Is Alcohol a Hidden Threat to Your Bone Density?

You probably know that excessive alcohol can damage your liver.

But did you know that it also affects your bone health?

Drinking too much weakens your bones, making them more prone to fractures — especially as you age, as well as if you’ve indulged in a few too many drinks in your younger years.

So, should you cut out alcohol entirely to protect your bones?

In this article, we’re going to discuss how alcohol affects your bones, how much is considered “too much” when it comes to bone health, and what you can do to reduce your risk of fractures.

How Alcohol Weakens Your Bones

The drinking habits you form in your younger years can have a lasting impact on your bone health as you age.

In fact, the more you drink when you're young, the more likely you are to experience bone loss later in life.

In a study published in the Journal of Studies on Alcohol and Drugs, researchers discovered that heavy episodic drinking can result in decreased bone density in college-aged women. (1)

Researchers defined "heavy episodic drinking" as having four or more drinks within two hours on 115 or more occasions since high school — roughly 1.6 episodes each month.

The results were clear: women who frequently engaged in binge drinking showed reduced bone mineral density in their vertebrae.

What’s more, their bone health was compromised even before reaching peak bone mass, which typically occurs in one’s late twenties.

These effects become even more severe in menopausal women or those already dealing with bone loss.

In fact, those who drink more than two alcoholic beverages daily are at: (2)

• A 23% greater risk of any fracture
• A 38% higher risk of fractures related to bone loss, and
• A 68% higher risk of hip fractures compared to moderate drinkers or non-drinkers.

 Moreover, heavy alcohol use can also increase your likelihood of falls, as it can impair the cerebellum, a part of the brain responsible for balance and motor skills. (3)

These accidents, whether from tripping on stairs or colliding with objects, can lead to serious fractures and slow down the healing process, making recovery even more challenging.

So, how does alcohol affect your bone health? There are two major ways.

Alcohol’s Effects on Bone Remodeling

Bone remodeling is a continuous process where the body replaces old, worn-out bone tissue with new, stronger material. (4)

This process involves a delicate balance between two key cell types: osteoclasts, which break down old bone, and osteoblasts, which build new bone.

Maintaining a balance between these cells is important to support the health and strength of our skeletal system.

Normally, bone remodeling happens in small, localized areas on the bone surface.

Osteoclasts create tiny cavities by resorbing bone, and once their job is done, osteoblasts step in to fill these cavities with fresh bone material. (5)

However, when osteoclasts dig too deep or osteoblasts can’t keep up with forming enough new bone, the balance is thrown off, leaving bones vulnerable.

This can create imbalances that can lead to conditions like low bone density or excessive bone growth, which in turn can cause pain and discomfort.

One of the culprits of these imbalances? Excessive alcohol consumption.

A study in the South African Medical Journal shows that alcohol reduces bone formation while increasing bone resorption, disrupting the natural cycle. (6)

Researchers compared the bone health of 19 heavy or moderate drinkers to 43 non-drinkers with femoral neck fractures.

Those who drank alcohol had lower trabecular bone volume, thickness, and bone formation compared to non-drinkers with weak, fragile bones.

Compared to moderate drinkers, heavy drinkers also had even higher rates of bone resorption and lower levels of bone formation.

The mineralization front, or the region where newly formed bone tissue is being hardened, was also reduced in alcohol drinkers.

However, the overall size and shape of the osteoid seams, the unmineralized bone matrix, remained unchanged.

This was supported by another study published in the Clinical Orthopaedics and Related Research, where heavy alcohol drinkers who suffered from unexplained bone loss had thinner bone walls. (7)

In this study, researchers looked at 11 men aged 35 to 50 with idiopathic bone loss.

Most of these men were mild alcoholics and heavy smokers, and two had a condition where too much calcium was absorbed.

When comparing their bone health to healthy men of the same age, they found that the patients had lower trabecular bone volume and thickness.

Bone formation was also reduced in the patients, but the rate of bone breakdown (resorption) was similar to that of the healthy men.

To understand this further, researchers measured osteocalcin, a protein that reflects osteoblast activity in mice.

The result? Alcohol exposure consistently reduced osteocalcin levels, showing that alcohol suppresses osteoblast function. (8)

The researchers also found that alcohol-fed rats had less bone volume, fewer osteoblasts, and slower bone formation, all of which are clear signs of impaired bone health.

