losing calcium in your urine

Are you losing too much calcium in your urine?

What’s the biggest problem with calcium? It may come as a surprise that while most people don’t have a problem getting enough calcium, there is a major problem for many people when it comes to keeping calcium in their body so that it can help strengthen bone.

In fact, 20% or more of people with osteoporosis suffer from hypercalciuria — excessive loss of calcium in the urine. No matter what the cause, hypercalciuria always jeopardizes bone and is associated with lower bone density and increased fracture risk.

The link between hypercalciuria and osteoporosis is so strong that expert researchers suggest everyone with a diagnosis of osteoporosis be screened for it.

Do you have hypercalciuria?

Luckily, there’s a fairly simple laboratory test to determine if you’re losing calcium. You’re asked to collect your urine over 24 hours and submit it for chemical analysis to determine how much calcium it contains. Most labs consider any 24-hour calcium loss over 250–300 mg of calcium to be excessive.

  • If your 24-hour urine calcium comes back high, don’t panic: You may have gotten that result simply because you are taking too much calcium. When there’s an unusually high consumption of calcium from diet and supplements, the body simply moves unneeded calcium from the body into urine to get rid of it. Your doctor will likely recommend you retake the test, but this time avoiding all calcium supplements (and probably also dairy foods) for a week before again collecting your 24-hour urine sample.
  • If your re-test shows you’re genuinely losing calcium, again: don’t panic. Excessive calcium loss in the urine can be due to factors like high intake of salt, caffeine, soda, or sugar, low levels of nutrients like magnesium, vitamin D, and vitamin K, and even prolonged stress. These factors all promote an acidic pH (which promotes calcium loss), and they’re all things you can begin correcting on your own.

Dietary and lifestyle changes may not always solve the problem (though they may), as loss of calcium can also be related to medical issues such as hyperparathyroidism, kidney issues, hyper-absorption of calcium, vitamin D toxicity, autoimmune sarcoidosis or excessive bone breakdown related to “silent” diseases like diabetes or thyroid disorders. If your calcium excretion is consistently high, such possible causes should be explored by your physician.

What are your options if you have hypercalciuria?

If testing confirms you’re losing excessive calcium but your healthcare practitioner can’t identify and correct the cause of this problem, it’s pretty common practice to recommend a thiazide diuretic, which is known to help keep calcium in the body.

I favor the approach used by functional medicine and naturopathic practitioners, which is to first try to reduce urine calcium loss with a program of lifestyle and nutritional changes, perhaps combined with acupuncture to enhance kidney functioning, before using medications. But no matter what therapeutic approach you choose, it’s always important to retest and make sure that you have effectively reduced the loss of calcium in the urine.

Keep in mind that a high loss of calcium in the urine not only weakens bone, but also puts you at risk of developing kidney stones. Thus, if you are experiencing a high loss of calcium in the urine, be sure to drink plenty of water; this dilutes urine and reduces the risk of kidney stones. (This works both ways: if you have a history of kidney stone formation, be sure to get testing for excessive urinary calcium loss.)

Here at the Center for Better Bones, I suggest every person with an osteoporosis diagnosis be tested to rule out hypercalciuria. For more information see my DVD on uncovering the hidden causes of bone loss and my article about testing for bone loss.


Diet and lifestyle contribute to urine calcium loss

High salt intake

High alcohol and caffeine consumption

A diet high in sodas, refined carbohydrates and sugar

Excess protein intake

Low intake of vegetables, fruits, root crops, nuts and seeds

Acid-forming diet

Low dietary intake of potassium, magnesium, vitamin K

Prolonged stress and high cortisol



Asplin JR, Donahue S, Kinder J, Coe FL. Urine calcium excretion predicts bone loss in idiopathic hypercalciuria. Kidney Int 2006;70:1463–1467.

Girón-Prieto MS, Cano-García M, Poyatos-Andújar A, et al. The value of hypercalciuria in patients with osteopenia versus osteoporosis. Urolithiasis August 2016. DOI: 10.1007/s00240-016-0909-2

Giannini S, Nobile M, Dalle Carbonare L, et al. Hypercalciuria is common and important finding and postmenopausal women with osteoporosis. Eur J Endocrinol 2003;149:209–213.



