How Stress Impacts Bone Health: What You Need to Know

When we think about stress, we often connect it to anxiety, sleep issues, or digestive problems. But did you know that chronic stress can also weaken your bones?

In today’s fast-paced world, stress is a near-constant part of life. And while short bursts of stress are normal—and even helpful in certain situations—long-term, unrelenting stress can silently sabotage your bone health. Let’s explore the powerful connection between stress, cortisol, digestion, and your skeletal system.

Our Days Can Be Filled with Stress Which Can Impact Our Bones

Cortisol: The Bone-Breaking Hormone?

Cortisol is your body’s primary stress hormone, released by the adrenal glands in response to a perceived threat. It plays a crucial role in your “fight or flight” response—but when stress becomes chronic, cortisol can become your bones’ worst enemy.

Here’s how elevated cortisol affects bone health:

• Breaks down bone tissue: Chronically high cortisol increases bone resorption—the process where bones are broken down faster than they’re rebuilt.

• Reduces calcium absorption: Cortisol interferes with calcium uptake in the gut and increases calcium excretion via the kidneys.

• Suppresses osteoblast activity: These are the bone-building cells, and they don’t function well under long-term stress.

• Disrupts sleep: Poor sleep quality from elevated cortisol reduces nighttime bone regeneration.

• Depletes nutrients: Stress drains essential nutrients like magnesium, vitamin C, and B vitamins—all crucial for bone strength and repair.

Stress Also Impacts Your Gut—Which Affects Your Bones

Your gut health and bone health are closely connected, and stress can interfere with both.

Chronic stress impairs digestion by:

• Reducing stomach acid and enzyme production, making it harder to break down and absorb bone-supportive nutrients like calcium, magnesium, and protein.

• Disrupting the gut microbiome, leading to inflammation and poor nutrient absorption.

• Increasing intestinal permeability (aka “leaky gut”), which contributes to systemic inflammation—a known factor in bone loss and poor immune regulation.

So when stress affects your gut, it creates a domino effect: reduced nutrient absorption → more inflammation → poorer bone health.

How Do You Know If Stress Is Disrupting Your Health?

The DUTCH Cortisol Awakening Response (CAR) test is like a mini stress test for your adrenal system. It measures your cortisol pattern during the first hour after waking and more which tells us how well your body is adapting to stress.

This test can reveal:

• Whether you’re in a “wired and tired” state

• If your adrenal output is flat or exaggerated

• How your stress response is impacting sleep, energy, hormones—and yes, your bones

  
  

Link for Complete CAR Test Information

Ready to Understand How Stress Is Affecting Your Body?

Stress management isn’t just for peace of mind—it’s essential for protecting your gut, your bones, and your long-term vitality.

If you’re curious about how stress is affecting your bones, digestion, or hormones, consider running the DUTCH CAR test.

Click here to order the Cortisol Awakening Response Test

Tips to Reduce Cortisol and Support Bone Health

Managing cortisol levels is essential for maintaining bone health. Here are some evidence-based strategies:

• Prioritize Quality Sleep

  Aim for 7–9 hours of uninterrupted sleep each night. Poor sleep can elevate cortisol levels.

  
  

• Engage in Regular Physical Activity

  Incorporate moderate exercise like walking or yoga to help lower cortisol and strengthen bones. Always check with your medical team to identify what activities are right for you.

  
  

• Practice Mindfulness and Relaxation Techniques

  Activities such as prayer, meditation, gratitude journaling, deep breathing, and yoga can reduce stress and cortisol levels.

  
  

• Stimulate the Vagus Nerve : The vagus nerve controls the parasympathestic nervous system. Activities like deep diaphragmatic breathing, humming and cold exposure increase vagal tone and reduce cortisol.

  
  

• Maintain a Balanced Diet

  Consume a diet rich in whole foods, including fruits, vegetables, lean proteins, and healthy fats. Limit intake of processed foods and added sugars.

  
  

• Consider Nutritional Supplements As Appropriate

  Supplements like omega-3 fatty acids, vitamin C and magnesium and L-theanine may help lower cortisol levels. Again, check with your medical team.

  
  

• Limit Caffeine and Alcohol Intake

  Excessive consumption of caffeine and alcohol can increase cortisol levels. Moderation is key.

  
  

• Foster Social Connections

  Engaging with a supportive community can buffer stress and reduce cortisol production.

  
  

• Spend Time in Nature

  Nature exposure ( also known as "forest bathing") reduces salivary cortisol and improves parasympathetic ( rest and restore) nervous activity.

  
  
  
  

Stress Management is part of the work I do in my bone health practice. You can download a goal sheet here:

Bone Health Goal Sheet

Your bones aren’t just shaped by calcium—they’re shaped by your lifestyle, your mindset, and how well you care for your stress levels. Chronic stress may be invisible, but its impact on your body is very real, from your hormones to your bones and beyond.

The good news? You have the power to shift the balance. Whether it’s a morning walk, deep breathing, reconnecting with nature, or checking your cortisol awakening response with a simple test, small steps can make a big difference.

Your health journey doesn’t have to be overwhelming. One calm moment, one supportive choice, one breath at a time.

Ready to learn more about how stress might be affecting your hormones or bones? Please Reach out—I’m here to help.

Best,

Jana Davis MS,RDN

References:

1. Pahk, K., Kwon, H., Joung, H., & Kim, K. (2021). Stress-related amygdala metabolic activity is associated with low bone mineral density in postmenopausal women: A pilot 18F-FDG PET/CT study. Frontiers in Endocrinology, 12, 721. https://doi.org/10.3389/fendo.2021.00721

2. Zhao, Y., Wang, X., Liu, J., et al. (2024). Psychological stress disturbs bone metabolism via miR-335-3p/Fos signaling in osteoclasts. eLife, 13, e95944. https://doi.org/10.7554/eLife.95944

3. Jackson, S. E., & Steptoe, A. (2019). Psychosocial stress and bone loss among postmenopausal women: Results from the Women’s Health Initiative. Journal of Epidemiology & Community Health, 73(10), 940–945. https://doi.org/10.1136/jech-2018-211597

4. Li, X., Zhang, Y., Wang, Y., et al. (2024). Association of midnight cortisol level with bone mineral density in Chinese patients with type 2 diabetes mellitus: A cross-sectional study. Journal of Clinical Endocrinology & Metabolism, 109(2), 456–463. https://doi.org/10.1210/clinem/dgad632