In fact, the rats had a reduced bone wall thickness of 52% – a result consistent with human studies showing reduced osteoblast activity in those who drink heavily. (9)

With all these studies, the evidence is clear: alcohol suppresses the work of osteoblasts, the bone-building cells, leading to decreased bone formation and increasing the risk of osteoporosis.

But apart from bone remodeling, alcohol can also affect how our body absorbs and uses calcium.

Alcohol’s Effects on Calcium Absorption

Our bones serve as more than just a framework for our bodies; they also act as a storage site for calcium and other essential minerals. (10)

This calcium is absorbed in the small intestine and regulated through various hormones that control its distribution between the bloodstream and bone.

However, alcohol can disrupt this balance by interfering with the hormones that regulate calcium metabolism.

So, what are these hormones, and in what ways does alcohol affect them when it comes to maintaining bone health?

Parathyroid Hormone (PTH)

Parathyroid hormone (PTH), produced by four small glands located behind the thyroid, helps maintain healthy calcium levels in our bones. (11)

When blood calcium levels drop, PTH is released to help regulate calcium balance, which it does in three ways: (12)

• First, PTH stimulates the release of calcium from your bones into the bloodstream by activating osteoclasts, the cells responsible for breaking down bone tissue. This process helps to ensure that your blood calcium levels remain stable.
• Second, PTH promotes the production of active vitamin D (calcitriol) in the kidneys. It also signals the kidneys to retain calcium, preventing it from being lost in urine.
• Third, this hormone encourages the small intestine to absorb more calcium from the food you eat, further supporting your body’s calcium needs.

Short-term alcohol intake can cause a temporary spike in parathyroid hormone (PTH), leading to fluctuations in calcium levels and increased calcium loss through urine. (13)

However, long-term heavy drinking can result in low blood calcium levels, or hypocalcemia, even when PTH levels return to normal.

This can impair parathyroid function over time, reducing the body’s ability to retain calcium effectively.

Vitamin D

Vitamin D helps increase the body’s ability to absorb calcium from the food we eat.

It is produced in the skin when exposed to sunlight and can also be obtained from foods like anchovies, oysters, egg yolks, and mushrooms.

However, for vitamin D to become active in the body, it must first be processed by the liver into 25OHD (calcifediol), and then by the kidneys, which convert 25OHD into its active form, 1,25(OH)2D (calcitriol). (14)

Unfortunately, heavy alcohol consumption can lower your levels of activated vitamin D.

This is primarily due to potential liver damage, affecting its ability to convert vitamin D into its active form. (15)

Alcohol can also reduce the levels of vitamin D-binding proteins essential for transporting vitamin D in the bloodstream. This reduction can hinder calcium absorption.

The good news is that cutting back on alcohol can help bring your calcium levels back to normal.

This was evidenced in a study published in the Journal of Addictive Diseases, which involved 25 women who were vitamin D deficient and had high levels of tartrate-resistant acid phosphatase 5b, a marker of bone loss.

After eight weeks in a rehabilitation program, they experienced improvements in their vitamin D levels. (16)

Reproductive Hormones

Reproductive hormones such as testosterone and estrogen promote bone health by increasing calcium absorption in the bones.

However, when this hormone balance is disrupted, often due to factors like alcohol consumption, it can result in bone loss.

Testosterone supports bone metabolism by supporting healthy urinary calcium excretion and inhibiting the renal calcium transport proteins. (17)

However, men with low testosterone, or hypogonadism, are at a much higher risk of fractures because of reduced bone mineral density (BMD).

This issue becomes more pronounced with age, as over 20% of men over 60 are affected by hypogonadism. (18)

For women, estrogen supports bone metabolism. It promotes the activity of osteoblasts, the cells responsible for forming new bone.

During menopause, estrogen levels naturally decline, leading to increased bone loss and a higher risk of osteoporosis. (19)

As estrogen decreases, osteocytes, osteoblasts, and osteoclasts — the cells that maintain and break down bone — are also affected. (20)

Not to mention, as we age, our natural antioxidant levels decrease, leaving us more susceptible to the damaging effects of free radicals.

Estrogen acts as a replacement antioxidant, helping to combat these free radicals that can harm our bones. (21)

However, the hormonal changes resulting from alcohol consumption can contribute to oxidative stress that may compromise your bone integrity.

