Common Prescription Drugs That Cause Bone Loss

Updated: April 28, 2023

Drugs That Cause Osteo

Did you know that many commonly prescribed drugs cause bone loss?

Since writing the 2nd edition of Your Bones, I’ve learned a great deal more about the surprising number of prescription – and over-the-counter drugs – that promote bone loss.

Watch the video below to discover what motivated me to dive deeply into the research to determine 12 known drug classes that promote bone loss and what you can do to combat their bone-destructive effects.

12 Known Drug Classes That Cause Bone Loss

For each of the classes of drugs that cause bone loss, I’ve summarized the key information you need into the following three sections:

  • Used to: The conditions the drugs are prescribed to manage.
  • How and why the drug(s) cause bone loss: Description of how the drug negatively impacts bone building.
  • Drug Information: Additional information pertaining to the respective drug class including but not limited to studies conducted.

Where possible, I’ve suggested alternate drugs with less harmful effects on bone, which you can discuss with your doctor. If you must continue to take one of the many drugs that cause bone loss, the final section of this article focuses on what you can do to combat their adverse effects on your bones and lessen your risk of developing osteoporosis.

I have included the relevant research and studies in case you want to read them for yourself (links provided within the text and at the bottom of the article). And remember that this article should not be taken as medical advice. Always consult your doctor (you can share these studies with them too).

Please note, as I know some of you may ask, we are not able to mention specific drug brands – so trade names are not included. You can enter the class of drugs on Wikipedia for a listing of commonly prescribed examples.

For easy navigation, click on any of the subcategories to jump to that specific section.

  1. Anticonvulsants
  2. Benzodiazepines
  3. Antidepressants
  4. Insulin-Sensitizing Medications
  5. Opioid Pain Medications
  6. Glucocorticoid Medications
  7. Calcineurin Inhibitors
  8. Antacids, H-2 Blockers, Proton Pump Inhibitors
  9. Loop Diuretics
  10. Anti-Coagulants
  11. Thyroid Hormone Medications
  12. Contraceptives

Doctor in a consultation for drugs that cause osteoporosis


Used to: Manage epilepsy, bipolar disorder, and neuropathic pain (e.g., pain resulting from diabetic neuropathy, spinal cord injury, multiple sclerosis, strokes, cancer chemotherapy)

How and why the drug(s) cause bone loss: These drugs interfere with our ability to absorb vitamin D and to metabolize it into the form that helps us absorb calcium.

Drug Information: Anticonvulsants can cause a deficiency of folate and/or vitamin B6, both of which are required to minimize homocysteine levels; a highly destructive inflammatory compound. High homocysteine levels boost inflammation throughout the body, and excess inflammation triggers the production and activity of osteoclasts, the specialized cells that break down bone.

Lastly, anticonvulsants reduce blood levels of vitamin K, which in its K1 form lowers inflammation, and in its K2 form, activates proteins that pull calcium into bone (osteocalcin), and keep calcium out of soft tissues (matrix Gla protein), like our blood vessels.

Ask your doctor about checking your vitamin D levels – both 25(OH)D, the form in which vitamin D is present in the bloodstream, and 1,25-D, the active hormonal form of vitamin D, which helps us absorb calcium.

If you are taking AlgaeCal Plus, you will get 1,600 IU of vitamin D3 daily, but you may require more. Also discuss supplementing with folate, B6, and vitamins K1 and K2. If you are taking AlgaeCal Plus, you will get 100 micrograms of vitamin K2 in its most effective (MK-7) form, but you may require more. The lab test used to determine whether your K2 needs are being met is a blood draw that checks levels of uncarboxylated osteocalcin (the protein directing calcium where it needs to go in your bones).


Used to: Manage epilepsy, anxiety, insomnia, depression, schizophrenia, restless leg syndrome.

How and why the drug(s) cause bone loss: These drugs bind to and block off dopamine receptors in a part of the brain called the hypothalamus. By this action, the benzodiazepines prevent dopamine, an important neurotransmitter, from being secreted. Shutting down dopamine secretion causes levels of another hormone called prolactin to rise because dopamine is what turns off the pituitary gland’s secretion of prolactin.

Drug Information: High prolactin levels (a condition referred to in the medical literature as “hyperprolactinemia”) suppress the activity of the hypothalamic-pituitary-gonadal axis. This is a triad of endocrine glands that interacts and secretes a number of hormones involved in reproduction. The hypothalamus produces gonadotropin-releasing hormone (GnRH). The anterior portion of the pituitary gland produces luteinizing hormone (LH) and follicle-stimulating hormone (FSH), and the gonads (ovaries in women, testes in men) produce estrogen and testosterone, respectively. (More precisely, the pituitary’s secretion of FSH and LH are what signal the gonads to produce estrogen, progesterone, and testosterone.)

Since estrogen and progesterone play very important roles in maintaining healthy bones in women, inhibiting their production by inhibiting FSH and LH causes bone loss.  Estrogen prevents excessive activation of osteoclasts (the specialized cells that break down old bone), while progesterone activates osteoblasts (the specialized cells involved in building new bone), plus both hormones exert a number of other bone-protective effects. This is why the drop off in the production of estrogen and progesterone that occurs with menopause contributes to bone loss.

Even in men, estrogen is essential for bone health. Men convert a small, but very necessary, amount of testosterone into an estrogen that plays a critical role in maintaining men’s bones. That’s why drugs that disrupt testosterone production, such as the aromatase inhibitors used in the treatment of prostate cancer, cause bone loss in men.3-5

When I first wrote about this, I noted a 2008 study conducted in Spain that assessed risk factors for osteoporosis and fractures in 4,960 postmenopausal women aged 50 to 65 years. The results? The two top risk factors identified for low bone density were low intake of calcium and benzodiazepine use.6

Since then a number of other papers have reported on benzodiazepines not only causing bone loss but also increasing risk of falling – a double whammy of adverse effects that greatly increases risk for fracture.7-11

Particularly if you are a postmenopausal woman or a man over age 50, and you must continue to take a benzodiazepine, discuss bio-identical hormone replacement (BHRT) with your doctor. Even if you are a premenopausal woman or a younger man, it would still be a good idea to request tests to evaluate your prolactin levels and bone mineral density (BMD). Even better, ask to have all your hormone levels checked, and if they are severely compromised, consider BHRT.

Smiling woman looking up against trees at park during autumn

Antidepressants: SSRIs, MAIOs, Atypical Antipsychotics

Used to: SSRIs (selective serotonin reuptake inhibitors) and MAIOs (monoamine oxidase inhibitors) are used to manage depression, anxiety disorders, some personality disorders (e.g., obsessive-compulsive disorder, eating disorders) and premature ejaculation. MAOIs are also used to treat Parkinson’s disease. Atypical antipsychotics are used to treat schizophrenia, bipolar disorder, and autism. TCAs (Tricyclic antidepressants), used to manage depression, are still in use, although they have largely been replaced by SSRIs.

TCAs are less frequently prescribed now, but are still in use and have the same adverse effects as SSRIs, and possibly even worse effects on bone (see the discussion of the Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE) below).

How and why the drug(s) cause bone loss: All these drugs inhibit dopamine production and neurotransmission, causing chronic elevation of the hormone prolactin, which disrupts HPA axis activity and the production of sex hormones, as explained above under Benzodiazepines.12-14

Drug Information: When first writing about the adverse effects on bone of antidepressant drugs I noted a study published 2011. This study involved over 27,000 postmenopausal women in Canada, which found selective serotonin reuptake inhibitors (SSRIs) increased risk for osteoporosis by 46%, atypical antipsychotics (tranquilizers, also called 2nd generation antipsychotics, increased risk by 55%, and benzodiazepines increased risk by 17%.15

Another very large study conducted in Spain—this one included more than 63,000 subjects—found SSRIs increased risk of osteoporotic fractures by 45%. MAOI antidepressants increased risk for osteoporosis by 15%, and benzodiazepines increased risk by 10%. A dose-effect relationship was seen with SSRIs and benzodiazepines – the longer any of these drugs were used, the greater the increase in risk for osteoporosis. In contrast, lithium, which is prescribed to manage bipolar disorder, was associated with a 37% lower risk for fracture.16

A study conducted looking into the effects of antidepressants on bone was published in the August 2016 issue of the journal Bone.  A total of 1,988 women (aged 57-67) participating in the Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE) cohort were followed for 5 years. During this time, bone loss was found to be significantly accelerated in the 319 women who took antidepressants. Those using TCAs (tricyclic antidepressants) lost more than three times as much bone as women not taking antidepressants (-3.6mg/cm(2) vs. -1.1mg/cm). SSRIs also increased the rate of bone loss, and the higher the dose, the greater the amount of bone lost.17

This study followed up on an earlier 5-year study, published in 2007, that reported a 0.82% average yearly loss in hip bone BMD in postmenopausal SSRI users compared to a 0.47% loss in non-users.18 In the present study, the 5-year difference between SSRI users and non-users was smaller: postmenopausal SSRI users’ yearly hip bone loss was -0.22% compared to a loss of -0.08% in postmenopausal women not using these drugs.

But this new study raises concerns about TCAs. When I wrote about these drugs two years ago, the research had suggested TCA use did not increase bone loss. In one study, tricyclic antidepressants were associated with 43% lower risk for osteoporosis.19

Unfortunately, this newer study found that TCAs are not a better option and may be an even more damaging to our bones than SSRIs. The postmenopausal women taking tricyclic antidepressants in this study lost even more bone than women taking SSRIs. TCA users’ annual rate of bone loss was −0.35% compared to just −0.08% in women not taking antidepressants.

SSRIs are very commonly prescribed antidepressants. These drugs are supposed to increase brain levels of the neurotransmitter serotonin, by preventing its reuptake by the neurons that secrete it. However, SSRIs also inhibit dopamine production and neurotransmission which, as explained above under Benzodiazepines, causes high prolactin levels, endocrine dysfunction and bone loss.20

The research continues to report very high rates of osteopenia and osteoporosis in people taking any of the long-term psychoactive drugs (e.g., anticonvulsants, benzodiazepines, antidepressants), and the higher the dose and longer the drugs were taken, the greater the bone loss.

Young Caucasian women have been found to be especially vulnerable to developing high prolactin levels (hyperprolactinemia), with the resulting inhibition of estrogen and progesterone production, and bone loss. Younger women taking any of these drugs and experiencing menstrual problems (an indication that the drug is disrupting normal function of the hypothalamic-pituitary-gonadal axis) should immediately alert their doctors and request tests to evaluate their prolactin levels and BMD.

If you must take a psychoactive medication, please discuss which drug might be least harmful with your doctor. Some of these drugs have a lesser antagonizing effect on dopamine receptors in the brain. Others are potent dopamine receptor antagonists, and it is by antagonizing dopamine receptors that antipsychotic drugs cause hyperprolactinemia—and thus osteoporosis.

