> For the complete documentation index, see [llms.txt](https://myhealingcommunity.gitbook.io/myhealingcommunity-docs/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://myhealingcommunity.gitbook.io/myhealingcommunity-docs/testing-monitoring-and-biomarkers/bone-health/supplementation.md).
# Supplementation
Diet comes first.
Some at-risk women may still need targeted supplemental support.
### Calcium
Aim for about 1200 mg/day total from diet plus supplements.
Use a food-first approach when possible.
In aromatase-inhibitor settings, supplements usually fill the gap rather than replace food intake.
Many people only need 200–400 mg/day from supplements.
Avoid supplementing calcium if serum calcium is above 9.5 mg/dL. Additional vitamin K2 may be needed.
Some forms:
* d-malate
* MCHA
* avoid citrates with kidney disease or a low-oxalate diet.
High-oxalate foods can cancel out roughly 150 mg of calcium in the same meal.
One example of combinations to avoid is spinach with yogurt in a smoothie.
### Vitamin D3
A practical target is 50–80 ng/mL or about 125–200 nmol/L.
### Magnesium
Use magnesium through both food and supplements when needed.
Aim for at least half as much magnesium as the calcium dose.
Some forms:
* di-malate
* glycinate
Di-malate is often considered the more absorbable option.
Glycinate is also well absorbed and is often chosen for its calming effect.
### Vitamin K support
Useful forms to know:
* K1
* K2 MK-4
* K2 MK-7
Use extra caution with clotting disorders, anticoagulant use, or related cardiac risk.
For more detail on vitamin K2 for bone support and reducing arterial calcification, see [Vitamin K2 research notes](/myhealingcommunity-docs/testing-monitoring-and-biomarkers/bone-health/vitamin-k2-research-notes.md).
One combination product is **Thorne Vitamin K** at 1 capsule twice daily.
Each capsule provides:
* vitamin K1 1 mg
* vitamin K2 MK-4 5 mg
* vitamin K2 MK-7 90 mcg
MK-4 can also be taken separately alongside MK-7.
One option is **Thorne vitamin K2 liquid**, which provides 1 mg MK-4 per drop.
For those who prefer a higher-dose MK-4 product, one option is **Klaire Labs/SFI Ultra K2 Menaquinone-4**.
Many companies offer 90 mcg MK-7 because it is less expensive to produce than the MK-4 form, but MK-4 may offer an advantage for bone health see [Vitamin K2 research notes](/myhealingcommunity-docs/testing-monitoring-and-biomarkers/bone-health/vitamin-k2-research-notes.md).
If you have a documented clotting disorder, atrial fibrillation under active management, or use anticoagulants, review any vitamin K supplement with your clinician before use.
Safety data for K2 in that setting remain limited.
### Trace minerals
Zinc, boron, vanadium, and silicon are also relevant to bone support.
Recommended copper- and iron-free options are **Seeking Health Trace Minerals II No CU or FE** or **Pure Encapsulsations Trace Minerals**.
### Protein-matrix support
Collagen matrix support depends on:
* proline
* glycine
* hydroxyproline
Some ideas:
* digestive support when protein breakdown is compromised by PPI use, oncology treatments, or other challenges
* bone broth
* collagen peptides (Gelita tradmarked peptides are recommended)
* amino acid supplement (Perfect Aminos is recommended)
Digestive support options include **HCl with pepsin** and **pancreatic enzymes**.
For people with low protein intake, vegetarian or vegan diets, or sarcopenia risk, options include **Perfect Amino** or **collagen peptides**, especially types I and III (**Gelita trademarked forms such as in Designs for Health Whole Body Collage**n).
### Creatine
Creatine may help support both muscle mass and bone.
A practical dose is 5 g twice daily.
Older adults may need 10–20 g/day to replenish stores.
Creatine may be appropriate for vegetarians and breast cancer survivors in remission.
**Use extra caution with creatine during active breast cancer because clinical data are limited.**
Creatine supplementation for older adults:\
### Genistein
Genistein may be a useful bone-support option with certain cautions.
Do not combine genistein supplementation with tamoxifen without clinician guidance.
In ER-positive disease, or during endocrine therapy, review genistein with the oncology team or pharmacist before use.
For more detail, see [Genistein and bone health](/myhealingcommunity-docs/testing-monitoring-and-biomarkers/bone-health/genistein-and-bone-health.md).
For ER-positive dosing, see [Genistein Dosing in ER-Positive Breast Cancer](/myhealingcommunity-docs/breast-cancer/er-positive-her2-negative/genistein-dosing-in-er-positive-breast-cancer.md).
Examples include:
* **MCS Formulas Genistein** as a non-soy, higher dose option
* **DFH Osteoben** as a calcium, magnesium, and genistein combination may not be appropriate for use in ER+ breast cancer due to the lower dose of genistein.
{% hint style="warning" %}
Supplement decisions depend on medications, kidney function, calcium status, clotting context, and cancer history.
Individual review matters.
{% endhint %}
### What’s in this hub
* [Bone density testing](/myhealingcommunity-docs/testing-monitoring-and-biomarkers/bone-health/bone-density-testing.md): DXA interpretation, T-scores, trabecular bone score, and scan-reading pitfalls.
* [Lab tests and root-cause workup](/myhealingcommunity-docs/testing-monitoring-and-biomarkers/bone-health/lab-tests-and-root-cause-workup.md): Baseline bloodwork, bone-turnover markers, and specialist follow-up tests.
* [Diet and protein](/myhealingcommunity-docs/testing-monitoring-and-biomarkers/bone-health/diet-and-protein.md): Protein targets, mineral priorities, and oxalate-related food notes.
* [Supplementation](/myhealingcommunity-docs/testing-monitoring-and-biomarkers/bone-health/supplementation.md): Calcium, vitamin D, magnesium, K vitamins, creatine, and related support notes.
* [Exercise and bone loading](/myhealingcommunity-docs/testing-monitoring-and-biomarkers/bone-health/exercise-and-bone-loading.md): Resistance work, impact loading, and bone-metastasis safety cautions.
* [Vitamin K2 research notes](/myhealingcommunity-docs/testing-monitoring-and-biomarkers/bone-health/vitamin-k2-research-notes.md): Reference links and caution notes on MK-4, MK-7, and arterial-calcification context.
* [Genistein and bone health](/myhealingcommunity-docs/testing-monitoring-and-biomarkers/bone-health/genistein-and-bone-health.md): Research notes on genistein for bone support, including oncology cautions.
---
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