This imbalance can hinder the body’s ability to produce new bone and maintain its structure, making your bones more fragile and increasing the risk of fractures.

Growth Hormone

Growth hormone (GH), secreted by the pituitary gland, supports bone growth and metabolism by improving the absorption of calcium and phosphate in the gut. (22)

It does this by enhancing vitamin D metabolism, which helps boost levels of 1,25-dihydroxyvitamin D3, an active form of vitamin D that promotes the absorption of these minerals necessary for bone formation and strength. (23)

Growth hormone also works with IGF-I to stimulate bone development. (24)

Insulin-like growth factor 1 (IGF-I), primarily produced in the liver, supports protein synthesis and promotes bone remodeling by enhancing the activity of osteoblasts, the cells responsible for bone formation. (25)

This ensures a healthy balance between bone formation and resorption, which maintains bone density and structural integrity.

However, research from The American Journal of Clinical Nutrition revealed that chronic alcohol consumption can lower growth hormone secretion, resulting in decreased liver production of IGF-I and hindering bone growth and development. (26)

The study involved 53 postmenopausal women who were randomly assigned to consume 0 g (control), 15 g (one drink), or 30 g (two drinks) of alcohol daily for eight weeks, with participants rotating through each intake level.

The results showed that IGF-I levels remained relatively stable with 15 g of alcohol but decreased by 4.9% at 30 g.

Moreover, alcohol can decrease growth hormone secretion by as much as 70%, which can further exacerbate bone loss. (27)

Cortisol

Cortisol, often referred to as the "stress hormone," not only affects how the body responds to stress but can also inhibit calcium absorption when levels are high. (28)

This can hinder the growth of bone cells, which results in increased bone resorption — the process where bone is broken down — and decreased bone mineral density (BMD).

Thus, high cortisol levels can weaken our bones over time.

Unfortunately, heavy drinking can raise cortisol levels even further, which can interfere with osteoblasts, the cells responsible for creating new bone tissue.

This can lead to a decrease in bone density and accelerate bone deterioration, making it harder for bones to heal after injuries.

A study published in The Journal of Clinical Endocrinology & Metabolism with nearly 3,700 test subjects showed that men who drank more alcohol had a 3% increase in cortisol for each unit of alcohol consumed. (29)

Heavy drinkers also had less decline in cortisol throughout the day, which means that their body's stress response was not functioning normally.

In women, heavy drinkers had a more pronounced cortisol spike upon waking up compared to those who drank moderately.

This suggests that long-term alcohol use can disrupt how our bodies regulate cortisol and absorb calcium, which can gradually harm our bone health and density.

Considering all this, you may be asking yourself:

Should you completely quit drinking alcohol? Or is it still possible to maintain healthy bones even if you've overindulged in the past?

Bone-Healthy Tips for Drinkers

If you’ve been drinking alcohol for a while and are concerned about your bone health, you’re not alone.

Many people worry about the risk of bone loss and the possibility of missing out on activities they love due to fragile bones.

Fortunately, there are lifestyle changes and interventions that can help support healthy bone density and reduce further loss.

One of the most effective ways to support your bones is to cut out alcohol completely.

While some research reports that having up to two drinks a day tends to be associated with higher bone mineral density (BMD) in areas like the spine, femur, and neck compared to non-drinkers… (30)

A review in Drug and Alcohol Dependence tells otherwise.

Researchers found that even moderate alcohol consumption can harm bone health over time: (31)

• Drinking 0.5 to 1 drink per day can increase the risk of bone loss by 1.38 times.
• Drinking 1 to 2 drinks daily can raise the risk by 1.34 times.
• Consuming 2 or more drinks a day can lead to a 1.63-times higher risk of low bone mineral density.

Therefore, even if you only drink moderately, you're still at risk of long-term bone problems like decreased bone density and fractures.

This is especially true as we get older and our bones naturally become weaker, and alcohol can speed up this decline.

So, if you want to keep your bones strong and healthy, cutting out alcohol may be in your best interest.

This is supported by a study published in Alcohol, Clinical and Experimental Research.

Researchers followed 53 men in an alcohol rehabilitation program.

At the start of the study, 15.1% of the test subjects had low BMD in the spine, 5.7% in the femoral neck, and 1.9% in the total hip.

