Billings Clinic
Especially For:

Complementary Medicine - Cam

Osteoporosis (Holistic)

Osteoporosis (Holistic)

About This Condition

Stand tall against osteoporosis. No matter what your age, it’s never too late to stop bone loss now for better posture and fewer fractures down the road. According to research or other evidence, the following self-care steps may be helpful.
  • Pump it up

    Make weight-bearing exercise a regular habit to increase bone density and prevent osteoporosis

  • Cut the caffeine

    Avoid excessive calcium loss in the urine by switching to healthier beverages

  • Aim for lifelong calcium and vitamin D nutrition

    An extra 800 mg of calcium and 400 to 800 IU of vitamin D a day can help protect the bones, from childhood through adulthood

  • Get your soy

    Make tofu, soy milk, soy protein, and other sources of beneficial isoflavones a regular part of your diet

  • Watch the salt

    Avoid excessive salt intake and high-salt processed and restaurant foods that may contribute to calcium and bone loss

About

About This Condition

Osteoporosis is a condition in which the normal amount of bone mass has decreased.

People with osteoporosis have brittle bones, which increases the risk of bone fracture, particularly in the hip, spine, and wrist. Osteoporosis is most common in postmenopausal Asian and Caucasian women. Premenopausal women are partially protected against bone loss by the hormone called estrogen. Black women often have slightly greater bone mass than do other women, which helps protect against bone fractures. In men, testosterone partially protects against bone loss even after middle age. Beyond issues of race, age, and gender, incidence varies widely from society to society, suggesting that osteoporosis is largely preventable.

Symptoms

Osteoporosis is a silent disease that may not be noticed until a broken bone occurs. Signs may include diminished height, rounded shoulders, dowager’s hump, and evidence of bone loss from diagnostic tests. Symptoms may include neck or back pain.

Healthy Lifestyle Tips

Smoking leads to increased bone loss.1 For this and many other health reasons, smoking should be avoided.

Exercise is known to help protect against bone loss.2 The more weight-bearing exercise done by men and postmenopausal women, the greater their bone mass and the lower their risk of osteoporosis. Walking is a perfect weight-bearing exercise. For premenopausal women, exercise is also important, but taken to extreme, it may lead to cessation of the menstrual cycle, which contributes to osteoporosis.3

Excess body mass helps protect against osteoporosis. As a result, researchers have been able to show that people who successfully lose weight have greater bone loss compared with those who do not lose weight.4 Therefore, people who lose weight need to be particularly vigilant about preventing osteoporotic fractures.

Eating Right

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

Recommendation Why
Get your soy
Make tofu, soy milk, soy protein, and other sources of beneficial isoflavones a regular part of your diet.

Soy foods, such as tofu, soy milk, roasted soy beans, and soy protein powders, may be beneficial in preventing osteoporosis. Isoflavones from soy have protected against bone loss in animal studies.5 In a double-blind trial, postmenopausal women who supplemented with 40 grams of soy protein powder (containing 90 mg of isoflavones) per day were protected against bone mineral loss in the spine, although lower amounts were not protective.6 In a double-blind study, administration of the soy isoflavone genistein (54 mg per day) to postmenopausal women for one year reduced bone breakdown, increased bone formation, and increased bone mineral density of the hip and spine.7 The effect on bone density was similar to that of conventional hormone-replacement therapy. The same amount of genistein also prevented bone loss in a two-year double-blind study.8

Choose dairy foods wisely
Different dairy products appear to have different effects on bone density and fracture rates. Opt for nonfat milk and yogurt over cottage cheese or American cheese.

The effect of dairy products on the risk of osteoporosis-related fractures is subject to controversy. According to a review of 46 studies,9 different dairy products appear to have different effects on bone density and fracture rates. Milk, especially nonfat milk, probably does more good than harm because of its relatively lower protein and salt content, as well as its higher level of calcium. Cottage cheese and American cheese, on the other hand, probably do more harm than good. Cottage cheese is high in protein and salt but low in calcium, factors which could contribute to bone loss. American cheese is extremely high in salt and high in protein. These foods are not recommended as calcium sources for the prevention of osteoporotic fractures. Although there may be better ways of getting calcium, younger women who wish to prevent osteoporosis might consider nonfat milk and nonfat yogurt to be reasonable dietary calcium sources.

Cut the caffeine
Avoid excessive calcium loss in the urine from by switching to healthier beverages, like herbal teas, juices, and water.

Caffeine increases urinary loss of calcium.10 Caffeine intake has been linked to increased risk of hip fractures11 and to a lower bone mass in women who consumed inadequate calcium.12 Many doctors recommend decreasing caffeinated coffee, black tea, and caffeine-containing soft drinks as a way to improve bone mass.

Curiously, while caffeine-containing tea consumption has been linked to osteoporosis in some studies,13 others have reported that tea drinkers have a lower risk of osteoporosis than do people who do not drink tea.14 , 15 Possibly, the calcium-losing effect of caffeine in tea is overridden by other constituents of tea, such as flavonoids .

Fine-tune your protein
Too much or too little protein in your diet may increase osteoporosis risk.

Studies attempting to uncover the effects of high animal protein intake on the risk of osteoporosis have produced confusing and contradictory results.16 , 17 , 18 , 19 , 20 The same is true of studies attempting to find out whether vegetarians are protected against osteoporosis.21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 Moreover, while some studies report that protein supplementation lowers death rates and shortens hospital stays29 or reduces bone loss among people with osteoporosis,30 others have found that such supplementation is of little value.31

These conflicting findings may occur in part because dietary protein produces opposing effects on bone. On one hand, dietary protein increases the loss of calcium in urine,32 , 33 which should increase the risk of osteoporosis. On the other hand, normal bone formation requires adequate dietary protein, and low dietary protein intake has been associated with low bone mineral density.34 Current research shows that finding the line between too much protein and too little protein remains elusive, though extremes in protein intake—either high or low—might possibly increase the risk of osteoporosis.

Watch the salt
Avoid excessive salt and high-salt processed and restaurant foods that may contribute to loss of calcium and bone.

Short-term increases in dietary salt result in increased urinary calcium loss, which suggests that over time, salt intake may cause bone loss.35 Increasing dietary salt has increased markers of bone loss in postmenopausal (though not premenopausal) women.36 , 37 , 38 Although a definitive link between salt intake and osteoporosis has not yet been proven, many doctors recommend that people wishing to protect themselves against bone loss use less salt and eat fewer processed and restaurant foods, which tend to be highly salted.

Steer clear of soda
People who drink sodas, particularly colas, may be more likely to experience bone loss and bone fractures.

People who consume soft drinks have been reported to have an increased incidence of bone fractures,39 although short-term consumption of carbonated beverages has not affected markers of bone health.40 The problem, if one exists, may be linked to phosphoric acid, a substance found in many soft drinks, particularly colas. In one study, children consuming at least six glasses (1.5 liters) per week of soft drinks containing phosphoric acid had more than five times the risk of developing low blood levels of calcium compared with other children.41 In a study in adults, higher consumption of cola beverages was associated with more bone loss in women, but not in men. Consumption of non-cola carbonated drinks, on the other hand, was not associated with bone loss.42 Although a few studies have not linked soft drinks to bone loss,43 the preponderance of evidence now suggests that a problem may exist.

Supplements

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by some in the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Supplement Why
3 Stars
Calcium
800 to 1,500 mg daily depending on age and dietary calcium intake
Calcium supplements help prevent osteoporosis, especially for girls and premenopausal women. It is often recommended to help people already diagnosed with osteoporosis.

Caution: Calcium supplements should be avoided by prostate cancer patients.