Can hidden celiac disease cause osteoporosis?

Hidden celiac disease and osteoporosis: Learning from Judy

Judy had never even heard of celiac disease when she was told she had extremely severe osteoporosis in 2009. She was 57, underweight and suffered from excessive and life-limiting fatigue, but had no digestive symptoms to suggest a hidden problem was lurking to cause her bone loss.

Frightened by the diagnosis, Judy tried two bone drugs for a few months, but felt much worse on one and quickly stopped the other due to tiresome daily injections and scary side effect warnings. Judy decided that bone drugs weren’t for her; she began researching natural approaches, and that’s how she found the Better Bones program. She started my Better Bones Builder supplement, developed an alkaline diet and began walking.

Despite her good efforts, Judy’s fatigue persisted. Finally, during her annual physical in 2011, Judy discovered she had celiac disease — an autoimmune disorder in which exposure to gluten (a protein in wheat, rye and other grains) leads the immune system to damage the intestinal tract, causing malabsorption. Although she had no digestive problems or other symptoms, her blood work showed her to be extremely iron deficient. She wasn’t losing iron through an intestinal bleed, so a thoughtful physician decided to test her for celiac, which often leads to malabsorption of iron and other nutrients. The blood test for celiac was positive, as was a follow-up intestinal biopsy.

All excessive bone loss has a reason

Shortly after her physical, she began her gluten-free diet in combination with iron infusions for her anemia and the life-supporting nutrients in the Better Bones Builder. Within weeks, she began to feel and look better, regaining both energy and weight. Even more important: Over the next 8 years, Judy’s bone mass increased by a remarkable 20% — and this was between the ages of 57 and 65, when most women expect to lose bone.

In short, the key factor to restoring her bones was uncovering that she had celiac disease. Using that information as incentive, she initiated a gluten-free yet alkalizing diet and incorporated our targeted nutrient supplementation and lifestyle suggestions to gain back her health, vitality, and bone. She’s an inspiration and a reminder of something I tell all my clients:  all excessive bone loss has a reason, and at any point in life we can start regaining bone strength!

For more information see my DVD, Uncovering the Hidden Causes of Bone Loss.

A message from Judy

“I would like to thank Dr. Brown for all the research she has done on osteoporosis. Because I found her website my life has changed.

“I began using the Better Bones Builder in 2009 after I was diagnosed with severe osteoporosis. Along with taking the Better Bones Builder I tried to eat better, alkalize and walk at least 3 times a week and doing this I have had significant improvement in my bones.

“Every time I have had a DEXA scan since my first one in 2009 I have experienced improvement in bone density. My gains in bone density and in overall well being were especially dramatic after detection of and treatment for hidden celiac disease in the fall of 2011. In particular, between 2014 and 2016 there was a 13.7% improvement in my hip and a 6.4% gain in my spine.

“I think this is very impressive and I will continue to take the Better Bones Builder and do the other parts of the Better Bones program. Thanks to Dr. Brown, I feel that I am not forced to take bone drugs that harm the body.”

underlying causes of osteoporosis

Is it osteoporosis — or something else?

Here is the scenario. A woman seeks my services, concerned and even fearful after having been told she has osteoporosis and should take a bone drug. We sit down and after a careful review of her case, I am led to ask, “What’s the real problem here? Is osteoporosis really the major issue?” Quite often, the answer is “no,” and then I ask, “Should we start by addressing bone, or is it more effective to start on another level?”

Here’s an example that reveals why:

Barbara’s story

Barbara came to consult with me about her doctor’s recommendation that she should begin bone drugs. Barbara, a nurse, had suffered from an autoimmune disease for years that caused debilitating digestive issues. Between the ages of 47 and 50, she experienced an autoimmune flare that left her only able to eat a small amount of food at each meal. She became extremely debilitated and lost 25% of her body weight — and 14.9% of her spinal bone density — before she had identified dietary and lifestyle modifications that could quiet the autoimmune activity.

Her doctor’s insistence that she use bone drugs was based on this rapid decrease in spinal bone density. But Barbara was now 53, her digestive issues were better, and her most recent DEXA showed only an insignificant loss in the spine — she’d even gained a bit in the hip.

