The link between osteoporosis and vitamin D deficiency that follows after menopause

Vitamin D is important for cellular calcium uptake, bone health, and a number of other functions. There is also a direct link between the widespread vitamin D deficiency problem and brittle bones and osteoporosis among post-menopausal women, according to a large Chinese study that is published in Frontiers in Nutrition. It is important to include magnesium and vitamin K2, as they also contribute to bone health.

The risk of osteoporosis goes up with increasing age. In women, the risk grows rapidly after menopause due to hormonal changes. You don’t notice that your bones are weak, which makes this condition even more tricky because it is often discovered at a stage where one can easily break a leg, a wrist, the hip etc.
Vitamin D plays a key role in bone health. One reason is that vitamin D increases the intestinal absorption of calcium, which is then carried with the blood to the bones. The parathyroid glands also have a vital function by producing PTH (parathyroid hormone) that helps regulate calcium levels in the blood. Vitamin D also regulates levels of osteocalcin that adds strength to the bones. Vitamin D deficiencies, unfortunately, are rather common, especially among women after menopause. Scientists have found that lack of vitamin D affects the mineral density in bone tissue. Also, it affects the parathyroid glands’ PTH production plus levels of BTM (bone turnover marker).
Multiple studies have looked at vitamin D’s role in bone health and produced conflicting results. This may be because they are too small or have other limitations. Here, it is important to remember that vitamin D supplements must be large enough to optimize blood levels of the nutrient.

Vitamin D deficiency harms the bones – especially after menopause

The new Chinese study included 8,532 post-menopausal women aged 50 years and older. A little less than half of the participants had been diagnosed with osteopenia, which means their bones are weaker than normal. Around half had been diagnosed with osteoporosis or brittle bones. The researchers measured blood levels of vitamin D, PTH, and osteocalcin in all participants. They also measured overall bone density, including in the lumbar spine, femoral neck, and the entire hip. Afterwards, comparisons were made of blood levels of vitamin D, PTH, and the BTM marker.
The study showed that both moderate and severe vitamin D deficiencies are common among post-menopausal women diagnosed with osteopenia and osteoporosis. There is also a link between vitamin D deficiency and bone density, PTH, and BTM. The scientists observed that those participants with weak bones who had the highest vitamin D levels in their blood had greater bone density in the femoral neck and the entire hip compared with those with the lowest vitamin D levels in their blood. The same tendency was observed in those who had osteoporosis. In addition, those with osteoporosis who had more vitamin D in their blood also had greater bone density in their lumbar spine, compared with those who had had less vitamin D in the blood. This study contributes to the understanding of how vitamin D affects bone health.

• Blood levels of vitamin D should ideally be higher than 75 nmol/L all year and throughout life

Strong bones also require vitamin K2, magnesium, and exercise

Many bone supplements only contain vitamin D and calcium, but we also need magnesium and vitamin K2, two nutrients that help remove calcium from the bloodstream and embed it in our bone tissue. It is important to take calcium and magnesium in the right balance.

References:

Xi Chen et al. Vitamin D status and its associations with bone mineral density, bone turnover markers, and parathyroid hormone in Chinese postmenopausal women with osteopenia and osteoporosis. Frontiers in Nutrition 2024

Zhaojun Mei et al. The role of vitamin D in menopausal women´s health. Frontiers in Physiology. 2023

Australian Menopause Centre. Vitamin D: ” The Sunshine Hormone” Helping You Manage Menopause.