Optimal bone Health and Osteoporosis, a whole-body approach

Written By Lorene Amet

Webinar review: Bone Health and Osteoporosis from Maria Rigopoulou’s webinar from the Institute for Optimum Nutrition: A Deeply Inspiring Day

Recently, I attended a live webinar with ION (the Institute for Optimum Nutrition) led by Maria Rigopoulou, a nutritional therapist with a remarkable personal story and deep clinical expertise in bone health.
I have found the webinar very valuable, moving, and practical professional —in part because Maria’s journey mirrors the lived experience of many of the people we support.

Below is a summary of the most important learning points for anyone dealing with osteoporosis, osteopenia, genetic predisposition, peri- or post-menopausal bone loss, underlying medical conditions, or complex medication histories.

  • Osteoporosis is not only a post-menopausal condition

  • It can affect young adults, including men

  • Genetics, health conditions, medications, diet, and stress all influence bone strength

  • Bone loss is not simply a “calcium issue”—it is a whole-body condition

Why Osteoporosis Develops: A Whole-Body Condition

Maria emphasised the many root causes of osteoporosis, including:

1. Genetic factors

Especially gene variants affecting:

  • Vitamin D metabolism

  • Detoxification

  • Estrogen pathways

  • Connective tissue structure

  • At the Lauriston Centre, we can guide you to arrange such genetic screening

2. Diet and nutrient status

Low protein, low micronutrient density, chronic restrictive dieting, or GI malabsorption. The Lauriston Centre can guide you in adjusting your diet for optimal food-first nutritional support.

3. Lifestyle and stress

Chronic sympathetic activation, overtraining, inactivity, poor sleep, circadian disruption. All of these matter and will impact bone health; our Functional Nutritionists can guide you with these.

4. Underlying medical issues

  • Chronic IBS

  • Inflammatory bowel disease

  • Thyroid or parathyroid dysfunction

  • Diabetes (DEXA scans may miss structural issues even with normal density)

  • Chronic infections

  • Chronic pain syndromes

  • GLP-1 agonists for weight loss — where up to 40% of weight lost may be bone and muscle mass

  • Long-term PPI use

5. Medications

Particularly relevant medications include:

  • Anticonvulsants

  • Steroids

  • PPIs

  • Some psychiatric medications

This was especially meaningful to me given my son’s long-term multi-AED regimen.

Bones Are Living, Metabolically Active Organs

Bones are dynamic tissues, not inert structures. They remodel continuously, with every bone cell replaced every 3–10 years.

Maria highlighted the lesser-known functions of bone:

  • Electrolyte and mineral balance

  • Hormonal signalling, including oestrogen recycling

  • Detoxification, storing heavy metals and buffering toxins

  • Fat storage (via yellow marrow)

  • Immune and endocrine functions linked with brain and gut metabolism

This interconnectedness means bone health is inseparable from:

  • Gut health

  • Inflammation

  • Immune regulation

  • Appetite and metabolic hormones

  • Sleep and circadian rhythm

Better Diagnostics: Beyond Standard DEXA

Standard DEXA scans have limitations:

  • They average cortical and trabecular bone, masking quality differences

  • T-scores compare you to healthy young adults

  • Z-scores compare you to same-age peers

  • Post-menopausal women are automatically “penalised” on T-scores (because these compare to average 30 year old values)

  • They do not assess bone quality, only mineral density

A better option: REMS (Radiofrequency Echographic Multi-Spectrometry)

This newer ultrasound-based method gives:

  • A more accurate assessment

  • Better evaluation of trabecular quality

  • A radiation-free experience

  • Higher reliability in certain populations (including younger adults)

REMS centres:
https://www.osteoscanuk.com/

Additional assessment: OsteoTest (nail keratin analysis)

https://randoxhealth.com/en-GB/product/home/fracture-risk-assessment-test-kit

This can help evaluate bone turnover risk when imaging is insufficient or difficult to interpret.

Functional Testing: What Really Matters

Some useful biochemical markers:

  • 24-hr urine calcium/phosphate (more sensitive than serum)

  • Vitamin D panel: 25-OH and 1,25-OH

  • PTH (parathyroid hormone)

  • Ferritin & iron status — essential for vitamin D activation

  • Bone-specific alkaline phosphatase (BSAP)

  • NTX, CTX, β-CTX — markers of bone resorption

  • P1NP & osteocalcin — markers of bone formation

  • Serum calcium/phosphate (less useful alone)

Advanced testing is rarely offered in mainstream care unless you are already on bisphosphonates, which restricts early intervention. However, the Lauriston Centre has access to such profile via SynLab.

Medication: Bisphosphonates — Benefits and Limits

Bisphosphonates reduce bone breakdown by inhibiting osteoclasts. However:

  • They also block healthy bone remodelling

  • Old, micro-damaged bone is not replaced

  • Long-term use (>5 years) increases risk of:

    • Atypical fractures

    • Jawbone and dental complications

    • Suppressed bone turnover

They can be helpful short-term, but require careful monitoring.

Nutrition & Supplementation for Bone Strength

Maria shared a comprehensive list of nutritional strategies:

Macronutrients

  • Protein: 1.2–1.5 g/kg (up to 2 g/kg if exercising)

  • Healthy fats: 20–35% of daily calories

  • Complex carbohydrates (only if tolerated)

Micronutrients

  • Vitamin K2

  • Vitamin B12, B6, folate

  • Magnesium

  • Calcium (including from red-clover Regobone)

  • Zinc

  • Silicon

  • Iron where needed

Other supportive nutrients

  • Omega-3

  • Collagen peptides

  • Creatine

  • NAD precursors

  • Melatonin — enhances osteoblast activity

  • Phytoestrogens: red clover (fermented), particularly beneficial in peri-/menopause

  • Adaptogens and botanicals: Astragalus, Reishi, Ashwagandha, Schisandra

  • Calcium-rich foods: maca, carob

Lifestyle Foundations: Movement, Breath & Circadian Rhythm

It is important to emphasise the mind–body connection in bone health:

Movement

  • Progressive resistance training

  • Balance work

  • Impact-loading (as safe/appropriate)

  • Postural alignment

  • Avoiding long periods of inactivity

The presentation includes detailed guidance on exercise types and intensities.

Breathing

  • Breathwork supports vagal tone, stress reduction, and anabolic recovery

Circadian rhythm & light

Synchronising bone and muscle metabolism requires:

  • Morning bright light exposure

  • Consistent sleep–wake patterns

  • Evening darkness and reduced blue-light exposure

Light entrains cortisol, melatonin, and appetite-regulation hormones—all of which influence bone.

Final Thoughts

This webinar was a powerful reminder that bone health is never just about bone.
It reflects:

  • Hormones

  • Digestion

  • Inflammation

  • Sleep

  • Stress

  • Genetics

  • Light exposure

  • Movement

  • Medications

  • And most importantly—our daily lifestyle choices

Whether you are navigating peri-menopause, living with osteoporosis, or caring for someone with complex medical needs, this integrative approach offers realistic, hopeful, and actionable strategies. Please reach out to discuss with one of our Functional Nutritionists.

Lorene Amet
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New Services at The Lauriston Centre: Family Functional Nutrition & Psychotherapy Services