Was osteoporosis really the problem to address first?

We realized that Barbara’s spinal bone density loss coincided with her serious, prolonged problem with esophageal spasms stemming from her autoimmune disorder and its related allergic responses. Rather than concentrate on her bones, it made more sense to address her autoimmune disorder, which was the likely root cause of her bone loss.

Changing our focus was also important because while Barbara’s bone density had stabilized and her digestion was better, she was still experiencing occasional esophageal spasms, palpitations, chest pain, and fatigue. Any flare of these symptoms could lead to another bout of rapid weight and bone loss.

To help alleviate these concerns, I suggested Barbara undertake a partial elimination diet, alkalize her pH, use a few immune-enhancing and bone-building nutritional supplements, exercise, and meditate daily. Within one month, Barbara reported she was feeling healthier and stronger than she had felt in the past six years.  Our plan now is to undertake a comprehensive Better Bones, Better Body program for building both Barbara’s immunity and her bone strength.  “Nourish the root to receive the fruit” is an ancient aphorism I keep in my back pocket — in this case to Barbara’s benefit.

Barbara is happy to share this short video interview that she had with me. We both hope it will encourage each of you to look for the root causes of any excessive bone loss.

Diabetes and osteoporosis

With World Diabetes Day on November 14, this is an ideal time to take a look at what osteoporosis and diabetes have in common. It’s a lot more than you may realize!

High blood sugar and high insulin levels damage bone

Scientists are untangling a multitude of ways in which high blood sugar and high insulin levels damage bone, including:

  • Suppressing bone turnover. Insulin has been known to contribute to the bone remodeling process for a number of years (Rosen & Motyl, 2010). But when insulin is present in excessive amounts (as in type 2 diabetes), bone resorption and circulating levels of osteocalcin both decrease — within hours of an insulin surge, according to a recent study (Ivaska et al., 2015).
  • Increasing inflammation. Hyperglycemia has been found to increase oxidative stress, which in turn promotes inflammation throughout the body (Fiorentino et al., 2015).
  • Weaknesses in collagen that occur when blood sugar is chronically high. This means that bone in someone with diabetes (regardless of type) is more fragile than would be expected for a given bone density, putting them at greater fracture risk. One recent symposium of international scientists even called for recognition of “diabetic osteodystrophy” given how well-known the connection between diabetes and poor bone health has become (Epstein et al., 2016).

Diabetes dramatically increases fracture risk

Even though folks with diabetes often have higher bone densities then their non-diabetic peers, they fracture much more. A recent systemic review of 16 studies confirms that those with type 2 diabetes have nearly 3 times the risk of hip fracture as age-matched non-diabetics. Persons with type 1 diabetes fare even worse, having more than a 6-fold increased risk of hip fracture as they age.

3 steps to manage blood sugar and support bone health

Given these connections, it might not be surprising that many steps you can take to manage blood sugar are the same things we recommend to support bone health:

  1. Get regular exercise. Just as exercise stimulates osteoblasts to build bone, it also makes cells more receptive to insulin — particularly in skeletal muscle. Studies have shown that even short-duration exertion can improve blood glucose levels (Colberg et al., 2013). So every time you walk, hop, or do yoga for bone health, you’re also maintaining your insulin sensitivity and reducing blood sugar.
  2. Try the Alkaline for Life diet. People with diabetes are urged to eat a diet rich in vegetables, legumes, whole grains, nuts and seeds, and lean meats with very limited processed sugars — sound familiar? My Alkaline for Life diet and diabetes-friendly diets such as DASH or the Mediterranean diet (Ley et al., 2014) advocate these foods for good reason, as they reduce inflammation and support stable blood sugar levels, making them good for bones as well as diabetes.
  3. Test your vitamin D. We know that vitamin D is essential for bone health. No surprise, correlations between both types of diabetes and low vitamin D have also been found (Song et al., 2013; Raab et al., 2014), so have your vitamin D level tested and make sure you have a 50 to 60 ng/dL level all year round.

And should you be among the nearly 10% of our population that already has diabetes, or if you have been told you are “pre-diabetic,” now is the time to get serious about both controlling your blood sugar and implementing my comprehensive Better Bones Program.