Conventional psychoactive drugs all cause hyperprolactinemia, but a few of the so-called “atypical” psychoactive drugs, supposedly, do not. The two following references are for the most recently published studies discussing this in the peer-reviewed medical literature: Share these with your doctor and ask for help finding the psychoactive drug with the lowest prolactin-raising profile: 21-22

Working with an integrative, functional medicine or naturopathic physician who can help you understand and naturally correct the underlying causes of your health issues is your best option. Resources that can help you find these doctors are listed at the end of this article.Group of active senior runners outdoors, resting and hugging in windy cold weather.

Insulin-Sensitizing Medications

Used to:  Manage type 2 diabetes. The class of drugs is called thiazolidinediones (also known as the glitazones)

How and why the drug(s) cause bone loss: These drugs trigger mesenchymal stem cells (the precursor cells that live in your bone marrow and can become either osteoblasts, which build new bone, or adipocytes, which store fat) to become adipocytes (fat cells). By doing so, the thiazolidinedione drugs thin your bones and increase your production of visceral adipose tissue (VAT, belly fat), which is highly pro-inflammatory. VAT is linked to not only abdominal (apple-shaped) obesity, but also to insulin resistance, type 2 diabetes, and other inflammatory diseases, including osteoporosis.

Drug Information: In relation to your bones, chronic low-grade inflammation causes excessive activation of osteoclasts (the specialized cells that remove old or damaged bone), and too much osteoclast activity promotes bone loss. 23

Numerous studies have demonstrated that activation of PPAR-γ in mesenchymal stem cells causes them to become fat cells instead of osteoblasts. In everyday language: your body produces more fat and less bone-building osteoblasts. For those interested in biochemistry: more specifically, the glitazones (rosiglitazone and pioglitazone) cause bone loss because they are selective agonists of peroxisome proliferator-activated receptor-γ (PPAR-γ). (An agonist is a chemical that binds to a receptor and activates it, triggering the production of the biological response it produces.)

Another factor that causes mesenchymal stem cells to be fat cells rather than osteoblasts is a diet rich in arachidonic acid, an omega-6 fatty acid found in large amounts in conventionally raised animal products and farm-raised fish. Ensuring your intake of omega-3 fats is sufficient to counterbalance your consumption of omega-6s can help. Omega-3s help mesenchymal stem cells develop into osteoblasts.  The easiest, safest way to do this is to take Triple Power Omega 3 Fish Oil, a highly powerful supplement that AlgaeCal has developed.

One tablespoon daily will provide you with a hefty dose of omega-3s along with two potent anti-inflammatory agents, curcumin and astaxanthin.  You can also lower your intake of arachidonic acid by choosing organic meats, dairy products and eggs from pastured animals; these foods will have a much healthier ratio of omega-6: omega-3 fats.   

In addition to causing your body to produce fat instead of bone, the thiazolidinediones decrease the expression of insulin-like growth factor-I (IGF-1), a protein our bodies produce that promotes bone formation.

These two actions already secure the thiazolidinediones a top spot on the list of bone-busting drugs, but here’s the kicker: The thiazolidinediones also stimulate osteoclast development and activity. So, these drugs attack your bones from both ends of the spectrum: they suppress bone building and increase bone breakdown.

Long-term treatment with thiazolidinediones increases the risk of fractures by up to 4-fold in postmenopausal women and in men. Risk correlates with the duration of thiazolidinedione treatment and gets really significant within 12 to 18 months.24

The most recent paper, a review discussing all the effects of these drugs, tells us they increase our risk not only for bone fractures, but also for fluid retention, heart failure, and bladder cancer. And they also raise levels of LDL cholesterol. LDL is the form of cholesterol that becomes harmful when damaged by inflammation, which the thiazolidinediones promote by increasing the production of pro-inflammatory belly fat.25

If you have insulin resistance or type 2 diabetes and must take an insulin-sensitizing agent, ask your doctor about using metformin rather than one of the glitazones. Metformin has a positive effect on osteoblast differentiation, and therefore a neutral or even potentially protective effect on bone.26

Many studies have now shown that a whole foods Mediterranean-type diet – a delicious, satisfying 40%-fat diet with flavorful extra virgin olive oil and walnuts, almonds and hazelnuts– and regular exercise can help combat type 2 diabetes, eliminate excess body fat, boost your energy (and your sex life), slow the aging process, and protect the health of your bones.27-34

For help with super quick (15 minutes or less) & easy recipes that will immediately become your favorites, see the non-profit, World’s Healthiest Foods website And look for my recipes posted on the AlgaeCal blog.

Opioid Pain Medications

Used to: Manage chronic pain. Morphine (sold under more than 100 trade names), Codeine, Hydrocodone, Oxycodone, Methadone, Tramadol are all types of opioid pain medications.

How and why the drug(s) cause bone loss:  Opioid drugs disrupt normal regulation of hormone production in the hypothalamic-pituitary axis (HPA). They increase the production of prolactin, which inhibits the production of estrogen and testosterone (see the full explanation above under Benzodiazepines); inhibit production of DHEA, which is the precursor in your body’s hormone production assembly line for testosterone and estrogen; and increase production of thyroid stimulating hormone, which directly suppresses bone remodeling.35

Drug Information: The use of opioids as a long-term treatment for chronic pain has increased so dramatically that opioid-induced deficiency of androgens (the hormones, DHEA and testosterone) has been given its own acronym in the medical literature: OPIAD.36

In addition to destroying your bones, opioid-induced hormone dysregulation may lead to menstrual irregularities and reduced fertility in premenopausal women. In pre- and postmenopausal women and in men, it may also cause sexual dysfunction, fatigue, depression, a loss of muscle strength and mass.37

If you must take an opioid medication for chronic pain, particularly if you are a postmenopausal woman or a man over age 50, discuss bio-identical hormone replacement (BHRT) with your doctor. Even if you are a premenopausal woman or a younger man, it would still be a good idea to request tests to evaluate your prolactin levels and BMD. Even better, ask to have all your hormone levels checked, and if they are severely compromised, consider BHRT.

And you can greatly lessen opioid medication’s damaging effects on your bones by ensuring you get optimal amounts of all the nutrients bones require. AlgaeCal Plus will be a huge help, providing plant-based calcium, vitamins D3 and K2, C boron and other important trace minerals. Also, lowering your overall inflammation by eating a healthy, whole foods Mediterranean-type diet, and taking Triple Power Omega 3 Fish Oil to ensure adequate omega-3s plus the anti-inflammatory protection of curcumin and astaxanthin. Plus, getting as much regular weight-bearing exercise as you can tolerate.

Girl smells sunflower in the sun - vitamin D

Glucocorticoid Medications

Used to: Manage allergies, asthma, autoimmune diseases.

How and why the drug(s) cause bone loss: Glucocorticoids suppress osteoblasts’ bone-building activity and hence bone formation, while, at the same time, osteoclast (bone-resorbing cells) numbers are either unchanged or slightly increased resulting in bone loss.

Drug Information: Glucocorticoids induce production of a protein called caspase 3 and other proteins that play key roles in cellular apoptosis (cell-suicide) in osteoblasts and osteocytes (what osteoblasts become after they begin secreting the bone matrix). So, glucocorticoids cause both osteoblasts and osteocytes to self-destruct. Osteocytes play a central role in skeletal sensing of the need for bone repair and in bone repair itself, so glucocorticoids’ induction of caspase 3 results in weakening of bone (within 6 months) — even when glucocorticoids are used at very low doses.

Glucocorticoids change the balance between receptor activator for NF-κB ligand (RANKL) and osteoprotegerin (OPG). RANKL is produced by osteoblasts and osteocytes (what osteoblasts become as they lay down new bone). It’s a key regulator of bone-resorbing osteoclast activation and survival. Osteoblasts and osteocytes also produce OPG, which is a decoy receptor for RANKL and thus inhibits RANKL from activating osteoclasts. The balance between RANKL and OPG is a key deciding factor of how much bone resorption is and will be happening (more RANKL = more bone breakdown; more OPG = less bone breakdown). Glucocorticoids tip this balance strongly in favor of RANKL.

Glucocorticoids also cause an increase in the production of macrophage colony-stimulating factor, a pro-inflammatory cytokine (signaling molecule) that triggers the production of more pro-inflammatory cytokines; inflammation further increases RANKL production and activation, thus further increasing the production and activity of osteoclasts. Glucocorticoids also directly prolong the lifespan of mature osteoclasts.

Glucocorticoids inhibit Wnt protein expression in mature (bone-building) osteoblasts, and this results in the precursor cells of osteoblasts (mesenchymal stem cells) becoming adipocytes (fat cells) instead of osteoblasts.

Glucocorticoids deplete vitamin D3.

Not surprisingly, BMD drops 6-12% within the first year of glucocorticoid use, and approximately 3% per year following. Fracture risk escalates up to 75% within the first 3 months.38-39

If you must take a glucocorticoid, you can still greatly lessen its bone-blasting effects by ensuring you get optimal amounts of all the nutrients bones require (AlgaeCal Plus will be a huge help), lowering your overall inflammation (eating a healthy, whole foods Mediterranean-type diet, and taking Triple Power), and getting regular weight-bearing exercise.

Calcineurin Inhibitors

Used to: Suppress immune system rejection of organ transplants. Typically given in combination with glucocorticoids in patients undergoing organ transplantation to help prevent organ rejection. Also now used to treat dry eye syndrome (keratoconjunctivitis sicca).

How and why the drug(s) cause bone loss:  These drugs markedly increase bone resorption via two mechanisms: they disrupt vitamin D metabolism and therefore calcium absorption, and cause secondary hyperparathyroidism.

Drug Information: Secondary hyperparathyroidism occurs as a protective response when calcium levels drop too low in the bloodstream, which they do when vitamin D is deficient or its metabolism is disrupted. In response, parathyroid hormone is secreted to trigger calcium release from bone, so calcium can be restored to its required levels in the bloodstream. When parathyroid levels are continuously elevated, calcium gets continuously withdrawn from bone.40-41

If you must take a calcineurin inhibitor, your needs for vitamin D3 will be increased. Ask your doctor about testing not only your 25(OH)D levels, but your 1,25-D level as well, and helping you to determine how much supplemental vitamin D3 you require. And ensure you are providing your bones with all the other key nutrients they must have, in addition to vitamin D3, to maintain themselves by taking AlgaeCal Plus.

Antacids, H-2 Blockers, Proton Pump Inhibitors

Used to: Manage indigestion, heartburn, GERD (gastroesophageal reflux disease)

How and why the drug(s) cause bone loss:  Antacids neutralize stomach acid after it has been produced. Without stomach acid, calcium cannot be made soluble, which is necessary for its absorption. Stomach acid is also required for the digestion of food. Many vitamins (particularly B12) and minerals required for healthy bones are not freed from the food matrix and rendered available for absorption without the action of stomach acid.

Drug Information: H-2 blockers block the action of the histamine-producing cells in the stomach lining, which signal the acid producing cells to secrete HCl (stomach acid), thus preventing the production of stomach acid.

Proton pump inhibitors block the proton pump inside the cells in the stomach lining that produce and secrete stomach acid. Proton pump inhibitors (PPIs) are the most potent of the acid-blockers; just one PPI pill can reduce stomach acid secretion by 90-95% for a full 24 hours.

