Rebuilding Bones

You may have heard bone loss can’t be stopped, or that bones can’t be significantly rebuilt, but this is not the case. You will never regain the bone density you had in your thirties, but stopping, slowing, and partially reversing bone loss are all possible. This is more important than ever, since we’re living longer than ever, and therefore our bones need to last longer.

The right foods and supplements are an indispensable part of bone-rebuilding. But, before you look at dietary changes, supplements, and exercise, it’s important to rule out or address any significant causes of your bone loss.

Common Causes of Bone Loss

The perfect diet for you and the best supplements money can buy may not fully overcome an influence such as one of these:

Medications. Some medications contribute to bone loss. Read the side effects printout and ask your pharmacist. It’s easy to look up “negative side effects” online for all your prescriptions and OTC medications. Steroids are especially harmful, including steroidal nasal sprays. A thyroid hormone level that is too low or two high will also contribute to bone loss. Be sure your Free T3 is tested, not just your TSH and T4. If you’re on a T3 or T4 medication, be sure the dose(s) keep your blood levels within the normal range, preferably close to the mid-range. See thyroid information below.

Low levels of estrogen and testosterone. Both are powerful bone-building hormones. Low levels of testosterone are common in men over 45, and low levels of both estrogen and testosterone are common in women over 45. Consider testing estrogen and testosterone and, if possible, choose bioidentical HRT (hormone replacement therapy). Start HRT during perimenopause or as soon after menopause as possible.

A faulty study released by the Women’s Health Initiative in 2002 claimed that HRT increases the risk of heart disease for women. Millions of women still don’t know this study was found to be flawed. Subsequent research showed that all the prior research showing HRT to be protective against heart disease was indeed correct.

For advice on testing and treatment, consult an OB-GYN or naturopath who is already supportive of bioidentical HRT, or get your MD connected with a pharmacist from a compounding pharmacy who is knowledgeable about bioidentical HRT. Lloyd Central Compounding Pharmacy in Portland, Oregon has topnotch pharmacists who work with patients and doctors all over the country. Doses should depend on a combination of blood values and symptoms, not just one or the other.

Insomnia. Bone-rebuilding occurs mostly during sleep, so poor or inadequate sleep interferes with normal bone health. Common causes of poor sleep include thyroid imbalance, sleep apnea, food or airborne allergies, imbalances in neurotransmitters (e.g., melatonin, serotonin, dopamine, etc.), any inflammatory condition (e.g., arthritis, osteoporosis, diabetes). Allergies and even mild inflammation often cause nervous system agitation that isn’t obvious but can interfere with quality and duration of sleep.

The most common cause of insomnia in the elderly is neurotransmitter imbalances; also known as clinical depression, although the person may not be emotionally depressed. One of the most effective and safest treatments for this is the right antidepressant used in ⅓ to ½ doses. More and more doctors are using this approach because sleeping pills are so addictive. The cannabinoid CBN (think N for nighttime) can also be very helpful for sleep, more helpful than the better-known cannabinoid CBD.

Thyroid hormone levels may be too low or too high. Loss of bone speeds up when thyroid hormone levels are too low or too high. For evaluation, always request Total T4 and Free T3. Most doctors check TSH and maybe T4 (levothyroxine) without checking levels of Free T3 (triiodothyronine), which is by far the most active form of the hormone and needed by every cell in the body. Some people don’t convert T4 to T3 very well. When only T4 is tested, they may be told their T4 is fine and not prescribed any medication, or they may be put on only T4 if it is low, neither of which will address poor T4-to-T3 conversion. In either case, their bones will continue to suffer. I usually recommend evaluation by a naturopath experienced in assessing and treating both thyroid and adrenal issues, even if you’ve already had a blood test for thyroid from an MD and whether you’re on medication for thyroid.

