Can Stress Damage Bone Health?

Bone health is important for all ages. And, as a naturopathic doctor, I see people of all ages, genders, cultures, and walks of life in my practice. With that said, the largest demographic I work with desire relief from the effects of perimenopause and menopause. They often experience weight gain, energy loss, and the onset of osteopenia and osteoporosis. When I’m working with a patient, I’m always working holistically, meaning, I do not just look at bone health. I look at the body, and the mind. I don’t just review the diet; I review the medications, stress, and lifestyle. This is what patients can expect from a thorough naturopathic review. The major contributors supporting bone health are adequate calcium and vitamin D intake along with the importance of stressing the bones through exercise, and destressing the mind. This latter point is often ignored when looking at bone health. Can stress damage bone health? Absolutely. This is where the mind meets the bone. The type of stress you are experiencing can make or break bones.

Proper Care and Feeding of Bones

It’s no secret, calcium and vitamin D are needed for optimal bone health. For adults under the age of 50, naturopathic doctors  recommend 1000mg of calcium daily. For those over 50 years of age, that amount should be increased to 1200mg daily. For vitamin D, 1000 IU’s per day is optimal.1 Dairy foods are the highest calcium concentrated foods available, but many people are intolerant of dairy, especially as they age. There are ways to compensate by adding fresh produce, specifically dark green vegetables to help build and maintain bone mass. Broccoli, kale, and collards are all excellent sources of calcium, especially when eaten raw or lightly steamed (boiling vegetables can draw out much of their mineral content). There are more benefits here than just calcium: 1. Fber in vegetables keeps the digestive tract regular, 2. Fiber also helps remove all sorts of toxins including excess cholesterol, and 3. Fiber aids in healthy hormone metabolism.

While calcium is always better absorbed when it enters the body from natural food sources, but don’t be afraid to supplement. However, an important health hack to remember is the body’s wisdom only permits it to absorb so much calcium in one sitting. The higher the calcium dose, the less it’s absorbed. For the maximum absorption, no more than 500 mg of calcium should be taken in a single dose. If you need more than 500 mg as a supplement, take the doses at least four hours apart.

Stress is a Little Known Factor in Bone Loss

Stress Can Damage Bone Integrity

Our bones hold the deepest part of our being. All the colloquialisms of feeling something or being scared “to the bone” reflect this reality. The body perceives fright and stress as one in the same. Stressful situations and events impact us in a myriad of ways. It changes our hormonal picture to be in “fight or flight” mode. The bone’s role in stress is to release calcium into the bloodstream so it’s readily available for immediate action by the muscles, which need calcium to contract.

Even if the perceived stress doesn’t warrant physical action, our body reacts to this response just the same, which negatively impacts the bone. And though you may not connect psychological health with bone health because the mechanisms are different, there are biological links in the body’s response to stress and the development of bone disease. When our body’s are stressed it alters what is called the hypothalamic-pituitary-adrenal (HPA) axis and that changes the secretion of growth hormones and increases the secretion of stress hormones. This cascades into an inflammatory response, which can lead to bone loss. Even more frustrating, many of the medications given for anxiety and depression, can lead to further bone loss (see more here for ways to manage stress and anxiety).

Long-term stress also leads to physical and mental burnout, which increases the likelihood of sedentary behaviors and reaching for unhealthy comfort foods. We all know these are never healthy choices, but many may not realize how these behaviors impact our bone health.

As a naturopathic doctor, I treat this kind of stress directly by assessing what mental health practices a patient uses or should use. I may introduce them to wonderful herbs that support the mind and spirit such as Holy Basil, Passionflower, Ashwagandha, and Saffron. Managing our stress can be a rich and rewarding place to learn about self-love. Appreciating who you are nourishes your entire body, bones and all, and makes life more meaningful.

Good Stress for Bone Health

With that said, there is another stress, that is good stress called exercise. Bones need ligaments to pull and signal them to stay strong and vital. This means your ligaments and bones need at least 30 minutes of weight bearing exercises per day. This can come in many flavors, including brisk walking,  jogging, lifting weights or even just carrying some heavy household objects like full milk jugs. It’s best to follow weight bearing exercise with gentle stretching such as yoga. This amazing combination of strength work and stretching nourishes the bones, the ligaments, and the muscles that animate them.