In addition, both H2-blockers and PPIs increase risk for chronic kidney disease. Vitamin D is converted into its active, hormonal form, 1,25-D, in our kidneys. This is the form in which vitamin D helps us absorb calcium. When our kidneys are not working well, our ability to absorb calcium is severely compromised. Once daily use of PPIs increases risk of chronic kidney disease by 15%; twice daily PPI use increases risk by 46%. Twice daily use of H2 blockers increases risk for chronic kidney disease by 39%.

Chronic use of PPIs is associated with significantly increased risk for chronic kidney disease and fracture.42-49

If you are taking one of these drugs, please work with a doctor who can help you figure out the cause(s) of your indigestion, heartburn or GERD. Your body may be reacting to some food(s) you regularly eat. You could have some unhealthy strains of bacteria in your digestive tract. You could be unable to effectively deal with the stress in your life because your genetic inheritance gave you slow versions of the enzymes that clear out cortisol. These are a few among the many potential reasons for digestive unhappiness, none of which are cured by taking stomach acid-suppressing drugs, and all of which can be safely, naturally treated – and cured –not just “managed” with a drug that destroys your bones.

Because your digestion is compromised, you will be unable to effectively release the vitamins and minerals your bones require from the foods you eat. The nutrients in supplements do not have to be disassociated from foods; they become readily available with much less digestive effort. If you are not already taking AlgaeCal Plus and Triple Power, this is yet one more reason to do so: these supplements can greatly improve the availability to you of the nutrients your bones require.

Doctor Measuring blood pressure - blood pressure meds are drugs that cause osteoporosis

Loop Diuretics

Used to: Manage high blood pressure, heart failure, liver cirrhosis, and certain kidney diseases.

How and why the drug(s) cause bone loss:  Loop diuretics directly increase urinary elimination of calcium, which causes a lowering of calcium’s concentration in the bloodstream. The lowering of calcium in the blood triggers the secretion of parathyroid hormone, which mobilizes calcium’s release from bone by increasing bone turnover.

Drug Information: Loop diuretics also increase sodium loss, often to the point of causing “hyponatremia,” an electrolyte disturbance in which the sodium ion concentration in the blood is lower than normal.  Approximately one-third of total body sodium resides in the bone, with 40% of bone sodium content being exchangeable with sodium in the bloodstream. A moderate but persistent loss of both bone sodium and calcium either indirectly, via an increased urination caused by loop diuretics, or directly, by hyponatremia [low sodium]-induced bone resorption, adversely impacts bone strength and increases fracture risk.

Hyponatremia also increases bone resorption by increasing osteoclasts’ formation and their bone resorbing activity.

Add to this the depletion in blood volume caused by all forms of diuretics, which increases the likelihood of dizziness when sitting up or rising into standing position (the medical term for this is “postural hypotension”), and you have the perfect set up for a fall, which further increases your risk for a fracture.

Loop diuretics may also deplete magnesium, which, after calcium, is the most important mineral required for bone health.50-56

The most recently published study discussing risk factors for osteoporosis, published in the May 2016 issue of the journal Endocrine, found loop diuretics increased odds for developing osteoporosis by a whopping 70%.

Only one other factor was found to increase risk for osteoporosis more than loop diuretics: former treatment with osteoporosis drugs, which increased odds of continuing to have osteoporosis by 350%! Think about what this tells us about the actual effects of these drugs on our bones!

In contrast to loop diuretics, the use of thiazide diuretics lowered odds of developing osteoporosis by 30% – and so did regular, heavy exercise.57

The takeaway here: if you must take a diuretic, use one of the thiazide diuretics (ask your doctor), and not a loop diuretic. And get some weight-bearing exercise – every day.


Used to: Some anti-coagulants prevent excessive blood clot formation, and others prevent deep vein thrombosis and pulmonary embolisms.

Commonly prescribed examples: There are several types, but low molecular weight types appear to be the least harmful to bone.

How and why the drug(s) cause bone loss: Anti-coagulants used to prevent excessive blood clot formation also prevent vitamin K recycling and therefore the activation of osteocalin, a vitamin K-dependent protein that brings calcium into bone, and matrix Gla protein, a vitamin K-dependent protein that prevents calcium from depositing in soft tissues, e.g., blood vessels, heart, kidneys, breast, brain.

Drug Information: The most common type of anti-coagulant does not impact cortical bone, but rapidly decreases trabecular bone volume by disrupting vitamin D metabolism and inducing secondary hyperparathyroidism, discussed above under Calcineurin Inhibitors. (If bones were like M&Ms, cortical bone would be the hard, outer candy shell and trabecular bone, the soft chocolate interior.) The result is a significant drop in osteoblast production and activity, and in osteoid surface in the bone. (Osteoids are what osteoblasts become after they begin depositing the bone matrix.)  In addition, these harmful effects are accompanied by a large increase in osteoclasts and bone resorption activity.58-59

The low molecular weight version may be less destructive to bone than other forms.  In contrast to the common unfractionated anti-coagulant, which is known to cause bone loss, a study just published (July 2016) found the use of the low-molecular-weight version during pregnancy did not increase loss of BMD.60-61

If you must continue to take an anti-coagulant, share this paper with your doctor and discuss switching to a low-molecular weight version. Also, consider taking Triple Power. Numerous studies show omega-3s – specifically compounds called “resolvins” that our bodies make when metabolizing EPA and DHA – prevent excessive blood clot formation (the medical term is thrombosis).62

Discuss with your doctor taking 2 tablespoons of Triple Power daily rather than the basic dose of 1 tablespoon. You might share the following two recent studies, which have shown (1) supplemental omega-3s greatly lessen likelihood of thrombus (clot) formation, (2) individuals with cardiovascular disease require a higher dose of omega-3s than those without cardiovascular issues.63-64

Thyroid Hormone Medications

Used to: Manage hypothyroidism (underactive thyroid). People are commonly given a synthetic thyroid hormone (a man-made version of thyroxine T4) sold under various trade names.

How and why the drug(s) cause bone loss: In 25% of patients, the dose of synthetic thyroid hormone prescribed is slightly higher than what is actually needed.65 Furthermore, an individual’s dosage requirement may change, so a dose that was initially right on may later turn out to be greater than what is needed. And too much thyroid hormone promotes bone loss.

Drug Information: A dose of synthetic thyroid hormone, even slightly in excess of need, causes suppression of TSH (thyroid-stimulating hormone). TSH directly protects bone by inhibiting the production of osteoclasts.66

In addition, low TSH is an indication of hyperthyroidism, a condition in which the thyroid is producing too much thyroid hormone (or in this case, in which the dose of supplemental thyroid hormone is too high). Hyperthyroidism significantly increases bone turnover and reduces bone mineral density (BMD). Although bone formation and bone resorption both increase, bone resorption far outpaces bone formation, so the end result is bone loss.

TSH should be monitored regularly and thyroid hormone dosage adjusted according to results in anyone on long-term thyroid hormone replacement therapy. This is rarely done. If you’re taking thyroid hormone, make sure you are checked at least twice yearly, and your dose adjusted if indicated.67-68

contraceptives cause osteoporosis

Contraceptives: Birth Control Pills, IUDs, Birth Control Shots

Used to: Prevent pregnancy. Oral contraceptives (birth control pills) contain either a combination of patented versions of estrogen (i.e., not bio-identical to normal human estrogen) along with patented versions of progesterone (called “progestins”) or just a progestin.

Birth control shots contain long-acting progestin-only contraceptive. They’re taken via injection every 3 months. IUDs that dispense the progestin are also often prescribed.

How and why the drug(s) cause bone loss:  Oral contraceptives lower blood levels of vitamin B6 and vitamin B12, causing levels of homocysteine to rise because its clearance requires these B vitamins. High levels of homocysteine promote inflammation and are associated with both cardiovascular disease and osteoporosis, in particular, with hip fractures.

Drug Information: One of the ways homocysteine harms bone, specifically, is by inhibiting an enzyme (called lysyl-oxydase) that plays an important role in collagen crosslink formation; this results in a weakened bone matrix. Homocysteine also causes the balance between RANKL and OPG to shift in favor of RANKL, promoting osteoclast production and activity. (RANKL and OPG are explained in the section on Glucocorticoids above.

Lastly, high homocysteine greatly increases oxidative stress (inflammation) throughout the body, another key instigator of osteoclast production and activity.69-70

Birth control pills, whether they contain only a patented version of estrogen or combine the “estrogen” with a “progestin,” patented analog of progesterone, work by inhibiting follicular development and preventing ovulation. For this reason, both types of birth control pills prevent ovulation and therefore formation of the corpus luteum, which is what produces progesterone. Birth control pills thus prevent the production of progesterone, and progesterone plays a key role in the development of osteoblasts.71-78

In the Canadian Multicentre Osteoporosis Study, oral contraceptive users had bone mineral density scores 2.3% to 3.7% lower than women who had never used oral contraceptives.79

One of the progestin-only contraceptives, medroxyprogesterone acetate, is the most widely used contraceptive worldwide. It’s given by injection every 3 months.

Because of its wide use in younger women and documentation that administration it may be associated with a loss of BMD, FDA has attached a black box warning to labels.80

Another progestin-only contraceptive, now being used in women as young as 14 years of age, is the IUD containing a progestin called levonorgestrel. IUDs containing levonorgestrel not only prevent ovulation, but typically cause amenorrhea (cessation of menstruation). Obviously, this is not helpful to young women, who are supposed to be building up their peak bone mass.

A recent meta-analysis estimated a BMD increase of 0.5% per year in women with normal ovulation, but a decrease in BMD of 0.7% per year in young women with ovulatory disturbances (anovulation—no ovulation, or short luteal phase). Studies show that they cause serious disturbances to your body.81

Drug-Induced Bone Loss Can Be Effectively Combatted

If you are having difficulty getting your doctor to monitor the effects on your bones of the medications you are being prescribed to manage — epilepsy, depression, anxiety or insomnia, restless leg syndrome, type 2 diabetes, chronic pain, allergies, asthma, autoimmune diseases, dry eyes, indigestion, heartburn, GERD, high blood pressure, liver disease, kidney disease, hypothyroidism, or use of birth control pills or IUDs – please share this information with your doctor.

The references cited are the most recent papers in the peer-reviewed medical journals. (And they include the PubMed IDs [PMID #], making it extremely quick and simple to locate these papers on PubMed). Educate your doctor, so you can get the health care you deserve. If your doctor refuses to become educated, find another, more competent physician.

Ideally, work with a physician knowledgeable about integrative, functional and/or naturopathic medicine, who can help you identify the underlying causes of your health issues and help you restore your health using effective and safe, natural means.

In the Resources section of Your Bones, I’ve provided a full list of medical organizations you can contact to help you find physicians in your area who can help you restore your health naturally. I cannot list them all here, but three such national groups are:

Your bones need all the nutrients they require to remodel, rebuild and maintain healthy structure and function.


