The Surprising Genes That Influence Your Bone Density
/Do you have bone density concerns like osteoporosis, osteopenia, or osteoarthritis in your family? Are you over 40-years-old? Or perhaps you’re interested in learning more about bone health than simply “get enough calcium and vitamin D”? If you answered yes to any of these questions, this two-part video and article series are for you.
Bone health is very personal for me because I live with osteopenia and osteoporosis. However, I'm actively working with insights from my genes and with really great clinicians and exercise physiologists to reverse these conditions. And reversing them I am! .
In this two part series, I will share with you what I know and what I have discovered about bone health and bone disease through my work in the fields of nutrition science and genomics where I have reviewed hundreds of DNA tests belong to hundreds of unique individuals. As you’ve probably guessed, what I have discovered is that bone health requires far more than your daily calcium and vitamin D.
I’ll be sharing my insights into the many factors that influence bone health, and the genes and nutrients I consider when looking at a genomic report. In the videos I explain in more detail how I look at genomic blueprints for insights into bone health—and health in general—and where I may see some risks and opportunities to prevent bone density from getting worse or even start turning it around.
Because there is a lot to take in, I am imparting my information in two videos and articles shared over two separate blog posts. Keep reading here or watch the accompanying video for part one. Part two is in my next blog post coming next month!
How I Look For Gene Patterns That Tell Your Bone Story
When trained clinicians like myself look at genomic reports, we're looking for are patterns. Patterns in genes that tell your unique health story and answer your unique health questions.
Specific to bone health, when I look at a genomic report, I'm looking for gene patterns that give me insight into whether you have the nutrients and biochemical support systems in your body to build or remodel bone. Or whether you have a number of genes variants (SNPs) and biochemical inefficiencies that can swing the balance toward bone resorption (depletion) and negative bone balance. Gene patterns I consider are those that impact methylation, hormone imbalance, inflammation, stress management, gut health and nutrient absorption to name a few. One gene never tells the story, but a whole chorus of genes does.
In reviewing a personal DNA or genomic report, once I can connect gene patterns to your life circumstances to include diet, exercise (which also means lifting weights), environment, work-life balance, I may advise additional laboratory testing to validate signposts from your genes (I TEST, I don’t guess).
I also look deeply into your diet to see if you have the nutrient availability to support the innate intelligence of your body. You’d be surprised how easily deficient our diets are, despite best intentions! I mean, are you personally eating 600 grams (2.6 cups) veggies/fruit a day? Watch the video to see if you are!
Then I put everything together and build a customized program with you that sets you on your best path to bone restoration, or bone loss prevention.
Genes are the foundation I work from. Period.
Now with that introduction complete, let’s get into Part One of The Surprising Genes That Influence Your Bone Density
What impacts bone density?
There is much more to optimizing your bone health than simply getting enough calcium and vitamin D. Consider these points:
While some medications can support the rebuilding of bone, many other medications can actually deplete your bone mass.
Stress has a huge effect on your bone health. Did anyone tell you that?
Anything that is toxic to the environment is toxic to you—and your bones are going to feel it.
Inflammation and oxidative stress are at the root of pretty much all disease —including your bones.
Too much alcohol or simply the act of smoking do your bones no favors. In fact, to the contrary
What you eat - of course!
There’s a deep connection between your hormones, their balance - and your bones.
Your bones are dynamic organs
It may be hard to picture, but bone is a dynamic, ever-shifting organ.
Your bones are constantly remodeling or “turning over” to replace the old with the new. You have bone-building cells (osteoblasts) and cells that are integral to bone breakdown, repair and replacement (osteoclasts).
As with all things in life, the challenge is balance. When the amount of bone you are losing exceeds the amount of bone you are building, you are in a negative balance, also known as resorption. Resorption shows up as lower bone density. Lower bone density is associated with osteopenia, osteoporosis or osteoarthritis. This is not the direction we want to go in. We want to keep the balanced tipped toward strong and healthy bones.
You want to think of your bones as a huge warehouse or storage depot. A place where your body can store nutrient information and also access it when it needs it. As with any warehouse, you want to have enough stock on hand, but not be overflowing or understocked. It’s the same for bone health. You don’t want to store useless or excess junk in your bones, nor do you want your bone to become a constantly depleted warehouse, which lowers your bone density.