So in honor of World Diabetes Day, I urge everyone to remember that taking care of your blood sugar is taking care of your bones — and vice versa!


Colberg, SR, Hernandez, MJ, and Shahzad, F. Blood Glucose Responses to Type, Intensity, Duration, and Timing of Exercise. Diabetes Care 2013 Oct; 36(10): e177-e177. http://dx.doi.org/10.2337/dc13-0965

Epstein S., Defeudis, G., Manfrini, S., Napoli, N., and Pozzilli, P on behalf of the Scientific Committee of the First International Symposium on Diabetes and Bone. (2016). Diabetes and disordered bone metabolism (diabetic osteodystrophy): time for recognition. Osteoporosis International 27: 1931–1951.

Fiorentino TV, Prioletta A, Zuo P, Folli F. Hyperglycemia-induced oxidative stress and its role in diabetes mellitus related cardiovascular diseases. Curr Pharm Des. 2013;19(32):5695-703.

Ivaska, K.K., Heliövaara, M.K., Ebeling, P., et al. The effects of acute hyperinsulinemia on bone metabolism. Endocr Connect 2015; 4(3): 155-162.

Janghorbani,M., et al. Systematic review of type 1 and type 2 diabetes mellitus and risk of fracture. Am J Epidemiol. 2007;166 (5):495–505.

Ley, S.H., Hamdy O., Mohan V., Hu F.B. Prevention and management of type 2 diabetes: dietary components and nutritional strategies. The Lancet 2014; 383(9933):1999–2007.

Raab, J., Giannopoulou, E.Z., Schneider, S. et al. Prevalence of vitamin D deficiency in pre-type 1 diabetes and its association with disease progression. Diabetologia (2014) 57: 902. doi:10.1007/s00125-014-3181-4

Rosen, C.J., Motyl, K.J. No bones about it: Insulin modulates skeletal remodeling. Cell 2010;142:198–200.

Song, Y., Wang, L., Pittas, A.G., Del Gobbo, L.C., Zhang, C., Manson, J.E., Hu, F.B. Blood 25-Hydroxy Vitamin D Levels and Incident Type 2 Diabetes. Diabetes Care 2013 May; 36(5): 1422-1428. http://dx.doi.org/10.2337/dc12-0962


What's wrong with standard osteoporosis treatment?

6 ways standard osteoporosis treatment is dead wrong: Part 2


I’ve written recently about two of my top six concerns about the standard approach to bone health.  And now, here are two more that emphasize how women are often being misled about how to best protect their bones:

3. Contemporary osteoporosis management treats bone as if it were separate and isolated from the rest of the body

It’s tempting to look at the body the way we look at cars — as a collection of independent parts, each with a specific job. But that’s not what the body is! It’s a set of dynamic, interconnected systems that are constantly changing in response to what goes on around us and inside us.

While most people lose some bone as they age, bones don’t just “wear out” over time, the way a car’s parts do. If bones are weak or rapidly become thin, it’s nearly always because of a larger systemic problem in the body. The most effective approach in this situation is a big-picture perspective that looks at bone health as an indicator of overall health — it’s been shown that older adults who experience a hip fracture have lower baseline health-related quality of life than those who don’t.

But the standard approach is to focus on the mechanics of bone breakdown and interfere with them. Most bone drugs work by targeting the cells that break bone down and stopping them from doing their job. Doing this doesn’t actually solve the problem — it just masks the effects.

Enduring bone health requires rebuilding strength and vitality. That’s why it makes sense to look at the complete body system — circulation, bone, acid-base balance — to find the places where something isn’t working right to cause bone loss, rather than focus in on halting bone loss itself, which is most often an effect of a larger problem.

4. High-dose calcium is still considered the first-line treatment, yet it does not prevent fracture, and may be harmful

Speaking of “larger problems,” let’s take a look at what happens when you try to address fracture risk with calcium supplements. There is tremendous controversy about calcium and bones, but now it’s becoming clear that high-dose calcium supplementation is not the solution.

