New research shows that stress and stress disorders can lead to osteoporosis. In the US there are over 1.5 million osteoporosis-related fractures. Some are debilitating. All are scary. Managing stress is one important way to protect your bone health. 

Osteoporosis can be viewed as an umbrella term that covers at least four different pathological conditions that threaten bone health. High stress can make things worse. 

Quick Review of Bone Remodeling

Healthy bone tissue is constantly being built up and broken down. It is a delicate balance, not completely understood. 

Osteoblasts are the bone cells that build up new bone. 

Osteoclasts are the bone cells that break down new bone. 

Think of a house that occasionally needs to be remodeled when things get old and need to be replaced. Healthy bones are always in the process of remodeling – breaking down the old and building up the new. 

Here are some conditions that can lead to osteoporosis. 

Low estrogen 

As women go through menopause, their estrogen levels naturally decline. Estrogen inhibits the activity of osteoclasts or bone eaters. Therefore, with less estrogen, there are more osteoclasts breaking down bone.  This can contribute to loss of bone mineral density, especially if the woman has other risk factors. 

The Aging Process 

As both men and women age, their bones naturally tend to weaken. To a certain degree, this is normal. As we age, the body produces fewer osteoblasts. However, the number of osteoclasts remains the same. The result over time is lower bone mineral density. 

It is important to exercise at all stages of life in part because exercise improves bone strength. It also improves balance and lean muscle mass. Seniors with good bone mineral density, good coordination, and strong muscles tend to fall down less. And when they do, the results aren’t likely to be catastrophic. 

Glucocorticoid Use

Have you watched any TV lately? If so, you will have seen numerous advertisements for glucocorticoid medications to treat a variety of inflammatory conditions. Another word for glucocorticoid is corticosteroid or steroids. Common examples include cortisone and prednisone. 

It only takes a few months of steroid use to weaken bone density. The use of such medications is the most common explanation for young people with osteoporosis. 

Here is a short list of medical conditions commonly treated with glucocorticoids: 

• Asthma

• Allergies 

• Crohn’s disease 

• MS

• Lupus 

• Rheumatoid arthritis 

Inactivity 

What do astronauts and bedridden people have in common? Neither is using their bones. Both are at risk of osteoporosis. This is why astronauts now understand the importance of exercising while in space as well as making up for the lack of gravity on bone remodeling once they get home. 

How Does High Stress Contribute to Osteoporosis? 

 

There are two kinds of stress, acute and chronic. An example of acute stress might include being robbed at gunpoint or receiving a scary medical diagnosis.  Chronic stress is stress that goes on for a long period of time without being properly managed. For example, working as a doctor or nurse in an ER in a big city might produce chronic stress. 

During acute or short-term stress, the body produces catecholamines or “fight or flight” hormones to get out of danger. Those hormones increase osteoclasts or bone eaters. 

With chronic stress, the body produces cortisol, a stress hormone that mimics the effects of glucocorticoid-induced osteoporosis. 

Acute stress can lead to chronic stress. PTSD is known to increase the chances of both osteoporosis and high levels of inflammation. 

People who live with high levels of stress are at risk of relying on very unhealthy substances to manage the situation. Smoking, alcohol, and drug use are all associated with higher incidences of osteoporosis. 

Furthermore, living with a diagnosis of osteoporosis can be a stress-inducing experience. Fear of falling and fear of losing one’s independence can lead to anxiety and depression. Those conditions lead to more stress and a further deterioration of bone health. 

What can be done to lower stress and improve bone health?

Non-Pharmaceutical Suggestions

• Vitamin D and Calcium: Almost all practitioners are in agreement that supplementation with both vitamin D and calcium will help improve bone health in the case of osteoporosis. Interesting enough, there is little research to support the exclusive use of either one. They should be paired together.  

• Magnesium: This mineral is also key to bone health. Importantly, supplementation with magnesium has been shown to help improve sleep and reduce anxiety. 

• Omega-3s: Fish oil is known to reduce inflammation and support brain health. 

• Meditation: There are many free apps available to encourage this stress-reducing habit. 

• Exercise: Daily movement, especially weight-bearing exercises such as walking and lifting weights, is known to improve bone density. It will also help improve mental health and reduce stress. 

Interested in learning more about what you can do to improve your own bone health? Sign up for my $25 one-hour class, Nutrition for Bone Health. 

Disclaimer 

The included information is not meant to or should not be used to replace or substitute medical treatment, recommendations, or the advice of your physician or health care provider. The information contained within is strictly for educational purposes and is based on evidence-based nutrition. If you believe you have a medical problem or condition, please contact your physician or healthcare provider. 

Reference 

Kelly, R. R., McDonald, L. T., Jensen, N. R., Sidles, S. J., & LaRue, A. C. (2019). Impacts of Psychological Stress on Osteoporosis: Clinical Implications and Treatment Interactions. Frontiers in psychiatry, 10, 200. https://doi.org/10.3389/fpsyt.2019.00200