Although insufficient when used as the only intervention, calcium supplements help prevent osteoporosis.44 Though some of the research remains controversial, the protective effect of calcium on bone mass is one of very few health claims permitted on supplement labels by the U.S. Food and Drug Administration.

In some studies, higher calcium intake has not correlated with a reduced risk of osteoporosis—for example, in women shortly after becoming menopausal 45 or in men.46 However, after about three years of menopause, calcium supplementation does appear to take on a protective effect for women.47 Even the most positive trials using isolated calcium supplementation show only minor effects on bone mass. Nonetheless, a review of the research shows that calcium supplementation plus hormone replacement therapy is much more effective than hormone replacement therapy without calcium.48 Double-blind research has found that increasing calcium intake results in greater bone mass in girls.49 An analysis of many trials investigating the effects of calcium supplementation in premenopausal women has also shown a significant positive effect.50 Most doctors recommend calcium supplementation as a way to partially reduce the risk of osteoporosis and to help people already diagnosed with the condition. In order to achieve the 1,500 mg per day calcium intake many researchers deem optimal, 800 to 1,000 mg of supplemental calcium are generally added to the 500 to 700 mg readily obtainable from the diet.

While phosphorus is essential for bone formation, most people do not require phosphorus supplementation, because the typical western diet provides ample or even excessive amounts of phosphorus. One study, however, has shown that taking calcium can interfere with the absorption of phosphorus, potentially leading to phosphorus deficiency in elderly people, whose diets may contain less phosphorus.51. The authors of this study recommend that, for elderly people, at least some of the supplemental calcium be taken in the form of tricalcium phosphate or some other phosphorus-containing preparation.

One trial studying postmenopausal women combined hormone replacement therapy with magnesium (600 mg per day), calcium (500 mg per day), vitamin C , B vitamins , vitamin D, zinc, copper, manganese, boron , and other nutrients for an eight- to nine-month period.52 In addition, participants were told to avoid processed foods, limit protein intake, emphasize vegetable over animal protein, and limit consumption of salt, sugar, alcohol, coffee, tea, chocolate, and tobacco. Bone density increased a remarkable 11%, compared to only 0.7% in women receiving hormone replacement alone.

3 Stars
Strontium
600 to 700 mg daily under medical supervision
Studies indicate that supplementing with strontium may help reduce bone pain, increase bone mineral density, and reduce the risk of some fractures.
Strontium may play a role in bone formation, and also may inhibit bone breakdown.53 Preliminary evidence suggests that women with osteoporosis may have reduced absorption of strontistaum.54 The first medical use of strontium was described in 1884. (Strontium supplements do not contain the radioactive form of strontium that is a component of nuclear fallout.) Years ago in a preliminary trial, people with osteoporosis were given 1.7 grams of strontium per day for a period of time ranging between three months and three years; afterward, they reported a significant reduction in bone pain, and there was evidence suggesting their bone mass had increased.55 More recently, in a three-year double-blind study of postmenopausal women with osteoporosis, supplementing with strontium, in the form of strontium ranelate, significantly increased bone mineral density in the hip and spine, and significantly reduced the risk of vertebral fractures by 41%, compared with a placebo.56 The amount of strontium used in that study was 680 mg per day, which is approximately 300 times the amount found in a typical diet. Increased bone formation and decreased bone pain were also reported in six people with osteoporosis given 600 to 700 mg of strontium per day.57  Although the amounts of strontium used in these studies studies was very high, the optimal intake remains unknown. Some doctors recommend only 1 to 6 mg of supplemental strontium per day—less than many people currently consume from their diets, but an amount that has begun to appear in some mineral formulas geared toward bone health. Strontium preparations, providing 200 to 400 mg per day, were used for decades during the first half of the twentieth century without any apparent toxicity.58 No significant side effects were observed in people taking large amounts of strontium; however, animal studies have demonstrated defects in bone mineralization, when strontium was administered in large amounts in combination with a low-calcium diet. People interested in taking large amounts of strontium should be supervised by a doctor, and should make sure to take adequate amounts of calcium. It should be noted that, although supplementing with strontium increases bone mineral density, only part of the increase is real. The rest is a laboratory error that results from the fact that strontium blocks X-rays to a greater extent than does calcium.59 People taking large amounts of strontium should mention that fact to the radiologist when they are having their bone mineral density measured, so that the results will be interpreted correctly.
3 Stars
Vitamin D
400 to 800 IU daily depending on age, sun exposure, and dietary sources
Vitamin D increases calcium absorption and helps make bones stronger. Vitamin D supplementation has reduced bone loss in women who don’t get enough of the vitamin from food and slowed bone loss in people with osteoporosis. It also works with calcium to prevent some musculoskeletal causes of falls and subsequent fractures.

Vitamin D increases calcium absorption, and blood levels of vitamin D are directly related to the strength of bones.60 Mild deficiency of vitamin D is common in the fit, active elderly population and leads to an acceleration of age-related loss of bone mass and an increased risk of fracture.61 In double-blind research, vitamin D supplementation has reduced bone loss in women who consume insufficient vitamin D from food and slowed bone loss in people with osteoporosis.62 , 63 However, the effect of vitamin D supplementation on osteoporosis risk remains surprisingly unclear,64 , 65 with some trials reporting little if any benefit.66 Moreover, trials reporting reduced risk of fracture have usually combined vitamin D with calcium supplementation,67 making it difficult to assess how much benefit is caused by supplementation with vitamin D alone.68

Impaired balance and increased body sway are important causes of falls in elderly people with osteoporosis.69 Vitamin D works with calcium to prevent some musculoskeletal causes of falls.70 In a double-blind trial, elderly women who were given 800 IU per day of vitamin D and 1,200 mg per day of calcium had a significantly lower rate of falls and subsequent fractures than did women given the same amount of calcium alone.71 Vitamin D in the amount of 800 IU per day effectively prevented falls in a double-blind study of elderly nursing home residents, but lower amounts were ineffective.72

Despite inconsistency in the research, many doctors recommend 400 to 800 IU per day of supplemental vitamin D, depending upon dietary intake and exposure to sunlight.

One trial studying postmenopausal women combined hormone replacement therapy with magnesium (600 mg per day), calcium (500 mg per day), vitamin C , B vitamins , vitamin D, zinc, copper, manganese, boron , and other nutrients for an eight- to nine-month period.73 In addition, participants were told to avoid processed foods, limit protein intake, emphasize vegetable over animal protein, and limit consumption of salt, sugar, alcohol, coffee, tea, chocolate, and tobacco. Bone density increased a remarkable 11%, compared to only 0.7% in women receiving hormone replacement alone.

2 Stars
Copper
2 to 3 mg daily
Copper is needed for normal bone synthesis, and one trial reported that copper reduced bone loss.

Copper is needed for normal bone synthesis. Recently, a two-year, controlled trial reported that 3 mg of copper per day reduced bone loss.74 When taken over a shorter period of time (six weeks), the same level of copper supplementation had no effect on biochemical markers of bone loss.75 Some doctors recommend 2 to 3 mg of copper per day, particularly if zinc is also being taken, in order to prevent a deficiency. Supplemental zinc significantly depletes copper stores, so people taking zinc supplements for more than a few weeks generally need to supplement with copper also. Calcium, magnesium, zinc, and copper are sometimes found at appropriate levels in high-potency multivitamin-mineral supplements .