Other Important reminders

  • No Smoking Section Please. Smoking cigarettes is directly associated with a host of worsening health effects, including those that impact the health and integrity of the bone.
  • Go Easy On caffeine and alcohol. They are fine in moderation but in excess can affect both our motivation and our hormones, which directly impact our bones.
  • Knowledge is Power. I recommend all my patients get a bone scan, called DXA, after the age of 65. It’s important to know your baseline and to know the level of intervention that is best for you.

Our bones do not live in isolation from the rest of the body—instead they hold us up—body, mind, and spirit. They support us through every movement of our lives, every joy, and every sadness. They are constantly giving of themselves to ensure we can be present in every moment. For longevity and for balance, it is essential to give back to them in the same way in body, mind, and soul.


Dr. Keenan is a licensed naturopathic doctor, lead industry medical writer, adjunct faculty member in the botanical sciences, and serves on INM’s Editorial Board. Dr. Keenan has taught botanical medicine and field classes for years both in the Pacific Northwest at Bastyr University and along the East coast from Maine to Georgia. Currently serving the Mid-Atlantic region, he will take any opportunity to discuss the amazing plant world.  Dr. Keenan is passionate about providing the most up-to-date scientific information in a way that allows the individual to make the most suitable decisions for their health regardless of whether they opt to incorporate natural medicines or not. When he is not in the office, it’s a good bet he is outside enjoying  the forest or the sea.


Read More on Naturopathic Solutions for Bone Health, Stress and Anxiety

Be Aware of Common Medications that Can Lead to Bone Loss

How do Naturopathic Doctor’s Treat Anxiety?

Stress as a Daily Toxin and What You Can Do About It

Eating More Fruits and Vegetables Linked to Lower Stress

Female Friendships Relieve Stress


References:

  1. Sunyecz J. A. (2008). The use of calcium and vitamin D in the management of osteoporosis. Therapeutics and clinical risk management, 4(4), 827–836.
  2. Wippert PM, Rector M, Kuhn G, Wuertz-Kozak K. Stress and alterations in bones: an interdisciplinary perspective. Front Endocrinol (Lausanne). 2017;8:96.
  3. Kelly RR, McDonald LT, Jensen NR, Sidles SJ, Larue AC. Impacts of psychological stress on osteoporosis: clinical implications and treatment interactions. Front Psychiatry. 2019;10.
  4. Azuma K, Adachi Y, Hayashi H, Kubo KY. Chronic psychological stress as a risk factor of osteoporosis. J UOEH. 2015;37(4):245-253

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Deb Hubers

Debra Hubers is a serial entrepreneur and has started seven businesses; ranging from an advanced genomics to an employer health care purchasing cooperative. Deb has over 35 years of experience in healthcare finance, education, technology, and pharmacogenomics.

Ms. Hubers has dedicated her career to measuring and improving healthcare outcomes. Her expertise is leveraging technology to deliver personalized, preventative medicine. Ms. Hubers co-founded La Vita Compounding Pharmacy in 2007. Collaborating with her business partner, physicians and strategic partners, Deb has grown La Vita to be one of the most respected and sought-after personalized medicine providers on the west coast. She is also Co-Founder of EpigeneticsRx, a leading provider of precise, personalized, prevention which positively impacts genetic expression.

Alex Keller, ND

Dr. Alex Keller, ND, AFMCP is a graduate of the University of Ottawa with an Honours Bachelor in Health Sciences and Psychology. Although originally intending to attend conventional medical school, following a three-month volunteer internship at a rural Kenyan hospital where he observed how doctors used local food to treat patients, he shifted his career goals and pursued a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine in Toronto.

After one year of practicing with the esteemed Dr. Chris Pickrell, ND, RH in a community acupuncture setting, in 2015 he and his wife Dr. Jenn Keller, ND moved to rural Ottawa, Canada where they started an organic farm and retreat center. In the same year, Alex and his athletic therapist sister Jess Keller combined their practices to form Keller Active Health, an integrative physical therapy clinic.

Ever curious and passionate about the education of evidence-based natural medicine, in 2017, Dr. Keller joined a fledgling Ottawa-based health tech startup named Fullscript. He serves as its Medical Director and oversees the development of medical education content for practitioners across North America.

