The Gut Microbiome and Bone Strength


Purpose of Review

Osteoporosis is commonly diagnosed through the clinical assessment of bone quantity using bone mineral density; however, the primary clinical concern is bone fragility. Bone fragility is determined by both bone quantity and bone quality. Over the past decade, the gut microbiome has emerged as a factor that can regulate diseases throughout the body. This review discusses how microbial organisms and their genetic products that inhabit the gastrointestinal tract influence bone quantity, bone quality, and bone strength.

Recent Findings

Recent studies have shown that the gut microbiome regulates bone loss during estrogen depletion and glucocorticoid treatment. A series of studies has also shown that the gut microbiome influences whole bone strength by modifying bone tissue quality. The possible links between the gut microbiome and bone tissue quality are discussed focusing on the effects of microbiome-derived vitamin K.


We provide a brief introduction to the gut microbiome and how modifications to the gut microbiome may lead to changes in bone. The gut microbiome is a promising target for new therapeutic approaches that address bone quality in ways not possible with current interventions.

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Research reported in the article was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) under the National Institutes of Health award numbers R21AR068061, R21AR073454, and R21AR071534.

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Correspondence to Christopher J. Hernandez.

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Castaneda, M., Strong, J.M., Alabi, D.A. et al. The Gut Microbiome and Bone Strength. Curr Osteoporos Rep 18, 677–683 (2020).

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  • Gut microbiome
  • Bone quantity
  • Bone quality
  • Bone material properties
  • Vitamin K