Just Stress... How Can It Weaken Your Bones?

How Can It Weaken Your Bones?

Stress is a significant factor that affects various aspects of health, including bone health.

Recent studies have shown that chronic stress is associated with reduced bone mass and an increased risk of osteoporosis.

Osteoporosis is a condition characterized by a decrease in bone mass and deterioration of bone structure, leading to a higher risk of fractures.

According to statistics from the World Health Organization (WHO), osteoporosis is considered a major public health issue, especially among the elderly.

While genetics, hormones, and nutrition are the primary factors influencing bone density, scientists have recently begun to recognize the role of psychological stress as a contributing factor to bone loss.

Mechanisms of Stress in Osteoporosis Development

1️⃣ The Effect of Cortisol

When the body experiences stress, it releases cortisol, a hormone secreted by the adrenal glands.

Cortisol plays an important role in regulating metabolism, inflammation, and stress responses.

However, persistently high cortisol levels can inhibit bone formation (osteoblast activity) and stimulate bone resorption (osteoclast activity) (Manolagas, 2000).

2️⃣ Chronic Low-grade Inflammation

Stress can trigger cellular-level inflammation by increasing the production of inflammatory cytokines such as IL-6 and TNF-alpha, which are known to promote bone resorption (Wright et al., 2014).

3️⃣ Changed Health Behaviors

Individuals under high stress are more likely to engage in risky behaviors such as smoking, excessive alcohol consumption, unhealthy eating, and physical inactivity — all of which can negatively impact bone mass (Compston et al., 2019).

4️⃣ Impact on Other Hormones

Chronic stress may lower the levels of estrogen and testosterone, hormones that are critical for maintaining bone mass, particularly in postmenopausal women (Seeman, 2001).

Stress is thus recognized as an important risk factor that can contribute to bone loss through multiple mechanisms.

Raising awareness about mental health and effective stress management is therefore an essential approach to the sustainable prevention of osteoporosis.

Article by:Pharmacist Nawaporn Sukdashosavang
B.Pharm, Mahidol University

References

1.Compston, J. E., McClung, M. R., & Leslie, W. D. (2019). Osteoporosis. The Lancet, 393(10169), 364-376. https://doi.org/10.1016/S0140-6736(18)32112-3

2.Manolagas, S. C. (2000). Corticosteroids and bone: mechanisms of osteoporosis. The Journal of Clinical Investigation, 106(3), 439-442. https://doi.org/10.1172/JCI10562

3.Seeman, E. (2001). Sexual dimorphism in skeletal size, density, and strength. The Journal of Clinical Endocrinology & Metabolism, 86(10), 4576-4584. https://doi.org/10.1210/jcem.86.10.7921

4.Wright, L. E., Frye, J. B., Lukefahr, A. L., & Yawn, B. P. (2014). Chronic psychological stress suppresses bone formation via corticotropin-releasing hormone. Endocrinology, 155(7), 2400–2408. https://doi.org/10.1210/en.2014-1049

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