Prior to medicine, Alex worked in the renewable energy sector, where he developed a deep passion for sustainable agriculture and environmental stewardship. This connection between medicine and agriculture now drives Alex to focus much of his energy on bringing awareness to the quality and sourcing standards in the supplement and organic agriculture supply chains.

Today, he splits his professional time practicing as a clinician, working for Fullscript, and expanding the farming operation while chasing his kids with Jenn and occasionally running ultra-marathon trail races. He is also currently completing an Executive MBA through the Quantic School of Business & Technology with a focus on supply chain innovation.

Pamela Snider, ND

Pamela Snider, ND, is Executive and Senior Editor for the Foundations of Naturopathic Medicine Project, producing a first of its kind international textbook of Naturopathic medicine through a series of international retreats and symposia. A nationally recognized integrative health and policy leader, she is active in both national and regional integrative health initiatives. Dr. Snider serves on the Board of Directors, was founding Executive Director and co-founder of the Academic Consortium for Integrative Health (ACIH/ACCAHCa consortium of the councils of schools, accrediting agencies and certifying bodies of the licensed, traditional and emerging integrative health professions, and is currently Vice Chair and co-founder of the Integrative Health Policy Consortium (IHPC).  Dr. Snider served as a founding Board Member of the Academy of Integrative Health & Medicine from 2014-2016. Her public policy work includes completing a two year appointment to the DHHS Center For Medicaid and Medicare Services (CMS) Medicare Coverage Advisory Committee (MCAC); serving as a Steering Committee Member for  the HRSA funded American College of Preventive Medicine NCCIM Integrative Medicine in Preventive Medicine Residency program, co-directing in USPHS Region X the Building Bridges Between Provider Communities Group, an exploration of interdisciplinary collaboration and common ground between public health and CAM; serving for 22 years on Washington State’s Health Professional Loan Repayment and Scholarship Program Advisory Committee (HPLRSP); providing technical assistance to and developing key language for the enabling legislation for NIH Center for Complementary and Alternative Medicine (NCCIH/NCCAM); and staffing Joseph Pizzorno ND during his appointment as Commissioner on the White House Commission on CAM Policy.

From 1994-2003, Dr. Snider served as Associate Dean for Public and Professional Affairs and Naturopathic Medicine at Bastyr University, dividing her work between academic and public affairs activities, including chairing the Naturopathic Medicine Program Curriculum Review Committee.  Dr. Snider has been teaching, publishing and lecturing widely on Naturopathic philosophy, theory integrative health, public policy, and other topics for over 30 years. Currently, an Associate Professor at National University of Natural Medicine (NUNM) in Portland, OR, Dr. Snider also continues at Bastyr University in her 22nd year as a faculty member teaching naturopathic medicine history, clinical theory, and global context. Among her Naturopathic medicine professional roles she serves on the Institute for Natural Medicine’s Leadership Council.  In 1989, she co-led the naturopathic profession with Dr. Jared Zeff, in developing a unifying definition of naturopathic medicine and its principles of practice adopted unanimously by the American Association of Naturopathic Physicians (AANP) House of Delegates. She was a co-investigator in the 2004 NIH NCCAM research study, the North American Naturopathic Medical Research Agenda and CAM Advisor in NIHCCAM’s Financing Integrative Health Care (University of Washington).  Her areas of experience include healthcare education; naturopathic and interdisciplinary clinical theory, curriculum development; clinical practice; government and legislative affairs, public policy, interdisciplinary collaboration, and community organizing.  Dr. Snider has received the Ontario Naturopathic Physician of the Year Award, the Physician of the Year Award from the AANP, the President’s Outstanding Vision Award and Distinguished Alumnus Award at Bastyr University, AANP’s President’s Award, an honorary Doctorate of Naturopathic Philosophy from the Canadian College of Naturopathic Medicine (CCNM), the William A Mitchell Vis Award from the AANP and The Gathering – NMSA’s Beacon Award. She received her ND degree in 1982 from Bastyr University of Natural Health Sciences and is a licensed naturopathic physician in the State of Washington. She lives with her husband and children at their homestead in North Bend Washington, in the beautiful mountain to sea landscape and home of The Revival – Restore the Vis, an annual student-led community gathering.

