Orthomolecular prevention of osteoporosis and muscle loss

Risk groups for osteoporosis and muscle atrophy include older adults, postmenopausal women (due to the drop in oestrogen levels), people with a lack of exercise, the chronically ill and people with malnutrition. However, men and even younger people can also be affected.

Early prevention is crucial to avoid bone fractures, loss of mobility and the need for long-term care.

This is where orthomolecular medicine comes in: It uses vitamins, minerals and other micronutrients in optimal doses to maintain health and prevent illness.

The orthomolecular approach means supplying the body’s own vital substances in a targeted manner in order to correct biochemical imbalances. An optimal supply of certain nutrients can make an important contribution to the prevention of osteoporosis and the fight against muscle loss. In Berlin, there are specialized centers such as VenaZiel Berlin, which offer orthomolecular prevention programmes – with detailed check-ups, laboratory analyses (vital substance profiles) and individually tailored micronutrient therapies.

This article provides a scientifically sound explanation of how osteoporosis and muscle loss develop and how you can prevent them with orthomolecular medicine. Specific recommendations on nutrition, dietary supplements and lifestyle – from vitamin D to K2, magnesium, calcium, omega-3 and proteins/amino acids – show how you can put osteoporosis prevention into practice (also in Berlin) and stop muscle loss.

Osteoporosis: causes and risk factors

Osteoporosis is a systemic skeletal disease in which bone density decreases and the microstructure of the bones deteriorates.

The bones become porous and susceptible to fractures – even minor stresses can lead to fractures. Osteoporosis is caused by an imbalance between bone formation and bone resorption in favor of resorption. But why does this balance get out of kilter? The causes are manifold:

• Age and hormonal changes: Bone formation slows down with increasing age. In women, oestrogen levels fall sharply during the menopause – oestrogen normally protects the bones, but its deficiency accelerates bone loss. In men too, a drop in testosterone with age can contribute to a reduction in bone density.  
• Lack of exercise: Physical activity, especially strength training and weight-bearing exercises, strengthens bones and muscles. Conversely, a lack of exercise leads to muscle weakness and reduced mechanical stimulation of the bones, which reduces their strength. Lack of exercise is a key risk factor – declining muscle strength also directly weakens the bone substance. This is a particular problem in our modern society where we spend a lot of time sitting down.  
• Lack of calcium and vitamin D: A sufficient supply of calcium is essential for stable bones. Calcium is the most important mineral building block of bones. Equally important is vitamin D, which promotes calcium absorption from the intestine and enables it to be incorporated into the skeleton. A chronic lack of calcium and vitamin D is one of the most common causes of osteoporosis.
  Vitamin D deficiency is common in old age, as the skin’s own production decreases – older people have a higher risk of vitamin D deficiency . If vitamin D intake is insufficient, bone density decreases and the risk of fractures increases. Magnesium deficiency also has an indirect effect: magnesium is required for the activation of vitamin D; too little magnesium reduces the formation of the active vitamin D hormone and thus weakens bone mineralization.  
• Nutritional deficiencies: In addition to calcium and vitamin D, other nutrient deficiencies can also damage bones. For example, protein deficiency leads to a poor bone foundation (collagen matrix), and vitamin K deficiency disrupts bone mineralization (more on this later). An over-acidifying diet (high consumption of phosphate additives in soft drinks, a very meat-rich diet with few vegetables, lots of table salt) also promotes bone loss. For example, soft drinks with phosphate and high salt consumption increase calcium excretion and weaken bones in the long term. Being underweight (BMI < 20) or chronic malnutrition can also impair bone health, as the body lacks building blocks.  
• Chronic diseases: Inflammatory diseases such as rheumatoid arthritis or chronic inflammatory bowel disease, endocrine disorders (e.g. hyperthyroidism), diabetes, chronic renal insufficiency and other chronic diseases can damage the bones. Inflammatory messenger substances or drug therapies that adversely affect bone metabolism often play a role here.  
• Medication: Prolonged treatment with cortisone (glucocorticoids) is a known osteoporosis trigger – cortisone inhibits the formation of new bone and promotes bone resorption. Proton pump inhibitors (stomach protection medication) and aromatase inhibitors (for breast cancer treatment) also increase the risk of osteoporosis if taken over a longer period of time. In addition, some antiepileptic drugs, anticoagulants and immunosuppressive drugs can have an unfavorable effect on bone metabolism.  
• Genetic predisposition: Individual genes determine to a certain extent how high the maximum bone density is and how quickly bone mass is lost with age. A family history of osteoporosis (parents with hip fractures etc.) increases the personal risk. However, lifestyle and orthomolecular prevention can often partially compensate for unfavorable genes.

Osteoporosis usually results from a combination of factors that cannot be influenced (age, gender, genes) and lifestyle factors (exercise, diet, UV exposure for vitamin D, substance use, illnesses). In terms of prevention, this means that exercise and micronutrient supply in particular should be optimized – this is where orthomolecular medicine offers effective starting points before fractures occur.