Multiple studies show that calcium does not decrease fracture risk except in those with a very low calcium intake — and some studies suggest that taking high-dose calcium supplements can lead to an increase in arterial calcification, stroke, kidney stones.  In my own research, it’s quite clear that while adequate calcium is needed for healthy bones, using high doses is counterproductive.

It seems wise to obtain the total 1,200 milligrams of calcium daily from diet and supplements as recommended by the National Institute of Health. At the same time, we recommend you also learn about the other key bone nutrients and make sure you obtain adequate doses of all these essential bone builders.

Stay tuned for next week’s blog for my final two reasons the standard approach to bone health doesn’t make sense. And as you’ll see, are far less effective and far more risky than commonly thought!

See Part 1 here.



Randall, AG et al., Deterioration in quality of life following hip fracture; a prospective study osteoporosis international 2000, 11(5);460-6.

Bischoff-Ferrari HA, et al., Calcium intake and hip fracture risk in men and women: a meta-analysis of prospective cohort studies and randomized controlled trials. Am J Clin Nutr. 2007

Bolland MJ, Leung W, Tai V, Bastin S, Gamble GD, Grey A, Reid IR. Calcium intake and risk of fracture: systematic review. BMJ. 2015;351:h4580. doi: 10.1136/bmj.h4580.
Bolland MJ, Grey A, Reid IR. Calcium supplements and cardiovascular risk: 5 years on. Ther Adv Drug Saf. 2013 Oct;4(5):199-210. doi: 10.1177/2042098613499790

* Information presented here is not intended to cure, diagnose, prevent or treat any health concerns or condition, nor is it to serve as a substitute professional medical care.

6 ways standard osteoporosis treatment is dead wrong: Part 3

In my previous two blogs, I’ve given you 4 important reasons why I don’t believe standard osteoporosis treatment is effective. In this final blog of the series, I want to emphasize that there is no magic bullet for optimal bone health – despite what you may have heard about calcium or bone drugs.  Here’s why:

5.    The calcium-centered focus has distracted us from the fact that at least 20 nutrients are essential for bone health

I’ve pointed out that calcium doesn’t reduce fracture risk and excessive calcium intake holds increased risk of cardiac problems. But if calcium isn’t the “magic bullet” for bones, what is? Well for one thing, adequate vitamin D levels are essential, and  a lot of doctors are finally realizing how important vitamin D is for bone health.

Yet too little attention is still paid to other essential bone nutrients — especially vitamin K, which makes a major contribution to bone health and supports many other systems as well, but also zinc, magnesium copper, boron, folate, manganese and vitamin C.

6.    Bone drugs are far less effective and far more risky than commonly thought

Here’s where it really becomes frustrating. Our health system pushes high-dose calcium (which doesn’t work) as the solution to low bone density (which is not necessarily the problem). Then when there’s no improvement in bone density from overloading the body with calcium, the typical next step is to prescribe a bone drug.

I’ve always maintained that such medications should be used only as a last resort, for very severe cases where drastic measures are needed — for instance, a person experiencing low-impact fractures or excessive, uncontrollable bone loss. This is not the situation for most people who have relatively low bone density .

With that in mind, it shouldn’t be surprising that the results of bone drug therapy are often  very disappointing. Even worse, the evidence suggests no benefit from bisphosphonate bone drugs on real-world hip fracture incidence. Nor do these drugs benefit people 80 years old and older — which is, of course, the group most likely to fracture a hip!

What it all boils down to is this: If we’re to really help people to live long, healthy lives free from the fear of bone fractures, we don’t need more bone drugs.  Instead, we need to change our approach by:

  • Carefully assessing each individual case to identify whether excessive bone loss or weakness exists;
  • Detecting and correcting both obvious and hidden causes of excessive bone weakening;
  • Broad-spectrum, whole-body support with nutrition, exercise, neuroendocrine and hormonal balance, stress reduction, and resilience enhancement.

Such an approach would limit bone drugs to the few specific situations where obvious bone weakness cannot be offset by natural means and requires heavy-duty intervention.

Missed the previous blogs?  Read more.

Part 1

Part 2

* Information presented here is not intended to cure, diagnose, prevent or treat any health concerns or condition, nor is it to serve as a substitute professional medical care.