Susan Haeger

Susan Haeger is Founder/Principal of Transformative Health Solutions Inc. She has applied her twenty plus years in executive leadership to help shape and drive adoption of progressive health policy for whole person healthcare. She was a section contributor to the 2021 INM/AANP published professional white paper, Naturopathic Physicians as Whole Health Specialists: The Future is Whole Person Health Care that provides supporting evidence for the profession’s significant and unique contributions to preventive, whole person care and models of integrative clinical practice.

Bruce Barlean

Bruce Barlean is an owner and founder of Barlean’s, a global dietary supplement manufacturer located in the Pacific Northwest in Ferndale, WA. Bruce has been actively involved in the Natural Products industry since 1989 and is passionate about making a difference in the world and positively impacting the lives of others.

Bruce believes that people can make a difference in the world through ordinary purchases. He is committed to improving the quality of life for every person on the planet by making the best products and by using the profits to support outreach programs. Bruce summarizes it simply, “We make good stuff to do good stuff”.

In the late 1980’s Bruce became passionate about how health could be dramatically improved with Flax Oil Supplementation. Bruce along with his entrepreneurial parents saw the potential to improve the lives of many people and in 1989 they began selling Flax Oil under the Barlean’s name. From 1989 – 2000 the business grew an average of 40% year over year. While most companies saw a decline in business in the 2001 recession, Barlean’s continued to grow and soon became America’s #1 selling flaxseed oil and continues to be to the present. The brand has since expanded to include additional oils, green food concentrates and other premium supplements. Bruce continues to drive innovation and over the years his products and company have won countless awards including: Eight consecutive Vity Awards for #1 EFA, Six consecutive Vity Awards for #1 Greens Food Supplement, Natural Choice Award for Best Specialty Supplement, Best Product of the Year, Best New Product, Gold Medal Taster’s Choice Award, Gold Medal American Masters of Taste Award, #1 Health Food Store Brand for Consumer Satisfaction by Consumer Lab, and Manufacturer of the Year.

In 2013 as the company was on the eve of celebrating the 25th year in business Bruce and his parents decided to take their desire to help people to a new level that they call Pathway to a Better Life – which is now seen in the Barlean’s logo. Bruce and his parents had always been generous in their giving and support of charities, but as part of the Pathway to a Better Life they decided to increased partnership with charitable organizations such as: Vitamin Angels, Compassion International, KidsTown International, Autism Hope Alliance, Engedi Refuge, Project 92, and others. And because so many people are unable to meet basic nutritional needs, Bruce created a comprehensive Omega-3 and multivitamin formula that he distributes free-of-charge to local food banks. In addition, Bruce decided the company would supply food banks with organic coconut oil to provide people with a health alternative to standard cooking oils.

Always generous with his time Bruce has served as a youth leader for his local church for several years and continues to mentor youth. He has been on several not for profit boards including; Whatcom County Pregnancy Center (2003-2006), Natural Products Association (dates?), and the Institute for Natural Medicine Leadership Council (presently).

The Barlean family have been avid supporters of Bastyr University since the 1990’s and in 2013 were given Bastyr’s most prestigious honor, the Mission Award, which recognizes their leadership over time in improving the health and well-being of the human community.

Bruce currently resides in Ferndale, WA with his wife Lisa and their two dogs: Heinz & Shadow. When he’s not helping others he can be found fishing (catch & release).

Get Involved!

Michelle Simon, PHD, ND

President & CEO

As president and CEO of INM, Dr. Simon brings her passion for working with organizations dedicated to improving the quality and delivery of healthcare. This desire stems from her years of practice as a licensed naturopathic physician. In addition to holding a Naturopathic Doctorate from Bastyr University she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill.

She has served on boards for the American Association of Naturopathic Physicians (AANP), the Naturopathic Physicians Research Institute (NPRI), and several advisory boards. Dr. Simon served nine years on the Washington State Health Technology Clinical Committee, as Ambassador to the Academy of Integrative Health and Medicine (AIHM) and was recognized as 2018 AANP Physician of the Year. Dr. Simon shares with her husband a passion for adventure travel, preferably by boat or motorcycle. She also enjoys teaching a women’s off-road motorcycling class.