Today we discussed 12 known drugs classes that cause bone loss. Unfortunately, these drugs are commonly prescribed. In fact, you may be taking one or more yourself right now…

If you are, know that you don’t wait for your bones to become weaker. Even if you must continue to take one or more of these drugs that cause bone loss, findings show that “active management” of bone loss in those with psychoactive drug-associated osteopenia/osteoporosis “can halt or even reverse this process.” And the same principle applies regardless of the drug category82

Intelligent “active management” means supplying your bones with optimal amounts of all the nutrients they require to remodel, rebuild and maintain healthful structure and function. You can do this by eating a healthful, whole foods, preferably organic, Mediterranean-type diet and taking AlgaeCal Plus and Triple Power.  And don’t forget regular weight-bearing exercise; it sends “build!” signals to your bones, improves your mood, keeps you trim, and boosts your energy.

Please share this information with friends and family

An ounce of prevention – in the form of a natural bone-building program targeted to combat the metabolic disturbances caused by these bone-busting drugs – can help prevent much needless misery.

Article Comments

Add New Comment

Your email address will not be published. Required fields are marked *

  1. Mary Donaldson-Evans

    February 15, 2012 , 11:02 am

    All very interesting, but what about the estrogen-blocking drug prescribed for post-menopausal women who have had breast cancer? Same advice? Thanks.

  2. Lara Pizzorno

    February 17, 2012 , 9:33 am

    Yes, by by inhibiting estrogen synthesis, this drug contributes to bone loss. More than 50 papers on this issue on PubMed, all published within the last 8 years. The good news here is that for all of us, estrogen levels plummet after menopause. Although estrogen play an important role in bone health, so do many other factors. You can still do a great deal to care for your bones naturally and keep your bones strong throughout your life. I listed a few of what I feel are absolutely essential things to do in the blog, but there is way too much for me to sum it all up here. Which is why I wrote Your Bones. If you have not read the book, please take a look. If you don’t want to buy it, they are sure to have it at your library. I just looked on Amazon, and it is available for as little as $7.11.

  3. kitat

    August 20, 2014 , 5:49 am

    well Lara i wanted to asking u about that medication name
    on the first pic

  4. Monica

    August 21, 2014 , 1:26 pm

    It’s just a generic photo of a bottle of medication — no specific medication.

    – Monica @ AlgaeCal

  5. Virginia Carreau

    January 7, 2018 , 11:32 am

    The last time I took a product with Stontium in it I developed superficial blood clots in my right leg.I need to protect my bones but I’m afraid it might happen again. The name of the product was Dr’s Best.

  6. Lara Pizzorno

    January 8, 2018 , 10:49 am

    Hi Virginia,
    I tried to discover what form of strontium is in Dr’s Best and the dosage provided — not easy to do; I could not find this information on line. Could you please let me know? I’m guessing it’s strontium citrate at the typical dose of 680 mg/d.
    Regardless, natural forms of strontium (e.g., strontium citrate, strontium chloride, etc.) have never been reported in the medical literature to cause blood clot formation. Strontium ranelate, the unnatural, drug form of strontium is well known to cause VTE, the formation of clots in the deep veins, which is one of many reasons the use of this drug has been severely restricted in Europe and why it is not approved for use at all in the U.S.
    Since a natural form of strontium is unlikely to have contributed to your blood clot formation, let’s think about WHY this might have happened.
    One reason for excessive superficial blood clot formation that immediately comes to mind is an imbalanced intake of omega-6 (too much) in comparison to omega-3 (too little). Insufficient omega-3 intake is extremely common! I suggest you consider testing your omega-6:omega-3 ratio and increasing your intake of omega-3s (EPA and DHA) if indicated, which you are highly likely to find is the case. You can find this test – a very easy to do finger prick test that you send in by mail here
    You might also consider taking half the typical dose of strontium citrate — in other words, 1 capsule per day of Strontium Boost, which would provide 340 mg daily rather than the typical dose of 2 capsules (680 mg/d). The latest studies show a half dose is helpful, especially when taken at night before bed, probably because the body tends to focus more on health maintenance tasks, including bone remodeling, at night while we sleep.
    Do let me know what your omega-6/3 ratio is and how you are doing.
    Be well,

  7. Linda Morrison

    February 15, 2012 , 11:15 am

    Yes, a recommendation for women who have had breast cancer would be welcome, especially since many of the natural formulations for building bone contain boron, which increases circulating blood levels of estrogen and promotes estrogen retention.

  8. Lara Pizzorno

    February 17, 2012 , 9:31 am

    Hi Linda,
    Great question! And one I cannot simply answer off the top of my head. I need to look at the research. Will do so and get back to you.

  9. Diane

    April 30, 2012 , 7:41 pm

    Lara, if I,m taking 680 mg strontium citrate would 770mg calcium(from Algae ) be enough calcium? I have a product called New Chapter Bone Strength and you take 6 small tablets per day..

  10. Todd

    November 19, 2012 , 9:13 pm

    Hi Lara,

    I’m having trouble using your reference section to find the studies used for your article, especially linking SSRIs and benzodiazepines to osteoporosis. Many of the reference numbers for the studies used in your article are for wikipedia and not for studies backing up your statements. I was on SSRIs for many years and now have osteoporosis, so being able to find legitimate and accessible research that may link the two is important to me. I’d appreciate if you could more clearly provide the links to the research you used, especially for the SSRIs and the benzodiazepines in your response to me.


  11. Lara Pizzorno

    November 19, 2012 , 9:52 pm

    Hi Todd,
    Not sure why you are having this problem nor what happened to the references I supplied with my blog; but the main point is how to help you, and it’s easiest for me to just give you a few of the recent papers here:
    Luz Rentero M, Carbonell C, Casillas M, et al. Risk factors for osteoporosis and fractures in postmenopausal women between 50 and 65 years of age in a primary care setting in Spain: a questionnaire. Open Rheumatol J. 2008;2:58-63. PMID: 19088873
    Bolton JM, Targownik LE, Leung S, et al. Risk of low bone mineral density associated with psychotropic medications and mental disorders in postmenopausal women. J Clin Psychopharmacol. 2011 Feb;31(1):56-60. PMID: 21192144
    Bolton JM, Metge C, Lix L, et al. Fracture risk from psychotropic medications: a population-based analysis. J Clin Psychopharmacol. 2008 Aug;28(4):384-91.PMID: 18626264
    Pinheiro Mde M, Ciconelli RM, Martini LA, et al.Risk factors for recurrent falls among Brazilian women and men: the Brazilian Osteoporosis Study (BRAZOS).Cad Saude Publica. 2010 Jan;26(1):89-96. PMID: 20209213
    Pinheiro MM, Ciconelli RM, Martini LA, et al. Clinical risk factors for osteoporotic fractures in Brazilian women and men: the Brazilian Osteoporosis Study (BRAZOS). Osteoporos Int. 2009 Mar;20(3):399-408. Epub 2008 Jul 3.PMID: 18597037

    That benzodiazepines promote bone loss is well known; many papers dicuss it. If you run a PubMed search using the terms “benzodiazepines” and “osteoporosis,” LOTS of papers will come up. Ditto for the wider class of SSRIs).

    If you have not read Your Bones, please check out a copy from your library and read it — or buy the book on Amazon, cost is less than $10 as publisher is a non-profit group. All the factors (except menopause) that negatively impact women’s bones also cause bone loss in men, and men have a few contributing factors (also discussed in Your Bones) that women typically do not have. Men also require all the nutrients that women do to rebuild bone. You can restore the health of your bones! You need to eliminate as much as possible all the factors that are promoting your bone loss (which you will be able to figure out when reading the book) and ensure your intake of all nutrients requried for building bone are supplied (all discussed in the book), along with some regular weight bearing exercise, and your bones will rebuild. You are pre-programmed to do so. I cannot summarize the entire book here, but like I said, you can get it at your library. Hope this helps, Lara

  12. cheri

    February 2, 2013 , 1:00 pm

    Hi- Isn’t it a good idea to get the parathyroid and thyroid blood levels checked periodically when one has osteoporosis or when one wants to explore the reasons why one has it? I have osteoporosis( I wrote a while back) and take armour hormone for hypothyroid. Recently I asked my Dr. to check my parathyroid hormone levels cause I knew if elevated levels were found that it can contribute to bone loss. A few blood tests ago my levels were elevated and so I increased vitamin D. Saw the endocrinologist. Now at 10,000 iu D the PTH is still elevated. My CA is normal. Kidneys ok.
    I see the Endo. next week but now she is talking about removing the parathyroid or go on osteoporosis drugs which I won’t do. I will found out why she says that.
    I can’t find info on High PTH levels and normal CA ,with normal D. Can being hyperthyroid increase your PTH? I appreciate your help even though it’s slightly off topic. Thanks! Cheri

  13. Lara Pizzorno

    February 2, 2013 , 3:59 pm

    Hi Cheri,

    Being hyperthyroid speeds up everything, so can certainly contribute to bone loss — but you write that you are taking armour thyroid because you have been diagnosed s hypothyoid — where are you? hyper or hypo? Have you been checked recently? Your armour thyroid prescription may need to be adjusted.

    Re your parathyroid glands, you need to run the tests to check ionized calcium and iPTH levels in your blood, plus a 24-hour urine calcium excretion test to see how much calcium your kidneys are clearing out. Is this what your endocrinologist ran for you? If so, and your test results are abnormal, then the question becomes, is it primary or secondary hyperparathyroidism?

    Primary hyperparathyroidism is relatively rare (prevalence of primary hyperparathyroidism has been estimated to be 3 in 1000 in the general population, but as high as 21 in 1000 in postmenopausal women. It is almost exactly three times as common in women as men.) Most often, it is due to a benign tumor. Once the offending parathyroid tumor is removed, your bone density should quickly begin to improve since an overactive parathyroid will not be constantly draining calcium from your bones. For lots more information about hyperparathyroidism, an excellent resource is

    Secondary hyperparathyroidism may result from insufficient consumption (or absorption) of calcium, vitamin D deficiency, chronic kidney or liver disease, or hypochlorhydria (low levels of stomach acid, which is quite common after age 50, and may be caused at any age by other factors, such as chronic use of acid-blocking drugs. If you are not secreting adequate stomach acid, you are not going to digest your food properly or solubilize calcium, so it can be effectively absorbed.

    Hope this gives you a few leads to discuss with your doctor, Lara

  14. cheri

    February 2, 2013 , 9:46 pm

    Hi- Thanks for your reply. I am hypo and am now hyper as my Primary Dr was trying to increase my levels.
    So does being hyperthyroid raise the PTH levels? I need to know how being hyperthyroid makes you lose bone.
    My story is too long to share but I had a hot nodule for 15 years that made me hyperthyroid. Had it removed in ’96.Then became hypo.
    I will mention the things you wrote about the parathyroid.Thanks

  15. Lara Pizzorno

    February 4, 2013 , 10:25 am

    Hi Cheri,
    As I explain in Your Bones (1st edition, pages 90-93 — cannot provide all the info here, but the key point for you is that high levels of parathyroid hormone cause increased osteoclast activity and bone resorption to liberate calcium from bone because calcium is required for many essential functions in our bodies, so its availability is tightly regulated. Bones are our calcium “bank” from which withdrawals will be made if calcium levels in the blood drop. Being hyperthyroid is going to speed up everything in your metabolism — including bone remodeling. I discuss this in Your Bones pp. 93 and following — each bone remodeling cycle involves 3-5 weeks of bone resorption followed by 3 months during which new bone is laid down to replace what has been removed. When the resorption phase is sped up, the rebuilding phase cannot keep pace, and the result is a loss of approximately 10% of bone mass per remodeling cycle. Hopefully, when your primary doctor adjusts your dose of thyroid hormone, your metabolism will normalize. Please ask your doctor about this ASAP.