Age-related muscle loss (sarcopenia): Causes

With increasing age, there is not only bone loss, but also a gradual loss of muscle mass and muscle strength – known as sarcopenia. This muscle atrophy leads to physical weakness, unsteadiness when walking, more falls and therefore indirectly to more bone fractures. But what causes muscles to shrink in old age? The most important causes are

• Natural ageing process: From around the age of 30, the body slowly breaks down muscle tissue, especially if it is not exercised regularly. Around 0.3-1.3 % of muscle mass is lost each year, partly replaced by fatty tissue. This process often accelerates from the age of 50. This anabolic resistance of the ageing muscle means that even with the same diet and activity, muscle building is less effective than in younger years. Without countermeasures, up to half of the muscles can be lost into old age . 
• Lack of exercise and inactivity: “Use it or lose it” is especially true for muscles. Lack of exercise is one of the main reasons for muscle atrophy in old age. Those who are hardly physically active or are immobile for long periods of time (e.g. due to illness or an office lifestyle) signal to the body that excess muscle mass is not needed – it regresses. Conversely, it is known that regular strength training can enable muscle growth into old age . 
• Insufficient protein supply (malnutrition): Older people often eat less – appetite and calorie requirements fall. Seniors often do not consume enough protein. Proteins are the building blocks of muscles. A lack of protein causes the body to break down muscle protein in order to maintain important functions, which leads to sarcopenia. In particular, a lack of certain essential amino acids (such as leucine) weakens muscle building – leucine normally acts as a trigger for protein synthesis in the muscle. Vitamin and mineral deficiencies (e.g. vitamin D or B vitamins) can also indirectly contribute to muscle weakness, for example by impairing energy metabolism or nerve function.  
• Hormonal changes: Anabolic hormones, which contribute to muscle building, decrease with age. Growth hormone and IGF-1 decrease, testosterone levels fall in men and oestrogen levels in women – all of these hormones have an influence on muscle protein synthesis. Insulin (important for the absorption of nutrients into the muscle) is also often less effective in old age. This hormonal decline favors muscle loss.  
• Chronic diseases: Heart failure, COPD (chronic obstructive pulmonary disease), kidney disease, diabetes, dementia, cancer and other chronic diseases can lead to cachexia or increased muscle wasting. Chronic inflammation, for example, releases cytokines that accelerate muscle wasting. In the case of diabetes, insulin resistance can weaken the muscles. In addition, illnesses often lead to inactivity and loss of appetite, which further exacerbates sarcopenia.  
• Medication: Some medications promote muscle atrophy, e.g. glucocorticoids (cortisone) – they not only increase bone loss but also muscle loss with long-term use. Certain cancer therapies, uncontrolled thyroid hormones or bedriddenness due to medication (sedation) can also have a negative impact.  
• Lifestyle factors: Smoking and alcohol damage the muscles in the long term (through oxidative stress, inflammation and hormonal imbalances). On the one hand, being overweight can put more strain on the muscles, and on the other, overweight people often tend to be inactive – both of which can reduce muscle quality. Conversely, being underweight is also risky, as there are often not enough nutrients available for muscle maintenance.

Overall, age-related muscle loss also results from a multi-factor structure. The good news is that many of the causes can be counteracted. Sufficient exercise and strength training, coupled with a protein-rich diet and targeted micronutrient intake (e.g. vitamin D) can significantly slow down muscle loss. Geriatrics experts recommend that older people consume at least 1.0-1.2 grams of protein per kilogram of body weight per day (instead of 0.8 g for younger people).

This can often only be achieved with high-quality protein-rich supplements. Vitamin D (800 IU daily) has also been shown to be effective in stopping muscle loss and maintaining muscle strength. All of this shows that orthomolecular medicine – i.e. the optimal supply of vital substances – can be a key factor in stopping muscle loss and maintaining functional capacity into old age.

Orthomolecular medicine: micronutrients to combat osteoporosis and muscle atrophy

Orthomolecular medicine focuses on providing the building blocks of life in optimal quantities. Certain vitamins, minerals, fatty acids and amino acids are particularly essential for bones and muscles. Here we present the most important micronutrients against osteoporosis and age-related muscle loss – as well as the scientific evidence on their benefits:

Vitamin D – the sun hormone for bones and muscles

Vitamin D plays a key role in bone health. It promotes the absorption of calcium in the intestine and the mineralization of bone. Chronic vitamin D deficiency leads to low bone density and increased fracture risk – many studies show that 25(OH) vitamin D blood levels below 20 ng/ml are associated with osteoporosis and increased hip fractures.

In Northern Europe and Germany in particular, many people – especially older people – have insufficient vitamin D levels, as skin synthesis via sunlight decreases with age. However, vitamin D is not only essential for bones, but also for muscle function: it supports muscle strength and coordination. An adequate supply of vitamin D can help to prevent falls in old age (because stronger muscles and better balance reduce the risk of falling).