One trial studying postmenopausal women combined hormone replacement therapy with magnesium (600 mg per day), calcium (500 mg per day), vitamin C , B vitamins , vitamin D, zinc, copper, manganese, boron , and other nutrients for an eight- to nine-month period.76 In addition, participants were told to avoid processed foods, limit protein intake, emphasize vegetable over animal protein, and limit consumption of salt, sugar, alcohol, coffee, tea, chocolate, and tobacco. Bone density increased a remarkable 11%, compared to only 0.7% in women receiving hormone replacement alone.

2 Stars
DHEA
Take under medical supervision: 50 mg per day
DHEA may be helpful in preventing osteoporosis. In one trial, bone mineral density increased among healthy elderly women and men who were given DHEA.
In a preliminary trial, bone mineral density increased among healthy elderly women and men who were given 50 mg per day of DHEA as a supplement.77 Similar results were found in two one-year double-blind trials that used 50 mg of DHEA per day.78 , 79 , 80 It is not known if supplementation would have the same effect in people with established osteoporosis. DHEA is a steroid hormone, and should be used only under the supervision of a doctor.
2 Stars
Fish Oil and Evening Primrose Oil
6 grams daily
Fish oil combined with evening primrose oil (EPO) may improve calcium absorption and promote bone formation.

A preliminary trial found that elderly women with osteoporosis who were given 4 grams of fish oil per day for four months had improved calcium absorption and evidence of new bone formation.81 Fish oil combined with evening primrose oil (EPO) may confer added benefits. In a controlled trial, women received 6 grams of a combination of EPO and fish oil, or a matching placebo, plus 600 mg of calcium per day for three years.82 The EPO/fish oil group experienced no spinal bone loss in the first 18 months and a significant 3.1% increase in spinal bone mineral density during the last 18 months.

2 Stars
Folic Acid (High Homocysteine)
5 mg with 1,500 mcg of vitamin B12 daily
Homocystinuria, a condition associated with high homocysteine levels, frequently causes osteoporosis. By lowering homocysteine levels, folic acid may help prevent osteoporosis.
Folic acid , vitamin B6 , and vitamin B12 are known to reduce blood levels of the amino acid homocysteine, and homocystinuria, a condition associated with high homocysteine levels, frequently causes osteoporosis. Therefore, some researchers have suggested that these vitamins might help prevent osteoporosis by lowering homocysteine levels.83 In a double-blind study of people who had suffered a stroke and had high homocysteine levels, daily supplementation with 5 mg of folic acid and 1,500 mcg of vitamin B12 for two years reduced the incidence of fractures by 78%, compared with a placebo.84 The reduction in fracture risk appeared to be due to an improvement in bone quality, rather than to a change in bone mineral density. However, supplementation with these vitamins did not reduce fracture risk in people who had only mildly elevated homocysteine levels and relatively high pretreatment folic acid levels.85 For the purpose of lowering homocysteine, amounts of folic acid and vitamins B6 and B12 found in high-potency B-complex supplements and multivitamins should be adequate.
2 Stars
Ipriflavone
600 mg daily along with 1,000 mg calcium daily
Ipriflavone promotes the incorporation of calcium into bone and inhibits bone breakdown, thus preventing and reversing osteoporosis.

Ipriflavone is a synthetic flavonoid derived from the soy isoflavone called daidzein. It promotes the incorporation of calcium into bone and inhibits bone breakdown, thus preventing and reversing osteoporosis. Many clinical trials, including numerous double-blind trials, have consistently shown that long-term treatment with 600 mg of ipriflavone per day, along with 1,000 mg supplemental calcium, is both safe and effective in halting bone loss in postmenopausal women or in women who have had their ovaries removed. Ipriflavone has also been found to improve bone density in established cases of osteoporosis in some,86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 but not all,97 clinical trials.

However, one double-blind study has failed to confirm the beneficial effect of ipriflavone. In that study, ipriflavone was no more effective than a placebo for preventing bone loss in postmenopausal women with osteoporosis.98 The women in this negative study were older (average age, 63.3 years) than those in most other ipriflavone studies and had relatively severe osteoporosis. It is possible that ipriflavone works only in younger women or in those with less severe osteoporosis.

2 Stars
Magnesium
Adults: 250 mg up to 750 mg daily; for girls: 150 mg daily
Supplementing with magnesium has been shown to stop bone loss or increased bone mass in people with osteoporosis.

In a preliminary study, people with osteoporosis were reported to be at high risk for magnesium malabsorption.99 Both bone100 and blood101 levels of magnesium have been reported to be low in people with osteoporosis. Supplemental magnesium has reduced markers of bone loss in men.102 Supplementing with 250 mg up to 750 mg per day of magnesium arrested bone loss or increased bone mass in 87% of people with osteoporosis in a two-year, preliminary trial.103 Supplementing with magnesium (150 mg per day for one year) also increased bone mass in pre-adolescent and adolescent girls in a double-blind study.104 Some doctors recommend that people with osteoporosis supplement with 350 mg of magnesium per day.

One trial studying postmenopausal women combined hormone replacement therapy with magnesium (600 mg per day), calcium (500 mg per day), vitamin C , B vitamins , vitamin D, zinc, copper, manganese, boron , and other nutrients for an eight- to nine-month period.105 In addition, participants were told to avoid processed foods, limit protein intake, emphasize vegetable over animal protein, and limit consumption of salt, sugar, alcohol, coffee, tea, chocolate, and tobacco. Bone density increased a remarkable 11%, compared to only 0.7% in women receiving hormone replacement alone.

2 Stars
Progesterone
Consult a qualified healthcare practitioner
Preliminary evidence suggests that progesterone might reduce osteoporosis risk by promoting bone density.
Preliminary evidence suggests that progesterone might reduce the risk of osteoporosis.106 A preliminary trial using topically applied natural progesterone cream in combination with dietary changes, exercise, vitamin and calcium supplementation, and estrogen therapy reported large gains in bone density over a three-year period in a small group of postmenopausal women, but no comparison was made to examine the effect of using the same protocol without progesterone.107 Other trials have reported that adding natural progesterone to estrogen therapy did not improve the bone-sparing effects of estrogen and that progesterone applied topically every day for a year did not reduce bone loss.108 109 In a more recent double-blind study, however, progesterone had a modest bone-sparing effect in post-menopausal women.110
2 Stars
Red Clover
Take an extract supplying 26 mg of biochanin A, 16 mg of formononetin, 1 mg of genistein, and 0.5 mg of daidzein per day
In one study, supplementing with isoflavones from red clover reduced the amount of bone loss from the spine by 45%, compared with a placebo.
In a double-blind study, supplementation with isoflavones from red clover for one year reduced the amount of bone loss from the spine by 45%, compared with a placebo.111 The supplement used provided daily 26 mg of biochanin A, 16 mg of formononetin, 1 mg of genistein, and 0.5 mg of daidzein.
2 Stars
Vitamin B12 (High Homocysteine)
1,500 mcg with 5 mg of folic acid daily
Homocystinuria, a condition associated with high homocysteine levels, frequently causes osteoporosis. By lowering homocysteine levels, vitamin B12 may help prevent osteoporosis.
Folic acid , vitamin B6 , and vitamin B12 are known to reduce blood levels of the amino acid homocysteine, and homocystinuria, a condition associated with high homocysteine levels, frequently causes osteoporosis. Therefore, some researchers have suggested that these vitamins might help prevent osteoporosis by lowering homocysteine levels.112 In a double-blind study of people who had suffered a stroke and had high homocysteine levels, daily supplementation with 5 mg of folic acid and 1,500 mcg of vitamin B12 for two years reduced the incidence of fractures by 78%, compared with a placebo.113 The reduction in fracture risk appeared to be due to an improvement in bone quality, rather than to a change in bone mineral density. However, supplementation with these vitamins did not reduce fracture risk in people who had only mildly elevated homocysteine levels and relatively high pretreatment folic acid levels.114 For the purpose of lowering homocysteine, amounts of folic acid and vitamins B6 and B12 found in high-potency B-complex supplements and multivitamins should be adequate.
2 Stars
Vitamin K
1,000 mcg daily
Vitamin K is needed for bone formation, and supplementing with it may be a way to maintain bone mass.

