When you’ve been recognized with osteopenia or osteoporosis, your physician has already mentioned calcium, vitamin D, and weight-bearing train with you. That is good recommendation, however there’s extra to it than simply these three issues.
There’s one other nutrient that deserves a seat on the desk. Most likely consider extra for preventing colds and the flu than for serving to with bones. It is vitamin C.
There is a rising physique of human analysis that means vitamin C performs a a lot larger position in bone well being than most individuals notice. Dr. Tom Levy, in his guide Demise by Calcium, discusses how vitamin C additionally helps bone well being. However that guide was revealed again in 2013, and there is extra analysis since then that verifies what he already discovered. Vitamin C is a strong teammate that helps all of the vitamins collectively construct wholesome bones for you. This is what the science exhibits and what you are able to do about it in the present day.
Your Bones Are Extra Than Simply Minerals
Most of us image bones as very mineral-dense constructions like sticks of calcium. However that is not the total image. Bones are roughly 50% protein by quantity. The first protein is kind 1 collagen. It is the collagen that varieties the versatile scaffold on which mineral is constructed. This scaffolding offers bones their energy and slight flexibility, they should take in affect with out snapping, like a brittle piece of chalk.
The calcium and different minerals fill in across the scaffold, which offers bones with their hardness and density. On a facet word, vitamin K2 cross-links one other protein, osteocalcin, which makes the protein scaffold even stronger. So vitamin K2 can be a key participant. However again to vitamin C.
With out wholesome collagen, the minerals do not have something to anchor onto. You may take all of the calcium you need, but when your protein construction isn’t there, your bones will probably be brittle and susceptible to fracture. And the primary requirement for constructing collagen is vitamin C.
How Vitamin C Builds and Protects Your Bones
Vitamin C helps bone well being via at the least 4 distinct pathways, every backed by human cell analysis and scientific proof.
It builds the collagen scaffold.
Vitamin C is crucial for the hydroxylation of proline and lysine — two amino acids that stabilize collagen fibers. With out sufficient vitamin C, collagen is structurally weak. That is why extreme vitamin C deficiency (scurvy) has been related to bone and joint issues for hundreds of years. Research with human osteoblast cells verify that vitamin C immediately stimulates kind I and sort III collagen synthesis in bone tissue (Malmir et al., British Journal of Diet, 2018).
It prompts bone-building cells.
Vitamin C promotes the differentiation and exercise of osteoblasts — the specialised cells chargeable for forming new bone. It enhances the expression of key bone-building markers, together with alkaline phosphatase and osteocalcin. Equally vital, vitamin C deficiency does the alternative: it impairs osteoblast operate whereas concurrently stimulating osteoclasts, the cells that break bone down. That is a double hit (Aghajanian et al., Journal of Bone and Mineral Analysis, 2015).
It helps defend bone cells from oxidative injury.
After menopause, declining estrogen exposes bone cells to elevated oxidative stress. Vitamin C neutralizes the free radicals that injury these cells — a protecting position that works independently of its collagen-building operate.
It flips genetic switches for bone formation.
Maybe probably the most thrilling current discovery got here from a 2022 examine revealed in Nature Communications. Researchers discovered that vitamin C does not simply assist assemble collagen — it epigenetically controls the genetic switches that activate bone-building genes. The examine confirmed that bone cell differentiation is “strictly and constantly depending on vitamin C,” indicating that this nutrient is concerned at a extra elementary degree than beforehand understood (Khani et al., Nature Communications, 2022).
What the Human Analysis Exhibits For Vitamin C and Bones
The analysis on the mechanisms of how vitamin C helps bones is nice, however we need to know: does it translate into actual outcomes in actual folks? So here is what the strongest human proof additionally tells us.
The Framingham Osteoporosis Research — one of the vital revered long-term epidemiological packages on the planet — tracked 958 women and men (imply age 75) over 17 years. Contributors with the very best whole vitamin C consumption had considerably fewer hip fractures and non-vertebral fractures in comparison with these with the bottom consumption. The distinction within the vitamin C consumption was really as a result of dietary supplements, not dietary consumption, on this inhabitants. An earlier evaluation from the identical cohort discovered that increased vitamin C consumption was related to considerably much less bone loss over 4 years (Sahni et al., Osteoporosis Worldwide, 2009; Sahni et al., Journal of Diet, 2008).
Two main meta-analyses have pooled information from a number of observational research to evaluate the general image. A 2019 evaluation in Frontiers in Endocrinology mixed 13 research and located that folks with the very best dietary vitamin C consumption had a 34% decrease danger of hip fracture in comparison with these with the bottom consumption (Solar et al., 2019). A 2018 evaluation within the British Journal of Diet discovered that increased vitamin C consumption was related to a 33% decrease danger of osteoporosis total and positively correlated with bone mineral density on the femoral neck and lumbar backbone — two of probably the most crucial fracture websites (Malmir et al., 2018). Collectively, these two meta-analyses discovered an analogous lower within the danger of hip fracture or osteoporosis.
Research centered particularly on postmenopausal girls constantly present the identical sample. Ladies with increased vitamin C consumption (137–176 mg/day) had considerably decrease osteoporosis danger in comparison with these consuming 91 mg/day or much less. Ladies recognized with osteoporosis had markedly decrease vitamin C ranges in blood than wholesome controls — 5.28 versus 9.77 mg/L (Brzezińska et al., Vitamins, 2020). Knowledge from the Boston Puerto Rican Well being Research confirmed that postmenopausal girls with ample plasma vitamin C had considerably increased hip bone density than these with low plasma vitamin C ranges (Mangano et al., Journal of Diet, 2021).