Evidence: In studies, vitamin D supplementation in older adults led to a reduction in the rate of falls and possibly fewer fractures, especially if there was a deficiency. The general recommendation for osteoporosis prevention is 800-1000 I.U. vitamin D daily, sometimes in combination with calcium . Orthomolecular therapists often test the 25(OH)D level in the blood and adjust the dose individually to achieve an optimal range (often 30-50 ng/ml).

Supplementation is particularly important in months with little sunshine or for at-risk groups (housebound, in need of care). Vitamin D can be administered in the form of drops, capsules or intramuscular injections. VenaZiel Berlin offers, for example, a vitamin D status determination in the laboratory and advises patients on the correct dosage to support both bone density and muscle strength (keyword: orthomolecular prevention of muscle atrophy and osteoporosis).

Vitamin K2 – the bone helper for calcium utilization

Vitamin K is known for its role in blood clotting, but its function in bone metabolism is just as important. Vitamin K (especially vitamin K2, menaquinone) activates certain proteins (GLA proteins such as osteocalcin) that incorporate calcium into the bones. In vitamin K deficiency, these proteins are insufficiently carboxylated and cannot bind calcium effectively. Studies show that vitamin K deficiency is associated with low bone density and increased fracture risk.

Supplementing with vitamin K can slow down bone loss. Vitamin K2 in particular has proven to be effective: In studies, vitamin K2 (MK-4) significantly increased bone density and reduced the occurrence of new bone fractures . Vitamin K1 (phylloquinone, from green vegetables) showed more effects on bone quality, while K2 also influences density.

In terms of prevention, this means Vitamin K2 (e.g. as MK-7 in doses of 100-200 µg/day) is increasingly recommended together with vitamin D in order to get the calcium where it belongs – namely into the bones (and not into the blood vessel walls). Orthomolecular physicians pay particular attention to sufficient K2, especially with a high vitamin D and calcium intake, in order to prevent arteriosclerosis and optimize bone formation. Fermented foods (natto, ripened cheese) are good natural sources – but a dietary supplement is often useful to achieve therapeutic levels.

Calcium and magnesium – teamwork for strong bones

Calcium is the main mineral in bones: Around 99% of the body’s calcium is found in the skeleton in the form of hydroxyapatite. An adequate intake of calcium (approx. 1000 mg per day for adults) from food and, if necessary, supplements is the basis of osteoporosis prevention. However, research has shown that calcium alone is not enough: pure calcium supplementation often only minimally increases bone density and hardly reduces the risk of fractures.

Much more important is the interaction with other factors: Calcium can only be effectively incorporated into the bones if enough vitamin D is available and the bones are stressed through exercise. There is also increasing evidence that very high doses of calcium without K2 and magnesium may increase the risk of arteriosclerosis – it is therefore better to rely on a balanced combination of minerals rather than isolated calcium.

Magnesium plays a central role in this network. Around 60% of the body’s magnesium is found in the bones . Magnesium is required for the crystallization of the bone matrix and regulates calcium metabolism: it influences calcium transport and the activation of vitamin D . Interestingly, significantly lower blood magnesium levels were found in osteoporotic women than in healthy women. Observational studies show a positive correlation between magnesium intake and bone density . A magnesium deficiency reduces the formation of the activated vitamin D hormone (calcitriol) and thus indirectly promotes bone loss.

Experts therefore conclude that magnesium supplementation is definitely recommended for the prevention of osteoporosis . Around 300-400 mg of magnesium per day (e.g. as magnesium citrate) is considered useful, especially if your diet is low in magnesium. Magnesium also relaxes the muscles and, in higher doses, can prevent muscle cramps – which in turn is helpful in old age in order to remain active and mobile.

In short: calcium is necessary, but it is not the only solution. A bone-healthy orthomolecular therapy always combines calcium with vitamin D, K2, magnesium and other trace elements – and recommends exercise. In the practice of VenaZiel Berlin, for example, not only calcium is tested as part of a “bone profile” in the blood, but also magnesium, vitamin D, K and even markers such as the omega-3 index or inflammation values in order to obtain a holistic picture. This allows you to target where there are gaps.

Omega-3 fatty acids – anti-inflammatory for muscles and bones

Omega-3 fatty acids (EPA and DHA, mainly from fish oil) are primarily known for their cardiovascular and anti-inflammatory effects. However, they are also attracting research interest in the context of muscle atrophy and bone health. Chronic inflammatory processes contribute to both osteoporosis (by stimulating bone-degrading osteoclasts) and sarcopenia (by breaking down muscle proteins). Omega-3 fatty acids act as anti-inflammatory mediators and could thus counteract both processes.

Muscle mass: A meta-analysis of 10 RCT studies showed that omega-3 supplements led to slight improvements in muscle mass and function in older adults. Higher doses in particular (>2 g EPA/DHA per day) over at least 6 months showed significant effects: An average of approx. +0.67 kg muscle mass and faster walking speed in those taking supplements .

In addition, individual studies have found that omega-3 improves muscle protein synthesis in older people and, in combination with strength training, increases muscle strength more than training alone. These results are promising – even if omega-3 is not a miracle cure, it seems to be a useful component in the prevention of sarcopenia, especially because of its anti-inflammatory properties .

