The importance of a healthy endocrine system and osteoporosis
I can’t imagine anyone jumping out of bed and thinking ‘mmm today is a good day to think about my endocrine system.’ That would seem rather odd when you have a business to run and a life to get on with. However, the further along in my journey I went and as I had further tests I began to just how important it was and how having a healthy lifestyle was paramount to it and me functioning properly.
It had never really struck me as important to research the endocrine system when I had the thyroid issue, yet as soon as I had my blood tests done in my search for my root cause, I became like a medical student pouring over this system. It felt like this was another thing that I had to understand so that ‘they’ couldn’t fob me off.
There have been two times in my life when my thyroid which is a part of the endocrine system has been out of whack. On neither occasion did my doctor invite me to have a bone density test or any other tests for osteoporosis. On the second occasion in 2016 and three times subsequently, I requested a test but was refused.
The doctor that I saw did not see the connection between the thyroid and any other system of the body, namely my bones. I wasn’t entirely sure myself, but I suspected that it was important. It seemed that once again I was being treated in a series of unconnected parts which at the time didn’t seem to matter. Once the fractures occurred and I started to dig deeper I found myself wondering about what had originally caused the thyroid to go wrong.
The Endocrine System
It all starts with the hypothalamus which alerts the pituitary gland to release certain hormones to the rest of the endocrine system, the hypothalamus ensures that the internal processes of your body are balanced and working as they should.
The endocrine system in overview:-
- Hypothalamus – Links nervous system to endocrine system
- Pituitary – “Master Gland” that regulates all other Endocrine Glands, also releases growth hormone
- Thyroid -Metabolism, body heat, bone growth
- Parathyroids – Use of Calcium and Phosphorous
- Adrenal -Response in an emergency or stressful situations, metabolism, blood pressure, salt balance
- Pancreas – Blood sugar
- Ovaries -Production of eggs; female characteristics
- Testes – Production of sperm; male characteristics
- Thymus – Parts of the immune system
Sadly many a burnt out entrepreneur has discovered that an unbalanced endocrine system can impact their business. The adrenals play a big role in so many things and when we are stressed for example cortisol is released which is ok short term, but over a longer term this is dangerous and high levels of cortisol can contribute to bone loss and osteoporosis. So not only will you feel fatigued you are also potentially creating an imbalance with far greater consequences.
Awareness of these systems enables us to be able to ensure that when we are talking to our doctors and nutritionists we can get the right tests to rule out any underlying issues.
Let’s take another brief look at the endocrine system and how it can impact us and our bones.
The Endocrine system
The endocrine system contains glands such as the thyroid, adrenals, pancreas and ovaries. In simple terms, each of these glands maintains a balance of many things in the body and is an important area to consider in osteoporosis.
This is known as the master gland and as such ‘manages’ many hormones:-
- Growth hormone – bones and muscles
- Prolactin – mammary glands
- Follicle Stimulating Hormone (FSH ) – Regulate puberty, development, and reproductive processes
- Luteinizing Hormone (LH) – Stimulates the production of estrogen and testosterone in the ovaries
- Thyroid Stimulating Hormone (TSH) – thyroid
- Adrenocorticotropic hormone (ACTH) – adrenals
None of these can be looked at in isolation. You may see growth hormone and think aha that looks after my bones, so that must be the one to consider, but what if that is ok and you have a problem with luteinising hormone which is disrupting your female hormones so that you now have low oestrogen which is impacting something else. We know for example oestrogen production slows down at menopause which impacts bone health. These all work in concert with each other.
Parathyroid glands[i] are four small glands of the endocrine system. Calcium levels are regulated by the parathyroid glands. You may or may not have an issue here. It’s an area that your doctor may be reluctant to explore as one of the underlying factors. The parathyroid keeps a constant check on your calcium activity. When levels fall the hormone is secreted and calls for vitamin D to increase absorption from the intestines (which is why your gut health is important) and bones until the balance is restored. This hormone also works with your kidneys to excrete less calcium in the urine.
Vitamin D (really a hormone) has to be activated by parathyroid hormone so that it can increase the amount of calcium that the intestines can absorb from food. Most osteoporosis advice suggests to not supplement with calcium rather get it from food. But as you can see if your parathyroid is not working properly and you have insufficient vitamin D then calcium is robbed from your bones.
In simple terms when the calcium level in blood decreases, the parathyroid glands produce more parathyroid hormone. When the calcium level in blood increases, the parathyroid glands produce less hormone. PTH causes the release of calcium from the bone into the blood; when blood calcium returns to normal levels, PTH secretion declines.
It is suggested that you ask your doctor for a PTH (intact parathyroid hormone ) test, alongside vitamin D3 25OH (25-hydroxy) and serum calcium in the same blood draw to rule out any underlying parathyroid issue
The thyroid is a gland in the endocrine system. It is shaped like a butterfly and is located at the base of your neck. The thyroid releases hormones which control your metabolism (the way in which your body uses energy). You can have either an overactive or underactive thyroid, those with an overactive thyroid are generally thinner than those with an underactive thyroid.