Vitamin K is needed for bone formation. People with osteoporosis have been reported to have low blood levels115 , 116 and low dietary intake of vitamin K.117 , 118 One study found that postmenopausal (though not premenopausal) women may reduce urinary loss of calcium by taking 1 mg of vitamin K per day.119 People with osteoporosis given large amounts of vitamin K2 (45 mg per day) have shown an increase in bone density after six months120 and decreased bone loss after one121 or two122 years.

Other preliminary studies have reported that vitamin K supplementation increases bone formation in some women123 and that higher vitamin K intake correlates with greater bone mineral density.124 However, a double-blind study found that supplementing with 500 mcg of vitamin K1 per day for three years had no effect on bone mineral density, when compared with a placebo.125 Some doctors recommend 1 mg vitamin K1 to postmenopausal women as a way to help maintain bone mass, though optimal intake remains unknown.

1 Star
Black Cohosh
Refer to label instructions
Black cohosh has been shown to improve bone mineral density in animals fed a low-calcium diet.

Black cohosh has been shown to improve bone mineral density in animals fed a low calcium diet,126 but it has not been studied for this purpose in humans.

1 Star
Boron
Refer to label instructions
Supplementing with boron has been reported to reduce urinary loss of calcium and magnesium. However, those already supplementing with magnesium appear to achieve no additional calcium-sparing benefit when boron is added. Therefore, people with osteoporosis should supplement with magnesium or boron, not both.

Boron supplementation has been reported to reduce urinary loss of calcium and magnesium in some,127 but not all,128 preliminary research. However, those who are already supplementing with magnesium appear to achieve no additional calcium-sparing benefit when boron is added.129 Finally, in the original report claiming that boron reduced loss of calcium,130 the effect was achieved by significantly increasing estrogen and testosterone levels, hormones that have been linked to cancer risks. Therefore, it makes sense for people with osteoporosis to supplement with magnesium instead of, rather than in addition to, boron.

One trial studying postmenopausal women combined hormone replacement therapy with magnesium (600 mg per day), calcium (500 mg per day), vitamin C , B vitamins , vitamin D, zinc, copper, manganese, boron , and other nutrients for an eight- to nine-month period.131 In addition, participants were told to avoid processed foods, limit protein intake, emphasize vegetable over animal protein, and limit consumption of salt, sugar, alcohol, coffee, tea, chocolate, and tobacco. Bone density increased a remarkable 11%, compared to only 0.7% in women receiving hormone replacement alone.

1 Star
Calcium and Vitamin D (Amenorrhea)
Refer to label instructions
Despite the lack of evidence that calcium and vitamin D supplements alone are helpful to amenorrheic women, they are still generally recommended to prevent the added burden of calcium and vitamin D deficiency from further contributing to bone loss.

A preliminary trial showed that bone loss occurred over a one-year period in amenorrheic exercising women despite daily supplementation with 1,200 mg of calcium and 400 IU of vitamin D .132 In a controlled study of amenorrheic nursing women, who ordinarily experience brief bone loss that reverses when menstruation returns, bone loss was not prevented by a multivitamin supplement providing 400 IU of vitamin D along with 500 mg twice daily of calcium or placebo.133 Despite the lack of evidence that calcium and vitamin D supplements alone are helpful to amenorrheic women, they are still generally recommended to prevent the added burden of calcium and vitamin D deficiency from further contributing to bone loss.134 Amounts typically recommended are 1,200 to 1,500 mg calcium and 400 to 800 IU vitamin D daily.

1 Star
Fish Oil
Refer to label instructions
Supplementing with fish oil may improve calcium absorption and promote bone formation.

A preliminary trial found that elderly women with osteoporosis who were given 4 grams of fish oil per day for four months had improved calcium absorption and evidence of new bone formation.135 Fish oil combined with evening primrose oil (EPO) may confer added benefits. In a controlled trial, women received 6 grams of a combination of EPO and fish oil, or a matching placebo, plus 600 mg of calcium per day for three years.136 The EPO/fish oil group experienced no spinal bone loss in the first 18 months and a significant 3.1% increase in spinal bone mineral density during the last 18 months.

1 Star
Horsetail
Refer to label instructions
Horsetail is a rich source of silicon, and preliminary research suggests that this trace mineral may help maintain bone mass.
Horsetail is a rich source of silicon , and preliminary research suggests that this trace mineral may help maintain bone mass. Effects of horsetail supplementation on bone mass have not been studied.
1 Star
Manganese
Refer to label instructions
A combination of minerals including manganese was reported to halt bone loss in one study. Some doctors recommend manganese to people concerned with bone mass maintenance.

Interest in the effect of manganese and bone health began when famed basketball player Bill Walton’s repeated fractures were halted with manganese supplementation.137 A subsequent, unpublished study reported manganese deficiency in a small group of osteoporotic women.138 Since then, a combination of minerals including manganese was reported to halt bone loss.139 However, no human trial has investigated the effect of manganese supplementation alone on bone mass. Nonetheless, some doctors recommend 10 to 20 mg of manganese per day to people concerned with maintenance of bone mass.

One trial studying postmenopausal women combined hormone replacement therapy with magnesium (600 mg per day), calcium (500 mg per day), vitamin C , B vitamins , vitamin D, zinc, copper, manganese, boron , and other nutrients for an eight- to nine-month period.140 In addition, participants were told to avoid processed foods, limit protein intake, emphasize vegetable over animal protein, and limit consumption of salt, sugar, alcohol, coffee, tea, chocolate, and tobacco. Bone density increased a remarkable 11%, compared to only 0.7% in women receiving hormone replacement alone.

1 Star
Silicon
Refer to label instructions
Silicon is required in trace amounts for normal bone formation, and supplementation with silicon has increased bone mineral density in a small group of people with osteoporosis.
Silicon is required in trace amounts for normal bone formation,141 and supplementation with silicon has increased bone formation in animals.142 In preliminary human research, supplementation with silicon increased bone mineral density in a small group of people with osteoporosis.143 Optimal supplemental levels remain unknown, though some multivitamin-mineral supplements now contain small amounts of this trace mineral.
1 Star
Vitamin B6 (High Homocysteine)
Refer to label instructions
Homocystinuria, a condition associated with high homocysteine levels, frequently causes osteoporosis. By lowering homocysteine levels, vitamin B6 may help prevent osteoporosis.
Folic acid , vitamin B6 , and vitamin B12 are known to reduce blood levels of the amino acid homocysteine, and homocystinuria, a condition associated with high homocysteine levels, frequently causes osteoporosis. Therefore, some researchers have suggested that these vitamins might help prevent osteoporosis by lowering homocysteine levels.144 In a double-blind study of people who had suffered a stroke and had high homocysteine levels, daily supplementation with 5 mg of folic acid and 1,500 mcg of vitamin B12 for two years reduced the incidence of fractures by 78%, compared with a placebo.145 The reduction in fracture risk appeared to be due to an improvement in bone quality, rather than to a change in bone mineral density. However, supplementation with these vitamins did not reduce fracture risk in people who had only mildly elevated homocysteine levels and relatively high pretreatment folic acid levels.146 For the purpose of lowering homocysteine, amounts of folic acid and vitamins B6 and B12 found in high-potency B-complex supplements and multivitamins should be adequate.
1 Star
Vitamin B-Complex
Refer to label instructions
In one trial postmenopausal women who combined hormone replacement therapy with B vitamins and other nutrients and dietary changes increased their bone density by a remarkable 11%.