Bone density: Some research results indicate that omega-3 fatty acids also have a positive effect on bone stability. For example, a Swedish study found that higher levels of DHA in the bones of adolescents correlated with higher bone density. Omega-3 could promote the storage of minerals. Epidemiological data from population studies show an inverse relationship between omega-3 intake and osteoporosis risk – in other words, people with omega-3-rich diets were less likely to have osteoporosis.

Animal experiments also suggest that omega-3 slows down the activity of osteoclasts and improves the calcium balance in the bone. These indications are not yet fully supported by large RCTs (“The results remain inconsistent”), but they are promising.

In orthomolecular practice, it is therefore often recommended to regularly consume oily sea fish (2-3 portions per week) or to take a high-quality fish oil supplement to achieve an omega-3 index of >8% (optimal for cell membranes and anti-inflammation). At VenaZiel, for example, the omega-3 index can be measured in the blood – a value below 5% is considered a severe deficiency, in which case targeted high-dose therapy with fish oil capsules would be recommended, which benefits the heart as well as bones and muscles.

It is important to take omega-3 supplements for at least 6-12 months in order to achieve structure-improving effects. Patients also benefit from improved inflammation levels, which can slow down the ageing process overall.

Proteins and amino acids – building materials for muscles and bones

Proteins form the basic substance of our muscles – without enough protein there is no muscle mass. However, bones also consist of ~20% organic matrix, primarily collagen, which gives bones elasticity and tensile strength. This collagen structure must be built up by the body, which also requires amino acids. A good protein supply is essential for bone health Studies show that older people with higher protein intake have better bone density and fewer fractures – probably because protein stimulates the production of insulin-like growth factor (IGF-1), which is bone anabolic, and increases muscle strength (which prevents falls).

However, it is important to find a balance: Extremely high protein intake, especially from animal sources, can increase the acid load and lead to increased calcium excretion. For this reason, nutritionists recommend 1-1.2 g protein/kg (plant-based to produce less acid) and plenty of fruit/vegetables at the same time to counteract acidosis. Important: It is better to increase protein intake and buffer excess with vegetables than to avoid protein for fear of acidity .

Some special amino acids have additional benefits for bones and muscles:

• Leucine: This essential amino acid is the strongest trigger for muscle protein synthesis. Just ~3 grams of leucine (contained in ~30 g of whey protein or e.g. 500 ml of buttermilk) is enough to activate the muscle-building signaling pathways. With age, the muscle reacts less well to leucine (anabolic resistance), which is why slightly higher doses may be necessary. A leucine-rich diet or supplement (BCAA) around strength training can counteract muscle loss. Buttermilk and whey protein are good sources.  
• Arginine & lysine: Studies have shown that these amino acids have positive effects on bone metabolism. Arginine is a precursor of nitric oxide (NO) and promotes blood circulation in the bones; arginine is also converted into proline in the body, an important collagen building block. In one study, arginine supplementation improved bone density in women with osteoporosis . The combination of arginine + lysine increased the activity of osteoblasts (bone formation cells) in cell cultures.
  Lysine, in turn, improves calcium absorption from the intestine and storage in the bones and is also involved in collagen synthesis. There is therefore some evidence that these amino acids (in high doses as a supplement) have a bone-strengthening effect.  
• Glycine and proline: Around a third of the amino acids in collagen are glycine. Although the body can produce glycine itself, studies indicate that endogenous glycine production is often not sufficient to fully cover the requirements for connective tissue. Orthomolecular physicians therefore also consider glycine supplementation for osteoporosis – e.g. in the form of collagen hydrolyzate, which is rich in glycine and proline. Proline is another key amino acid for collagen; it can also be substituted if necessary. This promotes the formation of a new bone matrix.  
• Creatine: A substance formed from three amino acids that is best known as a strength training supplement. Creatine can help to increase muscle energy in older people and improve muscle building in conjunction with training. There is evidence that creatine plus strength training builds more muscle mass and strength in seniors than training alone. Indirectly, this also supports bone health, as stronger muscles put more stress on the bones.

In short, proteins and certain amino acids provide the building material to maintain muscle fibers and bone matrix. Every older person should make sure they have a sufficient protein intake in their diet (about 20-30 g of protein per meal, spread throughout the day). In the case of malnutrition, loss of appetite or increased requirements, protein shakes or bars can be useful – these are also available for seniors (enriched with extra leucine, vitamin D and calcium).

Orthomolecular therapists also make targeted use of amino acids: e.g. arginine and lysine capsules for bone density, creatine for muscles or collagen hydrolyzate for bones, joints and skin. VenaZiel Berlin, for example, offers an aminogram analysis to identify deficiencies or imbalances in the amino acid balance and develops personalized supplementation plans based on this.