Selenium is needed for converting T4 to T3. 100-200 mcgs a day is safe. Many factors affect conversion, so taking selenium alone may not correct this problem. If you start selenium, be sure to have your levels of Free T3 rechecked in six weeks.

Chronic inflammation. Osteoporosis is an inflammatory condition. Some bone loss is normal with aging, but inflammation increases the rate of bone loss. Sugar, wheat grown in the U.S., and grain-fed meats and dairy are highly inflammatory foods. U.S. wheat has become inflammatory due to decades of extreme over-hybridizing and chemical sprays. If you eat a lot of beef and dairy, consider switching to 100% grass-fed (not just “grass-fed,” which is grain-finished). 100% grass-fed meat and dairy are anti-inflammatory. Also, any food you’re allergic to will be inflammatory. You can find lists of inflammatory and anti-inflammatory foods and a variety of anti-inflammatory diets online. I recommend 1-3 months of a strict anti-inflammatory diet, such as The Whole30 by Urban and Hartwig, or the Autoimmune Protocol (see the AIP diet at https://www.thepaleomom.com), and then continue to lean heavily into anti-inflammatory eating.

Weak digestion. Poor digestion interferes significantly with bone health. Common indications of poor digestion are chronic bloating, gas, diarrhea, constipation (even if managed), acid stomach/GERD (even if managed), and feeling full quickly. 

Adequate hydrochloric acid (HCL) levels are essential for good digestion. There are a variety of reasons for inadequate HCL, including the fact that production begins to fall around age 50. Additionally, the epidemic of treating heartburn with acid-suppressing medications instead of correcting the most common underlying causes is contributing to more and more digestive breakdown in Americans.

Lack of Exercise. Bones need to be exercised. When we’re too sedentary, they get the idea they aren’t needed and don’t keep up their capability to stay strong. Movement (especially with pressure from the muscles as they tighten and stretch) causes bones to pull in more nutrients for building density and strength. Also, stronger muscles help prevent falls and lower the risk of a bone breaking from a fall. 

Smoking. Smoking affects the body’s ability to absorb calcium and restricts the flow of oxygen-rich blood that nourishes bones. Also, nicotine slows the production of the bone-forming cells that are crucial to healing bone loss.

Do whatever it takes to quit! I recommend 1-800-QUIT-NOW. Their staff is professional, knowledgeable, and non-judgmental. They also provide some financial assistance for nicotine patches to get you started.

 

Foods & Supplemements for Rebuilding Bones

Unfortunately, rebuilding bones is an endeavor that requires more supplements than almost any other healing regimen. I wish I could tell you that you can do it with foods alone, but our food supply has been highly compromised by soil depletion, genetic modification, harmful processing, and contamination. Nutritious food is critical to maintaining healthy bones, but diet alone can rarely provide all the nutrients necessary for rebuilding bones once our hormone levels drop and the aging process takes hold.  

Starting in our fifties, our bodies start a continuous decline in hormone production, digestive capability, thyroid function, and other metabolic functions that affect the bones. One example of this is a decrease in hydrochloric acid production, which directly affects assimilation of minerals and protein to build bone. All of this makes bone-rebuilding more challenging than for a younger person. Because we’re living so much longer now (life expectancy at birth has nearly doubled in the last 200 years), we’re seeing many more elderly people with advanced bone loss.

High quality supplements are the most reliable way to provide the extra nutrients needed for rebuilding bones. Comparing government studies of nutrient values in raw foods from the 1960’s to today, the levels of nutrient losses are dramatic. One example is a 40% loss of vitamin C in broccoli.

If you have time to make bone broth and get your vegetables at the Farmer’s Market, you can get more of your bone nutrients from your diet. If you can afford to purchase only grass-fed meats and wild-caught seafood and buy mostly organic foods, you can reduce the amount of supplemental nutrients you’ll need for rebuilding your bones. But, regardless of how much effort you put into getting more of your nutrients from foods, you will still need to invest in some good quality supplements and take them consistently.

