Nearly every woman who we talk to thinks that low bone density is the greatest threat to her bone health. She thinks that porous bones are prone to fracture, and that dense bones are strong enough not to break.

The truth is, low bone density alone does not cause fractures. Every woman loses some bone density as she ages, but even when this bone loss is in the osteoporotic range, most women do not fracture. In fact, more than half of all fractures occur in people who do not have osteoporotic bone density.

Some women with thin bones will suffer a fracture, and others won’t. Understanding the difference between thin bone that fractures and thin bone that doesn’t is the key to protecting your own bones, no matter what your current bone density.

Low bone density does not cause fractures

The research on this point is clear: low bone density alone does not cause fractures. In one study of hip fractures in women, only 57% of women who fractured had low bone density, while 27% had medium bone density and 16% had high bone density! And keep in mind, 95% of the women in this study did not fracture at all, regardless of their bone density.

In fact, research shows that a severely osteoporotic vertebra with only 50% its normal amount of bone is still strong enough to withstand five times its normal strain load. This helps explain why in some countries, including France, Germany, China and Japan, women on average have lower bone density than in America, yet experience far fewer osteoporotic fractures. Low bone density is simply not the real problem.

Poor bone self-repair leads to weak bones

You may be wondering, if low bone density doesn’t cause fractures, what does? The answer lies in the quality of the bone, not simply the quantity.

Bone continually regenerates itself — at any given moment there are as many as a million places in your skeleton that are under repair. Tiny microfractures are healed, and old, fragile bone is replaced with stronger, new bone. This dynamic process gives your skeleton the ability to maintain high-quality bone, even as bone density declines. And high-quality bone is strong bone.

But when this self-repair process is disrupted, the structure of the bone begins to weaken. Usually this happens because of an imbalance in bone metabolism — too much bone is dissolved, too little bone is built, or, most likely, a combination of both.

Declining bone density is a common symptom of imbalanced bone metabolism, and thin, poor quality bone is most likely to fracture. But even bone with normal mineral density can break if it is not well maintained.

Have you had your bone density tested?

There is no direct measure of bone quality or strength. But there is a test for bone density, which is how some of the confusion arises. Conventional medicine likes to treat problems it can measure — and bone density is no exception.

Unfortunately, treating bone density exclusively doesn’t always result in healthier bones. Dense bones that are composed of old, stagnant tissue can be brittle and prone to fractures.

This is one of the major risks of bone density drugs (bisphosphonates) like Fosamax and Boniva. Bone density drugs stop the breakdown of bone, allowing minerals to accumulate and resulting in greater bone density. But without breakdown there is no repair. Within a year of using bone density drugs, the action of bone-building cells stops entirely. The resulting bone is dense, but usually poor quality and sometimes quite fragile.

So what does low bone density really say about your bone health?

Low bone density alone may not cause fractures, but this is not to say that bone loss doesn’t matter. Excessive bone density loss is an indication that your bone metabolism is out of balance, which means your bones are struggling to keep up with their demands.

Bone loss is not an isolated condition, nor does it mean your bone metabolism is faulty. Bone loss is usually a result of systemic imbalances elsewhere in the body. For example, if your body has as high acid burden, your bones donate their minerals to maintain the necessary blood pH level. If your body is receiving inadequate nutrition, your bones allow other organs to take their share first. These sacrifices are necessary for survival, but can cause bone breakdown to happen at a faster pace than new bone can be formed, which may result in lower bone density and poor quality bone.

Build better bones, not just denser bones

Rather than simply treating the symptoms of imbalanced bone metabolism — like low bone density — we should ask ourselves, How can we heal the underlying bone metabolism imbalance? That is, how can we reduce the factors that artificially accelerate bone loss and increase the activity of the cells that build new bone? And how can we do this without drugs?

When we take this approach we see improvements in bone quality and strength, rather than bone density alone. It works by supporting your bones’ natural self-repair mechanisms, reducing the burden on your bones, and encouraging new bone formation. Many women find their bone density increases with a natural approach to bone health, but more important the quality of the bone improves. The basic approach we recommend is:

  • An alkaline diet to help your bones conserve minerals
  • Nutritional support to your bone-building cells
  • Lifestyle changes, including exercise and stress relief

Bone density is a risk factor you have some control over — but it isn’t the definitive measure of bone health that most women think it is. Understand that the real opportunity for preventing fractures is building strength, not density alone. The good news is there’s a lot you can do to strengthen your bones, without drugs.

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