Unbeknownst to many of us living in this very demanding 21st century world, this is actually what is happening with our bones. They have become both an overflow site for unwanted toxic waste, as well as a revolving door for key nutrients your body needs. The problem is, someone keeps leaving the warehouse door open and nutrient information keeps flowing out. There are often not enough warehouse employees to restock the nutrients.
So as you can see, there’s clearly more to the bone story than calcium and vitamin D. Let’s dig in.
How genes provide insights into your bones
As you know, the foundation of all my work is genetics. Genetic reports are the signposts that provide clues into the efficiencies and inefficiencies of how our individual bodies work. No two reports are alike because no two humans are alike.
Genes help me look differently at bone health because they provide insights into so many things that impact your bones beyond calcium and vitamin D. These include
Genes that impact hormones, hormone balance and hormone detoxification
Inflammation
Methylation
Stress management
Detoxification
Nutrient sufficiency
Gut health
It is not uncommon at all for me to be working with individuals, especially those approaching midlife or older, and see significant enough patterns in their gene reports to suggest a bone mineral density scan is a priority test. It’s not because I can predict or diagnose (I am not a doctor, so I can’t), but it the gene signposts and nutrient insufficiencies from labs indicate a collision course for bones. Sadly, I am not often wrong and the osteopenia or osteoporosis diagnosis has set in.
And on that note, a word about gut health
When it comes to nutrition, if your gut is not doing its job to break down and absorb nutrients, all health bets are off. Bones are no exception. In fact they are probably taking the first hit. Even with the most prudent, diverse, nutrient rich diet in the world, if you can't absorb the nutrients, you can’t optimize your health. It doesn’t matter if you’re prudently taking your daily multi and/or your 2, 5 or 10,000 IUs of Vitamin D. If you’re still struggling to get nutrition profile and your Vitamin D to optimal levels, please see a licensed health professional or a nutrition expert who can help you get digestion and absorption to where it needs to be. Oh and get the right form and formulation of Vitamin D for YOU
Hint -Vitamin likes K2 and magnesium as nutrient pals and collaborates with vitamin A as its collaborator in the body
OK, let’s take a look at the genes I consider when assessing your bone health .
The caffeine-bone connection
Did you know that too much caffeine can deplete your bones? Caffeine is found in coffee, green and black teas, chocolate and a lot of the fortified bars and beverages in the sports arena. There is a reason that some people get the jitters when they drink too much caffeine. It’s a sign that their body cannot detoxify caffeine fast enough. Yes, caffeine can be toxic.
The American Journal of Clinical Nutrition, Volume 74, Issue 5, November 2001, Pages 694–700
The gene I look at to understand how you metabolize caffeine is called CYP1A2. You're either a fast, medium or slow metabolizer of caffeine. We also consider other genes such as NAT2 and COMT that can truly amplify the toxicity quotient of caffeine if they are also in their slow versus normal or fast forms. Genes don’t lie!
Specific to caffeine and bone density, the connection maybe beyond the genes I mention to how caffeine itself interferes with your Vitamin D Receptor, also known as your VDR gene. There are different forms of the Vitamin D receptor. In a 2001 study, researchers studied the impact of caffeine consumption on the bone mineral density of post-menopausal women. They noted that women with high daily caffeine consumption > 300mg/d had significantly higher rates of bone loss in the lumbar spine than those with <300 mg/d. When they further analyzed the data according to the genotype (form) of the VDR gene, they found differences between those who had the TT (Lower loss) versus tt (higher loss) form. Variants in the Vitamin D Receptor (VDR) can impact calcium uptake into the bone.
A 2021 study also confirmed the depleting impact of caffeine (regardless of your genes). Here researchers demonstrated that caffeine increased the excretion of calcium in urine by 77%. Depending on your VDR genotype (Not a feature of this study), you can see how caffeine could significantly exacerbate bone density. Caffeine drinkers, don’t take your bones for granted!