One trial studying postmenopausal women combined hormone replacement therapy with magnesium (600 mg per day), calcium (500 mg per day), vitamin C , B vitamins , vitamin D, zinc, copper, manganese, boron , and other nutrients for an eight- to nine-month period.147 In addition, participants were told to avoid processed foods, limit protein intake, emphasize vegetable over animal protein, and limit consumption of salt, sugar, alcohol, coffee, tea, chocolate, and tobacco. Bone density increased a remarkable 11%, compared to only 0.7% in women receiving hormone replacement alone.

1 Star
Whey Protein
Refer to label instructions
Some whey proteins may reduce bone loss. Milk basic protein (MBP) is a mixture of some of the proteins found in whey protein and has been shown to promote bone density

Some whey proteins may reduce bone loss.148 Milk basic protein (MBP) is a mixture of some of the proteins found in whey protein. A preliminary trial found that 300 mg per day of MBP improved blood measures of bone metabolism in men, suggesting more bone formation was occurring than bone loss.149 A double-blind trial found that women taking 40 mg per day of MBP for six months had greater gains in bone density compared with those taking a placebo.150 No osteoporosis-related research has been done using complete whey protein mixtures.

1 Star
Zinc
Refer to label instructions
Supplementing with zinc appears to be helpful in both preventing and treating osteoporosis.

One trial studying postmenopausal women combined hormone replacement therapy with magnesium (600 mg per day), calcium (500 mg per day), vitamin C , B vitamins , vitamin D, zinc, copper, manganese, boron , and other nutrients for an eight- to nine-month period.151 In addition, participants were told to avoid processed foods, limit protein intake, emphasize vegetable over animal protein, and limit consumption of salt, sugar, alcohol, coffee, tea, chocolate, and tobacco. Bone density increased a remarkable 11%, compared to only 0.7% in women receiving hormone replacement alone.

Levels of zinc in both blood and bone have been reported to be low in people with osteoporosis,152 and urinary loss of zinc has been reported to be high.153 In one trial, men consuming only 10 mg of zinc per day from food had almost twice the risk of osteoporotic fractures compared with those eating significantly higher levels of zinc in their diets.154 Whether zinc supplementation protects against bone loss has not yet been proven, though in one trial, supplementation with several minerals including zinc and calcium was more effective than calcium by itself.155 Many doctors recommend that people with osteoporosis, as well as those trying to protect themselves from this disease, supplement with 10 to 30 mg of zinc per day.

References

1. Hopper JL, Seeman E. The bone density of female twins discordant for tobacco use. N Engl J Med 1994;330:387-92.

2. Chow R, Harrison JE, Notarius C. Effect of two randomised exercise programmes on bone mass of healthy postmenopausal women. Br Med J 1987;295:1441-4.

3. Lloyd T, Triantafyllou SJ, Baker ER, et al. Women athletes with menstrual irregularity have increased musculoskeletal injuries. Med Sci Sports Exercise 1986;18(4):374-9.

4. Salamone LM, Cauley JA, Black DM, et al. Effect of a lifestyle intervention on bone mineral density in premenopausal women: a randomized trial. Am J Clin Nutr 1999;70:97-103.

5. Anderson JJ, Ambrose WW, Garner SC. Biphasic effects of genistein on bone tissue in the ovariectomized, lactating rat model (44243). Proc Soc Exp Biol Med 1998;217:345-50.

6. Potter SM, Baum JA, Teng H, et al. Soy protein and isoflavones: their effects on blood lipids and bone density in postmenopausal women. Am J Clin Nutr 1998;68(Suppl):1375-9S.

7. Morabito N, Crisafulli A, Vergara C, et al. Effects of genistein and hormone-replacement therapy on bone loss in early postmenopausal women: a randomized double-blind placebo-controlled study. J Bone Miner Res 2002;17:1904-12.

8. Marini H, Minutoli L, Polito F, et al. Effects of the phytoestrogen genistein on bone metabolism in osteopenic postmenopausal women: a randomized trial. Ann Intern Med 2007;146:839-47.

9. Weinsier RL, Krumdieck CL. Dairy foods and bone health: examination of the evidence. Am J Clin Nutr 2000;72:681-9 [review].

10. Kynast-Gales SA, Massey LK. Effect of caffeine on circadian excretion of urinary calcium and magnesium. J Am Coll Nutr 1994;13:467-72.

11. Hernandez-Avila M, Colditz GA, Stampfer MJ, et al. Caffeine, moderate alcohol intake, and risk of fractures of the hip and forearm in middle-aged women. Am J Clin Nutr 1991;54:157-63.

12. Harris SS, Dawson-Hughes B. Caffeine and bone loss in healthy postmenopausal women. Am J Clin Nutr 1994;60:573-8.

13. Kanis J, Johnell O, Gullberg B, et al. Risk factors for hip fracture in men from southern Europe: the MEDOS study. Mediterranean Osteoporosis Study. Osteoporos Int 1999;9:45-54.

14. Hegarty VM, May HM, Khaw KT. Tea drinking and bone mineral density in older women. Am J Clin Nutr 2000;71:1003-7.

15. Kao PC, P'eng FK. How to reduce the risk factors of osteoporosis in Asia. Chung Hua I Hsueh Tsa Chih (Taipei) 1995;55:209-13 [review].

16. Feskanich D, Willett WC, Stampfer MJ, Colditz GA. Protein consumption and bone fractures in women. Am J Epidemiol 1996;143:472-9.

17. Abelow BJ, Holford TR, Insogna KL. Cross-cultural association between dietary animal protein and hip fracture: a hypothesis. Calcif Tiss Int 1992;50:14-8.

18. Moriguti JC, Ferriolli E, Marchini JS. Urinary calcium loss in elderly men on a vegetable:animal (1:1) high-protein diet. Gerontology 1999;45:274-8.

19. Munger RG, Cerhan JR, Chiu BC. Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women. Am J Clin Nutr 1999;69:147-52.

20. Mannan MT, Tucker K, Dawson-Hughes B, et al. Effect of dietary protein on bone loss in elderly men and women: the Framingham Osteoporosis Study. J Bone Mineral Res 2000;15:2504-12.

21. Ellis FR, Holesh S, Ellis JW. Incidence of osteoporosis in vegetarians and omnivores. Am J Clin Nutr 1972;25:555-8.

22. Marsh AG, Sanchez TV, Midkelsen O, et al. Cortical bone density of adult lacto-ovo-vegetarian and omnivorous women. J Am Diet Assoc 1980;76:148-51.

23. Marsh AG, Sanchez TV, Chaffee FL, et al. Bone mineral mass in adult lacto-ovo-vegetarian and omnivorous males. Am J Clin Nutr 1983;37:453-6.

24. Hunt IF, Murphy NJ, Henderson C, et al. Bone mineral content in postmenopausal women: comparison of omnivores and vegetarians. Am J Clin Nutr 1989;50:517-23.

25. Lloyd T, Schaeffer JM, Walker MA, Demers LM. Urinary hormonal concentrations and spinal bone densities of premenopausal vegetarian and nonvegetarian women. Am J Clin Nutr 1991;54:1005-10.

26. Tesar R, Notelovitz M, Shim E, et al. Axial and peripheral bone density and nutrient intakes of postmenopausal vegetarian and omnivorous women. Am J Clin Nutr 1992;56:699-704.