  16. cheri

    February 7, 2013 , 8:47 am

    Thanks Lara- My Endo thinks it’s Primary Hyperparathyroidism even though my CA is normal. Doing an ionized CA (my suggestion from and 24 hr urine CA .

    Once she sees the results , then we proceed. I have an experienced Dr and hospital lined up. If it’s familial HP-then what do I do?

    I am on a natural regime for Osteo, K2-Thorne, D, Kaprex, Boron and Calcium formula and walking. I guess I will add strontium. Am on lower armour -heart rate is a tad better. Read that a lot of my unexplained symptoms could be from HP.

    Will let you know. Thanks


    February 6, 2013 , 10:40 pm

    this product is very good for osteoporosis, its a weighted vest by NYKNYC.COM the vest has given me back 13% of the bone I had lost in less than a yr.
    I highly recommend it to anyone who needs to strengthen bones and its safe cant hurt you like these drugs do.

  18. Patte Lau

    April 18, 2013 , 1:31 pm

    I read in Consumer Health reports that AlgaeCal contained mercury or lead? Is that correct or not. I would like to start taking AlgaeCalPlus and read you book Your Bones. Also can one take Algae Cal Plus with out strontium and still build bone?
    Thank you.

  19. Lara Pizzorno

    April 18, 2013 , 7:35 pm

    Hi Patte,
    I am copying in for you what I have posted elsewhere, both on this blog and on the National Osteoporosis Forum.

    Here are the facts re the safety of AlgaeCal in regards to lead:

    Numerous clinical studies using AlgaeCal, all of which include toxicology evaluations (which include ensuring safety from lead and any other toxic compound) have been published in different mainstream peer-reviewed medical journals. If you want to read them, just type “algaecal” into the search box on Pubmed.

    Because AlgaeCal is shown to be safe, Algaecal has received an NDI (New Dietary Ingredient) approval and GRAS (Generally Recognized As Safe) by the FDA (both are posted on AlgaeCal’s home page).

    ALL calcium supplements contain tiny tiny amounts of lead; this will include ANY calcium supplement you might take. If consumption of no lead is your goal, then you should not ingest any calcium supplements, period…You’d also better stop eating FOOD, because every vegetable contains lead, too — even organically grown vegetables. According to FDA’s publication, Total Diet Study Statistics on Elements Results (December 11, 2007):

    Food Amount of Lead in a 4 Ounce Serving
    Mixed nuts, roasted 10.2 mcg
    Brussels sprouts, fresh, boiled 7.9 mcg
    Sweet potato, fresh, baked 7.2 mcg
    Spinach, boiled 7.0 mcg

    In comparison, AlgaeCal contains LESS than food — just 5.2 mcg in a daily serving. So, if this amount is sufficient to make you concerned about taking AlgaeCal, you’d best stop eating nuts and veggies. I haven’t researched meat, but almost certainly, it will contain microgram amounts of lead since the animals eat grass & grain, which are necessarily grown on soils – and all our soils contain tiny tiny amounts of lead. Lead is a natural element ubiquitous in the soil, water, and air, and we cannot escape ingesting tiny amounts of this toxin every day. The US Government’s Centers For Disease Control publication “Inorganic Lead Exposure, Metabolism and Intoxication” states that “…typical intakes of lead from food, beverages and inhaled air are in the order of 300 – 500 mcg per day.”

    Fortunately, our bodies are capable of processing these tiny exposures, which as you can see, are many many times greater than the amount of lead found in a daily dose of AlgaeCal. We know how tiny the amount of lead is that is present in AlgaeCal — I feel very comfortable with this. Frankly, I’d like to see reports detailing how much lead is present is other calcium supplements being sold to us; such reports are glaringly absent. I am confident none will contain less lead than is found in AlgaeCal.

    Much dis-information has been posted about this, and it has caused much needless distress — for you and many others. I do not understand why the people trying to frighten us from using a healthful product like AlgaeCal are doing so. They should be ashamed of themselves. It is a huge disservice. I hope knowing the actual facts puts your mind at ease, Lara

  20. K

    July 7, 2013 , 12:43 am

    Hopefully, someone has already told you this by now. Calcium supplementation, especially as high as your 1,200 mg/day (and especially since you are taking vitamin D, which increases calcium absorption), significantly raises a woman’s (or man’s) likelihood of calcification in inappropriate areas of the body, especially if they are not ingesting large amounts of “Vitamin K2 mk-7.”

    Vitamin K2 mk-7 directs calcium out of the inappropriate areas of the body and into the areas of the body that are appropriate for calcification (ie. bone, nails, teeth).

    Inappropriate areas of the body for calcification include (but are not limited to): the inside and outside of blood vessels / arteries, the brain (dementia), the eye lens, the kidneys (stones), the gall bladder (stones), the heart, the lungs, joints, other organs.

    Calcium supplementation increases the likelihood of stroke, heart attack, atherosclerosis, heart disease, et cetera. It’s safer to obtain calcium from greens, nuts, seeds, and the rest of one’s diet than from supplementation.

    But absorption of the calcium from one’s diet will increase if one is in a position to safely raise their Vitamin D3 blood levels, which they can be if they have been taking enough Vitamin K2 MK-7 for awhile. (I regret that I am still unclear as to how long is sufficient before adding Vitamin D3 ingestion.)

    (Some regions of Japan for centuries have ingested around 1,000 mcg of Vitamin K2 mk-7 in their breakfast dish of “natto”: fermented soy beans or black beans. I know of no reason to have any concern about going at least that high.)

    (Two of the websites one can check out for more information about Vitamin D3 supplementation are Grassroots Health or Vitamin D Council.)

  21. Lara Pizzorno

    July 7, 2013 , 3:48 pm

    Hi Joy,
    Yes, I am well aware of the information you thoughtfully shared, and very glad to post your comment for those who might not already be aware of vitamin K2’s critical importance for calcium’s healthful use within our bodies.
    Vitamin K2 (as MK-7) is discussed — extensively –in several of my blog posts on AlgaeCal’s website — the post I think you will find most interesting is entitled, Strong Bones and a Healthy Heart Need More than Just Calcium — here’s a link to this blog, in which I discuss, at length, the studies you refer to regarding calcium and vitamin D as a possible contributing factor to heart disease, etc.:
    I also discuss the current research regarding all 3 forms of vitamin K relevant to bone health (K1, MK-4 and MK-7) at length in Your Bones, in both editions. In 2nd edition, see pages 172-177, 180-196, 198, 213-214, 219-220, 222, 311-315, 345, 352, 362.
    And have written medical journal review articles about the interrelationship of vitamins D and K for physicians — see Longevity Medicine Review — — on the homepage you will find a free-access article entitled “Vitamin K2: Essential for Prevention of Age-Associated Chronic Disease.” This article is written for medical professionals, but you will get the gist of it. Vitamin K2 is involved in much more than bone and heart health!
    Because MK-7 is more effective at a lower dose in activating the proteins responsible for putting calcium into bone (osteocalcin) and keeping it out of soft tissues (e.g., but not limited to — arteries, kidneys, breasts, brain — this K2-dependent enzyme is called “Matrix Gla Protein), MK-7 is the form of K2 used in AlgaeCal Plus.
    In Japan, it is true that natto is regularly consumed. A cup of natto typically supplies 435 mcg of MK-7; few people consume more than 1 cup daily; most consume less than this amount, thus very few Japanese are consuming 1,000 mcg of MK-7 per day. However, consuming this much would, most likely, be safe. I prefer to err on the side of caution and would NOT recommend taking 1,000 mcg of MK-7 daily. In the latest studies, daily doses of 360 mcg are being safely and beneficially used for individuals on hemodialysis for severe kidney disease and also for those with coronary artery disease (a condition in which significant calcification is present in the coronary arteries, i.e., the arteries that deliver blood to the heart). In the most recently published papers on the use of K2 (MK-7) for bone health, women with osteoporosis were given 180 mcg/day of MK-7 with highly beneficial results and no adverse effects.
    Vitamin D Council is an excellent resource for information about vitamin D — I have been a member of the Vitamin D Council website for many years now and support their work (they are a non-profit/ .org) with a monthly donation — I urge everyone reading this to consider doing so as well. The information they currently provide on vitamin K is, however, much less robust than their coverage of vitamin D. In addition to my book, Your Bones, an excellent resource for (well documented by peer-reviewed research) information about vitamin K2 is my friend, Dr. Kate Rheaume-Bleue’s book, Vitamin K2 and the Calcium Paradox. Given your comments above, I believe you would greatly enjoy Kate’s book — and mine as well.
    Thanks for taking the time to write in, Lara

  22. Lara Pizzorno

    December 5, 2014 , 8:15 am

    Hello Alice,

    I will reply in more detail next week. I am on the road right now, but will be taping a video clip next week on the issue of constipation caused by too high a dosage of supplemental calcium – which is what you are experiencing. The supplement you are taking contains 1,000 mg elemental calcium – yikes, this is way too much! If you eat foods containing calcium, you may be consuming more calcium than the upper limit of 1,500 mg that is recommended. The amount of K2 is insufficient –you need at least 120 mcg per day, maybe even more, to balance this much calcium!
    I will also be taping a video clip discussing hydroxyapatite – I no longer recommend this type of calcium supplement for a number of reasons, which I will also discuss in full in a video clip. In brief, hydroxyapatite is calcium bound to phosphorus, and will disassociate from the phosphorus during digestion – as it will from any compound to which it is bound. So, you are paying more for nothing – and in fact, you are paying more for additional phosphorus, which you definitely do NOT need or want. I recently finished writing a review article on the excessive phosphorus intake in the US and Europe, which has been connected to an increase in osteoporosis, cardiovascular disease, and all-cause mortality – not just in those with kidney disease, but in the general population. This article will be in the next issue of IMCJ.
    My advice to you is to take a calcium supplement that is properly balanced and does not contain phosphorus. If you look at AlgaeCal Plus, you will see it delivers a total of 720 mg of calcium per day, which you are to take in divided doses of 360 mg twice daily, and it also contains 90 mcg of K2 (MK-7), which is sufficient to balance this amount of calcium along with the 1,600 mg of vitamin D3 supplied. Because AlgaeCal Plus is properly designed, it will not cause constipation or bloating for you.
    Hope this helps, Lara

  23. Pam

    December 27, 2014 , 7:17 am

    I have ER+ breast cancer. DEXA showed low bone density. I would take AlgaeCal with D, K and magnesium, but am concerned about the Boron in it since Boron is thought to increase estrogen. I feel like I am in a catch 22 situation with this. Is there a “safe” amount of Boron that can be taken? Thanks

  24. Monica

    December 29, 2014 , 8:29 am

    Hi Pam,

    You can take AlgaeCal Plant Calcium, which does not have added boron like AlgaeCal Plus, instead.