The following are the most important nutrients and supplements for rebuilding bones:

Calcium. Calcium from animal foods is better absorbed and utilized than calcium from plant foods. However, very few animal foods other than dairy are high in calcium. Sardines, anchovies, and any other fish eaten with bones in are also excellent animal sources of calcium. Bone broth is another excellent source of calcium. 

Even though calcium is better absorbed from animal foods, I encourage people to get calcium from plant foods as well, especially since so many people don’t tolerate dairy foods. (See the section at the end of this handout: About Milk and Milk Products.) 

Good plant sources of calcium include broccoli, white beans, almonds, okra, bok choy, and dark leafy greens such as kale and collard greens. A little vinegar on those greens will help calcium absorption. One cup of broccoli has 180 mg calcium.
Amaranth, chia seeds, sesame seeds and oat straw tea are excellent sources. Just one ounce of sesame seeds has 227 mg. A daily cup of oat straw and nettles tea is a great way to get some calcium and several other nutrients needed for bone-rebuilding.

Calcium from foods is better absorbed and utilized than calcium from supplements. Studies show that 800 mg calcium from food contributes more to bone density than 1000 mg from pills. So, count the milligrams of calcium in your regularly eaten, high-calcium foods before deciding if you need supplemental calcium and how much. For example, one cup of milk has about 300 mg of calcium. One ounce of aged hard cheese (cheddar, Swiss, etc.) provides about 200 mg. Cottage cheese ranges from 200-300 mg per cup. One cup of yogurt has anywhere from 250-400 mg calcium, so check the labels. 

I rarely recommend more than 800 mg of supplemental calcium a day and often less or none, depending on the diet. Excess calcium, especially from supplements, contributes to hardened arteries, kidney stones, gallstones, and bone spurs. If you’re getting the other nutrients and digestive support you need for bone health, you shouldn’t need more than 600-800 mg a day, whether from diet or diet and supplements combined. 

Another possible problem with calcium in supplement form is that it tends to slow down the bowels. If starting or increasing calcium supplementation causes constipation, consider if you are 1) taking more than you need or 2) you need more magnesium, since magnesium softens stools and stimulates elimination. See the section below on magnesium for dosing instructions. Be sure your bowels are moving every day!! This is crucial to your overall health as well as your energy level and clarity of thinking.  

In supplements, calcium is found in several forms. The best-absorbed form is calcium lactate, but it’s not as widely sold as other forms. Calcium gluconate is also well-absorbed, but both lactate and gluconate forms are large molecules, so you’ll need to take more pills than other forms to get the same amount of calcium. (Despite its name, calcium lactate does not come from or contain dairy.) Calcium malate and calcium hydroxyapatite are also well-absorbed.

Calcium citrate is popular and well-absorbed, but the citrate can be irritating to tissues. Avoid calcium carbonate; it’s poorly absorbed and can be hard on the kidneys.

You won’t absorb more than about 500 mg of calcium at one time, so split your high-calcium foods and supplement doses accordingly.

Magnesium. Many Americans are low in magnesium. Besides compromising bone health, inadequate magnesium can cause leg cramps, restless legs, constipation, chocolate cravings, light sensitivity, high startle reflex, migraines, and irritability or trigger temper. Of course, all these symptoms can have other causes. Both low calcium and low magnesium can be the cause of leg cramps, but low magnesium is a much more common cause than low calcium.

Animal foods rich in magnesium include all meats and poultry, tuna, salmon, halibut, and mackerel. While magnesium from plant foods is not as easily absorbed as from animal sources, plant foods are still important sources of magnesium. These include legumes, coconut milk, pumpkin seeds, sesame seeds, sunflower seeds, almonds, cashews, filberts, cocoa, chocolate, bulgur, wheat germ, oats, oat bran, brown rice, rice bran, quinoa, amaranth, barley, beets, horseradish, Swiss chard, sweet potatoes, corn, and peas.

