Osteocalcin is a protein that helps build and maintain bones. Low levels can increase your risk of diabetes, obesity, heart disease, and liver problems. Read on to learn more about the osteocalcin test, normal serum levels, and how to increase osteocalcin naturally.
The osteocalcin test measures the amount of osteocalcin in your blood.
Osteocalcin is a protein hormone produced in the bones. It binds calcium and helps build and heal bones. Osteocalcin also increases insulin production, adjusts blood sugar levels, stimulates testosterone production, and improves muscle strength and brain health [1, 2, 3, 1, 3, 1, 1, 4,1, 5, 1].
You shouldn’t take supplements containing biotin or vitamin B7 at least 12 hours before the test. Otherwise, you don’t need to prepare for the test in any special way.
Why Doctors Order It
Osteocalcin blood levels reflect the rate of bone turnover. Therefore, the osteocalcin test is useful for monitoring disorders that affect bone health, such as osteoporosis, primary and secondary hyperparathyroidism, cancer with bone metastasis, and Paget’s disease .
Your doctor may order the osteocalcin test to monitor how well bone-building therapy is working. It may also be used to diagnose any of the above-mentioned disorders, along with other blood markers.
Osteocalcin Serum Levels
The levels of osteocalcin in your serum (liquid part of the blood) are usually reported in ng/mL (nanograms per mililiter).
The normal range is 8 – 32 ng/mL.
Values under 8 ng/mL are considered low and values above 32 ng/mL are marked as high. The normal range may slightly vary from lab to lab.
Some labs give a different range for men, pre- and post-menopausal women.
How to Increase Osteocalcin
The strategies listed below can help you increase low osteocalcin levels and strengthen your bones.
1) Vitamin K
Vitamin K is necessary to activate osteocalcin in the body. A lack of vitamin K results in a lack of osteocalcin protein in the bones. Vitamin K deficiency is also associated with low bone mineral density and increased risk of fractures [7, 8].
A placebo-controlled study of 40 healthy young men showed that vitamin K supplements increased osteocalcin levels after just 4 weeks. This improved the body’s use of insulin (by reducing insulin resistance) and the maintenance of healthy glucose levels. These results were consistent with other clinical studies involving the use of vitamin K supplements by young males as well as older women and men [9, 10, 11].
An analysis of blood samples from 896 persons suggested that most people do not receive enough vitamin K from their diet. However, vitamin K can be taken as a supplement, to ensure that the body produces enough osteocalcin. The best type of vitamin K to take for this is vitamin K2, particularly the MK-7 type .
However, persons who are taking some types of blood-thinning medication (anticoagulants), such as warfarin, must be careful. There is a significant risk that some of these medications will become less effective if vitamin K2 in MK-7 form is taken as well, and so this combination is not advised .
Osteocalcin levels are higher in people who are more physically active .
A link between more physical activity and higher osteocalcin levels has been found in 54 adolescents .
One hour of exercise, 3 times per week for 12 weeks, increased osteocalcin levels and bone mineral density in 29 women with osteoporosis (with an age range of 71 to 78) .
A study of 11 middle-aged men found that osteocalcin levels increased and remained at higher levels for several hours after a brief period of high-intensity exercise (4 sets of 4 minutes of cycling at nearly peak performance levels). This was also linked to increased insulin sensitivity .
There is also evidence that longer periods of less intense exercise can increase osteocalcin levels. A study involving 31 middle-aged subjects found a significant increase in osteocalcin levels after cycling for an hour, 3 to 4 days per week .
3) Diet/Calorie Restriction
In a study of 107 older, frail adults, osteocalcin blood levels increased on a calorie restriction diet .
However, in a study of 71 postmenopausal women, there was no link between weight loss and osteocalcin .
Finally, in 178 obese persons, high osteocalcin levels were associated with reduced body fat. However, osteocalcin levels actually decreased after weight loss .
4) Vitamin D
Vitamin D directly stimulates osteocalcin production .
In a clinical trial of 76 obese but otherwise healthy menopausal women between the ages of 51 and 63, vitamin D supplements in combination with a calorie-restricted diet increased osteocalcin and improved insulin sensitivity, compared to diet alone .