The thyroid gland makes two main hormones, Triiodothyronine (T3) and Thyroxine (T4). Two glands in the brain, the hypothalamus and the pituitary communicate to maintain T3 and T4 balance. Once again you can see it is about balance. The hypothalamus tells the pituitary to signal the thyroid gland to increase or decrease the amount of Thyroid Stimulating Hormone (TSH). If you have had blood tests for your thyroid you will recognise T3, T4 and TSH.
In my case, my hyperthyroid (overactive) issue was potentially causing rapid bone loss[ii] unbeknownst to me. With some changes to my diet, I resolved this in six weeks and it continues to be working properly according to regular blood tests. However, despite asking for a bone density test at this time I was told that this was unnecessary. This is because, as I said earlier, some doctors do not understand the link between thyroid and bone.
Depending on your personal circumstances and whether you have over or underactive thyroid, you can heal these through nutrition and lifestyle changes. The first thing is to get a test, listen to what your doctor/medical specialist suggest and then ask for a period of grace while you change your diet. You may already be taking drugs for your thyroid issue and in some cases (like my mum) have had part of your thyroid removed. Please work with a good naturopathic nutritionist to support you through what changes to make.
The adrenal glands [iii] are responsible help to main a balance of minerals and the secretion of hormones including cortisol, dehydroepiandrosterone (DHEA), aldosterone, oestrogen, progesterone and testosterone and neurotransmitters like epinephrine (adrenaline), norepinephrine. We know for example oestrogen production slows down at menopause which impacts bone health.
They are found above the kidneys. They play a role in balancing sodium and water and therefore hydration. Cortisol is what helps you respond to stress. During the fight-or-flight response, the body releases a surge of adrenaline, followed by a surge of cortisol. In short-term stressful situations cortisol is helpful, however, in long-term stressful situations, cortisol can have negative effects on your health. When cortisol levels rise it can interfere with osteoblast formation [iv] which reduces bone density.
The ovaries are the primary female reproductive organs. One of their functions is to secrete hormones. At menopause oestrogen levels fall significantly. This hormone is important for bone production because it supports osteoblast production. With this essential hormone, osteoblasts don’t produce enough new bone, which is one of the reasons that menopausal women are at risk[v].
Discussing what to do about hormone levels and whether you need to take additional oestrogen is a discussion for you and your healthcare practitioner/nutritionist.
In 2016 my estradiol levels were normal, by 2018 they were low, along with low DHEA and high prolactin. I’ll discuss this more in another blog.
When I went through the menopause I had an undiagnosed overactive thyroid and was given Prozac for anxiety. As a consequence of taking Prozac, I radically changed my diet, reversed the overactive thyroid, improved my sleep and overall health and stopped all menopause symptoms.
However, as I was not osteoporosis awake at that time I did not connect all of the pieces of the puzzle.
What I know in retrospect is that changing your diet and lifestyle can improve how you navigate menopause and reduce your risk of developing osteoporosis. Remembering that we lose bone density naturally as we age.
However, once we are bone aware, we can eat to support bones and our overall health.
The pancreas belongs to both the endocrine and digestive systems. It is responsible for maintaining the balance of blood glucose (sugar) and salt in the body.
The pineal gland is located deep in the centre of the brain, and was once known as the “third eye.” It’s role is in the secretion of melatonin which helps us with our wake and sleep cycles.
The thymus gland is located behind your sternum and between your lungs or breasts. It is only active until puberty after which it slowly becomes fat. Its role is to build up our immunity for the rest of our lives.
You can see that the endocrine system like many systems is important to bone health. Once again, it is all about looking for clues about our health.
Key things to think about
- Look for hidden causes of osteoporosis and become a health detective
- Ask your doctor test your blood (full blood panel) and ensure you include PTH, vitamin D, calcium, hormone panel, blood glucose, thyroid, DHEA, cortisol and serum CTX – they can advise of any others you specifically need
- Ask for urine tests to measure the rate of calcium loss
- Test for food intolerances such as gluten, nightshades, lactose and fructose. The doctor can test for celiac disease or you can eliminate and then see what happens when you add gluten products back in. Gluten often is at the root of many autoimmune problems and was something I eliminated when dealing with an overactive thyroid along with nightshades
- Take into account any medications you are taking and your diet and lifestyle
- Keep all of your results and monitor them on a regular basis
- If your results come back normal and are at the high or low end of the normal range, investigate further and put plans into place now to prevent osteoporosis or any other chronic dis-ease occurring
- Think gut health and work to improve that
- Get better hydrated – water will help so many issues
- Stop eating rubbish and work to improve your diet
- Nourish your soul and take time for you
- Declutter the rubbish from your life
The endocrine system is only one part of the osteoporosis story, but as you can see an important part.
References and resources
Osteoporosis - newly diagnosed? E-book
Osteoporosis - newly diagnosed? | Grab your E-book
30 things to do when newly diagnosed, confused and overwhelmed.