Other vitamins and trace elements

In addition to the “main players” mentioned above, there are numerous other micronutrients that together have a major influence on bones and muscles. Here is a brief overview:

• Vitamin B complex: Vitamins B₆, B₁₂ and folic acid regulate the homocysteine metabolism. An elevated homocysteine level is considered an independent risk factor for osteoporosis because homocysteine disrupts the structure of the collagen matrix and activates osteoclasts. A good supply of B₆, B₁₂ and folic acid lowers homocysteine and can therefore reduce the risk of fractures . Folic acid in particular showed the strongest effect in studies.
  In addition, vitamin B₆ is a cofactor of lysyl oxidase, which is necessary for the cross-linking of collagen fibers in bones – B₆ deficiency thus weakens bone strength . Vitamin B₁, in turn, is important for nerves and energy: a B₁ deficiency increases the risk of falls in older people because it can contribute to neurological disorders . Conclusion: B vitamins (especially B₆, B₁₂, folate and also B₂) belong in every orthomolecular osteoporosis prophylaxis.  
• Vitamin C: Ascorbic acid is essential for collagen synthesis – it is used to link collagen molecules, which gives bones and connective tissue their stability. Vitamin C also promotes osteoblast activity (alkaline phosphatase). In several studies, a higher vitamin C intake was associated with better bone density and a lower fracture risk. At the same time, vitamin C is a powerful antioxidant and protects bone cells from oxidative stress. It is also important for the muscles as it is involved in carnitine synthesis (energy supply). Good sources are fruit, berries, peppers and broccoli – if your intake is low, a supplement (500-1000 mg/day) can be useful.  
• Vitamin E and carotenoids: These antioxidants combat free radicals that occur during the ageing process. Vitamin E in particular has shown anti-osteoporotic properties in experimental studies by lowering inflammatory markers.
  A good vitamin E status could reduce the increased oxidative stress on bones caused by age or oestrogen deficiency. Secondary plant substances such as polyphenols (e.g. in berries, green tea, turmeric) have a similar protective effect on cells. Although the exact effects on bones/muscles are still the subject of research, a diet rich in antioxidants is generally recommended to prevent chronic degeneration.  
• Zinc: The trace element zinc is a cofactor in many enzymes and plays a decisive role in growth and cell division. Zinc deficiency reduces bone growth and the zinc content of bones decreases with age. Zinc promotes the formation of osteoblasts (bone formation) and inhibits osteoclasts (bone breakdown). Studies have shown that zinc supplementation can increase bone mass .
  In one study, the combination of calcium + zinc + manganese + copper was significantly more effective for the bone density of postmenopausal women than calcium alone. Zinc is also important for muscle regeneration (testosterone synthesis, protein synthesis). Care should therefore be taken to ensure sufficient zinc intake (~10-15 mg/day), e.g. through nuts, whole grains, meat or a multivitamin.  
• Magnesium, potassium & co.: Magnesium has already been mentioned – it is absolutely essential. Potassium from fruit and vegetables helps to neutralize the dietary acid load and reduces calcium losses via the kidneys. Studies have shown that an alkaline-rich diet or potassium citrate supplements reduce the rate of bone loss. Copper and manganese are cofactors of enzymes involved in collagen and cartilage formation (lysyl oxidase and glycosyltransferases). A manganese deficiency leads to bone damage in animals; in humans, the aforementioned combination therapy with manganese has shown a positive effect.
  Finally, iron is necessary for collagen formation and vitamin D metabolism (cytochrome P450). Hidden iron deficiency anemia can lead to fatigue and weakness, which indirectly inhibits movement and muscle performance. Orthomolecularly, it therefore makes sense to keep an eye on all these trace elements. A good multimineral preparation is often enough to rule out deficiencies. If there is a concrete suspicion (e.g. low ferritin levels, anemia, hair loss due to zinc deficiency), targeted substitution should be carried out.

As you can see, an orchestra of micronutrients is needed to keep bones and muscles healthy – there is no one “miracle nutrient”. Orthomolecular medicine therefore relies on broad-based nutrient combinations: first a high-quality multivitamin/mineral as a basic safeguard and, depending on the individual situation, additional targeted supplements (such as extra vitamin D, K2, omega-3, B vitamins, amino acids, etc.). The quality of the supplements is important: you should look for highly bioavailable forms and purity – because as the saying goes, “vitamins only benefit those who use them properly, not just those who sell them”.

In other words, orthomolecular therapy should be customized, based on diagnostics, so that exactly the vital substances that are missing are supplemented. This is exactly what is done in specialized practices such as VenaZiel in Berlin: here, comprehensive laboratory diagnostics of the nutrient status are carried out first, followed by individual advice and therapy tailored to the deficiencies identified and personal risk factors (age, illnesses, medication).

