The Best Supplements for Bone Recovery
Tiny Helpers for Boosting Bones
I may not be able to control this, but I'll be damned if I'm not going to influence every part of it that I can.
FROM THE TRENCHES
After my ORIF surgery, my doctor advised that I take calcium and vitamin D and C—which I did. But, me being me, I wondered if I could do more.
Health—at least in recent years-- is near or at the top of my priorities. Without it, I can’t do anything for myself, or for anyone else. Without it, I can’t enjoy much of my life. This injury, this surgery, and this prolonged recovery only made me surer of that fact. I sure wasn’t enjoying life as much as usual sitting in front of the TV with my leg propped up on a pillow.
So much of healing requires patience. You can't make a fracture knit together through sheer determination, and you can't exercise your way out of the early stages of recovery. Taking something that might help can feel like one small part of the process you can actually control. I was all about that.
I did a lot of research, bought a lot of vitamins and supplements, and take them still. By all accounts, I’ve healed well. Are the supplements the reason? They’re not magic, for sure.
But I feel they played a part.
What Your Bones Actually Need
Bone may look like an inert, rock-hard structure, but it is living tissue that is constantly being broken down and rebuilt. After a fracture, that rebuilding process goes into high gear.
That means your body needs raw materials. Some nutrients have obvious starring roles in bone health; others support the process indirectly. And some supplements marketed for bone healing have much less evidence behind them than the advertising might suggest.
The Big Players
Calcium gets top billing for a reason. It is the major mineral in bone, and your body needs an adequate supply while new bone is being formed. Dairy products, fortified plant milks, leafy greens and sardines are food sources; calcium carbonate and calcium citrate are common supplement forms.
But this is one of those cases where more is not automatically better. Too much supplemental calcium can cause problems, including kidney stones, and calcium can interfere with the absorption of iron and zinc. Calcium is also better absorbed in smaller amounts rather than one enormous dose.
Vitamin D and calcium belong in the same conversation because vitamin D helps your body absorb and regulate calcium and plays an important role in bone remodeling. Sunlight, fatty fish and fortified foods provide vitamin D, and supplements usually contain vitamin D2 or D3.
Vitamin D is another nutrient you don't want to take indiscriminately. Excessive amounts can cause calcium levels in the blood to become too high and potentially lead to nausea, fatigue and kidney problems. If deficiency is a concern, bloodwork can help determine whether supplementation is actually needed and how much.
Protein and collagen provide some of the structural materials involved in rebuilding. Bone isn't made of calcium alone. Collagen forms much of its framework, while adequate dietary protein helps repair bone, muscle and other tissues damaged by injury or surgery.
Protein can come from meat, fish, dairy products, eggs, beans and other foods, while collagen is available in gelatin, bone broth and collagen-peptide supplements. A protein or collagen supplement can be convenient during recovery, particularly if your appetite isn't great, but it shouldn't crowd actual food off the plate.
Vitamin C is part of this picture because your body needs it to produce collagen. Citrus fruits may be the obvious source, but berries, peppers and broccoli are also rich in vitamin C.
Again, megadosing doesn't necessarily provide extra benefit. Very large doses can cause stomach problems and, in susceptible people, may contribute to kidney stones.
The Supporting Cast
Several other nutrients play supporting roles in maintaining bone and helping the body repair itself.
Magnesium is involved in bone metabolism and helps the body activate vitamin D. Good food sources include nuts, seeds, whole grains and leafy green vegetables. Magnesium supplements come in several forms, including citrate and glycinate.
Too much supplemental magnesium can have an unmistakable downside: diarrhea and stomach upset. People with kidney problems also need to be particularly cautious about taking extra magnesium.
Vitamin K2 is involved with proteins that help incorporate calcium into bone. You'll find it naturally in foods such as natto, cheese and egg yolks, and it is widely sold as a supplement, often alongside vitamin D.
There is an important caveat: vitamin K can interact with certain anticoagulant medications, particularly warfarin. That's one reason adding a supplement isn't always as harmless as it sounds.
Zinc participates in cell repair, collagen formation and immune function—all useful processes when your body is healing. Meat, shellfish, legumes and nuts provide zinc, and supplemental forms include zinc gluconate and zinc picolinate.
High doses, however, can cause nausea and interfere with copper absorption. Zinc is another good example of a nutrient your body needs but doesn't necessarily need in enormous quantities.
What About Omega-3s, Creatine and Other Supplements?
This is where things become more interesting—and less clear-cut.
Omega-3 fatty acids, found in fatty fish, flaxseed and chia seeds as well as fish-oil supplements, have anti-inflammatory properties and may have benefits for bone health. But inflammation is also part of the body's normal healing response, and omega-3 supplements can affect bleeding. High-dose fish oil deserves particular attention if you're taking anticoagulants or preparing for surgery.
