Our entire skeleton carefully remodels itself, giving us brand-new bones every 10 years. Crystallized structures that are woven on the base of collagenous tissues are being built and broken down simultaneously. The immaculate structure with near-perfect structural life compatibility is always being maintained. Bones need to be always resilient, functional and robust. Many factors including our blood acidity, our health status, and even our hormone status play a significant role in maintaining our bone health.
Bone density is usually viewed as an issue of aging women as women are known to lose some bone density when they stop menstruating. Therefore many are recommended to be on a calcium supplement for the rest of their lives. Before heading to a supplement store to get a calcium supplement, it is important to note that not all calcium supplements are made the same. Studies demonstrate that some calcium supplements can accumulate in blood vessels and joints and may even impact the body negatively in a way that increases the likelihood of cardiovascular events. Moreover, the issue of bone density is not simply an issue of calcium deficiency. (1,2,3)
Build or Breakdown?
Healthy bones are a true work of art that is always under construction. The body is always balancing the laying and the breaking down of bones. Overall that balance plays a role in maintaining bone flexibility.
The notion that we can pile into the bone as many crystallizing minerals to make stronger bones is highly misleading. Crystalline structures that are made of calcium tend to be very brittle and can easily shatter on impact. Our bodies are designed to carve a truly revolutionary structure that is shatter-resistant and strong at the same time.
Most of the flexibility of bones comes from the organic bone matrix which is a protein and collagen net that infiltrates the crystalline hydroxyapatite. This net is made more resilient by the utilization of trace mineral silica. (4)
Though rarely discussed from a bone-health perspective, silica plays a large role in maintaining bone, teeth, nails, hair and skin. In fact, several studies show that some patients of osteomalacia appear to respond very poorly to calcium supplementation alone. (5)
The unique qualities of silica add strength and resilience to both bone structure and soft tissues. In fact, silica can be thought of as an organizing gel that prevents the over-crystallization of tissues. For soft tissues, silica enhances the ‘pull-resilience’ of tissues while for crystalline structures it enhances resilience to shatter. (6)
The catch with silica is that it is supplied to the body in small amounts, mostly from gains. Thus, people who have digestive issues or those who avoid gluten, get very little silica to begin with. On the other hand, supplemental silica sometimes comes from unnatural sources that are hard to recognise by the body. The lack of recognisability of the form of silica supplied can result in poor absorbability and, in some cases, stress on the kidneys. Therefore, it is important to always ensure adequate silica status and only supplement silica from a natural source like bamboo or the botanical family Equisetum, also known as horse-tail. (5,6, 7)
Building Healthy Bones
Healthy bones are made of calcium, potassium, magnesium, zinc, and even copper. Additionally, the process of making healthy bones requires Vitamin D to increase our absorption of calcium. Vitamin D enhances our absorption of calcium by about 25X. (8,9)
Additionally, Vitamin K2 is needed for the calcium that is absorbed to make its way into bone as opposed to joints and blood vessels. Vitamin C, on the other hand, is a collagen-boosting vitamin that combines with silica to add resilience and flexibility to bones and counteracts any brittleness. (10)
Different types of calcium are available on the market and may come from sources that can be non-bioavailable. Calcium that is not bioavailable is one that is not recognized by the body as a building block.
In other words, it is an ingredient that the body does not know what to do with. Most of the low-bioavailability calcium supplements out there are supplements that contain calcium from limestone.
Calcium carbonate, the type of calcium in limestone is the type of calcium that can upset the stomach, cause constipation and even significantly impact kidney health. On the other hand, calcium citrate has fewer side effects and significantly higher absorbability. (10, 11)
Additionally, calcium citrate supplements do not require to be taken with a meal as they do not require an acidic environment in order for them to be absorbed. (12)
Importance of Magnesium
Though magnesium is an active component of bones, magnesium is also important to include as a part of any bone health supplement as it counteracts the negative side effects of calcium. (13)
The truth is that any high calcium supplement carries the regular side effects of calcium, regardless of absorbability. Calcium is a contractor of muscles that is demonstrated to increase depression and increases the likelihood of constipation. (14, 15)
On the other hand, Magnesium does the opposite as it is known to be a muscle relaxant that helps with constipation and has been demonstrated to enhance mood. Thus, other than the important role it plays as a building block, magnesium is an important player in the creation of a side-effect-free bone health supplement.
For many North Americans, the inclusion of magnesium in the supplement regimen is important as the soils are not amended with magnesium which results in plants that are deficient in the nutrient. (16, 17)
Vitamin K2 and Bone Health
Vitamin K2 plays a role in bone density, hormone balance, healthy aging and even immune health. While the vitamin is little known and highly overlooked, currently, most bone-support supplements include some amount of vitamin K2 in the ingredient list. (18)
While vitamin K2 is a large player in healthy bone mineralization, what most supplements fail to demonstrate is the efficacy of vitamin K2 after being administered with calcium and other minerals and organic compounds.
Vitamin K2 is susceptible to degradation under harsh environments and sitting in a capsule with calcium is one such case. Thus, a high quality bone enhancement supplement is one that can demonstrate clear separation between its vitamin K2 and its minerals. (19)
Hormones and Co-factors
Tankeu AT, Ndip Agbor V, Noubiap JJ. Calcium supplementation and cardiovascular risk: A rising concern. The Journal of Clinical Hypertension. 2017 Jun;19(6):640-6.
