Your bones do more than just provide your body structural support and help you move, walk and run. They store important minerals such as calcium, phosphorus and magnesium; they protect your vital organs (brain, heart, lungs) from injury and produce white and red blood cells, integral for immunity and transporting oxygen to the tissues.
Bones are made of living tissue and continue to grow throughout your lifespan. They are being constantly broken down and regenerated with the help of specialized cells called osteoblasts and osteoclasts. Up to about 30 years of age, if you are getting the right nutrition and exercise, your body makes more bone mass than it loses.
The best time to acquire peak bone mass (maximum density and strength your bones can achieve) is childhood and adolescence. After you turn 30, the rate at which bones are built becomes slower than the rate at which they are broken down. In other words, after 30 years of age, you are losing more bone mass than you are making. This can lead to osteoporosis – thinning or weakening of bones that make you prone to fractures and injuries. Many factors contribute to this bone loss as you age – insufficient intake of nutrients, genetics, not getting enough exercise and reducing levels of hormones. For example, for woman the levels of estrogen begin to decline after menopause, making menopausal women more prone to developing osteoporosis.
Building healthy bones throughout your life is a key to slowing down the bone loss and prevent osteoporosis. This can be achieved by lifestyle changes. And getting a healthy dose of certain vitamins and minerals is one important part of this strategy.
So, what’s best for your bones? While calcium comes foremost to mind, you need other nutrients to help calcium do its job and to maintain a healthy skeletal system through many other mechanisms.
This one needs no introduction. Calcium is a building block of your bones and is the most abundant mineral in the body. More than 99% of total calcium present in the body is stored in the bones and teeth.
In addition to building bones and keeping them healthy, you also need calcium for other critical functions including:
- Maintaining healthy heartbeat
- Blood clotting
- Muscle contraction
- Transmission of nerve impulses
- Secretion of hormones
Regular and sufficient calcium intake through your diet or supplementation will ensure your body has all it needs so that it does not steal from the bones. Dairy products such as milk and cheese are an excellent source of calcium, but they don’t necessarily work for everybody, especially people who are lactose intolerant. Other natural sources of calcium include leafy greens (kale, collards, spinach, turnip greens, mustard greens), broccoli, beans, almonds, sesame seeds, okra, dried figs, oranges and bok choy. Some types of fish like salmon, sardines and tuna also provide calcium in the diet. You can also take calcium supplements if you believe you are not getting adequate calcium from your diet.
However, calcium intake in isolation is not enough to maintain bone health. Your body must also be able to absorb the mineral and use it effectively. As we are going to see, calcium alone can’t make your bones strong and healthy. It needs additional help. Some of the major players that help calcium do its job and support bone health in a number of ways are vitamin D, vitamin K2, and magnesium. In fact, too much of calcium without enough of these minerals can do more harm than good.
While you certainly need calcium for a lot of things, including bone mineralization, its levels in the blood need to be tightly regulated. You don’t want too much calcium in your blood circulation, otherwise it can get into in places where it can cause trouble, such as blood vessels, muscles, intestines and kidneys. Excessive calcium build-up in these places can cause constipation, kidney stones, arrhythmia and muscle spasms. It can also lead to the formation of plaque in the arteries, a process that increases your risk of blood clots, angina, heart attacks and strokes. This is where magnesium and vitamin K2 help.
2. Vitamin D
Vitamin D is one of the most popular supplements people take for their bone health. You need vitamin D to help you absorb calcium that you get from foods or supplements. This is how it works.
When calcium levels in the blood take a dip, PTH (parathyroid hormone) serves another purpose besides pulling calcium from the bones to compensate for the loss. PTH also tell kidneys to make more vitamin D, which is needed to absorb calcium from the intestines.
According to the International Osteoporosis Foundation, taking 800 to 1000 IU/day can reduce the risk of falls and fractures by about 20 % in people above 60 years or more. 
Researchers are getting more insights into how vitamin D can influence many aspects of your health.
For example, having healthy vitamin D status:
- Helps regulate immunity (boosts the innate immunity and helps fight infections; regulate adaptive immunity and reduce the risk of autoimmune conditions)
- Lowers inflammation
- Reduces the risk of heart disease
- Reduces symptoms associated with depression
- Maintains healthy pregnancy and reduces risk of asthma, respiratory tract infections and wheezing disorders in early childhood.
Certain factors put you at an increased risk of becoming vitamin D deficient – such as age, dark skin, spending too much time indoors, obesity, regular use of sunscreen, celiac disease and inflammatory bowel disease. As we are just going to find out, magnesium deficiency is another important factor that contributes to vitamin D deficiency. Unfortunately, not many are aware that you need magnesium to allow the body to properly utilise vitamin D.
When you think about the best supplements for bone health, chances are your list stops with calcium and vitamin D. While this duo is clearly important to achieve strong bones, magnesium is no less important in this regard. How does it work?
- Magnesium helps to absorb and utilize calcium.
- Enzymes in the liver need magnesium as a co-factor to convert vitamin D into calcitriol, the active form of vitamin D that your body can use.
- Magnesium works along with PTH (parathyroid hormone) and vitamin D to regulate calcium levels.
- When calcium levels in the blood rise, magnesium stimulates the production of calcitonin from the thyroid glands. Calcitonin removes calcium from the blood and soft tissues; and puts it back into the bones. This improves bone density and prevents osteoporosis.
- Magnesium maintains healthy muscle and nerve functions. Low magnesium levels can cause muscle weakness, increasing the risk of falls and fractures.