Genes, estrogen and your bones
Your estrogen hormone (Women and Men) supports bone health in two primary ways. Firstly, it a bone-builder, stimulating cells your bone-building osteoblasts. Secondly, estrogen can perform an anti-inflammatory function by turning off inflammatory molecules such as Nf-🇰B and IL-6. These inflammatory molecules are associated with bone breakdown. Genetically, variants or SNPs in the IL-6 gene can actually result in an increase in the production of this inflammatory molecule. So we can see how important estrogen and other inflammation control molecules such as EPA and DHA (Omega-3) are to bone health. Inflammation = bone degradation
Given that estrogen plays an important regulatory and balancing role in bone health, its useful to know which genes might impact its ability to show up and do its job. Before we look at that, it is important to acknowledge that as we age, hormone levels decline, including estrogen. In cases of precipitous bone density loss, repletion of hormone levels can be a useful strategy for some individuals. The book, Estrogen Matters by Avrum Blum, MD and Carol Tavris, PhD is an illuminating read on the role of estrogen in the long term health of women.
Specific to genes that impact hormone availability, the CYP19A1 (the aromatase enzyme) converts pre-estrogens into active forms of estrogen. When its not working as well, you may have less activated estrogen and actually higher levels of testosterone.
Another gene SHBG encodes for the sex hormone binding globulin protein. This protein binds and transports both estrogen and testosterone. Note here that testosterone is also important for bone remodeling and lower rates in men are associated with lower bone mass. Given the integral role that SHBG plays in transporting estrogen and testosterone around the body, variants in this gene are associated with lower the availability of these hormones, which can negatively impact bone density. The role of SHBG in osteoporosis is examined in this review.
Inflammation, IL-6 and your bones
It doesn't matter, whether it's your brain, heart or bones, inflammation is the root cause of imbalance in your body.
High levels of inflammatory molecules can negatively impact the starter cells for bone, slowing down their healthy maturation into bone-building osteoblasts. Inflammation can also make the existing osteoblasts less functional. In other words, inflammatory molecules can alter your bone balance in a negative way, resulting in more bone breakdown than rebuilding, lowering your bone density.
One of these inflammatory compounds you’ve met before.
IL-6 is particularly negative because it will stimulate the development of osteoclasts—your bone breakdown cells. This can throw the bone balance off even more toward breakdown.
Some of these inflammatory molecules are important and inflammation can be healthy to a certain point. But when it gets out of hand, the results can negatively impact your health, and in this case - your bones.
Nutrigenomics To The Rescue!
We can introduce foods that contain bioactive molecules to turn down the ability of a gene to do its job. Learn more about bioactives here. Grab bioactive-rich recipes here.
Bioactives that help turn down the negative inflammatory impact of IL-6.
Quercetin: found in alliums, onions, chives, leeks, capers, potent radishes and their leaves, fennel and elderberry
Ursolic Acid: found in apple peels and the herbs rosemary and sage (the fresher the herb, the better)
Luteolin: found in oregano (preferably Mexican oregano), thyme, celery seeds and juniper berries
Rutin: found in buckwheat
Even if you don't have a genetic test you can build these foods into your diet because we all have the IL-6 gene. If you had the choice to prioritize any foods, I recommend foods that contain these bioactives because they’re going to help muffle this gene a little bit.
That’s it for Part One. If you’re ready for Part Two, where I talk about how bone density is much more than Vitamin D and calcium, simply click on the button below.
References
Prema B Rapuri, J Christopher Gallagher, H Karimi Kinyamu, Kay L Ryschon. Caffeine intake increases the rate of bone loss in elderly women and interacts with vitamin D receptor genotypes, The American Journal of Clinical Nutrition, Volume 74, Issue 5, November 2001, Pages 694–700.
Reuter SE, Schultz HB, Ward MB, Grant CL, Paech GM, Banks S, Evans AM. The effect of high-dose, short-term caffeine intake on the renal clearance of calcium, sodium and creatinine in healthy adults. Br J Clin Pharmacol. 2021 Nov;87(11):4461-4466.
Hoppé E, Bouvard B, Royer M, Audran M, Legrand E. Sex hormone-binding globulin in osteoporosis. Joint Bone Spine. 2010 Jul;77(4):306-12.
