• Calcium.
This mineral is vital for skeletal mineralization, blood clotting, conduction of nerve impulses, buffering of acidic blood, enzyme activity, and muscle contractions.

• Phosphorus.
This mineral is important for energy, enzyme activity, muscle contraction, and nerve contractions.

• Magnesium.
This is one of the most important nutrients in your body. It is vital for cell energy metabolism, nerve conduction, cell membrane integrity, electrolyte balance, and the proper functioning of over three hundred enzymes. Deficiency reduces osteoblast bone formation and increases osteoclast bone resorption. Magnesium is necessary for release of the hormone calcitonin from the thyroid gland, and for the production of parathyroid hormone. Both hormones are necessary for bone health.

• Zinc.
Zinc deficiency is common. It is often seen in malabsorption syndromes, alcoholism, and with long-term intense exercise. Zinc deficiency contributes to bone loss and is linked to low BMD and reduced IGF-1. The enzyme that converts the thyroid hormone T4 to the active form, T3, is zinc dependent, and therefore zinc deficiency may lead to low thyroid function.

• Potassium.
High dietary intake and supplementation with potassium will rectify chronic low-level metabolic acidosis and concomitant urine calcium losses. Adequate potassium is important for overall acid-base balance.

• Boron.
Supplemental boron may help to increase BMD by increasing estrogen levels in postmenopausal women. Note: If you have a cancer that is estrogen sensitive, such as breast, uterine, or ovarian cancer, boron supplementation should be avoided.

• Manganese.
Deficiency of this trace mineral is linked to osteoporosis.

• Copper.
This mineral is important for enzyme activity and acts as a catalytic agent during biochemical processes involved in the formation of bone. Deficiency is rare.

• Silica.
This trace mineral is important for the development of strong collagen fibers. When silica is deficient, bone collagen structural cross-links develop poorly and lead to reduced bone strength.

• Vitamin A.
This is necessary for bone health, but excess vitamin A (retinol) intake correlates to low BMD.

• Vitamin B Complex.
Vitamins B2, B6, B12, and folic acid are all important for reducing homocysteine if it is elevated. Reducing elevated homocysteine with the supplementation of these vitamins will help reduce fracture risk.

• Vitamin B2 (Riboflavin):
This vitamin is important for tissue respiration and enzyme activity.

• Vitamin B6 (Pyridoxine).
Vitamin B6 is necessary to produce hydrochloric acid for good digestion and calcium absorption. It’s also important for vitamin K to work well.

• Vitamin B12 (Cyanocobalamin).
Vitamin B12 is important for nerve sheath health and red blood cell production. Vitamin B12 deficiency is common when stomach acidity is low, and with the use of proton pump inhibitors (PPIs).

• Folate.
This is important for normal red blood cell development.

• Vitamin C.
This important antioxidant maintains structural integrity of collagen fibers, boosts energy metabolism, and enhances immune function.

• Vitamin D.
This vitamin comes in two forms: vitamin D3 and vitamin D2. It ensures adequate blood calcium levels by increasing calcium absorption from the gut. If calcium intake is insufficient and blood calcium levels drop, PTH from the parathyroid gland is released, and more vitamin D (if in adequate supply) is activated. This activated vitamin D stimulates osteoblasts to release RANKL, a chemical messenger that activates osteoclastic bone resorption in order to access calcium stores. Production of PTH depends on adequate magnesium. When supplementing with vitamin D, always include adequate calcium and magnesium. Optimal vitamin D levels improve absorption of calcium, improve strength, and reduce fracture risk. In addition, this vitamin helps to decrease the risk of cancer, diabetes, and heart disease.

• Vitamin K.
This is crucial for blood coagulation and bone formation. Deficiency is associated with low BMD and increased fracture risk. Vitamins K and D work in concert. Vitamin D increases calcium absorption from the gut, and vitamin K prevents calcium loss in the urine. In bone, vitamin D stimulates osteoblasts to produce the protein osteocalcin, which is so important for mineralization, and vitamin K activates the osteocalcin. Inadequate vitamin K contributes to soft tissue calcification.

• Essential Fatty Acids (EFAs).
The EFAs, alpha-linolenic acid (omega-3) and linoleic acid (omega-6), are long-chain polyunsaturated fatty acids that must be obtained through your diet or by supplementation. They are important for healthy cell membranes and have a primary role in your immune system’s regulation of inflammation. The conversion of linolenic acid to EPA and DHA (other forms of omega-3, which are also important for disease prevention), and linoleic acid to other important fatty acids, is through the enzyme delta-6-desaturase. The function of this enzyme is adversely affected by low levels of zinc, vitamin B6, and magnesium. Omega-3 deficiency is common and is linked to heart disease, cancer, insulin resistance, depression, accelerated aging, diabetes, Alzheimer’s, and other diseases.

• Amino Acids.
These are the building blocks of protein. They are vital to your bone health and overall health. They are important for the growth and repair of all tissues, including bone collagen. Amino acids also provide the foundation for all hormones, messenger cytokines, and enzymes involved in each step of the bone remodeling process. People with osteoporosis are commonly deficient in amino acids, especially when there is malabsorption or poor digestion. The amino acid lysine, found in meat, dairy, and eggs, is particularly important for bone health. If you have osteoporosis, and especially if you are a vegetarian, make sure you supplement your diet with 500 mg/day of lysine.


Excerpt from THE WHOLE-BODY APPROACH TO OSTEOPOROSIS: How to Improve Bone Strength and Reduce Your Fracture Risk (New Harbinger Publications)

Author's Bio: 

R. Keith McCormick, DC, is a chiropractor in private practice in western Massachusetts. He specializes in the nutritional management of patients with bone fragility. McCormick is a former U.S. Olympian (1976) and a current Ironman Triathlon competitor.