Interventions to prevent bone loss in astronauts during space flight
Open accessAbstract
This paper reviews the interventions to stabilize calcium balance and bone metabolism and prevent bone loss in astronauts during space flight. Weightlessness during space flight results in calcium, vitamin D, and vitamin K deficiency, increases urinary calcium excretion, decreases intestinal calcium absorption, and increases serum calcium level, with decreased levels of serum parathyroid hormone and calcitriol. Bone resorption is increased, whereas bone formation is decreased. The loss of bone mineral density (BMD) in the spine, femoral neck and trochanter, and pelvis is 1.0-1.6% per month. High calcium intake and vitamin D supplementation during space flight does not affect bone metabolism, but prevents an elevation of serum calcium level through increased calcitriol level, while vitamin K counteracts the reduction in bone formation. However, there are no data to show the efficacy of pharmaceutical agents for prevention of development of osteoporosis in astronauts during flight, although the preventative effect of bisphosphonates, testosterone, and vitamin K2 on cancellous bone loss in the tibia or BMD loss in the hindlimb was reported in tail-suspended mature rats. It still remains uncertain whether these agents can prevent cortical bone loss caused by weightlessness in tail-suspended rats. Therefore, in addition to calcium, vitamin D, and vitamin K supplementation, agents that have both potent anti-resorptive and anabolic effects on cancellous and cortical bone may be needed to stabilize calcium balance and bone metabolism and prevent bone loss in astronauts during space flight.
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Astronauts are at risk of progressive bone and cartilage loss while in space.
“Astronauts are not only at risk of progressive bone and cartilage loss while in space but must also face the reality that space-related bone and joint changes may persist for years after their return to Earth despite efforts made to protect their skeletal systems [8,9,10,11,12,13].”
From Osteoclasts and Microgravity (2020) · cites this paper as [9]
The Introduction reports progressive bone loss during space flight, including monthly decreases in bone mineral density. Our copy does not report cartilage loss, so the cited paper supports only the bone-loss portion of the claim. (LLM, conf=0.88)
Experimental — accuracy not yet measuredSpace-related bone and joint changes may persist for years after astronauts return to Earth despite efforts to protect their skeletal systems.
“Astronauts are not only at risk of progressive bone and cartilage loss while in space but must also face the reality that space-related bone and joint changes may persist for years after their return to Earth despite efforts made to protect their skeletal systems [8,9,10,11,12,13].”
From Osteoclasts and Microgravity (2020) · cites this paper as [9]
The Introduction (page unavailable) says osteoporosis after space flight may increase fracture risk in later life, and the Conclusions discuss limited evidence for interventions to prevent bone loss. The paper does not establish that bone changes persist for years after return despite protective efforts, and it does not address persistent joint or cartilage changes. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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- Authors
- Iwamoto, J., Takeda, T., & Sato, Y.
- Affiliations
- Keio University (JP)
- Venue
- The Keio Journal of Medicine
- Publisher
- Keio Journal of Medicine
- Published
- 2005
- Volume
- 54
- Issue
- 2
- Pages
- 55-59
- ISSN
- 0022-9717 (ISSN-L)
- 1880-1293
- OpenAlex
- W2040263020
- Cited by
- 114
- References
- 29
- Citations by year
- 2025: 7 · 2024: 4 · 2023: 5 · 2022: 14 · 2021: 7 · 2020: 9 · 2019: 15 · 2018: 7 · 2017: 1 · 2016: 6 · 2015: 5 · 2014: 6 · 2013: 2 · 2012: 1
- FWCI
- 3.17
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Keio Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Spaceflight effects on biology
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
- Keywords
- astronauts, microgravity, bone resorption, bone formation, bone mineral density, calcium balance, vitamin D supplementation, vitamin K supplementation, bisphosphonates, testosterone, tail suspension test, osteoporosis prevention, parathyroid hormone, 1,25-dihydroxyvitamin D3
- MeSH terms
- Aerospace Medicine, Animals, Bone and Bones, Bone Resorption, Calcium, Calcium, Dietary, Energy Intake, Diphosphonates, Humans, Osteoporosis, Space Flight, Testosterone, Vitamin D, Vitamin D Deficiency, Vitamin K, Vitamin K Deficiency, Weightlessness, Biomarkers, Bone Density, Sodium Chloride, Dietary, Weightlessness Simulation, Astronauts, Weightlessness Countermeasures, Dietary Supplements, Vitamin K 2, Rats
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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