There are many forms of magnesium in supplements. Some of the best-absorbed forms are magnesium lactate (dairy-free, despite the name), magnesium glycinate, and magnesium citrate. Although the citrate form is the most common form on the market, some people find it irritating to the bowels.

Magnesium tends to loosen stools, but don’t expect all magnesium- rich foods to help with constipation or low stool volume. In fact, nuts tend to slow down the bowels; even nuts high in magnesium.

Individual needs vary, but optimal supplementation usually ranges around 300–600 mg a day. The old supplementation guideline was a 2:1 ratio of calcium to magnesium (e.g., 500 mg calcium and 250 mg magnesium). Most Cal-Mag supplements still provide this 2:1 ratio. However, many people, especially those with fair colorings (red/blonde hair as a toddler, green/blue eyes, fair skin), need a 1:1 ratio or even more magnesium than calcium. I encourage people to purchase separate calcium and magnesium supplements so they can adjust doses to their needs and symptoms. You may need to adjust your magnesium intake based on any symptoms you have of low magnesium, as described above. It’s hard to overdose on magnesium, since excessive intake will cause loose stools and you’ll know you’re getting too much.

Trace Minerals. The best sources of trace minerals are vegetables and fruits, but our soils and foods don’t provide the levels they used to. A great way to get more trace minerals is bone broth. You can purchase it locally or online or make your own. Bone broth also provides collagen, a protein essential to bone, cartilage, skin, hair, and fingernails.

Multiple vitamin-mineral supplements don’t supply enough trace minerals for rebuilding bone. Without bone broth, you’ll need a separate trace mineral supplement, preferably a whole-food supplement, such as those made by New Chapter, MegaFood and Garden of Life.

Three Calcium Taxis

The next three supplements are called “calcium taxis” because they ensure calcium is delivered to bone tissue and not to other, undesirable places. A lack of calcium taxis can lead to bone spurs, gallstones, kidney stones, and calcium buildup in arteries (hardening of the arteries) – all because of calcium going where it isn’t meant to be. These nutrients are essential to bone health and without all three, you may slow bone loss, but bone-rebuilding is rarely possible.

1. Vitamin D3. Like all vitamins, vitamin D is not a single substance. There are at least five forms of vitamin D. UV light converts cholesterol in the oil in your skin into a form of vitamin D, which is then absorbed into the bloodstream and sent to the liver to be converted into a different, usable form.

Because of major changes in our foods and habits such as daily bathing removing skin oils, congested livers from hydrogenated fats, poor capillary circulation from sedentary lifestyles, and the widespread use of sunscreen, even people with regular, generous exposure to sun usually have inadequate levels of vitamin D. Vitamin D deficiency is now recognized as a world-wide problem for all ages.

The only significant food source of vitamin D is fatty fish such as salmon, tuna and mackerel. Farmed salmon has tested to provide only about ¼ of the vitamin D found in wild salmon. Some cheeses, beef liver and egg yolks contain small amounts. A supplement is almost always needed.

Check all your supplement labels and count all sources of vitamin D from supplements. Count vitamin D from D-fortified foods such as milk and orange juice if you eat these frequently.

Optimal dosing for most people is 5,000 IUs per day. Don’t exceed 10,000 IUs per day for more than a month. Your physician may recommend dosing as high as 50,000 IUs by pill or injection once a week until low levels are corrected. Just be sure the doctor orders a blood test (25-hydroxy vitamin D) within 3 months to avoid excessive intake. Because vitamin D can be toxic in excessive amounts, you should have your level tested about every 3-4 months until your level is stable on a specific, regular dose, and then tested once a year.

A common laboratory reference range is 25-100 ng/mL, but 60-80 is the optimal range for bone-rebuilding and maintenance. Some physicians tell patients that anything within the reference range is fine. Be assertive and tell your doctor you want your levels to be in the upper normal range for rebuilding your bones.