    – Monica @ AlgaeCal

  25. Monica

    December 30, 2014 , 11:11 am

    Hi Pam,

    Following up your question regarding boron and safety, Lara has just recently filmed some videos on boron on our AlgaeCal YouTube Channel. I believe you will find them very helpful.

    Why boron is essential for healthy bones:

    The Many Benefits of Boron:

    – Monica @ AlgaeCal

  26. Susan Richards

    April 7, 2016 , 1:03 pm

    I am starting to take AlgaeCal Plus. In addition I will be taking 4000IU extra Vit D3, 600mg extra Magnesium Citrate, and 100 mcg extra K2 (MK-7). I have to take a higher dosage of D3 because of a long-term prescription drug that I must continue to take. My question is about Vit A. I read from multiple sources that more Vit D supplementation requires supplementing with Vit A. What is the recommended ratio of D & A, and what type should the Vit A be (retinol, carotenoids, etc.)? Could I use a plant-based Vit A supplement? Thanks.

  27. Lara Pizzorno

    April 9, 2016 , 12:45 am

    Hi Susan,

    Yes, vitamin A works with both vitamin D and vitamin K2 and the 3 nutrients must be in balance for healthy bone remodeling. Vitamin A has been maligned as causing bone loss, but, when in balance with vitamin D, it does not and in fact, promotes healthy bone rebuilding. I’ll be writing a lot more about all this and will explain the ways in which the 3 nutrients interact in future posts on AlgaeCal’s website, but to reply to your question ASAP, here’s the bottom line.

    As of yet there is no established optimal ratio for vitamins A and D, but since they balance each other’s activities in the nucleus of your cells, it seems rational to consume approximately as much vitamin A as vitamin D. The UL (upper limit) for vitamin A is 10,000 IU per day (70,000 IU per week), so if you are taking 6,000 IU of D3 daily (from AlgaeCal Plus and the additional 4,000 IU of D3 you are taking), you can very safely take around 6,000 IU of vitamin A as well. Vitamin A supplements are most commonly available in doses of 5,000 IU – an amount that should be adequate to balance your vitamin D3 intake.

    No, you cannot rely upon a plant-based supplement for your vitamin A.
    Vitamin A deficiency is quite widespread both because of lack of this nutrient in the Standard American Diet [SAD] (the only really good source is liver), and also because many people (including medical professionals) believe, mistakenly, that everyone can convert beta-carotene into vitamin A. Beta-carotene is called “pro-vitamin A” because it has been thought that humans can convert beta-carotene into vitamin A. We have known for the last 10 years that this is not the case. In fact, the vast majority of folks cannot convert beta-carotene into vitamin A because of their genetic inheritance. Very common single nucleotide polymorphisms –SNPs– in the enzymes required to convert beta-carotene to retinoic acid (vitamin A) render these enzymes ineffective in making the conversion. At least 70% of us have one or more of these SNPs. Beta-carotene continues to be referred to as “vitamin A,” and you are likely to see “authorities” telling you that various plant foods, such as sweet potatoes, carrots or mangoes, are rich in vitamin A, when what they contain is beta-carotene, not retinoic acid. Let me underscore this: Beta-carotene is NOT vitamin A and does not provide balance for the actions of vitamin D and does not exert vitamin A’s effects. Only if you are among the small number of folks whose genetic inheritance includes the rare active versions of the enzymes that can convert beta-carotene into vitamin A will you produce some vitamin A from beta-carotene. AND you will still not convert all the beta-carotene you consume into retinoic acid.

    Human clinical studies suggest that real vitamin A — in balance with vitamin D — is beneficial, not harmful to bone. The most recent papers indicate that high vitamin A intake combined with low intake of vitamin D is what favors a decrease in BMD and increase in fracture risk. Current thinking is that it is the ratio between vitamin A and vitamin D that determines vitamin A’s effects on bone, not vitamin A alone.
    Furthermore, vitamin A is required for immune tolerance, and vitamin A insufficiency promotes inflammation, and chronic inflammation activates osteoclasts and promotes bone loss. A recently recognized subset of immune cells, the helper T cells of the TH17 lineage, generate highly inflammatory messenger molecules called IL-17 cytokines, which turn on a key player in the inflammatory cascade called NFκB, thus really ramping up inflammation. Retinoic acid (vitamin A) inhibits the differentiation of these TH17 cells and promotes the generation of other immune cells (regulatory T cells) that produce an anti-inflammatory cytokine called IL-10.

    It’s great that you are now taking AlgaeCal Plus – if you’ve read the latest research on this unique trace mineral-rich, plant-derived calcium supplement, you already know that it will definitely help you build bone. And you are absolutely correct in wanting to also supplement with sufficient REAL vitamin A to balance the amount of vitamin D3 you require.
    Be well!

    Conaway HH, Henning P, Lerner UH. Vitamin a metabolism, action, and role in skeletal homeostasis. Endocr Rev. 2013 Dec;34(6):766-97. doi: 10.1210/er.2012-1071. Epub 2013 May 29. PMID: 23720297
    Henning P, Conaway HH, Lerner UH. Retinoid receptors in bone and their role in bone remodeling. Front Endocrinol (Lausanne). 2015 Mar 11;6:31. doi: 10.3389/fendo.2015.00031. eCollection 2015. PMID: 25814978
    Caire-Juvera G, Ritenbaugh C, Wactawski-Wende J, et al. Vitamin A and retinol intakes and the risk of fractures among participants of the Women’s Health Initiative Observational Study. Am J Clin Nutr. 2009 Jan;89(1):323-30. doi: 10.3945/ajcn.2008.26451. Epub 2008 Dec 3. PMID: 19056568
    Pizzorno L. Vitamin A: tolerance extends longevity. Longevity Medicine Review. 2009
    Pizzorno L. Common genetic variants and other host-related factors greatly increase susceptibility to vitamin A deficiency. Longevity Medicine Review. 2010

    – Lara

  28. Monica

    April 11, 2016 , 4:53 am

    Hi Susan,

    Lara has reached out directly to answer this 🙂

    – Monica @ AlgaeCal

  29. Susan Richards

    April 10, 2016 , 11:48 am

    Lara – Thanks for the information above. I have a copy of Your Bones (2013), and after reading about the need for other vitamins/minerals along with Ca, D, Mg, & K2 I was considering a multi vitamin/mineral supplement.
    It says Vit A is 5000IU, but is listed beta-carotene & acetate. So no telling what percentage is what. Can you recommend a multivitamin containing Vit A (retinoic acid) OR can you recommend a multivitamin with Vit A being purchased separately? I’d like to avoid having multiple supplements to buy, cost being a big factor. I currently will have AlgaeCal Plus, extra Vit D, extra Mg, extra K2, Fish Oil, and was hoping to use the multivitamin listed above to cover the rest. Please email me if you don’t want to put specific product names on this website. THANKS!

  30. Patricia Martin

    July 9, 2016 , 6:04 am

    It is my husband that has osteoporosis and is on a prescription bone medication 70/vitD3 5600.once a week. He is also on pred 2mg daily for polymyalgia rheumatica. I recently started him on algae cal plus. Is this too much vit D3?

  31. Monica

    July 25, 2016 , 1:35 am

    Hi Patricia,

    The only way to know for sure is to have your husband get his levels of 25(OH)D tested. The Vitamin D Council will now send you a test kit in the mail. It’s easy and very accurate– a tiny finger prick is all that’s needed to get a drop of blood for this test – and then you just pop it back in the mail. Otherwise, you can ask your doctor for this test.

    Everyone is different and has different needs, therefore, testing must be done before you can know how much vitamin D3 is ‘too much’ for the individual.

    – Monica @ AlgaeCal

  32. Jackie Lewis

    August 30, 2016 , 3:09 pm

    Hi Lara,
    My doctor told me that it was better to get calcium from my diet, if possible. So I drink milk, fortified OJ (with calcium & D), almond drink (with calcium & D), and I eat cheese and yogurt. I also take a Vit. D supplement, magnesium, and Omega 3. However, I do not get much Vit. K2 from my diet. Is there a K2 supplement that you can recommend? In addition–I just ordered your book from the library–I hope it helps. I hope I can find an osteoporosis specialist in the Los Angeles area, as I haven’t been able to find anyone in the San Luis Obispo area.
    Thank you,

  33. Monica

    August 31, 2016 , 9:15 am

    Hi Jackie,

    It’s definitely ideal to get as much calcium from your diet as possible. Although, the Standard American Diet typically does not provide enough calcium to reach the recommended daily amount and so supplementation is usually necessary for most people. But if you are getting enough, then that’s fantastic!

    In terms of a vitamin K and specifically K2 you’ll want to look for a supplement in the form of vitamin K2(MK-7), Lara has discussed this extensively and her videos and posts can be found here:

    Also, check out:

    Wonderful to hear that you’ve ordered her book. There is so much valuable information in it!

    – Monica @ AlgaeCal

  34. Sarah Bertram

    June 2, 2017 , 7:06 am

    Thanks so much for your work, it’s so useful! However I am rather a different case… I am just 26 years old and was diagnosed with what they are calling idiopathic osteoporosis (although they are not sure if it is another form of brittle bones disease by the treatment is the same! In their eyes at least!) around 3years ago having suffered a number of fractures. My Deza scan scores are around -3, one slightly lower one slightly higher. It’s not an easy prognosis for someone so young and, from appearances, v fit active and healthy albeit v slim. I am trying to gain some weight as am told this may help however I’m struggling as I have some allergies and have a v high metabolism!

    However to look at your point on contraceptives. I have been put on a high dose of daily oestrogen and testosterone gels as the only osteoporosis treatment they are happy to give a pre-menopausal woman. Firstly it concerns me that any medication that ‘could cause infertility’ is being taken by anyone regardless of their child bearing desires! That can’t be something you should put in your body?! I also have the IUD that releases progesterone and haven’t had a natural period in almost 10 years as before that I was on the pill. I hate the oestrogen/testosterone gels as am having a load of side effects that I believe are related whatever the doctors say. I would like to stop them and probably remove the IUD but I don’t want to do something that would be severely damaging to my bones! However from what you say these hormones may not be helping me at all and therefore coming off it all could be a good idea?!

    I’m really struggling and have worked HARD for the past 3years to find anyone who knows anything about this issue at such a young age, ANY advice you could give me would be so useful! Thank you so much, Sarah

  35. Monica

    June 5, 2017 , 1:31 pm

    Hi Sarah,

    I believe Lara has emailed you personally to follow up. Hope her feedback helps you!