6 ways standard osteoporosis treatment is dead wrong: Part 1


It’s no secret that I’m not a fan of the way bone drugs like Prolia® and Fosamax® are used these days. But people sometimes misinterpret my thinking as being “anti-drug” — yet it’s not just the drugs I object to. It’s how medicine in general approaches bone health and fracture risk.

I have at least 6 major objections to the standard approach, but for the sake of brevity, we’ll look at them two at a time over the next three weeks.

1.    Treatment is based on bone mineral density — but bone mineral density does not predict fracture

Having a low-side bone density isn’t actually a health problem. It doesn’t hurt or limit mobility — it doesn’t even necessarily mean the bones aren’t strong! It’s only when you fracture a bone that you have a health problem — and more, you cannot predict fracture by bone density alone. In fact, the majority of people whose bones are so fragile they experience a low-trauma fracture do not have an “osteoporotic” bone density.

That’s why treating low bone density bones as a “disorder” that “needs to be addressed” with heavy-duty medications makes no sense. Weak bones, on the other hand, need intervention. And, as far as weak bones go, there’s almost always an underlying problem causing the depletion of bone strength — whether it be nutritional, hormonal, bone-damaging medications, or some other hidden health condition or lifestyle factor. Properly detected and corrected these underlying causes can greatly reduce the risk of fracture. This is why a real fracture risk assessment and an assessment of underlying causes are so critical to developing a comprehensive bone-building program.

2.    The standard medical approach to osteoporosis is fear-based — and fear actually damages bone

Given that a low-side bone density does not necessarily indicate weak bones, why do you suppose doctors are so adamant that people with a low-side bone density need treatment? They’re afraid their patient will have a serious fracture.

But fear of fractures is itself bone damaging and can be a self-fulfilling prophecy — literally, as studies have linked higher levels of stress and the stress hormone cortisol with osteoporosis and increased fracture risk. A recent Danish study, for example, showed that just the perception of stress — seeing yourself as stressed — increases risk of osteoporotic fracture by 68%. It is bad enough that we have so many reasons to fall into stress and worry, we really do not need our health professional piling on more stress with unfounded fears of fracture. Again, what’s needed is a fracture risk assessment leading to a comprehensive bone building program — one that includes stress reduction and hope.

It’s interesting to note that Traditional Chinese Medicine holds that bone health is determined by the “kidney energy” and that fear is the emotion that disrupts the kidney energetic system. (And even Western medicine links osteoporosis with renal disease because the kidneys play such a central role in vitamin D metabolism, mineral reabsorption, and acid-base balance. (As I have discussed before, when kidneys can’t adequately buffer metabolic acids, calcium from bones is called upon to rescue essential pH homeostasis.) The ancient Chinese wisdom tradition suggests that the kidneys control bone and fear damages the kidneys — and I have found this to be true. All in all, we need less fear and more hope and bone-building solutions.

This isn’t all of course. Look for my post next week giving two more problems with the standard approach to bone health!



Adeva, M. M., and G. Souto. 2011. Diet-induced metabolic acidosis. Clinical Nutrition 30(4):416–421.

Azuma, K., Y. Adachi, H. Hayashi, and K. Y. Kubo. 2015. Chronic psychological stress as a risk factor of osteoporosis. Journal of UOEH 37(4):245–253.

Häussler, B., H. Gothe, D. Göl, G. Glaeske, L. Pientka, and D. Felsenberg. 2007. Epidemiology, treatment and costs of osteoporosis in Germany: The BoneEVA Study. Osteoporosis International 18(1):77–84.

Lu, Nan. 2010. Traditional Chinese medicine: A woman’s guide to a hormone-free menopause. TCMWF Publishing, New York.

Seeman, E., J. P. Devogelaer, R. Lorenc, T. Spector, K. Brixen, A. Balogh, G. Stucki, and J. Y. Reginster. 2008. Strontium ranelate reduces the risk of vertebral fractures in patients with osteopenia. Journal of Bone and Mineral Research 23(3):433–438.

Stone, K. L., D. G. Seeley, L. Y. Lui, J. A. Cauley, K. Ensrud, W. S. Browner, M. C. Nevitt, S. R. Cummings, and Osteoporosis Fractures Research Group. 2003. BMD at multiple sites and risk of fracture of multiple types: Long-term results from the Study of Osteoporotic Fractures. Journal of Bone and Mineral Research 18(11):1947–1954.