Li K, Kaaks R, Linseisen J, Rohrmann S. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC-Heidelberg). Heart. 2012 Jun 15;98(12):920-5.
Reid IR, Bolland MJ, Grey A. Does calcium supplementation increase cardiovascular risk?. Clinical endocrinology. 2010 Dec;73(6):689-95.
Benjamin RM. Bone health: preventing osteoporosis. Public health reports. 2010 May;125(3):368-70.
Martin KR. The chemistry of silica and its potential health benefits. The Journal of nutrition, health & aging. 2007 Mar 1;11(2):94.
Chumlea WC. Silica, a mineral of unknown but emerging health importance. The journal of nutrition, health & aging. 2007 Mar 1;11(2):93.
Rawat K, Nirmala C, Bisht MS. Quantitative assessment of silicon in fresh and processed bamboo shoots and its potential as functional element in food, nutraceuticals and cosmeceuticals. In11th World Bamboo Congress 2018.
Zheng J, Mao X, Ling J, He Q, Quan J. Low serum levels of zinc, copper, and iron as risk factors for osteoporosis: a meta-analysis. Biological trace element research. 2014 Jul;160(1):15-23.
Christakos S, Dhawan P, Porta A, Mady LJ, Seth T. Vitamin D and intestinal calcium absorption. Molecular and cellular endocrinology. 2011 Dec 5;347(1-2):25-9.
Viguet-Carrin S, Garnero P, Delmas PD. The role of collagen in bone strength. Osteoporosis international. 2006 Mar;17(3):319-36.
Hanzlik RP, Fowler SC, Fisher DH. Relative bioavailability of calcium from calcium formate, calcium citrate, and calcium carbonate. Journal of Pharmacology and Experimental Therapeutics. 2005 Jun 1;313(3):1217-22.
Sakhaee K, Bhuket T, Adams-Huet B, Rao DS. Meta-analysis of calcium bioavailability: a comparison of calcium citrate with calcium carbonate. American journal of therapeutics. 1999 Nov 1;6(6):313-21.
Castiglioni S, Cazzaniga A, Albisetti W, Maier JA. Magnesium and osteoporosis: current state of knowledge and future research directions. Nutrients. 2013 Aug;5(8):3022-33.
Beyer FR, Dickinson HO, Nicolson D, Ford GA, Mason J. Combined calcium, magnesium and potassium supplementation for the management of primary hypertension in adults. Cochrane Database of Systematic Reviews. 2006(3).
Siesjö BK, Bengtsson F. Calcium fluxes, calcium antagonists, and calcium-related pathology in brain ischemia, hypoglycemia, and spreading depression: a unifying hypothesis. Journal of Cerebral Blood Flow & Metabolism. 1989 Apr;9(2):127-40.
Sojka JE. Magnesium supplementation and osteoporosis. Nutrition reviews. 1995 Mar 1;53(3):71-4.
Jee SH, Miller ER, Guallar E, Singh VK, Appel LJ, Klag MJ. The effect of magnesium supplementation on blood pressure: a meta-analysis of randomized clinical trials. American journal of hypertension. 2002 Aug 1;15(8):691-6.
Capozzi A, Scambia G, Lello S. Calcium, vitamin D, vitamin K2, and magnesium supplementation and skeletal health. Maturitas. 2020 Oct 1;140:55-63.
Ochiai M, Nakashima A, Takasugi N, Kiribayashi K, Kawai T, Usui K, Shigemoto K, Hamaguchi N, Kohno N, Yorioka N. Vitamin K2 alters bone metabolism markers in hemodialysis patients with a low serum parathyroid hormone level. Nephron Clinical Practice. 2011;117(1):c15-9.
Seyidoglu N, Inan S, Aydin C. A prominent superfood: Spirulina platensis. Superfood and Functional Food The Development of Superfoods and Their Roles as Medicine. 2017 Feb 22:1-27.
Grosshagauer S, Kraemer K, Somoza V. The true value of Spirulina. Journal of agricultural and food chemistry. 2020 Mar 5;68(14):4109-15.
Zioupos P, Currey JD, Hamer AJ. The role of collagen in the declining mechanical properties of aging human cortical bone. Journal of Biomedical Materials Research: An Official Journal of The Society for Biomaterials, The Japanese Society for Biomaterials, and The Australian Society for Biomaterials. 1999 May;45(2):108-16.
Ferrando AA, Green NR. The effect of boron supplementation on lean body mass, plasma testosterone levels, and strength in male bodybuilders. International Journal of Sport Nutrition and Exercise Metabolism. 1993 Jun 1;3(2):140-9.
Nielsen FH, Hunt CD, Mullen LM, Hunt JR. Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women 1. The FASEB journal. 1987 Nov;1(5):394-7.
Canguven O, Talib RA, El Ansari W, Yassin DJ, Al Naimi A. Vitamin D treatment improves levels of sexual hormones, metabolic parameters and erectile function in middle-aged vitamin D deficient men. The Aging Male. 2017 Jan 2;20(1):9-16.