A 2017 study published in the European Journal of Epidemiology found that high levels of magnesium lowers fracture risk by almost 44% in middle-aged Caucasian men , and 2013 study highlights how magnesium deficiency “contributes to osteoporosis directly by acting on crystal formation and on bone cells and indirectly by impacting on the secretion and the activity of parathyroid hormone and by promoting low grade inflammation…. Overall, controlling and maintaining magnesium homeostasis represents a helpful intervention to maintain bone integrity.” 
Are you taking high doses of vitamin D but still experiencing bone pain, muscle aches and other symptoms typically associated with vitamin D deficiency? Given the crucial role of magnesium in the metabolism of vitamin D, this kind of response is hardly surprising. Being low on magnesium means your body is not able to effectively use vitamin D.
In addition, taking high doses of vitamin D will create an additional need for magnesium. After all, you need this mineral to convert vitamin D into its active, usable form. In addition, enzymes required to use and absorb vitamin D also need magnesium as their co-factor. So, if you are taking mega doses of vitamin D, it means your body will extract magnesium from bones, teeth and muscles, where it is primarily stored, and cause even more magnesium deficiency in the body. This results in symptoms such as muscle weakness, joint pains and aches, muscle cramps, irregular heartbeat, chronic fatigue, constipation and migraines.
Besides supporting bone health, you need magnesium for a number of other functions:
- DNA synthesis and repair
- ATP production
- Metabolism of fats, proteins and carbohydrates
- Regulation of stress hormones
- Balanced neurotransmitters that are involved in anxiety, mood disorders and stress.
- Synthesis of glutathione, one of the most important antioxidants that your body produces on its own
- Maintaining mineral balance
Low mineral content in the soil, chronic stress and poor diet that is typically lacking in whole foods are primary reasons why you may be deficient in this important mineral. Chronic stress, which can come from emotional distress, financial worries, being ill for a long time or dealing with a chronic infection, can deplete your magnesium levels in two ways. Firstly, stress leaches more magnesium form the body and we tend to excrete more magnesium in urine during stressful situations. Secondly, you use more magnesium to deal with a flux of stress hormones and their side effects.
In addition, old age, inflammatory bowel disease, poor kidney function, diabetes and certain medication may also cause poor levels of magnesium in the blood. In that case, taking magnesium supplements is usually the best way to improve your levels. Using magnesium oil spray applied on the skin is very effective in replenishing your magnesium levels. Regular oral supplements may cause stomach upset, nausea, vomiting and diarrhoea in some people, although Liposomal supplementation will reduce the risk of stomach upset and is extremely effective. But the transdermal route certainly helps you avoid, almost totally, these common side effects.
4. Vitamin K2
Your body needs vitamin K2 for a lot of functions, one of them being the proper utilization and regulation of calcium in the body. Vitamin K2 makes sure that the calcium available to the body goes to tissues that need it, such as bones and teeth. It also prevents calcium to reach places where it can cause health issues. How does it work?
Vitamin K2 activates proteins that are responsible for optimizing calcium use in the body. It activates osteocalcin, a protein secreted by osteoblasts – the bone-forming cells. What does osteocalcin do? It takes calcium from the blood and binds it to the bone matrix, leading to increased bone density. This makes the bone stronger and less prone to fractures. Osteocalcin won’t become fully activated without vitamin K2.
Matrix Gla-protein (MGP) is another protein that needs vitamin K2 to become functional. As one of the most potent calcium inhibitors, MGP binds to calcium and removes it from the arteries, thus preventing its accumulation.
A 2015 meta-analysis of 19 randomized controlled trials concluded that vitamin K2 plays a role in maintaining and improving bone mass density; and reduces the risk of fractures in postmenopausal women with osteoporosis.  Other research found that vitamin k2 supplements may help postmenopausal women to prevent bone loss. It suggested that supplementation with Mk-7, which is essentially vitamin K2, decreased the decline in bone mineral density and bone strength that accompanies old age. 
You get healthy amounts of vitamin K2 from fermented foods such as natto, cheese and sauerkraut. Meat, eggs and dairy products also provide some vitamin K2, but this is usually insufficient to fulfil the body’s requirement for K2. Even an otherwise healthy diet won’t contain enough K2 if you are not consuming fermented foods like natto on a regular basis. You can avoid vitamin K2 deficiency by taking high quality vitamin K2 supplements. Factors such as liver disease, celiac disease, Crohn’s disease, use of statin drugs, consuming low-fat diet and long-term use of antibiotics makes you deficient in vitamin K2.
Don’t overlook the importance of getting regular exercise
The key to preventing osteoporosis is to make strong bones during childhood and early adulthood years. As previously mentioned, this is the time when you can achieve peak bone mass. Adequate nutrition and maintaining your mineral intake is extremely important but so is getting regular exercise, especially weight-bearing such as walking, running, or climbing stairs. In addition, swimming and cycling can help strengthen muscles, which also improve your bone health.
If you are taking calcium and vitamin D for improved bone health, don’t forget your magnesium and vitamin k2. These nutrients work together to improve your bone density and reduce your risk of osteoporosis later in life.
- Vitamin D. International Osteoporosis Foundation
- Kunutsor et al. Low serum magnesium levels are associated with increased risk of fractures: a long-term prospective cohort study. European Journal of Epidemiology. 2017
- Castiglioni te al. Magnesium and Osteoporosis: Current State of Knowledge and Future Research Directions. Nutrients. 2013
- Katarzyna Maresz. Proper Calcium Use: Vitamin K2 as a Promoter of Bone and Cardiovascular Health. Integr Med (Encinitas). 2015
- Huang et al. Does vitamin K2 play a role in the prevention and treatment of osteoporosis for postmenopausal women: a meta-analysis of randomized controlled trials. Osteoporos Int. 2015