Specific recommendations: Optimize diet, supplements and lifestyle

Now that we have looked at the most important nutrients and the scientific background, the question arises: How can you prevent osteoporosis and muscle loss in practice? Here are some concrete, easy-to-implement tips – for Berlin and everywhere:

1. bone and muscle-healthy diet

• Calcium-rich food: Incorporate calcium-rich foods into your daily diet. Good sources are dairy products (cheese, yoghurt – ideally not too low in fat, as vitamin D is fat-soluble), green vegetables (broccoli, kale, spinach), almonds and calcium-rich mineral water (make sure it contains calcium >150 mg/L). Aim for a total intake of around 1000 mg calcium per day from food and, if necessary, supplements. Tip: 100 g Emmental cheese, for example, provides ~1000 mg calcium, 100 g kale ~200 mg.  
• Vitamin D supply: Soak up daylight and sun as often as you can – in Berlin, it is recommended that you expose your face and arms to the sun for ~15 minutes every day from April to September (midday, without sun cream) to build up your body’s own vitamin D. In the fall/winter or if you hardly ever get out in the sun, a vitamin D supplement is almost always necessary. Have your vitamin D level checked by your doctor or e.g. via VenaZiel and take a suitable dose (often 1000-2000 I.U. daily) in consultation with your doctor. Remember: Vitamin D is fat-soluble – take it with a meal with some fat to optimize absorption. Calcium cannot work without sufficient vitamin D!  
• Emphasize protein: Make sure you have plenty of protein in every meal, especially if you are over 60 or already notice muscle weakness. We recommend 1-1.2 g of protein per kg of body weight per day. At 70 kg, this would be around 70-84 g of protein. Good sources: Low-fat quark, fish, lean meat, eggs, pulses, soy products. Aim to eat yoghurt with nuts (protein + calcium) for breakfast, pulses or a piece of fish at lunchtime and lean meat or tofu with vegetables in the evening. If appetite or chewing problems make it difficult, protein drinks (e.g. whey protein shakes, which are also used in hospitals for malnourished patients) can help. A protein intake (20-30 g) is particularly useful after physical training to boost muscle growth. Older people often need a little more protein because the muscle is less sensitive to it.  
• Fruit and vegetables – for vitamins and bases: Five portions of colorful fruit and vegetables a day not only provide vitamin C, K, folate, magnesium and potassium for the bones, but also help to prevent acidosis. Vegetables and fruit have an alkalizing effect and buffer the acids produced during protein breakdown. This is important because an acidic environment activates osteoclasts and promotes bone loss . So: every plate should also contain “green stuff”. Particularly recommended: green leafy vegetables (lots of vitamin K and calcium), berries (vitamin C, antioxidants), tomatoes, peppers (vitamin C), bananas (potassium), avocado (magnesium, healthy fatty acids).  
• Nuts, seeds, whole grains: These provide magnesium, zinc, manganese, copper, protein and healthy fats – an ideal package for bones and muscles. A handful of nuts (walnuts, almonds, hazelnuts) daily provides magnesium and omega-3 (walnuts) as well as protein. Sesame and poppy seeds are true calcium wonders (1000 mg+ per 100 g, of course you usually eat less, but as tahini/paste it can be useful). Whole grains contain more minerals than white flour – oat flakes, for example, provide magnesium, iron and zinc.  
• Fatty sea fish & omega-3: Include salmon, herring, mackerel or sardines in your diet 1-2 times a week. These fish provide omega-3 fatty acids (EPA/DHA) and vitamin D. With regard to osteoporosis, some experts recommend the Mediterranean diet – this contains a lot of fish (omega-3) and olive oil/nuts, but less red meat. If you hardly like fish or do not eat it for ethical reasons, you can take fish oil capsules or algae oil (vegan DHA). Dosage depending on requirements ~1000-2000 mg omega-3 (EPA+DHA) per day, preferably with meals. Omega-3 supports bone and heart health and may improve muscle function.  
• Drink enough: Good hydration is important for the metabolism – “drying out” muscles and bones is also unfavorable. Drink about 1.5-2 liters a day, ideally water or unsweetened herbal/green tea. Some mineral waters are rich in calcium and magnesium, which is doubly beneficial. Alcohol, on the other hand, should only be consumed in moderation – high alcohol consumption is associated with reduced bone density and muscle atrophy (it also increases the risk of falling).  
• Limit harmful stimulants: Nicotine is poison for bone cells – smokers have a significantly increased risk of osteoporosis and poorer muscle circulation. One more good reason to stop smoking. Excessive caffeine (more than ~4 cups of coffee a day) can increase calcium excretion. However, moderate coffee consumption is not problematic, especially when taken with milk. Avoid soft drinks containing phosphates (cola etc.) as far as possible – they disrupt the calcium-phosphate balance in the bones.  
• No radical diets: Avoid starvation or crash diets where you lose a lot of weight in a short space of time. This often results in the loss of valuable muscle mass and nutrient deficiencies that weaken the bones. Slow, moderate weight loss (if necessary) with sufficient protein and vital nutrients is much better.

To summarize: Eat a colorful, wholesome and protein-rich diet. It’s certainly not possible to eat perfectly every day, but try to make a bone-healthy diet your standard. In a city like Berlin, for example, there are many opportunities to get fresh vegetables (weekly markets), calcium-rich mineral water (e.g. from the Brandenburg region) and a wide variety of proteins (from Turkish yogurt to vegan protein sources in health food stores). Take advantage of the offer! And if there are any gaps, supplement with high-quality supplements – preferably after consulting experts.