27. Tylavsky FA, Anderson JJ. Dietary factors in bone health of elderly lactoovovegetarian and omnivorous women. Am J Clin Nutr 1988;48(3 Suppl):842-9.

28. Lau EMC, Kwok T, Woo J, Ho SC. Bone mineral density in Chinese elderly female vegetarians, vegans, lacto-vegetarians and omnivores. Eur J Clin Nutr 1998;52:60-4.

29. Tkatch L, Rapin CH, Rizzoli R, et al. Benefits of oral protein supplementation in elderly patients with fracture of the proximal femur. J Am Coll Nutr 1992;11:519-25.

30. Schürch MA, Rizzoli R, Slosman D, et al. Protein supplements increase serum insulin-like growth factor-I levels and attenuate proximal femur bone loss in patients with recent hip fracture. A randomized, double blind, placebo-controlled trial. Ann Intern Med 1998;128:801-9.

31. Espauella J, Guyer H, Diaz-Escriu F, et al. Nutritional supplementation of elderly hip fracture patients. A randomized, double-blind placebo-controlled trial. Age Aging 2000;29:425-31.

32. Heaney RP. Nutrient interactions and the calcium requirement. J Lab Clin Med 1994;124:15-6 [editorial/review].

33. Kerstetter JE, Allen LH. Dietary protein increases urinary calcium. J Nutr 1990;120:134-6.

34. Kerstetter JE, Looker AC, Insogna KL. Low dietary protein and low bone density. Calcif Tissue Int 2000;66:313.

35. Zarkadas M, Geougeon-Reyburn R, Marliss EB, et al. Sodium chloride supplementation and urinary calcium excretion in postmenopausal women. Am J Clin Nutr 1989;50:1088-94.

36. Evans CE, Chughtai AY, Blumsohn A, et al. The effect of dietary sodium on calcium metabolism in premenopausal and postmenopausal women. Eur J Clin Nutr 1997;51:394-9.

37. McParland BE, Boulding A, Campbell AJ. Dietary salt affects biochemical markers of resorption and formation of bone in elderly women. Br Med J 1989;299:834-5.

38. Devine A, Criddle RA, Dick IM, et al. A longitudinal study of the effect of sodium and calcium intakes on regional bone density in postmenopausal women. Am J Clin Nutr 1995;62:740-5.

39. Wyshak G, Frisch RE. Carbonated beverages, dietary calcium, the dietary calcium/phosphorus ratio, and bone fractures in girls and boys. J Adolescent Health 1994;15:210-5.

40. Smith S, Swain J, Brown EM, et al. A preliminary report of the short-term effect of carbonated beverage consumption on calcium metabolism in normal women. Arch Intern Med 1989;149:2517-9.

41. Mazariegos-Ramos E, Guerrero-Romero F, Rodríquez-Morán F, et al. Consumption of soft drinks with phosphoric acid as a risk factor for the development of hypocalcemia in children: a case-control study. J Pediatr 1995;126:940-2.

42. Tucker KL, Morita K, Qiao N, Hannan MT, Cupples LA, Kiel DP. Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham Osteoporosis Study. Am J Clin Nutr 2006;84:936-942.

43. Kim SH, Morton DJ, Barrett-Connor EL. Carbonated beverage consumption and bone mineral density among older women: the Rancho Bernardo Study. Am J Public Health 1997;87:276-9.

44. Reid IR, Ames RW, Evans MC, et al. Long-term effects of calcium supplementation on bone loss and fractures in postmenopausal women: a randomized controlled trial. Am J Med 1995;98:331-5.

45. Hosking DJ, Ross PD, Thompson DE, et al. Evidence that increased calcium intake does not prevent early postmenopausal bone loss. Clin Ther 1998;20:933-44.

46. Owusu W, Willett WC, Feskanich D, et al. Calcium intake and the incidence of forearm and hip fractures among men. J Nutr 1997;127:1782-7.

47. Rulm LA, Sakhaee K, Peterson R, et al. The effect of calcium citrate on bone density in the early and mid-postmenopausal period: a randomized, placebo-controlled study. Am J Ther 1999;6:303-11.

48. Nieves JW, Komar L, Cosman F, Lindsay R. Calcium potentiates the effect of estrogen and calcitonin on bone mass: review and analysis. Am J Clin Nutr 1998;67:18-24.

49. Bonjour JP, Carrie AL, Ferrari S, et al. Calcium-enriched foods and bone mass growth in prepubertal girls: a randomized, double-blind, placebo-controlled trial. J Clin Invest 1997;99:1287-94.

50. Welten DC, Kemper HCG, Post GB, van Stavberen WA. A meta-analysis of the effect of calcium intake on bone mass in young and middle aged females and males. J Nutr 1995;125:2802-13 [review].

51. Heaney RP, Nordin BEC. Calcium effects on phosphorus absorption: implications for the prevention and co-therapy of osteoporosis.J Am Coll Nutr 2002;21:239-44.

52. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

53. El-Hajj Fuleihan G. Strontium ranelate—a novel therapy for osteoporosis or a permutation of the same? N Engl J Med 2004;350:504-6 [Editorial].

54. Ferrari S, Zolezzi C, Savarino L, et al. The oral strontium load test in the assessment of intestinal calcium absorption. Minerva Med 1993;84:527-31.

55. McCaslin FE, Janes JM. The effect of strontium lactate in the treatment of osteoporosis. Proc Staff Meetings Mayo Clinic 1959;34(13):329-34.

56. Meunier PJ, Roux C, Seeman E, et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 2004;350:459-68.

57. Gaby AR. Preventing and Reversing Osteoporosis. Rocklin, CA: Prima Publishing, 1994, 88-9 [review].

58. Skoryna SC. Effects of oral supplementation with stable strontium. Can Med Assoc J 1981;125:703-12.

59. Reginster JY, Deroisy R, Dougados M, et al. Prevention of early postmenopausal bone loss by strontium ranelate: the randomized, two-year, double-masked, dose-ranging, placebo-controlled PREVOS trial. Osteoporos Int 2002;13:925-31.

60. Brot C, Jorgensen N, Madsen OR, et al. Relationships between bone mineral density, serum vitamin D metabolites and calcium: phosphorus intake in healthy perimenopausal women. J Intern Med 1999;245:509-16.

61. Sahota O. Osteoporosis and the role of vitamin D and calcium-vitamin D deficiency, vitamin D insufficiency and vitamin D sufficiency. Age Ageing 2000;29:301-4.

62. Dawson-Hughes B, Dallal GE, Krall EA, et al. Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women. Ann Intern Med 1991;115:505-12.

63. Adams JS, Kantorovich V, Wu C, et al. Resolution of vitamin D insufficiency in osteopenic patients results in rapid recovery of bone mineral density. J Clin Endocrinol Metab 1999;84:2729-30.

64. Nordin BE, Baker MR, Horsman A, Peacock M. A prospective trial of the effect of vitamin D supplementation on metacarpal bone loss in elderly women. Am J Clin Nutr 1985;42(3):470-4.

65. Lips P, Graafmans WC, Ooms ME, et al. Vitamin D supplementation and fracture incidence in elderly persons. Ann Intern Med 1996;124:400-6.

66. Komulainen M, Tuppurainen MT, Kroger H, et al. Vitamin D and HRT: no benefit additional to that of HRT alone in prevention of bone loss in early postmenopausal women. A 2.5-year randomized placebo-controlled study. Osteoporosis Int 1997;7:126-32.

67. Droisy R, Collette J, Chevallier T, et al. Effects of two 1-year calcium and vitamin D3 treatments on bone remodeling markers and femoral bone density in elderly women. Curr Ther Res 1998;59:850-62.

