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The Bone-Gut Axis: A Revolutionary Approach to Predicting Osteoporosis

The Bone-Gut Axis: A Revolutionary Approach to Predicting Osteoporosis

Jan 22, 2024 | Research Findings

Disclosure: This post may contain affiliate links that I may earn a small commission from, at no additional cost to you. I only recommend products I use or have used myself. All opinions expressed here are my own.

Surprising New Insights Into Bone Health

Over the past decade or so, research examining the role of the gut microbiome has been an exciting area of study that has established the importance of a healthy microbiota for avoiding chronic disease — including autoimmunity, diabetes, cancer, and cardiovascular disease. It is also closely tied to immune response, obesity risk, and even neurological disorders such as autism, depression, and anxiety. This is why I have stressed the importance of tending to the gut for years — it is literally the foundation of health. And now researchers have found another compelling reason for making gut health a priority: bone density and strength.

xray of hand making ok sign

Healthy Microbiome and Gut, Strong Bones

A fascinating study published in the autumn of 2023 may have discovered a novel method for strengthening the bones — namely, probiotics and prebiotics.

Using high-resolution imaging from the Framingham Third Generation Study and the Osteoporotic Fractures in Men (MrOS) study, the team first identified two problematic gut bacteria that are detrimental to bone health — Akkermansia and Clostridiales DTU089.6,7

Lead researcher Douglas P. Keil, professor of medicine at the Marcus Institute for Aging Research at Harvard Medical School and Beth Israel Deaconess Medical Center, notes in Medical News Today:

“We do not precisely know why these bacteria would be connected to skeletal health, but we do know that Akkermansia abundance in the intestine is linked to obesity and that obesity may be related to compromises in skeletal integrity.”

He adds, “The same reasoning applies to the Clostridiales bacterium called DTU089 that is associated with lower physical activity. We know that low physical activity is related to bones that are less dense and strong. Also, the bacteria in the intestine can produce other factors that may adversely affect the bone, namely factors that increase general low-level inflammation, which can have deleterious effects on bone cells.”4

Interestingly, previous studies established that people with lower protein intake and physical activity had higher amounts of DTUO89 in the gut. 5,6

In light of these findings, the researchers believe that supporting a healthy gut microbiome via probiotics and prebiotics may establish and preserve bone health — and avoid the risk of osteoporosis later in life.

Several additional studies found that the fermentation of plant fibers in the gut produced short-chain fatty acids that increased calcium absorption and bone density/strength in both adolescents and animal models.2 Likewise, research in Frontiers in Endocrinology highlights the importance of a balanced microbiome for bone health:

“The GM [gut microbiome] is also a source for vitamin K2, which is required for the function of osteocalcin and can influence bone formation by stimulating OBs. Moreover, studies have shown that decreased levels of vitamin K2 due to antibiotic-induced microbiome depletion is associated with a reduction in osteocalcin and bone strength in mice. […]

Pre-clinical mouse studies have found that administering probiotics such as VSL#3 and bacterial strain Lactobacillus rhamnosus GG can be beneficial for bone health via restoring GM and intestinal permeability. In estrogen deficient mice, in which estrogen dampens cytokines involved in stimulating osteoclastogenesis and bone loss, it was found that the administration of Lactobacillus reuteri protected against bone loss.

Moreover, other studies have demonstrated that in mice with glucocorticoid-induced microbial dysbiosis or post-antibiotic-induced gut dysbiosis, supplementation of Lactobacillus reuteri could dampen trabecular bone loss by reducing gut dysbiosis and intestinal barrier dysfunction.”1

With the importance of gut health firmly established as a key component of building and maintaining strong bones, it most likely won’t come as a surprise that we will now turn our attention to practical ways we can support it.

Healthy food selection

Science-Backed Strategies for Gut Health

While there are a number of methods for supporting a healthy gut and microbiome, my top three recommendations are diet, lifestyle, and herbal medicines. Let’s begin with diet.

Considering our gut houses trillions of bacteria — both “good” and “bad” — it is important that we know how to feed and encourage the beneficial strains, while minimizing those that can be problematic. One of the best ways to do this is by eating plenty of unrefined plant foods rich in fiber, prebiotics, probiotics, and resistant starch. See this post for a full list of suggestions.