2. Vitamin K2.

Again, like all vitamins, vitamin K is a complex of several vitamins. Vitamin K2 is the most important form for bone, blood vessels, and other tissues. The only food sources of K2 are from beneficial bacteria found in certain fermented foods and a few specific meats and dairy products. Natto, a fermented soybean product, has the highest Vitamin K2 content. Natto is available as a food or in supplement form. Other sources include grass-fed meats, grass-fed cow and goat cheeses, grass-fed butter, and egg yolks and livers from pasture-raised poultry.

Vitamin Code Raw K-Complex from Garden of Life and MK7 Vitamin K2 by Protocol for Life Balances are good choices, but there are other good ones on the market, mostly made from natto. Even people who are sensitive to soy will usually tolerate natto because it’s a fermented product. Natto should be organic to avoid GMOs.

Take a minimum of 200 mcg/day and a maximum of 100 mcg for every 1000 IU of Vitamin D that you take. Taking 300 mcg per day is effective and affordable.

3. Omega-3 Fatty Acids.

Besides helping control where calcium is delivered, Omega-3 fatty acids are an anti-inflammatory that helps slow down the degenerative process of bone loss.

The best food sources of Omega-3 fatty acids are fatty fish (e.g., salmon and cod), legumes/beans, 100% grass-fed meats, pasture-raised poultry, and 100% grass-fed butter. Because most of our meat and poultry is grain-fed, and few people eat fish or beans frequently, most people’s diets are too low in these essential fatty acids. 

Getting both animal and plant sources is ideal. Good supplemental animal sources are salmon oil and cod liver oil. Good supplemental plant sources are flaxseed and hemp seed oils. All of these except salmon oil come in liquid or capsule form. If you purchase a straight oil, be sure you keep the bottle refrigerated.

Three high-quality brands that are mercury-free are Pure Icelandic Cod Liver Oil from Dropi, Fermented Cod Liver Oil from Green Pasture, and Cod Liver Oil from Standard Process.

Optimal intake is about 3,000 mg oil per day. This is the mg of oil, not the mg of fatty acids. Most gelcaps of cod liver, flaxseed, krill, and hemp oils provide 1,000 mg of oil each, so 3 capsules a day is a common and effective dose.

Zinc. We need this mineral to produce hydrochloric acid. Good food sources include oysters, beef, lamb, pork, chicken, pumpkin seeds, cashews, cocoa, chocolate, raisins, and currants. You may not get enough zinc from foods to produce adequate stomach acid. As a supplement, zinc is inexpensive and helps in both bone-rebuilding and immunity.

The recommended dose for zinc is 15-30 mg once a day. Excess zinc can cause copper deficiency, so take 25-30 mg daily only for the first 2-3 months to give your HCL recovery an initial boost, then change to 15 mg a day or take a higher dose 3 days a week. A great supplement is Jarrow’s Zinc Balance. It has 15 mg zinc and 1 mg copper.

Vitamin C. Vitamin C is essential for producing collagen, the most common protein in the body and in our bones. There are many fruit and vegetable sources of vitamin C. Search online for lists of vitamin C-rich foods. Be aware that prolonged storage, heat from cooking and exposure to water or air can cause loss of vitamin C from foods.

If your diet isn’t providing 300 mg a day or more, you’ll need a supplement. Choose a whole-food vitamin C supplement, such as one made by MegaFood, New Chapter or Garden of Life. Vitamin C occurs in nature as a complex that includes bioflavonoids, hesperidin, and rutin. Ascorbic acid alone is not vitamin C!

Additional Supplements That Can Help

Electrolytes. These are charged minerals that float in the blood and other body fluids. Examples are sodium, potassium, calcium, and magnesium. They are key in maintaining electrical conductivity and fluid movement throughout all tissues. Good electrolyte levels promote healing because they boost capillary circulation, which helps nutrients reach all cells. 