A small however notable randomized trial discovered that postmenopausal girls who obtained simply 250 mg/day of vitamin C along with their customary osteoporosis therapy confirmed considerably larger bone mineral density after 1 yr than these on customary therapy alone. That is not even very a lot vitamin C, but it surely was sufficient to make a distinction. The researchers concluded it was “a secure and low-cost addition to straightforward therapy” (Biomedical and Pharmacology Journal, 2014).
One vital nuance: a 2024 examine utilizing Mendelian randomization — a genetic technique for testing causality — didn’t discover a direct genetic causal hyperlink between vitamin C ranges and osteoporosis danger (Liu et al., Hereditas, 2024). This doesn’t suggest vitamin C is unhelpful, but it surely does counsel the connection is complicated. Vitamin C probably works greatest as a part of a complete dietary strategy, as a staff member, not because the star quarterback.
The Bone Well being Group: Vitamin C’s Place within the Lineup
Supplemental vitamin C, along with what you get out of your vegatables and fruits, seems to be useful based mostly on the proof above. Bone well being is a staff effort.
You want calcium for the constructing blocks. You want magnesium to steadiness calcium. Vitamin D helps calcium get absorbed to the precise locations. Vitamin K2 directs the calcium to the precise locations—to the bones and to not gentle tissues like cartilage and the partitions of your arteries.
Weight-bearing train stimulates bone transforming and strengthens bones. Vitamin C builds the collagen scaffold that holds issues collectively. It additionally prompts the cells that kind new bone and protects them from oxidative injury. A complete-foods plant-based weight loss plan with somewhat additional vitamin C is nice for bones, because the vitamins work synergistically. A vitamin D3 / K2 complement can be vital.
Sensible Steps You Can Take Right this moment
The Hallelujah Eating regimen emphasizes a excessive consumption of contemporary, uncooked vegatables and fruits, in addition to vegetable juice. This may present you simply with 200-300 milligrams of vitamin C a day simply out of your meals.
As well as, 1,000 milligrams of vitamin C in complement kind, resembling liposomal vitamin C or sodium ascorbate, is a superb thought and can assist bones. Most animals make their very own vitamin C, and there are various causes why the next consumption of vitamin C is helpful, as I’ve written about beforehand.
The Backside Line
It will be good to have extra large-scale randomized managed trials, however we now have sufficient proof to behave, from long-term inhabitants research, small trials, analyses of a number of research, and mechanistic research that present how vitamin C works.
Vitamin C is affordable and is broadly accessible. You need to take extra vitamin C for a lot of causes, together with stronger bones.
In case your DEXA scores have you ever involved, do not suppose you are doing all you may by simply taking calcium and vitamin D. You are able to do much more to manage your personal well being.
Undertake the Hallelujah Eating regimen and eat a big salad on daily basis. Keep energetic with weight-bearing train and take additional vitamin C. Use a holistic dietary strategy to completely help your physique, together with your skeleton.
References
- Sahni S, et al. (2009). “Protecting impact of whole and supplemental vitamin C consumption on the chance of hip fracture — a 17-year follow-up from the Framingham Osteoporosis Research.” Osteoporosis Worldwide, 20(11):1853–1861. PubMed
- Sahni S, et al. (2008). “Excessive vitamin C consumption is related to decrease 4-year bone loss in aged males.” Journal of Diet, 138(10):1931–1938. PubMed
- Zeng LF, et al. (2019). “Can Dietary Consumption of Vitamin C-Oriented Meals Cut back the Danger of Osteoporosis, Fracture, and BMD Loss? Systematic Evaluate With Meta-Analyses of Latest Research.” Frontiers in Endocrinology, 10:844. PubMed
- Malmir H, Shab-Bidar S, Djafarian Okay. (2018). “Vitamin C consumption in relation to bone mineral density and danger of hip fracture and osteoporosis: a scientific evaluation and meta-analysis of observational research.” British Journal of Diet, 119(8):847–858. PubMed
- Brzezińska O, et al. (2020). “Position of Vitamin C in Osteoporosis Improvement and Therapy — A Literature Evaluate.” Vitamins, 12(8):2394. PubMed
- Liu Z, et al. (2024). “Serum vitamin C ranges and danger of osteoporosis: outcomes from a cross-sectional examine and Mendelian randomization evaluation.” Hereditas, 161:43. PubMed
- Thaler R, Khani F, et al. (2022). “Vitamin C epigenetically controls osteogenesis and bone mineralization.” Nature Communications, 13:5883. PubMed
- Aghajanian P, et al. (2015). “The Roles and Mechanisms of Actions of Vitamin C in Bone: New Developments.” Journal of Bone and Mineral Analysis, 30:1945–1955. PubMed
- Morton DJ, Barrett-Connor EL, Schneider DL. (2001). “Vitamin C Complement Use and Bone Mineral Density in Postmenopausal Ladies.” Journal of Bone and Mineral Analysis, 16(1):135–140. PubMed
- Zhang R, et al. (2023). “Affiliation between a number of nutritional vitamins and bone mineral density in older adults.” BMC Musculoskeletal Problems, 24:113. PubMed
- Mangano KM, et al. (2021). “Ample Plasma Vitamin C Is Associated to Better Bone Mineral Density amongst Postmenopausal Ladies from the Boston Puerto Rican Well being Research.” Journal of Diet, 151(12):3764–3772. PubMed
- Pande V, Choubey J. (2014). “Does Administration of Vitamin C Enhance Osteoporosis in Put up-Menopausal Ladies.” Biomedical and Pharmacology Journal, 7(2).DOI
