High calcium intake has been associated with high bone mineral density (BMD).

However, without sufficient estrogen, (as well as other factors) the rate of bone resorption (the breaking down of bone) increases, leading to a loss of bone mass. Which leads to the development of osteoporosis.  As a result bones become weak and brittle, increasing the risk of fractures. Low estrogen decreases bone resorption (the breakdown of bone tissue) and reduces bone mineral density because estrogen helps maintain calcium balance. Estrogen helps the body absorb calcium both directly and indirectly by stimulating the production of a form of Vitamin D in the kidneys that aids in calcium absortion.

The combination of decreased absorption and increased breakdown can lead to a negative calcium balance, where more calcium is lost from the body than is taken in. This is generally caused when menopause occurs.

For postmenopausal women, bioidentical hormone replacement can help restore estrogen levels and protect bone density. See my article on my website regarding the benefits of bioidentical hormones versus synthetic.

Estrogen plays an important role in bone health for both men and women. However, if not replaced, estrogen levels decrease sharply during menopause.

The calcium requirement for adults may be defined as the mean calcium intake needed to preserve calcium balance to meet the significant obligatory losses of calcium through the gastrointestinal tract, kidneys, and skin. The required dose for calcium is about 800 mg. per day. There is a rise in obligatory calcium excretion at menopause, which increases the calcium requirment in postmenopausal women to about 1000 mg and implies an allowance of perhaps 1200 mg or even more if calcium absorption declines at the same time.

Trials in which calcium and estrogen have been directly compared have shown that the latter is generally more effective than calcium in that it produces a small, but often significant bone gain. This superiority of estrogen over calcium could be due to the former’s dual action on calcium absorption and excretion or to a direct action of estrogen on bone itself.

This is not to imply that all forms of osteoporosis are due to negative calcium balance. In corticosteroid osteoporosis and in age-related osteoporosis in men, depression of bone formation is probably a critical factor. Nontheless, established osteoporosis of all kinds is so commonly associated with malabsorpotion of calcium and/or high obligatory calcium excretion as to suggest that negative calcium balance has at least a contributory, if not a causal role in most forms of osteoporosis.

Tests for low bone density can be ordered by your physcian. The test is known as a DEXA bone density test.

Who is at risk

Women are more at risk of developing osteoporosis than men because the hormone changes that happen at the menopause directly affect bone density.

Women are at even greater risk of developing osteoporosis if they have:

• An early menopause (before the age of 45)
• A hysterectomy (removal of the womb) particularly when the ovaries are also removed
• Absent peiods for more than 6 months as a result of over-exercising or too much dieting

Men

In most cases, the cause of osteoporosis in men is unknown. However there is a link to the male hormone testosterone which helps keep the bones healthy.

Men continue producing testosterone into older age, but the risk of osteoporosis is increased in men with low levels of testosterone.

In around half of men, the exact cause of low testosterone levels is unknown, but known causes include:

• Taking certain medicines, such as steroid tablets
• Alcohol misuse
• Hypogonadism (a condition that causes abnormally low testosterone levels

Hormone Disorders

• Many hormones in the body affect bone turnover. If you have a disorder of the hormone-producing glands, you may have a higher risk of developing osteoporosis
• Hormone-related disorders that can trigger osteoporosis include:
• Overactive thyroid gland
• Reduced amounts of sex hormones (oestrogen and testosterone)
• Disorders of the pituitary glands (hyperparathyroidism)

Other Factors Thought to Increase the Risk of Osteoporosis and Broken Bones Include:

• A family history of osteoporosis
• A parental history of hip fracture
• A body mass index of 19 or less
• Long-term use of high-dose steroid tablets. These are widely used for health conditions such as arthritis and asthma
• Having an eating disorder, such as anorexia or bulimia
• Heavy drinking and smoking
• Rheumatoid arthritis
• Malabsorption problems, as in coalic disease and Chrohn’s disease
• Some medicines used to treat breast cancer that affect hormone levels
• Long periods of inactivity, such as long term bed rest.

Strenght Training

In addition to effective nutrient dense nutrition, strength training is a very important benefit in rebuilding bone. Bone and muscle can be rebuilt at any age. Strength training may also help you live longer. There are many benefits in strength training that help us maintain a functional aging process. Without it the body deteriorates.

New studies (https://pubmed.ncbi.nlm.nih.gov/28975661/) show that strength training can improve bone density in postmenopausal women, as well as for those with osteopenia and osteoporosis. For people who have osteopenia, strength training can be very beneficial and can prevent osteoporosis in develolping further. Strength training can also reverse some of the damages of osteoporosis itself.

Bone density improves when you stress or “bend” bones. Bending a bone means that you put enough weight through your bones that it causes temporary deformation that sends a signal to your body to start making new bones.

Strength training (also known as resistance training) is exactly what it sounds like. Strength training means using a low number of “reps” (or repetition of a certain exercise before you take a break) to build muscle mass and physical strength by utilizing weights, kettlebells, dumbbells and resistance brands, or through using your own body weight, such as with pushups and pullups.

Weight training is a generic term that typically involves using heavier weights to build muscles, while weightlifting generally means exercises that build muscle size and bulk. For example, muscle mass is important for certain sports, such as football and wrestling, endurance sports and activties such as rock climbing, rowing and swimming, says Sania Killion (https;//www.uchealth.org), a physical therapist who specalizes in rehab at the UCHealth Sports Therapy Clinic, Colorado Center.

Ms. Killion said “When you run, jump or land hard on your heels, force is put through the bone shaft, which in turn, stimulates bone growth.” NOTE: This isn’t recommended for everyone. Strengthening can be achieved in other ways.

Strength training also helps to boost “good” (HDL) cholesterol, while lowering “bad” LDL (low density lipoprotein) cholesterol.

Strength training increases your metabolism long after you stop your workout for 14 to 48 hours after you leave the gym. That translates into burning more calories.

if you never worked with strength training ask a physical therapist to help you get started. Then follow up with a qualified and certified fitness trainer.

Other helpful information can be found on https://www.uchealth.org/today/what-women-need-to-knowabout-strength-training.