68. Chapuy MC, Arlot ME, Duboeuf F, et al. Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med 1992;327:1637-42.

69. Maki BE, Holliday PJ, Topper AK. A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. J Gerontol 1994;49:M72-84.

70. Leboff MS, Hawkes WG, Glowacki J, et al. Vitamin D-deficiency and post-fracture changes in lower extremity function and falls in women with hip fractures. Osteoporos Int 2008;19:1283-90.

71. Pfeifer M, Begerow B, Minne HW, et al. Effects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. J Bone Miner Res 2000;15:1113-8.

72. Broe KE, Chen TC, Weinberg J, et al. A higher dose of vitamin D reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc 2007;55:234-9.

73. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

74. Eaton-Evans J, McIlrath EM, Jackson WE, et al. Copper supplementation and bone-mineral density in middle-aged women. Proc Nutr Soc 1995;54:191A.

75. Baker A, Turley E, Bonham MP, et al. No effect of copper supplementation on biochemical markers of bone metabolism in healthy adults. Br J Nutr 1999;82:283-90.

76. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

77. Villareal DT, Holloszy JO, Kohrt WM. Effects of DHEA replacement on bone mineral density and body composition in elderly women and men. Clin Endocrinol (Oxf) 2000;53:561-8.

78. Jankowski CM, Gozansky WS, Schwartz RS, et al. Effects of dehydroepiandrosterone replacement therapy on bone mineral density in older adults: a randomized, controlled trial. J Clin Endocrinol Metab 2006;91:2986-93.

79. Weiss EP, Shah K, Fontana L, et al. Dehydroepiandrosterone replacement therapy in older adults: 1- and 2-y effects on bone. Am J Clin Nutr 2009;89:1459-67.

80. Von Muhlen D, Laughlin GA, Kritz-Silverstein D, et al. Effect of dehydroepiandrosterone supplementation on bone mineral density, bone markers, and body composition in older adults: the DAWN trial. Osteoporos Int 2008;19:699-707.

81. Van Papendorp DH, Coetzer H, Kruger MC. Biochemical profile of osteoporotic patients on essential fatty acid supplementation. Nutr Res 1995;15:325-34.

82. Kruger MC, Coetzer H, de Winter R, et al. Calcium, gamma-linolenic acid and eicosapentaenoic acid supplementation in senile osteoporosis. Aging 1998;10:385-94.

83. Gaby AR. Preventing and Reversing Osteoporosis. Rocklin, CA: Prima Publishing, 1994, 88-9 [review].

84. Sato Y, Honda Y, Iwamoto J, et al. Effect of folate and mecobalamin on hip fractures in patients with stroke: a randomized controlled trial. JAMA 2005;293:1082-8.

85. Sawka AM, Ray JG, Yi Q, et al. Randomized clinical trial of homocysteine level lowering therapy and fractures. Arch Intern Med 2007;167:2136-9.

86. Agnusdei D, Bufalino L. Efficacy of ipriflavone in established osteoporosis and long-term safety. Calcif Tissue Int 1997;61:23-27.

87. Head KA. Ipriflavone: an important bone-building isoflavone. Altern Med Rev 1999;4(1):10-22 [review].

88. Avioli LV. The future of ipriflavone in the management of osteoporotic syndromes. Calcif Tissue Int 1997;61(Suppl 1):S33-5 [review].

89. Adami S, Bufalino L, Cervetti R, et al. Ipriflavone prevents radial bone loss in postmenopausal women with low bone mass over 2 years. Osteoporos Int 1997;7:119-25.

90. Nozaki M, Hashimoto K, Inoue Y, et al. Treatment of bone loss in oophorectomized women with a combination of ipriflavone and conjugated equine estrogen. Int J Gynaecol Obstet 1998;62(1):69-75.

91. Gennari C, Adami S, Agnusdei D, et al. Effect of chronic treatment with ipriflavone in postmenopausal women with low bone bass. Calcif Tissue Int 1997;61(Suppl 1):S19-22.

92. Gennari C, Agnusdei D, Crepaldi G, et al. Effect of ipriflavone—a synthetic derivative of natural isoflavones—on bone mass loss in the early years after menopause. Menopause 1998;5(1):9-15.

93. Ohta H, Komukai S, Makita K, et al. Effects of 1-year ipriflavone treatment on lumbar bone mineral density and bone metabolic markers in postmenopausal women with low bone mass. Horm Res 1999;51:178-83.

94. Melis GB, Paoletti AM, Bartolini R, et al. Ipriflavone and low doses of estrogens in the prevention of bone mineral loss in climacterium. Bone Miner 1992;19 (Suppl 1):S49-56.

95. Gambacciani M, Ciaponi M, Cappagli B, et al. Effects of combined low dose of the isoflavone derivative ipriflavone and estrogen replacement on bone mineral density and metabolism in postmenopausal women. Maturitas 1997;28:75-81.

96. Hanabayashi T, Imai A, Tamaya T. Effects of ipriflavone and estriol on postmenopausal osteoporotic changes. Int J Gynaecol Obstet 1995;51:63-4 [letter].

97. Alexandersen P, Toussaint A, Christiansen C, et al. Ipriflavone in the treatment of postmenopausal osteoporosis: a randomized controlled trial. JAMA 2001;285:1482-88.

98. Alexandersen P, Toussaint A, Christiansen C, et al. Ipriflavone in the treatment of postmenopausal osteoporosis: a randomized controlled trial. JAMA 2001;285:1482-88.

99. Cohen L, Laor A, Kitzes R. Magnesium malabsorption in postmenopausal osteoporosis. Magnesium 1983;2:139-43.

100. Cohen L, Kitzes R. Infrared spectroscopy and magnesium content of bone mineral in osteoporotic women. Isr J Med Sci 1981;17:1123-5.

101. Geinster JY, Strauss L, Deroisy R, et al. Preliminary report of decreased serum magnesium in postmenopausal osteoporosis. Magnesium 1989;8:106-9.

102. Dimai H-P, Porta S, Wirnsberger G, et al. Daily oral magnesium supplementation suppresses bone turnover in young adult males. J Clin Endocrinol Metab 1998;83:2742-8.

103. Stendig-Lindberg G, Tepper R, Leichter I. Trabecular bone density in a two year controlled trial of peroral magnesium in osteoporosis. Magnesium Res 1993;6:155-63.

104. Carpenter TO, DeLucia MC, Zhang JH, et al. A randomized controlled study of effects of dietary magnesium oxide supplementation on bone mineral content in healthy girls. J Clin Endocrinol Metab 2006;91:4866-72.

105. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

106. Prior JC. Progesterone as a bone-trophic hormone. Endocr Rev 1990;11:386-98.

107. Lee JR. Osteoporosis reversal: the role of progesterone. Int Clin Nutr Rev 1990;10:384-91.

108. Riis BJ, Thomsen K, Strom V, Christiansen C. The effect of percutaneous estradiol and natural progesterone on postmenopausal bone loss. Am J Obstet Gynecol 1987;156:61-5.

109. Leonetti HB, Long S, Anasti JM. Transdermal progesterone cream for vasomotor symptoms and postmenopausal bone loss. Obstet Gynecol 1999;94:225-8.

110. Lydeking-Olsen E, Beck-Jensen JE, Setchell KD, Holm-Jensen T. Soymilk or progesterone for prevention of bone loss: a 2 year randomized, placebo-controlled trial. Eur J Nutr 2004;43:246-57.

