Orthopedic surgeon explains how having enough calcium and vitamin D can reduce your osteoporosis risk

Women with thyroid disorders are likely to break bones more often because of how the hormonal imbalance adversely affect bones. Know how to protect bones.

Fractures are not in isolation. They don't happen solely because of an accidental fall. Rather, they highlight the concerning condition of osteoporosis, where bones become weak and brittle, more likely to break even from small bumps or slips. Often, many remain unaware, as this ‘silent disease’ only comes to light when there's a fracture. Further, thyroid disorders aggravate osteoporosis in women. This double trouble of hormonal imbalance of the thyroid and weak bones makes women more vulnerable to breaking bones easily.

Women with thyroid disorders are more likely to have weak bone health, tend to fracturing bones more. (Shutterstock)

Dr Kiran Kharat, senior consultant orthopaedic surgeon, Ruby Hall Clinic, in an interview with HT Lifestyle, shared that women with thyroid disorders are at a higher risk of breaking bones because they develop osteoporosis. Along with this, she also highlighted the role of vitamins and calcium in supporting bone health.

She said, “Osteoporosis is a condition where bones become fragile and are more likely to break. It’s especially concerning for women with thyroid disease, whether it's hypothyroidism (an underactive thyroid) or hyperthyroidism (an overactive thyroid), because both conditions can negatively affect bone health and accelerate bone loss. While bone health is influenced by several factors, calcium and vitamin D play two of the most crucial roles in maintaining strong bones and preventing osteoporosis, especially in women with thyroid conditions.”

Women with thyroid at a higher risk of breaking their bones?

The thyroid is a gland that’s located in the front of the neck below the larynx (Adobe stock)

There are two types of thyroid, and Dr Kharat shared that both result in changes of bone metabolism. She listed how and why the changes happen:

• Hypothyroidism: When it is treated with medications like levothyroxine, it can result in excess thyroid hormone in the bloodstream if the dosage isn’t well balanced. Over time, too much thyroid hormone may increase bone turnover, causing bone to break down faster than it is rebuilt.
• Hyperthyroidism: It naturally accelerates many of the body’s processes, including bone resorption, the breakdown of bone tissue. This speeds up bone loss, reducing bone mineral density and increasing the risk of fractures.

Two micronutrients that benefit women with thyroid disorders to reduce osteoporosis risks

Good nutrition helps support bone health from the thyroid’s influence, which affects bone density. Dr Kharat identified two key micronutrients, calcium and vitamin D, as key players in mitigating the risk of bone fractures by reducing the negative impact of hormonal imbalances.

1. Calcium

Calcium helps support bone health. (Shutterstock)

Dr Kharat unpacks both the micronutrients, first beginning with calcium, the very mineral that is the foundation of bone health.

She said,“Calcium is the main mineral found in bones, making it a key component in maintaining bone strength and density. For women with thyroid disease, ensuring a consistent and sufficient intake of calcium is particularly important to offset the bone loss triggered by their condition or its treatment. Women over the age of 50, who are also more likely to be postmenopausal and already at risk of osteoporosis, should aim for 1,200 mg of calcium per day.”

She further shared 4 sources of calcium:

• Dairy products: milk, yoghurt, cheese
• Green leafy vegetables: spinach, kale, methi (fenugreek)
• Nuts and seeds: almonds, sesame seeds
• Fortified foods: calcium-fortified cereals, plant-based milk, and orange juice

But she cautioned those who are on thyroid meds that they need to space out calcium supplements and thyroid meds. Dr Kharat said,“If you're taking thyroid medication like levothyroxine, timing matters. Calcium supplements can interfere with the absorption of thyroid hormone. It’s best to take thyroid medication on an empty stomach and calcium supplements at least 4 hours later, but always consult your doctor or dietitian for personalised guidance.”

2. Vitamin

This image released by Milk Street shows a recipe for honey-miso salmon and broccolini traybake. (Milk Street via AP)

Vitamin is another vital pillar in supporting bone health. Describing the importance of vitamin, Dr Kharat added, “If calcium is the building block of bone, vitamin D is the helper that ensures your body can actually absorb and use that calcium effectively. Without enough vitamin D, even a calcium-rich diet won’t fully protect your bones. For women with thyroid disease, especially autoimmune conditions like Hashimoto’s thyroiditis or Graves’ disease, vitamin D metabolism is often impaired. Low vitamin D levels can lead to poor calcium absorption, increasing the risk of bone thinning and fractures.”

Recommending the ideal dose of vitamin and accompanying blood tests, she added, “Most adults need 600–800 IU of vitamin D daily. Women with thyroid disease may require higher amounts depending on blood levels. Moreover, a simple 25(OH)D blood test can help determine if supplementation is needed.”

Addressing the vitamin deficiencies, she listed out the key sources:

• Sunlight: The most natural source. Aim for 15–30 minutes of sun exposure (preferably between 10 AM and 3 PM) on bare skin without sunscreen, several times a week. In India, sunlight is abundant, but cultural practices, indoor lifestyles, or skin coverage can reduce exposure. Hence, supplementation may still be necessary.
• Foods: Fatty fish (salmon, sardines), fortified milk, fortified orange juice, egg yolks.
• Supplements: Your doctor may recommend vitamin D3 supplements if levels are low. These can be taken weekly or daily, depending on your needs.

Lifestyle habits that help reduce Osteoporosis risks

Be physically active by clocking in your daily step count. (Shutterstock)

Barring diet, lifestyle habits are also one of the key players in the bone health equation. These include regular exercise and even getting early bone density tests to ensure you are not ignoring early signs of bone loss. Here are the habits Dr Kharat suggested:

1. Stay physically active

• Weight-bearing exercises like walking, dancing, or stair climbing help build bone density.
• Strength training and yoga can improve balance and coordination, reducing the risk of falls and fractures.

2. Avoid smoking and limit alcohol

• Both smoking and excessive alcohol consumption are linked to lower bone density and increased fracture risk.
• Limiting these can significantly improve overall bone health.

3. Get bone density tests

• If you’re over 50, postmenopausal, or have had thyroid disease for many years, ask your doctor about a DEXA scan (bone density test).
• This helps detect osteoporosis early, even before a fracture happens.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.