The importance of sodium as an electrolyte is underappreciated. The only food naturally high in sodium is milk. Our main source of sodium is salt. Contrary to popular opinion, salt is not something most people need to avoid. In fact, many people today are too low in sodium and need to salt their foods more. A low blood sodium level can cause problems as serious as a high blood sodium level. Common symptoms of low sodium are ankle edema, fatigue, low blood pressure and heat intolerance/heat stroke. 

Many people with high blood pressure can salt without any negative effect on their blood pressure. Anyone can figure this out for themselves by experimenting with their salt intake and monitoring their blood pressure closely. Ideal blood pressure is 120/80. So, unless you know that you don’t tolerate salt due to high blood pressure or some other reason, salt your foods regularly to taste, preferably with unrefined salt, such as sea salt or Himalayan salt. Celtic Sea Salt from Selina Naturally is a very good salt.

For potassium, eat potassium-rich foods such as apricots, potatoes, bananas, tomatoes, and dark leafy greens. Search online for lists of potassium-rich foods.

You can also get an initial boost of nutrient delivery to your bones from 1-3 months of an electrolyte supplement. They’re usually sold as a liquid or powder concentrates to dilute in water. Good brands include Celtic Sea Salt Electrolyte Powder from Selina Naturally and TB Electrolyte Supplement from TB12. Avoid the usual sports drinks with artificial colorings and flavorings and sugar.

Hydrochloric Acid (HCL) or Betaine Hydrochloride. Hydrochloric acid is made in the stomach. It’s essential for digestion of proteins and assimilation of minerals, the two building blocks of bone. With aging, our production declines. Few people aged 50 and older are producing adequate HCL.

Betaine Hydrochloride is the supplement form of hydrochloric acid. It comes in a range of potencies, often around 600-650 mg per pill. Optimal dosing ranges widely for individuals, from about 400-1200 mg per meal. Not everyone tolerates taking HCL. For more detailed instructions on dosing and tolerance, request my handout Low Stomach Acid and the Use of Betaine Hydrochloride. 

Digestive Enzymes. Good digestion is key to rebuilding bone. Your body releases enzymes into the mouth, stomach, and small intestine to break down food, making nutrients available for assimilation. With aging, enzyme production declines. 

You may not need to take enzyme capsules long-term. Consider taking them for a few months, and see if you have decreased heaviness, bloating or gas after eating. Then try discontinuing them to see if these symptoms return. If so, resume taking the enzymes.

Consider taking 1 pill per meal, perhaps 2 with dinner or your biggest meal. If you are taking at least 600 mg of betaine hydrochloride (HCL) per meal, you may not need enzymes, since adequate stomach acid triggers the release of more enzymes.

Collagen. Collagen is the most abundant protein in the human body and the main protein in bone. Nutrients such as vitamin C, zinc, copper, and certain amino acids are needed for collagen production. But, with aging, even with generous intake of these nutrients, most people won’t make enough collagen to keep their tissues in good repair. This is one of the reasons that elderly people often have thin skin and easy bruising.

Food sources of collagen include all animal proteins: meat, poultry, eggs, seafood, and dairy. Legumes are rich in collagen-promoting nutrients. Remember that hydrochloric acid is essential for digestive breakdown of proteins, especially animal proteins (see section above on HCL), and therefore just eating more protein is not enough.

There are several types of collagen. Type I is the type that most improves the health and strength of bone, hair, skin, and nails. Type II supports cartilage the most, which is very important for all joints, including spinal. I recommend Vital Proteins Collagen Peptides by Vital Proteins (in pill form or a powder you can add to shakes, soups, coffee or other beverages) and Type II Available Collagen by Jarrow (in pill form). Follow label instructions for dosing for the first three months, then reduce by as much as half.

