Does Caffeine Affect Your Osteoporosis Risk?

Caffeine consumption appears to increase your risk of losing bone density, which can lead to osteoporosis (brittle bone disease) and broken bones.

This article looks at the research behind caffeine and osteoporosis, how much caffeine is too much, what it means for your osteoporosis risk, and how to mitigate it.

Caffeine and Calcium Absorption

The problem with caffeine is that it interferes with how your body uses calcium, which is essential to bone health. For calcium to do its job of maintaining your bone health, your body first has to absorb it.

Multiple studies suggest that high levels of caffeine consumption prevent calcium absorption, so the important mineral flushes out of your system and down the toilet when you urinate. 

How Much Is Too Much?

So far, research suggests that only high levels of caffeine consumption are a problem. But what’s considered high?

Most studies say less than 400 milligrams (mg) daily poses no significant risk of health problems, including osteoporosis.

For perspective, 400 mg of coffee equals roughly:

• Three or four eight-ounce (oz) cups of coffee
• Nine or 10 cans of most caffeine-containing sodas
• Five Red Bull energy drinks

A 2022 study concluded that 800 mg of caffeine over nine hours did, in fact, increase the amount of calcium in participants’ urine. The calcium level rose substantially—by 77%.

Again, that amount of caffeine would equal about eight cups of coffee, up to 20 sodas, or 10 Red Bulls during the average workday.

But researchers say urine calcium levels may only present part of the picture. The total effect of caffeine consumption on your body’s use of calcium is still to be determined.

And it’s important to note that studies haven’t looked at the results of low or moderate caffeine consumption over many years.

When comparing caffeine amounts on labels, be sure to check the serving sizes, as well.

What This Means for Your Osteoporosis Risk

If you regularly consume moderate to high amounts of caffeine, you may want to take steps to lower your osteoporosis risk.

You can do this by consuming less caffeine and/or incorporating other healthy lifestyle choices, such as exercising and quitting smoking.

Additional Risk Factors for Osteoporosis

Many factors influence your risk of developing osteoporosis. Some you can change, and others you can’t. 

If you have multiple unchangeable risk factors, you may want to work harder at the ones you can control. Unmodifiable risk factors include:

• Being older than 50
• Being assigned female at birth
• Being post-menopausal
• Family history of osteoporosis
• Weighing under 125 pounds
• Previous falls 
• Previous broken bones
• Losing height due to aging
• Having White or Asian ancestry
• Previous bariatric surgery
• Genetic factors

Certain conditions can also increase your risk. It’s possible that getting proper treatment for other conditions may lower your osteoporosis risk. These conditions include:

• Kidney disease, especially a history of kidney stones
• Chronic liver disease
• Inflammatory diseases (e.g., rheumatoid arthritis, inflammatory bowel disease (IBD))
• Heart disease
• Dementia
• Diabetes
• Hyperparathyroidism (parathyroid glands secrete too much parathyroid hormone)
• Hypogonadism (sex glands produce insufficient levels of sex hormones)
• Eating disorders, which can cause nutritional deficiencies

Some medications also increase your risk of losing bone density. They include:

• Daily oral corticosteroids
• Thyroid hormone replacement
• Immunosuppressant drugs
• The blood thinner Coumadin (warfarin)
• Proton pump inhibitors, such as Prilosec (omeprazole)

If your osteoporosis risk is high, ask your healthcare provider whether an alternative medication would be better for you.

Modifiable risk factors include:

• Low testosterone levels in those assigned male at birth
• An unhealthy diet high in junk food
• Calcium, vitamin D, or vitamin K deficiency
• Lack of physical activity
• Smoking cigarettes/tobacco use
• High alcohol consumption
• Chronic stress

How to Counteract the Effects of Caffeine

The simplest way to eliminate the osteoporosis risk posed by caffeine is to:

• Eliminate caffeine
• Lower caffeine consumption
• Add milk or real cream (not artificial creamers ) to your coffee

Other ways you can improve your bone health include:

• Increasing dietary calcium
• Taking calcium supplements 
• Taking vitamin D supplements (vitamin D increases calcium absorption)
• Getting more exercise, especially weight-bearing exercise that strengthens bone
• Quitting tobacco use
• Cutting down on alcohol consumption

If you're at risk for osteoporosis, talk to your healthcare provider about a bone density test. After an osteoporosis diagnosis, make sure you take the prescribed medication.

Be sure to include your healthcare provider in decisions about nutritional supplements, dietary changes, and increased physical activity. They can help you make the right decisions.

Summary

High levels of caffeine intake may increase your risk of osteoporosis. About 400 mg a day or less probably won’t cause bone loss (or other health problems), while 800 mg or more is considered the threshold for osteoporosis risk.

To mitigate this risk, you can consume less caffeine, increase calcium intake, exercise more, stop smoking, and drink less alcohol.

Talk to your healthcare provider about your caffeine intake, osteoporosis risk factors, and what changes are best for your health.