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
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
- 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.
- Wippert PM, Rector M, Kuhn G, Wuertz-Kozak K. Stress and alterations in bones: an interdisciplinary perspective. Front Endocrinol (Lausanne). 2017;8:96.
- 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.
- Azuma K, Adachi Y, Hayashi H, Kubo KY. Chronic psychological stress as a risk factor of osteoporosis. J UOEH. 2015;37(4):245-253