2. movement and training: “Use it or lose it”

Without physical activity, even the best nutrients are of limited help. Regular exercise is essential for strong bones and strong muscles:

• Strength training: The most important stimulus for building or maintaining muscle is resistance training. This does not have to be heavy weights in the gym (although targeted training there is very effective); it can also be exercises with your own body weight (squats, push-ups, climbing stairs), Thera-Band or light dumbbells. Studies show that even 80- to 90-year-olds can still build muscle significantly through strength training! Start gently and slowly increase the intensity and volume. Ideally, you should do 2-3 strength training sessions per week that target all the main muscle groups. Just 20-30 minutes per session can be enough if you do them regularly. Stronger muscles also put more strain on the bones and encourage them to remain denser . It also improves coordination, which prevents falls. 
• Endurance and everyday exercise: In addition to targeted strength training, you should generally remain active in everyday life. Any kind of exercise counts – walking, cycling, gardening, dancing. Official recommendations for older adults are 150 minutes of moderate exercise per week (e.g. 5×30 minutes of brisk walking). In Berlin, this can be easily integrated, e.g. by walking distances or doing activities in the many parks and green spaces. “Sitting marathons” in front of the TV or computer should be interrupted: get up at least once every 1-2 hours, walk a few steps, stretch. Even these little things help to stimulate muscles.  
• Balance and coordination training: Balance and mobility exercises are particularly important for preventing falls. Classic examples: Tai Chi, yoga, senior gymnastics, dance. Even simple exercises such as standing on one leg, walking on heels and toes or stability training with a wobble board strengthen the small muscles and train balance. Many sports clubs or physiotherapy practices (also in Berlin) offer fall prevention courses. A trained musculature reacts more quickly, so slips can be absorbed more easily.  
• Fresh air and sunshine: Combine exercise outdoors if possible – this way you kill two birds with one stone: training + vitamin D synthesis. A walk in daylight (even in winter at lunchtime) brings light to the skin for vitamin D and stimulates circulation. Nature has also been proven to be good for the psyche, which indirectly benefits physical health.  
• Physiotherapy if required: If you already have limitations (osteoporosis with vertebral fracture, osteoarthritis, neuromuscular problems), get support from physiotherapists. They can create an individual program that is safe and tailored to your needs. It is important to reduce your fear of exercise – many osteoporosis patients avoid exercise out of fear of fractures, but this is counterproductive. In Berlin, there are osteoporosis sports groups and rehabilitation courses where you can exercise under supervision.

Remember: exercise is medicine. In combination with orthomolecular care, the result is a powerful duo. As Dr. Sieber from the DGIM aptly put it: “Muscle building is possible into old age” – you just have to take every opportunity to be active. And Prof. Wackerhage, a sports physician, recommends taking up to 40 g of protein directly after training to achieve the maximum anabolic effect in aging muscles. This synergy of training + nutrients is the ideal way to strengthen muscles and bones.

3. take advantage of orthomolecular diagnostics and advice

In view of the many nutrients and factors involved, it makes sense to seek professional support – especially if you belong to a risk group or are already showing the first signs of bone loss/muscle loss. Orthomolecular medicine in Berlin (e.g. at VenaZiel, a practice with a focus on orthomolecular medicine) offers comprehensive prevention programs. What can you expect from such care?

• Thorough medical history: First, your personal situation is analyzed: Family history (has there been osteoporosis or hip fractures in your relatives?), your own previous illnesses (diabetes, rheumatism, thyroid disorder, hormonal problems, depression – all of these can be relevant), current medication (some can affect bone density, such as cortisone or gastric acid blockers) dietary habits (e.g. do you eat less dairy products or avoid the sun?), lifestyle (exercise, smoking, alcohol), etc. Complaints such as back pain, muscle weakness, cramps or bone fractures in the past are also recorded. This medical history already provides indications of risk factors that can be specifically addressed.
• Laboratory diagnostics – the vital substance check: The core of the orthomolecular analysis is a comprehensive blood test profile that includes all relevant micronutrients and markers. Particularly important in the prevention of osteoporosis and sarcopenia:
  • Vitamin D (25-OH): To determine whether a deficiency exists. Values above 30 ng/ml are considered good, below 20 ng/ml there is a need for action.
  • Vitamin B₁₂, B₆, folic acid + homocysteine: A high homocysteine level (>10 µmol/L) increases the risk of osteoporosis, which is why B vitamins are tested. If necessary, homocysteine is measured in the blood and then specifically lowered with e.g. methylfolate and B₁₂.
  • Bone metabolism markers: Special markers such as bone remodeling products (CTX, PINP) or bone-specific alkaline phosphatase can be determined in order to estimate the current rate of bone resorption. Parathyroid hormone is also sometimes measured, as it is elevated in vitamin D deficiency and pulls on the bone.
  • Calcium, magnesium, phosphate: basic parameters for assessing the mineral balance.
  • Trace elements: Zinc, copper, selenium, manganese, iron – all of these can be determined in whole blood or serum. This allows you to recognize a latent zinc deficiency, for example, which can be remedied.
  • Inflammation markers: CRP hs or interleukin-6 can indicate smoldering inflammation affecting bones and muscles.
  • Hormone status if required: In men, a testosterone level can be determined, in women possibly oestrogen/FSH (if menopause is unclear). Thyroid levels (TSH) are important because hyperthyroidism accelerates bone loss.
  • Muscle parameters: Creatine kinase (CK) as an indicator of muscle substance, possibly vitamin D receptor gene variants or neuromuscular markers if specific questions exist.
  • Omega-3 index: As mentioned above, this measures the content of EPA/DHA in the red blood cells – optimally >8%, many are <5%, which indicates a deficiency.
  • Other values: Depending on the patient, 25(OH)D3 binding protein, IGF-1, DHEA or other anti-ageing markers can also be looked at.

