helping to maintain strong, healthy bones throughout life. As always, a personalized approach, tailored to individual needs, will yield the best results in supporting bone health naturally.

Whether we are able to assist with bone health needs, or other hormonal concerns, we look forward to assisting you in your health and wellness journey.