Sorry for the AI, I couldn’t remember a lot of items on the list:
OTC ESSENTIALS (supportive, safe, foundation for bone health)
- Calcium – 1,000–1,200 mg/day
- Role: core bone mineral
- Efficacy: 5/10 alone (supports bones, doesn’t grow much)
- Tolerability: 9/10 (well tolerated, may cause mild constipation)
- Vitamin D3 – 800–2,000 IU/day
- Role: helps calcium absorption, supports bone remodeling
- Efficacy: 5/10 alone
- Tolerability: 10/10
- Magnesium – 200–400 mg/day
- Role: bone structure, aids vitamin D metabolism
- Efficacy: 4–5/10
- Tolerability: 9/10
- Vitamin K2 (MK-7) – 100–200 mcg/day
- Role: directs calcium into bone (activates osteocalcin)
- Efficacy: 6/10
- Tolerability: 10/10
- Electrolytes & trace minerals (zinc, boron, manganese, copper)
- Role: support bone matrix and metabolism
- Efficacy: 4–5/10
- Tolerability: 10/10
OTC OPTIONAL / SUPPORTIVE SUPPLEMENTS
- Collagen peptides – 5–10 g/day
- Role: supports bone matrix and collagen
- Efficacy: 6/10
- Tolerability: 10/10
- Omega-3 fatty acids (EPA/DHA) – 1–2 g/day
- Role: reduces inflammation, helps bone turnover
- Efficacy: 5/10
- Tolerability: 10/10
- Silicon / Silica – 5–10 mg/day
- Role: supports collagen and bone structure
- Efficacy: 4–5/10
- Tolerability: 10/10
HORMONES / ANABOLIC SUPPORT (more potent, requires medical guidance)
- HGH (Growth Hormone)
- Role: stimulates bone formation, especially in GHD
- Efficacy: 9/10 (for increasing thickness)
- Tolerability: 7–8/10 (injection, potential side effects: edema, insulin resistance, joint pain)
- Androgens / Testosterone (if low)
- Role: supports bone mass and density
- Efficacy: 7–8/10
- Tolerability: 7–8/10 (side effects: acne, hair growth, mood changes, long-term cardiovascular considerations)
- Ideal TSH / Thyroid Balance
- Role: thyroid hormones regulate bone turnover
- Efficacy: 7/10 (correcting deficiency stabilizes bone, doesn’t actively thicken)
- Tolerability: 10/10 if properly managed
MEDICATIONS (strongest effects, divided by action)
1. Anabolic (build new bone, increase thickness)
- Teriparatide / Abaloparatide (PTH analogs)
- Overall Score: 9/10
- Effectiveness: very strong; stimulates new bone formation
- Tolerability: decent; daily injection, mild nausea or leg cramps
- Romosozumab (sclerostin inhibitor)
- Overall Score: 8.5/10
- Effectiveness: rapid gains, dual action (builds bone + reduces resorption)
- Tolerability: good; minor injection-site reactions, some cardiovascular caution
2. Anti-Resorptive (preserve bone, prevent loss)
- Bisphosphonates (Alendronate, Risedronate, Zoledronate)
- Overall Score: 8/10
- Effectiveness: solid antiresorptive, oral or IV
- Tolerability: generally good; oral forms can cause GI upset, rare atypical femur fracture/jaw issues long-term
- Denosumab (RANKL inhibitor)
- Overall Score: 7.5/10
- Effectiveness: very potent; 6-month injection
- Tolerability: good; rare rebound bone loss if stopped abruptly
3. Moderate / Optional / Historical
- Hormone replacement (estrogen/testosterone) – 6/10
- Role: moderate effect on bone, especially in postmenopausal women
- Tolerability: short-term good; long-term clot or cardiovascular risk
- SERMs (Raloxifene) – 5.5/10
- Role: moderate effect, mostly on spine
- Tolerability: okay; hot flashes, clot risk
- Calcitonin – 4.5/10
- Role: weak antiresorptive; nasal spray
- Tolerability: very good; rarely used now
SUMMARY / BEST APPROACH
- Foundation: OTC essentials (calcium, vitamin D, magnesium, K2, trace minerals)
- Supportive: collagen, omega-3, silicon
- Anabolic / thickness-focused: teriparatide/abaloparatide, romosozumab, HGH (if GHD), and androgens if deficient
- Preserve bone: bisphosphonates or denosumab
- Hormone balance: thyroid and sex hormones
- Supplements alone won’t thicken bones, but they maximize therapy and bone health
supplements / minerals sometimes considered but often omitted:
- Strontium ranelate / strontium citrate – can increase bone density by both slowing resorption and slightly stimulating formation; effectiveness 6–7/10; tolerability moderate (GI issues, not widely used in the US due to cardiovascular concerns for ranelate)
- Copper, manganese, boron (trace minerals) – i mentioned them briefly, but some guides skip them entirely; supportive, minor effect
- Silicon / silica – minor structural support, often overlooked
- Vitamin C – helps collagen synthesis in bone matrix; usually supportive
- Phosphorus – usually adequate from diet, sometimes overlooked in deficiency cases
medications / drugs sometimes missed:
- Strontium ranelate (as above, prescription in some countries)
- High-dose calcitriol / active vitamin D analogs – mainly for renal patients; bone effect secondary
- New experimental anabolic agents – e.g., newer PTH receptor modulators, anti-sclerostin antibodies in trials
other hormones / factors:
- IGF-1 analogs or mimetics – indirectly anabolic, often omitted
- Parathyroid hormone “pulsatile vs continuous” distinctions – not always mentioned in practical guides
basically, the main omissions are:
- strontium compounds
- less common trace minerals or vitamin C support
- experimental or region-specific meds
the ones i included (teriparatide, romosozumab, bisphosphonates, denosumab, HGH, sex hormones, and supportive vitamins/minerals) cover the majority of clinically validated, widely available bone-thickening strategies.