Zinc supplements increased osteocalcin levels in 22 shorter-than-average children. However, this has not been linked to more growth (height and weight) .
7) Olive Oil
A 12-month clinical trial of postmenopausal women with decreased bone mass (but without a diagnosis of osteoporosis) showed that an olive tree extract increased blood osteocalcin levels, leading to increased bone density in the spine .
8) Omega-3 Fatty Acids
9) Ellagic Acid
Ellagic acid is found in many fruits and vegetables such as pecans, walnuts, pomegranates, raspberries, strawberries, and cranberries. It f1unctions as an antioxidant, preventing cell damage .
Ellagic acid increased osteocalcin in rats after tooth extraction .
10) Milk Thistle
Silymarin increased osteocalcin, bone healing, and bone density in mice with bone fractures .
A 24-month DB-RCT suggests that icariin may help prevent bone loss in postmenopausal women. Icariin maintained osteocalcin levels and prevented bone tissue loss .
12) Insulin Therapy/Low Glucose
Type 1 diabetes can cause changes in the skeleton, especially when glucose levels are poorly controlled. Several studies have found that insulin therapy increases osteocalcin levels, leading to improved bone structure and flexibility in type 1 diabetes [34, 35].
Alendronate (Fosamax, Binosto) is a drug used to treat osteoporosis and Paget disease.
The use of alendronate in low doses is associated with increased osteocalcin and improved bone repair .
In a study of older women with rheumatoid arthritis, long-term treatment with teriparatide (48 weeks) increased osteocalcin levels .
Since people with rheumatoid arthritis have a higher risk of osteoporosis, pre-treatment with teriparatide may be beneficial .
Elderly adults who received ibutamoren had increased osteocalcin levels, showing that this treatment has a positive effect on improving bone health in the elderly .
However, we recommend against taking ibutamoren without medical supervision until studies confirm its effecitivess and safety.
16) Stop Smoking
Smoking lowers osteocalcin levels by interfering with the genes that produce osteocalcin. This can lead to difficulties with bone healing, and can loosen teeth and dental implants by weakening bone tissue in the mouth and jaw (alveolar bone) .
17) Avoid Glucocorticoids
However, glucocorticoids may also reduce osteocalcin in the bones, which may increase the risk of osteoporosis in people who take glucocorticoids regularly .
Reducing the dosage of glucocorticoids in 208 patients with rheumatoid arthritis led to improvements in osteocalcin levels and bone metabolism .
18) Correct Iron Deficiency
There may be a link between iron deficiency and low osteocalcin.
In rats, iron deficiency reduced osteocalcin, lower bone mineral density, and reduced bone strength .
Skip this part if you are not interested in genetics and haven’t sequenced your DNA.
Two SNPs in the Osteocalcin Gene, BGLAP, may make you prone to high or low osteocalcin levels.
In 5,561 older people, the ‘T’ variant of rs1800247 was associated with higher osteocalcin levels in women. In men, those with the ‘T’ variant had a higher risk of bone fractures .
However, in another study with 302 athletes, no relationship was observed between this variant and bone quality. This genetic variant may only be relevant in older people .
In another study of 5,647 people, those with the ‘C’ variant had a lower risk of high blood pressure (hypertension). This may be because osteocalcin improves insulin sensitivity and energy metabolism .
This variant is found close to the osteocalcin gene and may influence its production. In 998 women, the rs1543294 variant was associated with higher osteoporosis-related fracture risk .
Irregular Osteocalcin Levels?
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Your osteocalcin serum levels can reveal a bone disorder. Doctors may order the osteocalcin test to make a diagnosis, along with other blood markers. They also use it to monitor how well bone-building drugs are working. Don’t take niacin for at least 12 hours before the test.
The normal range of osteocalcin in the serum is 8 – 32 ng/mL.
If your levels are low and/or if your bones are weak, consider increasing your intake of vitamin K2, omega-3, and olive oil. Vitamin K is particularly important, as it is needed to activate osteocalcin in the body.
You should also get regular exercise and enough vitamin D, stop smoking, and lose weight if you are obese. Manganese, zinc, and milk thistle supplements may also help.