All of these tests result in a highly individualized nutrient profile. At VenaZiel Berlin, for example, a “bone profile” or “muscle function profile” is offered, which specifically contains the above-mentioned values.

The advantage: you can see exactly where action is needed and can personalize your diet. Because not everyone needs all supplements indiscriminately – one person may have a great vitamin D level, but a zinc deficiency; the next has good omega-3, but B12 is too low, etc. Orthomolecular means tailor-made.

• Individual supplementation and therapy planning: Based on the findings and your lifestyle, the orthomolecular physician will then draw up a therapy plan. This may include
  • Specific dietary supplements with dosage: e.g. vitamin D3 daily at breakfast; vitamin K2 MK-7; magnesium citrate; fish oil EPA+DHA; calcium citrate (if diet does not provide enough calcium); multivitamin; protein shake; etc. All precisely adapted to the measured values and goals.
  • Infusion therapies: Insome cases, high-dose vitamins are given by infusion, e.g. high-dose vitamin C for oxidative stress, or amino acid infusions to promote blood circulation. Vitamin D can also be administered as an intramuscular depot injection if oral intake is a problem.
  • Nutritional advice: In addition to supplementation, you will receive tips on which foods you should eat more of (e.g. specifically: “more almonds, natural yoghurt every day, salmon once a week” etc.) and which should be avoided (“max. 1 cola per week”, “not sausage every day, more lean meat/fish”).
  • Lifestyle advice: An exercise plan will be discussed with you (often orthomolecular doctors also have knowledge of sports medicine or work together with physiotherapists). If you are overweight or underweight, recommendations will be made. Smoking advice if relevant. If necessary, also fall prevention measures (remove carpets, prescribe aids).
  • Follow-up: After a few months, it is checked whether the values and condition have improved. Laboratory checks of vitamin D, homocysteine, bone density measurement (DXA) or hand strength measurement can objectively show the success. At VenaZiel, for example, follow-up checks are part of the program so that doses can be adjusted if necessary.

The advantage of using services such as VenaZiel Berlin is that you receive expert guidance and do not supplement on your own. This guarantees evidence-based evidence and safety: you receive effective, tested preparations and avoid overdoses or unnecessary medication.

In addition, professional support motivates you to stay on the ball – be it with regular training or the consistent intake of nutrients. Prevention is a long-term investment, but one that pays off: with strong bones and muscles, you will remain mobile and independent into old age.

Conclusion

Osteoporosis and age-related muscle loss are not inevitable fates – with the right preventive measures, a lot can be done to prevent bone loss and preserve muscles. A scientifically based orthomolecular strategy addresses the causes: It compensates for micronutrient deficiencies (vitamin D, K2, calcium, magnesium, omega-3, protein and much more), has an anti-inflammatory effect and supports the body’s own rebuilding mechanisms. At the same time, exercise and strength training provide the stimuli that bones and muscles need to stay strong.

A holistic approach is important: it doesn’t help to just swallow tablets and be inactive, nor is exercise alone enough without the necessary “building blocks” for the body. It’s the combination that makes the difference – and this is precisely where the strength of orthomolecular prevention lies. It is based on data and diagnostics, so that an individually tailored approach is taken. Studies support the effectiveness of many nutrients, such as vitamin D, which can reduce fractures and falls; vitamin K2, which lowers the rate of bone fractures; protein and amino acids, which build muscle and bone matrix; omega-3, which reduces inflammation and slightly increases muscle mass. These findings can be put into practice today, so that everyone can do something for bone health – before the first fracture instead of after.

Especially people in big cities like Berlin, who perhaps don’t get much sun in winter or have a stressful office life, should think about prevention. Services such as those offered by VenaZiel Berlin make it easier to get started: here you receive competent all-round care, from laboratory diagnostics to the creation of an orthomolecular plan and support with lifestyle changes. Osteoporosis prevention in Berlin doesn’t have to be complicated – it can be tackled step by step together with experts.

In the end, the effort pays off several times over: strong bones, strong muscles, fewer falls and fractures, better quality of life into old age. Prevention is always better than aftercare – it’s best to start actively promoting your bone and muscle health today. Your future self will thank you for it! Keep moving, eat a wholesome diet and use the help of orthomolecular medicine if necessary – this will keep your bones and muscles stable and healthy.