    – Monica

  36. Elvira Broekhuizen

    January 7, 2018 , 7:21 am

    I asked this question before! I am a 56 year old Asian woman who was diagnosed with osteoperosis on my hip and neck. I also have osteoarthitis. Mynproblem
    With calcium supplements stems from the fact that I develop
    Calcium stones jn my kidneys. My urologist told me to take Citracal and I was taking it,
    He told me that that does not give you stones. I do have a tinynone that developed in my kidney recently so I stopped the Citracal. I
    Would like to know the likelihood of Algaeca giving me kidney stones? I am
    Also on thyroid and blood pressure medications. Thank you.

  37. Lara Pizzorno

    January 8, 2018 , 5:40 pm

    Hello Elvira,

    AlgaeCal will not increase your risk of kidney stone formation. The latest research confirms that up to 1,200 mg of calcium daily does not increase and, in fact, lowers risk. (Prezioso D, Strazzullo P, Lotti T, et al. Dietary treatment of urinary risk factors for renal stone formation. A review of CLU Working Group. Arch Ital Urol Androl. 2015 Jul 7;87(2):105-20. doi: 10.4081/aiua.2015.2.105.PMID: 26150027)

    What does increase risk is a diet high in salt, processed foods and/or animal products and low in fresh fruits and vegetables. Such a diet results in metabolic acidosis and insufficient consumption of magnesium, potassium and citrate, all of which are required to prevent stone formation. And it will also increase risk of osteoarthritis.

    You may want to discuss supplemental magnesium citrate with your doctor, particularly since you have high blood pressure and magnesium helps relax our blood vessels, improving blood flow. However, I do not suggest taking potassium citrate – you have to take too many pills and gastrointestinal discomforts are a very common side-effect.

    I do suggest increasing consumption of citrate via citrus fruits — lemons, limes, oranges, but not grapefruit since it contains a compound called naringenin that inhibits key enzymes involved in detoxification. The latest research confirms the beneficial effects of increasing citrus fruit consumption for prevention of kidney stone formation. Here’s a paper discussing this. Suggest you share it with your doctor: Rahman F, Birowo P, Widyahening IS, Rasyid N. Effect of citrus-based products on urine profile: A systematic review and meta-analysis. F1000Res. 2017 Mar 6;6:220. doi: 10.12688/f1000research.10976.1. eCollection 2017.

    I also suggest making your lemonade or limeade or orangeade with sparkling Pellegrino. You’ll be getting lots of good minerals, including calcium & magnesium along with the citrate, and Pellegrino is much more enjoyable to drink than tap water. Be sure to buy your Pelligrino in glass bottles, not plastic. Plastic flavored water does not promote health. To one bottle of Pellegrino, add 1 TBS. organic maple syrup along with the juice of an organic lemon or lime or orange. You’ll need to pour out about 1/3 of the bottle to have room for the juice. Make your drink, screw the top back on and you’re set for the day. Delicious! You might as well enjoy your medicine.

    One last suggestion — if you have not had your thyroid hormone levels checked recently, ask your doctor to run this lab test for you, so you can verify that the dosage of thyroid medication you are taking is optimal for you — neither too high nor too low. Too high a dose promotes bone loss.

  38. Lynn Lake

    June 10, 2020 , 3:24 am

    May I ask, is fizzy Pellegrino OK to drink?

  39. Blaire AlgaeCal

    June 10, 2020 , 9:19 am

    Absolutely, Lynn! Lara mentioned a yummy drink she likes to make with Pellegrino in a previous comment – I will share what she said below ?

    “I also suggest making your lemonade or limeade or orangeade with sparkling Pellegrino. You’ll be getting lots of good minerals, including calcium & magnesium along with the citrate, and Pellegrino is much more enjoyable to drink than tap water. Be sure to buy your Pelligrino in glass bottles, not plastic. Plastic flavored water does not promote health. To one bottle of Pellegrino, add 1 TBS. organic maple syrup along with the juice of an organic lemon or lime or orange. You’ll need to pour out about 1/3 of the bottle to have room for the juice. Make your drink, screw the top back on and you’re set for the day. Delicious! You might as well enjoy your medicine.”

    Let us know if you have further questions!

    – Blaire @ AlgaeCal

  40. Helen

    January 7, 2018 , 11:58 am

    I am taking algeacal plus and strontium but do I need the triple power you mention too??

  41. Lara Pizzorno

    January 8, 2018 , 2:08 pm

    Hello Helen,
    As I mention in my reply to Virginia (please see my reply for her in the comments section of this article), the typical Western diet is excessively high in pro-inflammatory omega-6 fatty acid, arachidonic acid, and provides far too little of the anti-inflammatory omega-3s, EPA and DHA. An imbalanced intake of omega-6 (too much) in comparison to omega-3 (too little) promotes a state of chronic inflammation, and chronic inflammation provokes osteoclast production and activity, promoting bone loss. Insufficient omega-3 intake is extremely common and promotes bone loss, not just by increasing inflammation but through numerous additional mechanisms, which I have written about in several posts on AlgaeCal’s website — just use the search option and enter omega-3s to pull up these articles. It’s quite likely that you would benefit greatly from supplemental EPA and DHA, which Triple Power provides in an exceptionally high quality, palatable, easy to consume form. I suggest you consider testing your omega-6:omega-3 ratio to determine your current omega-6:omega-3 status to confirm whether you need to increase your intake of omega-3s. This information will also enable you to determine how much EPA/DHA your body requires daily to improve this ratio and may inspire you to make dietary changes as well that will increase your consumption of EPA/DHA. You can find this test – a very easy to do finger prick test that you send in by mail here
    Hope this helps. Be well,

  42. Katheeine

    January 8, 2018 , 5:01 am

    Hello Lara –
    Thank you SO much for all you are doing here.

    Re thyroid problems, my understanding is that natural thyroid extract does not harm bone density.

    Have you looked at this?



  43. Lara Pizzorno

    January 8, 2018 , 10:23 am

    Hi Katherine,
    You’re so welcome — delighted you’re finding the information helpful. ENDING osteoporosis is my mission in this life — no one should ever have to suffer from this naturally preventable, reversible condition.
    Re thyroid extract — whether it’s natural Armour Thyroid, synthetic T4 or synthetic T3, too much thyroid hormone will put your metabolism into fast forward mode, increasing all metabolic activities, including the rate of bone remodeling. This promotes bone loss because the removal of old bone takes only 3-5 weeks, while its replacement takes ~3 months. In other words, our bone-resorbing osteoclasts finish their work far more rapidly than our bone-building osteoblasts, and the latter simply cannot keep up when osteoclast activity is abnormally accelerated.
    To protect your overall as well as bone health, please ask your doctor to check your levels of T4 and T3 at least once a year to ensure the amount of supplemental thyroid you are taking is precisely the amount you need. When beginning to take supplemental thyroid hormone, it’s a very good idea to check your T4 and T3 levels after the first few months.
    In the Labs appendix in Your Bones, pgs. 320-323, I discuss the test I believe is optimal that should be run to see where all your hormones currently are. I also offer some reasons why thyroid function can become impaired and what to do to restore healthful function naturally. This is a complicated topic — too much information to summarize in a reply here — so please review this section in the book (which you can check out from your public library if you don’t want to purchase a copy) and discuss these issues with your doctor. Even if you still require some supplemental thyroid, it’s best to do all you can to support the healthful function of your thyroid.
    Be well,

  44. Sally B

    April 11, 2018 , 12:29 pm

    I noticed you mentioned K2 and D, but didn’t mention strontium, which has been paired with Algaecal for some time. Are they getting away from insisting strontium is part of the Algaecal protocol for maximum absorption? Thanks.

  45. Lara Pizzorno

    April 12, 2018 , 2:08 pm

    Hi Sally,
    No, I still recommend both AlgaeCal Plus and Strontium Boost for optimal support of healthy bone rebuilding. I don’t specifically refer to strontium everywhere I mention vitamin D or K2, just as I don’t discuss boron or every other important trace mineral — and there are quite a few, all of which are naturally present in AlgaeCal Plus — in relation to vitamin D and K2. This does not mean that all are not necessary for bone health, just that I can’t cover everything in every post. As you know, although my bones have now been in excellent shape for several years since I began taking AlgaeCal Plus, after reviewing the research on strontium and reacquainting myself with the dozens of ways in which this mineral promotes healthy bones, I started taking Strontium Boost again at half the typical dosage to maintain my bones’ health – and will continue to do so until I’m no longer in this body (which I hope will be a very long time from now ?)

  46. Ravi

    June 11, 2018 , 9:33 am

    Hi Lara,

    I have had a tibial plateau fracture 7 years back and was operated on, Of late, started having pain in my knee.

    My doc has prescribed – Collagen Peptide &
    Glucosamine for improving my situation.

    Wanted to know if these are safe.

  47. Lara Pizzorno

    June 12, 2018 , 6:13 pm

    Hi Ravi,
    Both are not only safe but effective — you’ve got a well informed doctor! Two further points that will improve your outcome: (1) Vitamin C and a number of trace minerals are essential for optimal collagen formation. Ensure you’re getting at least 1,000 mg of vitamin C daily from whole foods and supplements. If taking supplemental vitamin C, take no more than 500 mg at a time. More than this taken at once will not be utilized as effectively. Re trace minerals, two of the most important for collagen formation are silicon and boron — both of which AlgaeCal Plus will provide for you in amounts shown to be effective in the research. (2) The form of glucosamine is important. You want glucosamine sulfate, not glucosamine hydrochloride. A number of papers have reported positive outcomes from the use of glucosamine sulfate, and negative outcomes from the use of glucosamine hydrochloride. I’ve included the references from 2 recent papers below for you. The first reports significant beneficial effect from glucosamine sulfate; the second reports no benefit from glucosamie hydrochloride. When you see media assertions that glucosamine is not helpful, you can be sure the form used in the research was glucosamine hydrochloride.
    Bruyère O, Altman RD, Reginster JY. Efficacy and safety of glucosamine sulfate in the management of osteoarthritis: Evidence from real-life setting trials and surveys. Semin Arthritis Rheum. 2016 Feb;45(4 Suppl):S12-7. doi: 10.1016/j.semarthrit.2015.11.011. Epub 2015 Dec 2. PMID: 26806187; Kwoh CK, Roemer FW, Hannon MJ, et al. Effect of oral glucosamine on joint structure in individuals with chronic knee pain: a randomized, placebo-controlled clinical trial.Arthritis Rheumatol. 2014 Apr;66(4):930-9. doi: 10.1002/art.38314.PMID: 24616448
    Be well, Lara

  48. vijayalakshmi.nadakuditi

    June 25, 2018 , 5:18 am

    Hello Lara,

    I had a tibial plateau fracture, and of late, started getting knee pain. My doctor suggested taking a powder composing the below
    – Collagen Peptide
    – Glucosamine

    I am worried if the above can cause bone loss. Do you have any information on this?


  49. Jenna AlgaeCal

    June 26, 2018 , 11:30 am

    Hi Lakshmi,

    Lara answered this question in response to Ravi just below 🙂

    – Jenna @ AlgaeCal

  50. Kathy Risner

    December 25, 2019 , 8:33 am

    Perhaps I am missing it, but have tried to find exactly what class of heart meds can contribute to bone loss.