Fosamax® is a registered trademark of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.

Prolia® is a registered trademark of Amgen Inc.

Men and osteoporosis risk

Did you know that 25% of men over the age of 50 will experience an osteoporotic fracture?

Or that nearly 30% of all hip fractures occur in men? What’s more, their long-term outcome for hip fracture as a whole is worse than that of women.

Because osteoporosis is often described as a woman’s concern, many men may not realize they’re at risk for harmful bone loss too. As part of National Osteoporosis Awareness & Prevention Month, it’s time to share the news with your male family and friends so that they can take action too.

Risk factors for osteoporosis and fragility fractures in men

The vast majority of factors that weaken bone in women are also risk factors for men:

  • Inadequate vitamin D
  • Low nutrient intake
  • Being underweight
  • Physical inactivity and low muscle mass
  • Deficiency of sex hormones which results in accelerated bone loss in men just as in women. For men this is mostly an issue of testosterone, but men also have some estrogen and this “female” hormone helps protect their skeleton.
  • The use of various bone-depleting medications including steroids (glucocorticoids), anti-depressants, proton pump inhibitors and anticonvulsants. Steroid medications directly cause osteoporosis when used over time, even in 5 mg doses
  • Various medical conditions such as hyperparathyroidism or thyroid disease, rheumatoid arthritis, multiple myeloma, etc.
  • Lifestyle factors particularly smoking and excessive alcohol intake. Consumption of 10 or more alcoholic drinks per week is associated with a moderately increased risk of fracture.
  • Having a previous fracture. Older men with a prevalent vertebral fracture have three times increased risk of sustaining new fractures compared to men without vertebral fracture. (Karlsson et al. 2016)
  • A family history of hip fractures. A Swedish study found that men who had grandfathers who had suffered a hip fracture had both lower bone density and smaller bones than those who did not have a male relative who had fractured. (Rudäng et al. 2010)

A natural approach to bone health works best for men too

Very few studies have tested the common bone drugs in men. A 2015 reports an overall lack of evidence concerning the effectiveness of bisphosphonates for reducing hip and other non-vertebral fractures in osteoporotic men.

I suggest for men and women that bone drugs be used as a “last resort” only when all hidden medical causes of bone loss have been explored and all known lifestyle and nutrient interventions have been tried and proven unsuccessful. You can read more about my natural approach to bone-building here.



Karlsson, M. K., M. Kherad, R. Hasserius, J. A. Nilsson, I. Redlund-Johnell, C. Ohlsson, M. Lorentzon, D. Mellström, and B. E. Rosengren. 2016. Characteristics of prevalent vertebral fractures predict new fractures in elderly men. Journal of Bone & Joint Surgery Am. 98(5):379–385.

Rudäng, R., C. Ohlsson, A. Odén, H. Johansson, D. Mellström, and M. Lorentzon. 2010. Hip fracture prevalence in grandfathers is associated with reduced cortical cross-sectional bone area in their young adult grandsons. Journal of Clinical Endocrinology and Metabolism 95(3):1105–1114.

Willson, T., S. D. Nelson, J. Newbold, R. E. Nelson, and J. LaFleur. 2015. The clinical epidemiology of male osteoporosis: A review of the recent literature. Clinical Epidemiology 7:65–76.


Is losing height normal?

1 minute with Dr. Brown: Is losing height normal?

Got a minute? Every week I receive dozens of questions from women like you with concerns about their bone health. In my new series, “1 Minute with Dr. Brown,” I will try to answer your most pressing questions. If you have a question, send it in to us at center@betterbones.com

Question: I shrunk an inch at age 50. Is this normal?

Does osteoporosis run in the family?

1 minute with Dr. Brown: Will I get osteoporosis too?

Got a minute? Every week I receive dozens of questions from women like you with concerns about their bone health. In my new series, “1 Minute with Dr. Brown,” I will try to answer your most pressing questions. If you have a question, send it in to us at center@betterbones.com

Question: My mother had osteoporosis. Will I get osteoporosis too?