Bone-Rebuilding Tea. All these herbs contribute in some way to bone health. Make an herbal blend with equal parts of oatstraw, horsetail shoots, nettle leaf, raspberry leaf, dandelion leaf and red clover flower tops. (You can also add alfalfa leaf and parsley leaf.) Boil one quart of water. Take the pan off the stove and allow it to cool for a minute or two. Add 4 Tbsps. of the blend. Cover and steep for 30-60 minutes, then strain. Keep covered or refrigerated. Drink 3-4 cups a day. This recipe is from Linda B. White, M.D. you can read her articles at https://www.everydayhealth.com/authors/linda-b-white/.

A Bone-Rebuilding Supplement Regimen

Choosing supplements can be confusing and overwhelming. So, here is one example of a good regimen of supplements for bone-rebuilding. If you can’t find these brands, consider substitutes from any of these quality brands: Pure Encapsulations, MegaFood, New Chapter, Garden of Life, and Jarrow. All these brands are available online or at Natural Grocers in Bend. There are other good brands, but these are a few of the best for the price that are available in retail stores and online. Always check supplement labels for any ingredients you’re allergic to. 

1. Multivitamin: One Daily by MegaFood, 60 tablets. Take 1 per day at any meal.
2. Calcium, option A: Calcium Lactate by Progressive Labs, 100 capsules. This is the best-absorbed form of calcium available. Despite its name, calcium lactate does not have any dairy in it. The only drawback is the lactate form it is a larger molecule and therefore takes more pills to get the same amount of calcium compared to other forms. This has 115 mg calcium per capsule, so you would take 5 per day, split into two doses. If this is too many pills to take, considering all the others you’ll be taking, try option B.
3. Calcium, option B: Calcium Malate by Designs for Health, 120 capsules. This is well-absorbed and provides 500 mg calcium per 2 capsules, along with 100 IUs vitamin D per 2 capsules. Take 2 per day, preferably split into two doses.
4. Magnesium Glycinate by Pure Encapsulations, 180 capsules. This provides 120 mg magnesium per capsule (a low dose), allowing you to micromanage the amount of magnesium you can handle. Spread doses over the day (2-3 meals and maybe bedtime) to avoid causing loose stools and gradually work up to bowel tolerance.
5. Trace Minerals by Pure Encapsulations, 60 capsules. One a day at any meal.

6. Zinc 15 by Pure Encapsulations, 60 capsules. One a day at any meal.
7. Omega-3 Fatty Acids: Arctic Cod Liver Oil by Nordic Naturals, 90 softgels. Take 2-3 per day, always in the middle of a meal (not before or after) to prevent any possibility of tasting the oil in your throat later as it dissolves. If this still occurs, keep the capsules in the freezer and they will thaw and dissolve in the small intestine instead of the stomach. I recommend unflavored.
8. Vitamin D: Vitamin D3 125 mcg (5000 IU) by Pure Encapsulations, 120 softgels. One a day at a meal with fat.
9. Vitamin K2: 1) MK-7 Vitamin K2 by Protocol for Life Balances, 2) Vitamin Code Raw K-Complex by Garden of Life, and 3) MK-7 by Jarrow, 90 or 180 mcg pills. Aim for 200 – 300 mcg a day, even 400 mcg for the first 3 months. Can be taken all at once at a meal with fat.
10. Complex C by MegaFood, 180 tablets. This is optional if your fruit and vegetable intake supplies an average of 200 mg vitamin C per day or more. Take 1 a day with or without food.
11. Collagen: 1) Vital Proteins Collagen Peptides by Vital Proteins (Types I and III for bone, skin, hair and nails; pill or powder form) and 2) Type II Available Collagen by Jarrow, 60 capsules (Type II for cartilage; pill form). Follow dosing instructions on labels. These are optional based on your budget for supplements. It’s highly recommended if you can afford to do it, especially in the first year.

Doing More for Your Bones with Foods

If you want to get as many bone-rebuilding nutrients as you can from foods, and thereby cut down on the amounts needed from pills, you can do some initial searching to determine how much your diet now contributes. You may not have time to make bone broth, but you can lean into the foods that have generous amounts of nutrients you need.