    Thanks you

  51. Blaire AlgaeCal

    December 26, 2019 , 3:28 pm

    Good question, Kathy! In this article, anti-coagulants and loop diuretics are the listed classes of heart medications that can cause bone loss; having said that, other classes of heart medications could potentially cause bone loss as well. If you have questions on any specific medication, it’s best to speak with your pharmacist/doctor ❤️

    – Blaire @ AlgaeCal

  52. Victor

    May 30, 2020 , 12:48 am

    Hello Lara, I am happy to stumble in here cuz you are doing a wonderful job.. I notice i have taken a lot of an opiod pain med for some enhancements which i believe is the reason i am have weak or loss bones cuz i can’t open some jam jar, I have back pains frequently whenever i have long long sitting or standing even when lying down forward for long, my fingers bones get easily turned or twisted.. Please, how can correct it? I am a poor guy that afford scan or drugs.

  53. Blaire AlgaeCal

    June 1, 2020 , 1:15 pm

    Hi Victor,

    Thank you for reaching out. We’re so sorry to hear what you’re going through.

    Victor, if you are over the age of 50, we recommend getting your hormone levels checked, and discussing bio-identical hormone replacement (BHRT) with your doctor. This may also be covered by your insurance company.

    Furthermore, it’s a good idea to take AlgaeCal Plus and Triple Power Fish oil, which will supply you with nutrients beneficial for your health. Along with this, we recommend a healthy Mediterranean-type diet & regular exercise. Feel free to check out healthy recipes & great exercises on our blog here.

    Hope that helps! Let us know if you have further questions ?

    – Blaire @ AlgaeCal

  54. Karen

    November 13, 2020 , 8:07 am


    Ive been reading your article with great interest.

    You wrote that TCA’s are a greater risc to osteoporosis than SSRI’S.
    See your comment below.

    Unfortunately, this newer study found that TCAs are not a better option and may be an even more damaging to our bones than SSRIs. The postmenopausal women taking tricyclic antidepressants in this study lost even more bone than women taking SSRIs. TCA users’ annual rate of bone loss was −0.35% compared to just −0.08% in women not taking antidepressants.

    The conclusion is the Conclustion of the article you mention (2016).

    Conclusions: In conclusion, the use of SSRIs seems to accelerate postmenopausal bone loss in a dose-response manner. Associations between TCA and other antidepressant use and bone loss may also exist. Thus, the possibility of increased risk of osteoporosis should be considered when prescribing antidepressants for postmenopausal women.

    So I do not understand why you say that TCA are possibly worse for the bones than SSRI’s.
    The article says that association between TCA’s and other antiepressants and bone loss may also exist.

    Kind regards, Karen

  55. Lara Pizzorno

    November 13, 2020 , 9:47 am

    Not sure I understand your question. I base my warnings regarding TCAs on the latest papers published in 2016 and 2020. These indicate TCAs also cause bone loss and are not a safer option than SSRIs. 2016 paper: “potentially serious adverse events … encompass gastrointestinal symptoms (nausea, diarrhea, gastric bleeding, dyspepsia), hepatotoxicity, weight gain and metabolic abnormalities, cardiovascular disturbances (heart rate, QT interval prolongation, hypertension, orthostatic hypotension), genitourinary symptoms (urinary retention, incontinence), sexual dysfunction, hyponatremia, osteoporosis and risk of fractures, bleeding, central nervous system disturbances (lowering of seizure threshold, extrapyramidal side effects, cognitive disturbances), sweating, sleep disturbances, affective disturbances (apathy, switches, paradoxical effects), ophthalmic manifestations (glaucoma, cataract) and hyperprolactinemia. …such adverse events may persist after drug discontinuation, yielding iatrogenic comorbidity. Other areas of concern involve suicidality, safety in overdose, discontinuation syndromes, risks during pregnancy and breast feeding, as well as risk of malignancies. Thus, the rational selection of ADs should consider the potential benefits and risks, likelihood of responsiveness to the treatment option and vulnerability to adverse events. The findings of this review should alert the physician to carefully review the appropriateness of AD prescription on an individual basis and to consider alternative treatments if available.
    2020 paper:
    “Based on the current literature, we tentatively suggest that tricyclic antidepressants may increase the risk of fracture via mechanisms other than a direct effect on bone mineral density.” What this paper shows is that while BMD may not be affected, TCAs increase fracture risk significantly. One of the 8 studies discussed re TCAs found hip fracture risk in women using TCAs increased 83%. Another showed a 26% increase in fracture risk. Another found TCA use was associated with a standardized incidence ratio (SIR) of 1.4 (1.3-1.5) for hip fracture — i.e. 40% increase in risk. Yet another, this one a case control study, showed current users of TCAs had an increased risk of sustaining a hip fracture with a crude odds ratio (OR) of 1.9 — i.e., 90% increase in risk. Another involving 6763 participants showed an Odds risk for fracture (adjusted for multiple potential medication and physical illness confounders) of 1.76 (76% increase) in current users of TCAs. So while the precise mechanisms via which TCAs increase fracture risk have not yet been elucidated, in my opinion, these findings provide sufficient evidence to state that TCAs are not a better option for our bones.

  56. Penny

    September 25, 2022 , 1:24 pm

    Hi Lara,
    I was on Tamoxifen for 5 years, ending about 10 years ago. Could this drug cause bone loss?
    Thanks, Penny

  57. Brianne Bovenizer

    September 26, 2022 , 3:06 pm

    Hi Penny,

    This is a great question! If you are not yet a member of our AlgaeCal community on Facebook, I would encourage you to join for more information on this that I think you will find helpful! To learn more about this community, click HERE! 🙂

    I hope this helps!

    – Brianne @ AlgaeCal

  58. Barbara Bayuk Ross

    March 21, 2023 , 6:10 am

    Great presentation of how medications, diet, exercise & judicial use of supplements are able to reduce osteoclasts and support osteoblast formation.
    I am excited to start algaecal & continue to improve my health status.

  59. Brianne AlgaeCal

    March 21, 2023 , 9:24 am

    Thanks so much for commenting Barbara, and we are so happy that you found this information helpful! For more information and personalized support, you can reach our Bone Health Consultants 7 days a week at 1-800-820-0184 (USA & Canada, toll-free) or by email at [email protected]. Let us know if you have any questions! 🙂

    – Brianne @ AlgaeCal

  60. Kirsti Koski

    April 12, 2023 , 2:54 pm

    Very interesting! Would you mind sharing your thoughts on Ortho Molecular Products Strotium taken with Metagenics Bone builder with boron compare with your studies. I feel like time matters so would like the best since my bones are osteoporosis; and I am taking a Fluoxitin. Also been diagnosed with Celiac disease about 30 years ago.I am 62 had spinal compression fracture at age 30

  61. Shelby AlgaeCal

    April 13, 2023 , 10:41 am

    Hi Kirsti,

    Thank you so much for reaching out, and your feedback on our article! We’re truly sorry to hear that you’ve been diagnosed with Celiac disease and experienced a spinal compression fracture in your 30’s, and we absolutely understand that you’re looking to best support your bone health moving forward!

    Kirsti, while we can’t speak to the safety or efficacy of taking either product from the other companies mentioned in your query, we certainly can speak to our products! AlgaeCal is the only calcium supplement clinically supported to increase bone mineral density, with no adverse side effects being found in our studies. With that in mind, our human clinical studies have shown that when taking AlgaeCal Plus and Strontium Boost, on average you’re able to see a 3% increase in bone density each year, and you’re welcome to read more about our research HERE.

    Furthermore, it may help to know that we aren’t aware of any interactions between Fluoxetine and our supplements, although we do recommend double checking this with a doctor or pharmacist, as we aren’t health care professionals. 🙂

    We would love to answer any other questions you have and get started on our program, so please feel free to reach out to our Bone Health Consultants at 1-800-820-0184 (USA & Canada toll-free) – we’re always happy to help!

    – Shelby @ AlgaeCal

  62. Susana C

    May 23, 2023 , 6:27 pm

    I have found valuable information (body aches, loss of teeth, anticoagulants, hunched back) that leads me to think that my husband would benefit from a DEXA scan and taking omega and vitamin D3. He will ask his provider to order one thanks to what I learned reading this.

  63. Manja

    May 24, 2023 , 8:01 am

    Hi Susana,

    We’re happy to hear you found our information valuable. Although women make up the vast majority of osteo-sufferers, and have more risk factors, men are affected by various risk factors too. After peak bone mass (around age 40), both men and women begin to lose about 1% of their total bone mineral density each year. Women, however, tend to develop osteoporosis much earlier in life (usually in their fifties) because of menopause.

    So while men typically don’t experience this rapid rate of bone loss in their fifties, by age 65 or 70, men and women lose bone mass at the same rate. Other factors such as medical conditions, prescription medications, genetics, hormonal changes, lifestyle choices, illness and injury can also contribute to a man’s osteoporosis diagnosis. In fact, we have an article covering this topic here.

    Rest assured, AlgaeCal is clinically supported to increase bone density and we have helped thousands of men and women work back toward a healthy bone density both safely and naturally. Many members of our community have shared their success stories and experiences with the AlgaeCal program, and among these are men who have seen remarkable results.

    If you would like more information, our Bone Health Consultants are available 7 days a week at 1-800-820-0184 (USA & Canada toll-free)!

    – Manja @ AlgaeCal

  64. Barb

    January 12, 2024 , 2:44 pm

    I have a neurogenic bowel due to Spina Bifida and am highly prone to constipation. I need to know if AlgaeCal or your other products cause constipation. Thank you for any information you can provide

  65. Yoori AlgaeCal

    January 15, 2024 , 4:34 pm

    Thank you for reaching out, Barb! It is not common to experience constipation with AlgaeCal. Most calcium supplements cause constipation because they supply only calcium or calcium and vitamin D. It takes a variety of nutrients for proper absorption of calcium, and AlgaeCal Plus provides all of these…in the right amounts! For more information on this topic, visit our website HERE. I hope this helps!

    – Yoori

  66. Mary McK

    May 3, 2024 , 9:30 pm

    Thank you for this information to share with my doctor. I am on synthetic thyroid medication, so hopefully my doctor can help me with something more natural.

  67. Barbara Gritczek

    May 16, 2024 , 7:30 am

    Very informative and helpful.

This article features advice from our industry experts to give you the best possible info through cutting-edge research.

Lara Pizzorno
MDiv, MA, LMT - Best-selling author of Healthy Bones Healthy You! and Your Bones; Editor of Longevity Medicine Review, and Senior Medical Editor for Integrative Medicine Advisors.,
Dr. Liz Lipski
PhD, CNS, FACN, IFMP, BCHN, LDN - Professor and Director of Academic Development, Nutrition programs in Clinical Nutrition at Maryland University of Integrative Health.,
Dr. Loren Fishman
MD, B.Phil.,(oxon.) - Medical Director of Manhattan Physical Medicine & Rehabilitation and Founder of the Yoga Injury Prevention Website.,
Prof. Didier Hans
PHD, MBA - Head of Research & Development Center of Bone Diseases, Lausanne University Hospital CHUV, Switzerland,