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Smart Supplementation: My Top 5 for Bone Health

The fifth pillar of my BONES Method is Smart Supplementation. Trying to figure out what supplements you should be taking to keep your bones strong and healthy can be very confusing.

We all know that calcium and vitamin D are important for bone health, but the truth is that our bones need a constant supply of over 20 different nutrients. Ideally, we should get these nutrients from food. Unfortunately, modern farming practices, the use of pesticides and synthetic fertilizers, and the erosion of nutrient-rich topsoil has led to a decline in the concentration of nutrients in our food. Some sources suggest that our food today may be up to 40% less nutritious than it was 50 years ago!

Although I am an advocate of “food first,” getting all the nutrients your bones need from food is difficult and supplementation is often necessary.

What supplements should you be taking? Figuring this out can be tricky. We are all metabolically and biochemically unique individuals and the nutrients required for one person might be very different from those required for another. So making generalized supplement recommendations in a blog can be tough, but I do have 5 nutrients that I feel almost everyone needs to be supplementing.

5 Nutrient Supplements Essential for Bone Health

1. Calcium. I know there is a lot of controversy over calcium supplements. Many feel that calcium, especially in the form of supplementation, is not beneficial and can actually be harmful. However, I believe that it is very hard to get all the calcium your bones need from food, especially if you are sensitive to dairy products or have issues with oxalates. Foods highest in calcium include dairy, leafy green vegetables and some nuts, like almonds, and seeds like chia and sesame seeds. If you are sensitive to dairy products and rely heavily on green leafy vegetables for calcium, you need to be careful about the oxalates in greens such as spinach, collard greens, and swiss chard which can prevent absorption of calcium. So you can see where it can get tricky for people like me who are sensitive to dairy and oxalates!

It is also important to remember that calcium is a critical nutrient for so many processes in the body, like muscle contraction, nerve conduction, blood clotting, and blood pressure. When you are not taking in enough calcium, your body will draw calcium out of the bones, where it provides strength and structure, to supply calcium for these other functions. So although many in the field of nutrition don’t think people should be supplementing with calcium, I think it is critical to make sure you are getting enough.

My general rule of thumb when it comes to calcium is to calculate, the best you can, the amount of calcium you get in your diet and then supplement to reach 1000 mg of calcium a day. If you calculate that you are getting 800 mg of calcium in your diet, then you only need to supplement with 200 mg. If you are not getting enough calcium from your diet, low-dose supplementation (200-300 mg) can help. In order to safely supplement with calcium, you also need to supplement with vitamin K2, vitamin D, and magnesium.

2. Vitamin K2. As I have talked about in the past, K2 is the nutrient that shuttles calcium into the bone so it doesn’t settle in the blood vessels or other soft tissue. Vitamin K-2 has been found to activate the protein osteocalcin which helps to integrate calcium into the bone where it belongs. I generally recommend 100-200 mcg of vitamin K2 a day.

3. Vitamin D3. Although our body makes vitamin D from the sun, most of us have a hard time making enough vitamin D because we spend most of our days inside, use sunscreen when we go out or live in the northern latitudes where it is impossible to get adequate sun rays for 6-8 months of the year. The amount of vitamin D that you need is very individual and should be based on serum blood levels. Most labs give a reference range that indicates that anything over 30 nanograms/mL is considered normal. However, there is an abundance of research that suggests vitamin D levels should be higher than that. I like to see vitamin D levels in the range of 50-60 ng/L. A rule of thumb for dosing vitamin D is to take 1000 IUs of vitamin D3 to increase serum levels about 10ng/mL. I don’t believe in mega dosing of vitamin D as there has been some recent research indicating that too much vitamin D can actually have a detrimental effect on our bones. With moderate supplementation, it has been shown to take about 6 weeks for serum levels to reach their peak.

4. Magnesium. Magnesium is also one of my top supplements because it’s necessary for the proper utilization of vitamin D and calcium. It’s needed to balance two very important hormones, calcitonin, and PTH, which regulate the absorption of calcium into bone. Magnesium also supports just about every function in our body! I generally recommend supplementing with equal amounts of calcium and magnesium. If you are taking 200 mg of calcium, then you need to supplement with 200 mg of magnesium. Even if you are not taking calcium supplements, I generally recommend that people supplement with magnesium since magnesium deficiency is common. Generally, 200 to 350 mg/day is a good amount. Taking over 350 mg/d may start to cause loose stools.

5. Omega 3 Fatty Acids. The omega 3 fatty acids in fish oils help to fight inflammation. Unless you are eating fatty fish, flax and chia seeds every day, it is hard to get enough of these beneficial oils in our diet. Additionally, most of us end up getting too much omega 6 fatty acids from vegetable oils and nuts. Too many omega 6 fatty acids and enough omega 3 fatty acids can actually contribute to inflammation in the body. Inflammation is one of the root causes of bone loss and osteoporosis. Anything that promotes inflammation activates your osteoclast cells, which leads to the breakdown of your bones. EPA and DHA are the 2 most important anti-inflammatory fatty acids in fish oil. Although different amounts of EPA and DHA have different purposes, a general daily dose of about 300-500 mg of EPA and DHA are beneficial for fighting inflammation. It is essential to find a high-quality fish oil that has been 3rd party tested for purity.

Beyond the above, there are a lot of other nutrients our bones need like boron, zinc, manganese, and vitamins C and B. However, generally, these nutrients can be obtained through diet if you are eating healthily.

Try to meet your nutrient needs with food first, and use supplements to fill in the gaps.

I do offer a supplement review….where I go over your health history, your medications, your diet, your lifestyle and then put together a more personalized supplement protocol for you.

If interested, please reach out to me at susan@nurturedbones.com or schedule a free 15 min consult by CLICKING HERE.

Susan Brady

Master of Physical Therapy Doctor of Integrative Medicine Certified Integrative Health and Nutritionist

With over 30 years of experience in physical therapy, specializing in treating osteoporosis and musculoskeletal conditions, I have developed my BONES Method™—a holistic approach that naturally supports every aspect of bone health. This comprehensive method is designed to strengthen your bones, enhance overall well-being, and promote a balanced, vibrant life.