111. Atkinson C, Compston JE, Day NE, et al. The effects of phytoestrogen isoflavones on bone density in women: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr 2004;79:326-33.

112. Gaby AR. Preventing and Reversing Osteoporosis. Rocklin, CA: Prima Publishing, 1994, 88-9 [review].

113. Sato Y, Honda Y, Iwamoto J, et al. Effect of folate and mecobalamin on hip fractures in patients with stroke: a randomized controlled trial. JAMA 2005;293:1082-8.

114. Sawka AM, Ray JG, Yi Q, et al. Randomized clinical trial of homocysteine level lowering therapy and fractures. Arch Intern Med 2007;167:2136-9.

115. Hart JP. Circulating vitamin K1 levels in fractured neck of femur. Lancet 1984;2:283 [letter].

116. Tamatani M, Morimoto S, Nakajima M, et al. Decreased circulating levels of vitamin K and 25-hydroxyvitamin D in osteopenic elderly men. Metabolism 1998;47:195-9.

117. Feskanich D, Weber P, Willett WC, et al. Vitamin K intake and hip fractures in women: a prospective study. Am J Clin Nutr 1999;69:74-9.

118. Booth SL, Tucker KL, Chen H, et al. Dietary vitamin K intakes are associated with hip fracture but not with bone mineral density in elderly men and women. Am J Clin Nutr 2000;71:1201-8.

119. Knapen MHJ, Hamulyak K, Vermeer C. The effect of vitamin K supplementation on circulating osteocalcin (Bone Gla protein) and urinary calcium excretion. Ann Intern Med 1989;111:1001-5.

120. Orimo H, Shiraki M, Fujita T, et al. Clinical evaluation of Menatetrenone in the treatment of involutional osteoporosis—a double-blind multicenter comparative study with 1-alpha-hydroxyvitamin D3. J Bone Mineral Res 1992;7(Suppl 1):S122.

121. Iwamoto I, Kosha S, Noguchi S, et al. A longitudinal study of the effect of vitamin K2 on bone mineral density in postmenopausal women a comparative study with vitamin D3 and estrogen-progestin therapy. Maturitas 1999;31:161-4.

122. Shiraki M, Shiraki Y, Aoki C, Miura M. Vitamin K2 (menatetrenone) effectively prevents fractures and sustains lumbar bone mineral density in osteoporosis. J Bone Miner Res 2000;15:515-21.

123. Craciun AM, Wolf J, Knapen MH, et al. Improved bone metabolism in female elite athletes after vitamin K supplementation. Int J Sports Med 1998;19:479-84.

124. Feskanich D, Weber P, Willett WC, et al. Vitamin K intake and hip fractures in women: a prospective study. Am J Clin Nutr 1999;69:74-9.

125. Booth SL, Dallal G, Shea MK, et al. Effect of vitamin K supplementation on bone loss in elderly men and women. J Clin Endocrinol Metab 2008;93:1217-23.

126. Kadota S, Li JX, Li HY, et al. Effects of cimicifugae rhizome on serum calcium and phosphate levels in low calcium dietary rats and on bone mineral density in ovariectomized rats. Phytomed 1996/97;3(4):379-85.

127. Nielsen FH, Hunt CD, Mullen LM, Hunt JR. Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women. FASEB J 1987;1:394-7.

128. Meacham SL, Taper LJ, Volpe SL. Effect of boron supplementation on blood and urinary calcium, magnesium, and phosphorus, and urinary boron in athletic and sedentary women. Am J Clin Nutr 1995;61:341-5.

129. Hunt CD, Herbel JL, Nielsen FH. Metabolic responses of postmenopausal women to supplemental dietary boron and aluminum during usual and low magnesium intake: boron, calcium, and magnesium absorption and retention and blood mineral concentrations. Am J Clin Nutr 1997;65:803-13.

130. Nielsen FH, Hunt CD, Mullen LM, Hunt JR. Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women. FASEB J 1987;1:394-7.

131. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

132. Baer JT, Taper LJ, Gwazdauskas FG, et al. Diet, hormonal, and metabolic factors affecting bone mineral density in adolescent amenorrheic and eumenorrheic female runners. J Sports Med Phys Fitness 1992;32:51-8.

133. Kalkwarf HJ, Specker BL, Ho M. Effects of calcium supplementation on calcium homeostasis and bone turnover in lactating women. J Clin Endocrinol Metab 1999;84:464-70.

134. Fagan KM. Pharmacologic management of athletic amenorrhea. Clin Sports Med 1998;17:327-41 [review].

135. Van Papendorp DH, Coetzer H, Kruger MC. Biochemical profile of osteoporotic patients on essential fatty acid supplementation. Nutr Res 1995;15:325-34.

136. Kruger MC, Coetzer H, de Winter R, et al. Calcium, gamma-linolenic acid and eicosapentaenoic acid supplementation in senile osteoporosis. Aging 1998;10:385-94.

137. Gold M. Basketball bones. Science 1980;80:101-2.

138. Raloff J. Reasons for boning up on manganese. Science News 1986;Sep 27:199 [review].

139. Strause L, Saltman P, Smith KT, et al. Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals. J Nutr 1994;124:1060-4.

140. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

141. Carlisle EM. Silicon localization and calcification in developing bone. Fed Proc 1969;28:374.

142. Hott M, de Pollak C, Modrowski D, Marie PJ. Short-term effects of organic silicon on trabecular bone in mature ovariectamized rats. Calcif Tissue Int 1993;53:174-9.

143. Eisinger J, Clairet D. Effects of silicon, fluoride, etidronate and magnesium on bone mineral density: a retrospective study. Magnes Res 1993;6:247-9.

144. Gaby AR. Preventing and Reversing Osteoporosis. Rocklin, CA: Prima Publishing, 1994, 88-9 [review].

145. Sato Y, Honda Y, Iwamoto J, et al. Effect of folate and mecobalamin on hip fractures in patients with stroke: a randomized controlled trial. JAMA 2005;293:1082-8.

146. Sawka AM, Ray JG, Yi Q, et al. Randomized clinical trial of homocysteine level lowering therapy and fractures. Arch Intern Med 2007;167:2136-9.

147. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

148. Toba Y, Takada Y, Yamamura J, et al. Milk basic protein: a novel protective function of milk against osteoporosis. Bone 2000;27:403-8.

149. Toba Y, Takada Y, Matsuoka Y, et al. Milk basic protein promotes bone formation and suppresses bone resorption in healthy adult men. Biosci Biotechnol Biochem 2001;65:1353-7.

150. Aoe S, Toba Y, Yamamura J, et al. Controlled trial of the effects of milk basic protein (MBP) supplementation on bone metabolism in healthy adult women. Biosci Biotechnol Biochem 2001;65:913-8.

151. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

152. Sahap AO. Zinc and senile osteoporosis. J Am Geriatr Soc 1983;31:790-1.

153. Relea P, Revilla M, Ripoll E, et al. Zinc, biochemical markers of nutrition, and type I osteoporosis. Age Ageing 1995; 24:303-7.

154. Elmståhl S, Gullberg B, Janzon L, et al. Increased incidence of fractures in middle-aged and elderly men with low intakes of phosphorus and zinc. Osteoporos Int 1998;8:333-40.

155. Strause L, Saltman P, Smith KT, et al. Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals. J Nutr 1994;124:1060-4.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

Print This Page
Email to a Friend
Home | Contact | Site Map | Site Privacy Policy | Terms & Conditions | Patient Privacy Policy | Medical Records | Fast Command
2800 10th Ave. North | P.O. Box 37000 | Billings, Montana 59107 | 406.238.2500
© Copyright 2014 Billings Clinic. All Rights Reserved.