To assess your intake of bone-rebuilding nutrients from foods, go online. For each of the nutrients listed in this handout, search for “list of foods high in (the nutrient)” or “top ten foods high in (the nutrient)”. From these lists, create a list of the foods you like or are willing to try. Then, do your best to consistently bring more of these foods into your diet.

You can also search on the amount of any nutrient in a specific food. Search for “amount of (the nutrient) in (the amount) of (the food)”. The answer often comes up immediately above the search results.

On the other hand, if you want to simply add bone-rebuilding supplements to your regular diet (hopefully one that emphasizes anti-inflammatory foods), this works as well. In this case, be sure you do a rough count of your calcium intake from any dairy and take only enough supplemental calcium to get the amount needed. Note the information below about getting too much zinc as well. Other than calcium and zinc, you’re unlikely to overdose on any of the nutrients listed here.

Challenges with Milk and Milk Products

When it comes to its impact on health, milk is a highly complicated topic. There are so many factors that affect milk quality and milk tolerance. Milk is a highly adulterated food unless you have access to raw milk from grass-fed cows or goats.

Milk and cheese are wonderful sources of protein and calcium. Unfortunately, many people are sensitive to dairy and may not know it, because allergy symptoms are often subtle and inconsistent and can mimic symptoms of other common health issues.

A person may react to a protein in milk (a true allergy), to some other natural substance in the milk (a food sensitivity) or a substance that is an unnatural additive or a byproduct of processing (we still call this a food sensitivity even though it isn’t because of something originally part of the food).

Most milk cows in this country are fed grains and other foods such as soy and additives that cause their flesh and milk to be very different foods than our ancestors consumed. For example, meat and whole milk from grass-fed cows are good sources of Omega-3 fatty acids, but meat and whole milk from grain-fed cows are much lower in the anti-inflammatory Omega-3’s and much higher in the inflammatory Omega-6 fatty acids.

Fermentation of milk in the making of cheeses, yogurts and kefir makes the nutrients more available. I generally recommend grass-fed cheese (cheese made from milk from grass-fed cows) as a high-calcium dairy food rather than regular milk or cheese. 

Another factor in milk sensitivity is possible intolerance of the high amount of a1 protein in most milk. This is known as “a1 milk” and makes up nearly all milk on the market. You could have the best quality organic milk and still react to the a1 protein. The dominance of this type of protein is related to the breed of cow.

The older, more traditional breeds of milk cows have the genes for producing much higher levels of the a2 beta casein protein – namely Guernsey, Jersey, Charolais, Normande, Brown Swiss and Limousin. This is known as “a2 milk”. Goats also produce milk that is dominantly a2.

Many people sensitive to a1 milk can tolerate a2 milk. Check out my favorite, delicious brand of a2 milk at https://www.a2milk.com and http://cascadiacreamery.com/beyond_organic.html. It is available at Whole Foods and other grocers in the Bend area. For further information, search online.

About DEXA Scans

It is recommended that you get all your scans at the same facility, on the same machine if there is more than one, and even by the same technician if possible. Different machines and the position the tech uses to place your spine and leg on the table can affect results.

Most insurances pay for DEXA scans only once every two years, but during bone-rebuilding efforts, I recommend once a year. DEXA scans are relatively inexpensive, so consider paying for your own. It’s hard to wait two years when you’re putting in the time, effort and money to get results.

Be sure you keep a copy of the results of all your scans. It’s important to be able to compare your T-scores over time. Remember that DEXA scans are a measure of the amount of minerals in your bones and not a measure of bone strength. And always keep in mind that DEXA scan results are, by themselves, not a reliable indicator of the risk of bone fracture. Be sure to use the FRAX test as well. Find the test at https://frax.shef.ac.uk/FRAX/tool.aspx?country=9.