Creatine is much better known as a sports supplement than a bone supplement. It can support muscle mass and strength, which may become particularly relevant after weeks of inactivity and muscle loss. Stronger muscles also help support the recovering limb as rehabilitation progresses.
There is research interest in whether creatine might have additional benefits for bone, but the case for taking it specifically to make a fracture heal faster isn't established. Creatine monohydrate is the most commonly used supplemental form. It can cause water retention or digestive upset, and people with kidney disease should discuss its use with a physician.
And then there are supplements such as horsetail (Equisetum arvense).
Horsetail has been used traditionally for centuries and contains silica, a mineral involved in connective tissue and bone. That makes it sound like a natural fit for fracture recovery, and you'll find plenty of claims that it helps strengthen bones.
The evidence is much thinner than the claims.
Human research specifically demonstrating that horsetail improves fracture healing is limited. It can also interact with medications, including diuretics, and the plant contains thiaminase, an enzyme that can break down vitamin B1. Long-term unsupervised use could therefore create problems rather than solve them.
That's worth remembering whenever a supplement is described as "natural." Natural and harmless aren't synonyms.
More Isn't Better
One of the easiest traps to fall into during recovery is thinking that if a little of something helps, a lot should help more.
That's not how nutrition works.
Your body needs calcium, but excessive supplemental calcium can cause problems. It needs vitamin D, but vitamin D toxicity is real. It needs zinc, but too much zinc can interfere with another essential mineral. Even vitamin C—something most of us regard as exceptionally benign—can cause trouble at very high doses.
Supplements can also overlap. A multivitamin may contain vitamin D and zinc. Your calcium supplement may contain more vitamin D. A "bone health" formula may contain calcium, magnesium, D and K. Add separate bottles of each, and you may be taking considerably more than you realize.
Read the labels and add up the totals.
Food First
Bones aren't built from pills alone.
A varied diet can supply protein, calcium, vitamin C, magnesium, zinc and many of the other nutrients your body needs while healing. Food also provides calories—and recovery requires energy.
This isn't the ideal time for an aggressively restrictive diet. Your body has construction work underway. Nevertheless, just because it’s not an ideal time for an aggressively restrictive diet doesn’t mean that ice cream, tortilla chips and French fries should hold a prominent place on the menu.
I usually burn a lot of calories in my everyday, active life, normally clocking over 10,000 steps before noon. But when I was non-weightbearing, my activity took a nosedive. My appetite didn’t follow suit. I was bored. I felt sad. The macaroni and cheese understood me.
Beware! Taking the weight off is inevitably harder than putting it on. Try to make healthy choices.
Think protein at meals, fruits and vegetables, calcium-rich foods and enough overall nutrition to support healing. Supplements can fill genuine gaps, but they don't replace the grocery store.
Here’s where you can check out what you need to know about healthy eating for ankle fracture recovery.
WORTH KNOWING
The supplement industry can make fracture recovery sound deceptively simple: take this combination, drink this powder, buy this bottle and build bone faster.
Human biology isn't quite that cooperative.
Some nutrients are unquestionably necessary for healthy bone formation. That's different from proving that taking additional amounts of those nutrients will make a well-nourished person's fracture heal faster.
If you have a deficiency, correcting it may be important. If you're already getting enough, piling on more may accomplish very little—and occasionally can cause harm.
ASK YOUR SURGEON
Before adding supplements during fracture or surgical recovery, consider asking:
Do I need any particular supplements based on my diet, age or bloodwork?
How much calcium and vitamin D should I be getting each day?
Should I get my vitamin D level checked?
Could any of my supplements interact with my prescription medications?
Are there supplements I should avoid while taking blood thinners?
Which supplements should I stop before surgery, and how far in advance?
When is it safe to restart them afterward?
And bring the actual list. "I take a few vitamins" isn't nearly as useful as telling your medical team exactly what you take and how much.
MY TAKE ON IT
I'm not very good at sitting around waiting for my body to heal. That probably understates it. I have a life to live! Horses to ride! Adventures to unravel!
I imagine you’d like to get back to your life, too.
Yes, healing takes time. You can't bully a bone into knitting faster, and no supplement is going to turn a six-month recovery into six weeks. But that doesn't mean I'm content to sit back and wait for nature to take its course.
My philosophy is to do what I reasonably can to stack the deck in my favor. You might say I'm throwing things against the wall—but I'm not throwing blindly.
If there's something promising with reasonable evidence behind it and little downside for me, I'm willing to consider it—even if nobody can guarantee that it will make a measurable difference.
Some things have good evidence behind them, some have intriguing but preliminary evidence, and some may amount to little more than expensive urine. Supplements can interact with medications and surgery, and too much of a good thing can become a bad thing.
So read. Ask questions. Look at the evidence. Talk to your doctor. Know what you're taking and why you're taking it.
Then make your own informed decisions.
Recovery takes time. That's the part we can't control.
What we do with that time is another matter.