Next is lifestyle. Did you know your habits can make (or break) gut health? It’s true! Stress reduction, exercise, and even the thoughts that you have all impact the microbiome. So it is crucial to make sure we include practices in our daily routine that support the beneficial bacteria in our gut.

Nicoles Apothecary Balanced Gut Tincture

And now we come to one of the most effective methods for supporting the gut: herbal remedies. Below are several outstanding options, all of which are included in my powerful (and often life-changing) Balanced Gut Blend.

Reishi Mushroom

  • Helps leaky gut through anti-inflammatory action
  • High in beneficial beta-glucans, glycoproteins, and triterpenes to support gut health

Turkey Tail Mushroom

  • Calms inflammation
  • Excellent source of prebiotics for encouraging a healthy microbiome by controlling the overgrowth of candida, while also feeding the “good” bacteria in the gut.


  • Anti-inflammatory
  • Soothes mucous membranes

Slippery Elm and Marshmallow Root

  • Forms a protective layer that helps the gut to regenerate

Lion’s Mane Mushroom

  • High in antioxidants that cool the inflammatory response


“I have multiple sclerosis and have suffered from IBS for many years. I have a gluten sensitivity as well. THIS TINCTURE IS FANTASTIC. I’m telling you. I am very sensitive to things. So I can only do 20-30 drops a day, but that’s all I need. My IBS is GONE! Gone. How does that happen?!

I love this product. I can eat gluten now when I really want that pizza and I don’t have bowel issues. It’s insane how much this actually healed my leaky gut and keeps my sensitivity at bay. I will continually purchase this product and tell others about it, because it is THAT good. Thank you, Nicole.” -Alycia

If you are seeking to improve your gut and microbiome health for stronger bones, there is no better option than my Balanced Gut Blend. Visit the apothecary today to learn more!

Nicole Apelian

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  1. Cooney, O. D., Nagareddy, P. R., Murphy, A. J., & Lee, M. K. S. (2021). Healthy Gut, Healthy Bones: Targeting the Gut Microbiome to Promote Bone Health. Frontiers in Endocrinology, 11, 620466. https://doi.org/10.3389/fendo.2020.620466
  2. Weaver CM. Diet, gut microbiome, and bone health. Curr Osteoporos Rep. 2015 Apr;13(2):125-30. doi: 10.1007/s11914-015-0257-0. PMID: 25616772; PMCID: PMC4996260.
  3. Wallace, T. C., Marzorati, M., Spence, L., Weaver, C. M., & Williamson, P. S. (2017). New Frontiers in Fibers: Innovative and Emerging Research on the Gut Microbiome and Bone Health. Journal of the American College of Nutrition, 36(3), 218–222. https://doi.org/10.1080/07315724.2016.1257961
  4. “Healthy gut microbiome linked to greater bone density in older adults”, Corrie Pelc, fact checked by Jill Seladi-Schulman, Ph.D. Medical News Today, October 5, 2023. https://www.medicalnewstoday.com/articles/gut-microbiome-bone-health
  5. Magzal, F., Shochat, T., Haimov, I., Tamir, S., Asraf, K., Tuchner-Arieli, M., Even, C., & Agmon, M. (2022). Increased physical activity improves gut microbiota composition and reduces short-chain fatty acid concentrations in older adults with insomnia. Scientific reports, 12(1), 2265. https://doi.org/10.1038/s41598-022-05099-w
  6. Farsijani, S., Cauley, J. A., Peddada, S. D., Langsetmo, L., Shikany, J. M., Orwoll, E. S., Ensrud, K. E., Cawthon, P. M., & Newman, A. B. (2023). Relation Between Dietary Protein Intake and Gut Microbiome Composition in Community-Dwelling Older Men: Findings from the Osteoporotic Fractures in Men Study (MrOS). The Journal of nutrition, 152(12), 2877–2887. https://doi.org/10.1093/jn/nxac231
  7. Framingham Heart Study (FHS) Third Generation (Gen III), OMNI 2, and New Offspring (NOS) Cohorts, National Heart, Lung, and Blood Institute, May 12, 2023. https://biolincc.nhlbi.nih.gov/studies/gen3/

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