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Bone Support Dietary Supplements
Many companies produce dietary supplements for bone health. Many people buy calcium and other bone health supplements thinking that they might promote bone growth or reduce osteoporosis risk. By definition, dietary supplements are not approved by the FDA to diagnose, treat or prevent a disease; however, manufacturers of some dietary supplements can make certain claims, as approved by the FDA. For example, labels for calcium supplements can state that calcium “reduces osteoporosis risk.”1Other ingredients you might find are boron, strontium, magnesium, soy isoflavones, vitamin K2 (as MK4™ or MK7), horsetail (Equisetum arvense) and omega-3 fatty acids. So what’s the evidence for their effectiveness in promoting bone health?
Calcium and Vitamin D
Calcium and vitamin D may reduce osteoporosis risk according to the FDA. . In terms of reducing fractures, calcium may decrease fractures by about 16%.2Vitamin K2 (MK4 and MK7)
MK4 and MK7 are two types of vitamin K2 that are commercially available in dietary supplements. However, MK7 has never been shown to reduce fractures. In contrast MK4 has been shown to decrease fractures, and has even been approved by the Ministry of Health in Japan since 1995.3 Multiple clinical trials using 45 mg per day of MK4 show that this amount, and only this amount, of MK4 taken daily may decrease fracturesby 80% or more.4,5,6 Even at extremely high doses in humans of 135 mg/day of MK4, and 250 mg/kg body weight per day in rats showed that MK4 does not increase the risk for blood clots.7,8 MK4 is understood to be safe at all amounts, and effective at promoting bone health and building strong bones when 45 mg/day are taken with calcium and vitamin D.Boron
Boron, a trace mineral needed in only tiny amounts, was first discovered in 1910 as being required for plant development and health. In 1985 researchers discovered that humans also require boron. Some foods are good sources of boron, including pears, prunes, apples, raisins, and tomatoes. Studies have shown that 3 milligrams (mg) of boron daily reduces urinary excretion of calcium and magnesium, especially when dietary magnesium is low. Boron supplementation elevates the serum concentrations of 17 beta estradiol and testosterone, again only when dietary magnesium is low. This suggests that boron may promote bone health. However, there is no evidence that boron in bone health supplements improves bone mineral density, decreases bone loss or decreases fractures.Strontium
Several rigorous clinical trials have evaluated strontium for its bone building effects. Strontium ranelate (SR) is a form of strontium salt from ranelic acid patented by a French company. SR is the only form of strontium that has ever been studied in clinical trials, and is not available in the US. Strontium citrate is the form of strontium available in osteoporosis supplements in the US and has never been studied in clinical trials for its bone building effects.SR is approved for osteoporosis treatment in most of Europe but not in the US. Studies in rats concluded that SR does have an affinity for bone, decreases bone loss and can build bones.9 A laboratory study determined that SR can promote osteoblast production.10 Clinical trials in have shown that taking 500-2000 mg per day of SR can decrease vertebral fractures by 23% to 49%, as well as increase bone mineral density.11,12
People may want to think twice before taking strontium for several reasons. First, strontium is not approved by the US FDA. Second, strontium is heavier than calcium. As such X-rays from a bone density scan bounce off the strontium to a greater degree than calcium, and change what’s called the “refractive index.”13 Unless the radiologist understands this and uses a mathematical calculation to correct for this, the bone density scan will be inaccurate.14 Since radiologists are not taught this in medical school or residency, even if you tell them that you are taking strontium most probably the radiologist will have no idea how to correct for it and provide an accurate result.
