Bones & hormones- they do more than just rhyme

“To thrive in life you need three bones. A wishbone. A backbone. And a funny bone.”
-Reba McEntire

I can’t quite help you with a funny bone or wishbone, but I can certainly help you with a backbone! Around the time of menopause in women, estrogen declines, and progesterone plummets, leaving bones susceptible to actually break down more than they’re built up, placing women at a higher risk of osteopenia and perhaps osteoporosis. Ironically, milk and calcium supplements would be recommended for bone health, as well as a common medications like bisphosphinates (i.e. Fosamax- can actually cause jaw necrosis and interfere with absorption), yet these don’t account for hormone imbalances… or the many other risk factors that can lead to brittle bones.

While decline in bone health is common amongst women, men are not immune- it’s just more apparent in women due to the drop of hormones, but it’s only one piece of the puzzle. Before discussing risk factors, let’s delve into what exactly makes bones. Bones are made up of minerals like calcium, as well as phosphate, magnesium, and sodium, plus a collagen matrix inside that provides a bit of give (our bones aren’t completely rigid). Our bones are constantly broken down and rebuilt, known as remodeling, so we can regulate calcium levels, repair any damages, shape the skeleton during growth periods (i.e. puberty), and under control of our thyroid and parathyroid (4 glands located in the back of the thyroid) glands. Estrogen also helps bone cells repair and regenerate (i.e. premenopausal women without a period are also at risk for declining bone health), yet progesterone has shown to also help with bone building. One problem- most people are deficient in progesterone.

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Hormone imbalance, especially estrogen dominance, is common amongst both men and women, with subtle cues over the decades like irregular and/or painful periods, weight gain, can’t lose weight, poor sleep, mood changes, infertility, thyroid issues- in fact, many of the symptoms are similar to hypothyroid. Fat cells can also turn testosterone into estrogen, which makes losing weight an uphill battle, and recent research now debates whether extra weight is really protective against bone health. Added estrogen (a common culprit) can also lead to higher estrogen through the gut as there’s a certain type of bacteria that metabolize and excrete estrogen. Ironically enough, this can also happen with low estrogen- weakening the gut lining and potentially decreasing calcium absorption. This inflammation can hinder our ability to absorb vitamin D, a crucial nutrient (and actually a hormone) that helps the body retain calcium. And vitamin D helps protect against inflammation.

So somehow the focus for treatment turned right into minerals and only a brief convo about hormones (osteoporosis has been treated with estrogen therapy, except it’s not always a favorite due to the potential risks)…

Additional risk factors (many of these also lead to hormone imbalances) include a poor diet (not getting proper nutrients), low estrogen, low testosterone & DHEA, birth control pills, sedentary lifestyle, alcohol, smoking, certain medications (i.e. proton pump inhibitors, corticosteroids, SSRI’s, blood pressure medications, NSAIDs).

Fortunately, there are so many risk factors here that can be modified, and actually many of these have common treatments so even what seems like a lot- really isn’t! Here’s how you can balance your hormones, and protect your bones!:

  • Put down the calcium supplement- and milk, & aim for this instead- Actually, calcium taken by itself in women has been studied to increase risk of heart attack through increasing deposits of plaque in arteries. No bueno. And milk.. well many people can’t really digest milk anyways (taking lactid is no excuse- your body already told you it’s not happy), and studies now show drinking too much (i.e. over 3 glasses per day) can actually increase risk of fractures. Head on over to the dark leafy greens! Foods like spinach, kale, and collards contain not only calcium, but a huge ‘bang for your buck’ on other vitamins and minerals that are included in bones, help metabolize estrogen, help with weight loss, feed good gut bacteria, and help us detox other crap from our environment. Give these a quick steam as they have a constituent that can slightly hinder thyroid function. That said, any of these raw will be a better choice than any of those risk factors (and fried foods, etc.).

  • Add in weight bearing exercises to your routine- This is one of the best pieces of advice, and it doesn’t have be super heavy! Added weight provides some extra pressure to our bones to additionally signal breakdown and clearance of old stuff, and build up the fancy new bone! Even every day activities like carrying a backpack, moving pieces around the house, carrying kids/pets/items, all contribute! Ladies, you are not going to bulk up, and men, chances are you won’t either (or not to the extent you think/would like). If you’re concerned, please work with a personal trainer, even if just for a few sessions to ensure you’re doing everything correctly, and broaden your scope of exercises.

  • Optimize vitamin D levels- One of my critiques going through bloodwork is that those ranges are pathological, like when our physiology is just exhausted from compensating and we don’t feel great. Except now time and time again we don’t feel great anyways but our labs look normal. The range of vitamin D is 30-100, yet is there really a difference if someone’s level is a 29 or 31?? Not so much.. aim for levels around 50, and make sure your supplement is D3 and not D2 (the body has to convert it to D3). Vitamin D is the building block of hormones, and helps calcium get absorbed.

While there are many risk factors, it’s imperative to determine which ones are your biggest obstacles to cure, and of course if any medications could be of hindrance. I can help with all of that. Bone health is imperative to take care of and keep in mind especially when we’re younger as that’s when we can make our strongest foundation. However, because there’s so many influences to healthy bone, regardless of where you started, it can be reversed through diet, lifestyle, proper supplementation, and even certain herbs that are rich in these minerals. If you’d like to learn more about how to protect your bones, and make it part of your lifestyle (so it’s all prevention!), let’s find some time to chat. Maybe we’ll even find/strengthen those wishbones and funny bones! :)