Elevated markers of bone breakdown (crosslaps) were also observed in 34% of the patients, while 17% had lower levels of osteocalcin, a marker of bone formation.

But that’s not all…

Another study published in Menopause found that postmenopausal women who stopped drinking alcohol showed increased markers of bone turnover after just two weeks. (32)

Additionally, after a 14-day period of abstaining from alcohol, osteocalcin levels rose by approximately 4.1%, meaning that the women had healthy bone formation during this time.

However, once alcohol was reintroduced, osteocalcin levels declined by 3.4%, along with another bone marker, C-terminal telopeptide (CTx), which decreased by 3.5%.

These markers returned to baseline values, reflecting the levels measured before any abstinence or consumption of alcohol.

So, if you want to enjoy the benefits of healthy bones, like being able to give piggyback rides to your grandkids, or enjoy a game of pickleball with friends, revisiting relationship with alcohol can be helpful.

Aside from cutting back on alcohol, there are several healthy lifestyle habits you can adopt to support your bones:

• Avoid Smoking: Smoking often goes hand in hand with drinking and is detrimental to bone health. Therefore, if you smoke, consider quitting. (33)
• Stay Active: Engage in weight-bearing and resistance training exercises to strengthen your bones and prevent further loss. You can reach out to the Bone Coach Team for the best and safest workouts for optimal bone health. (34)
• Eat a Bone-Healthy Diet: Focus on foods rich in calcium, vitamin D, vitamin K, magnesium, and vitamin C, which are all essential for maintaining bone health.

Below are our top food sources for these bone-supporting nutrients:

• Calcium: Sources include cultured and fermented dairy, sardines, mackerel, arugula, mustard greens, sesame seeds and figs.
• Vitamin D: Found in fatty fish such as salmon and sardines, egg yolks, and mushrooms, and synthesized from sunlight exposure.
• Vitamin K2: Present in beef liver, grass-fed butter, dark chicken meat, hard cheeses, and fermented foods like kimchi and natto.
• Vitamin C: Abundant in camu camu berries, citrus fruits, red and yellow bell peppers, and lacinato kale.
• Magnesium: Available in green leafy vegetables, pumpkin seeds, avocados, and dark chocolate.

BUT… you don’t need to eat all these foods every day to give your bones the support they need.

At Healthy Bones Co., we’ve developed a supplement that combines all these essential nutrients and minerals into one convenient formula.

It’s designed to simplify your bone health regimen, especially if you’ve consumed alcohol in the past.

Introducing OsteoElements Pro, your easy solution for stronger bones.

Protect Your Bones Against Alcohol-Related Damage

If you enjoy the occasional drink, you might be concerned about its impact on your bone health.

OsteoElements Pro is here to help.

This powerful supplement features a unique blend of highly absorbable vitamins and minerals designed to protect and support your bones.

It helps maintain bone strength and integrity while building a resilient bone matrix.

Each ingredient works synergistically to promote optimal bone health, ensuring you stay active and strong as you age.

• Calcium: The building block of bone strength, calcium is vital for developing hard tissue that provides your bones with the support they need.
• Vitamin D: This essential vitamin regulates calcium levels in the body, ensuring proper bone mineralization and formation for stronger bones.
• Vitamin K: Enhanced with geranylgeraniol (GG), vitamin K directs calcium into your bones and out of your soft tissues, optimizing its use where it's needed most.
• Magnesium: Supports the mineralization of bones, helping maintain their density and strength.
• Vitamin C: This powerful antioxidant supports collagen synthesis, a critical component for maintaining the integrity of bone and connective tissue.
• Trace Minerals: Zinc, copper, manganese, and boron each contribute to different aspects of collagen production and bone strength, creating a robust foundation for your skeletal health.
• Vitamin E Tocotrienols: These antioxidants foster a healthy inflammatory response, further bolstering your bone wellness.

Moreover, the benefits of OsteoElements Pro extend well beyond just your skeletal system. By taking four capsules daily, you also support other essential systems in your body, including:

• Cardiovascular health*
• Immune system support*
• Healthy teeth*
• Balanced mood*
• Maintenance of vitamin D levels*

Take proactive steps today to protect your bones from the damage caused by alcohol, and enjoy an active and healthy future.

Try OsteoElements Pro now!

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