Osteoporosis: It’s More Than Weak Bones — The Hidden Role of Bone Marrow and Your Immune System

In this episode, Dr. Hugh Wegwerth dives deep into the truth about osteoporosis—and why it’s not just about weak bones.

Get the full lecture notes 

Most people think osteoporosis only affects bone strength, but the reality is far more complex. Inside your bones lives your bone marrow, the powerful engine that creates stem cells, red blood cells, and immune cells. When bone health declines, so does your immune system.

What You’ll Learn:

• Why bone loss starts silently and how chronic inflammation speeds it up
• The link between bone marrow and immune health—and why both weaken together
• How inflammation and aging cause “marrow fat” buildup, leading to more disease
• What “inflammaging” really means and how it drives chronic illness
• The truth about bone density scans (DEXA) and what they miss
• How new lab tests like the CTX blood marker reveal early bone loss
• The Functional Medicine approach to reversing inflammation and restoring bone marrow function
• Why women in perimenopause and menopause face faster bone decline—and how to fight back naturally

Key Takeaways:

• Your bone marrow makes your immune system.
• Chronic inflammation destroys both bone and immunity.
• Bone marrow fat = weaker health and faster aging.
• Functional medicine looks at the root cause, not just the bone density number.
• You can rebuild bone strength and immune power naturally with the right strategy.

Tune in and learn how your bones are more alive than you think — and how protecting your marrow could be the key to living strong for life.

To schedule a Zoom consultation, visit www.DrHughWegwerth.com

Transcript

0:01

This is Doctor Hugh, and I got an awesome webinar coming up here and it is called osteoporosis. Why? It's more than just weak bones. So if you are a female, um, and you're going through perimenopause, you're concerned about osteoporosis, bone loss. If you have any kind of chronic systemic inflammation, you need to watch this video. Because what's happening is your bones are slowly being eroded. But more than that, it's way more than that. Your actual bone marrow is being affected. So that's what the webinar is all about today is bone marrow and your health and bone health, which is very, very critical because, uh, if you have poor bone health, you have a totally 100% weak immune system. So let's get into this. All right. So over here you can see right here this is a big fracture right. So inflammation of the hip bone right in there. So let's answer this question is. What happens inside your body when bone loss begins and inflammation takes takes over. So when you start to lose bone mass, your body becomes chronically inflamed. And then very, very bad things start to happen when you become chronically inflamed. Now here's just a really basic diagram. I think you've seen a lot of these diagrams right here. This is osteoporosis. This is healthy bone. And this is what we call the spongy bone right here. And this is really in your bigger bone. So that's your hip bone right there. And then we have osteoporosis right here. And then you can see how the bone isn't as dense. Now really what happens here is when you go to normal healthy bone. Osteoporosis. It's not like all of a sudden one day you wake up and you have osteoporosis, right? It's a gradual, slow process over decades that will cause your bones to become less dense. So you have healthy bones, then you have osteopenia, then you have full blown osteoporosis. Now I want to make this very, very clear. It's just more than just bone loss. It's actually the bone marrow within your bones that is hindering and decreased function. And that creates your whole entire immune system. So the way God designed this right here, you can see the age right here we have 0 to 1. Then we have 1 to 10. Then we have 10 to 20. Then we have adults. Now the bone marrow here. This is really what is making all our all of our cells, all of our immune system. Is that what they call what they call red bone marrow? Then as we start to age, you can see that the red bone marrow becomes less and less and less, and that becomes less and less and less with what we call yellow bone marrow. But the red bone marrow is the most important bone marrow that God gave you. So we want to preserve the red bone marrow in our body, and that's going to cause you to be healthy long term. Now, in here you can see even here in an adult, you can see how we just have a small fraction of the bone that is actually now producing bone marrow or all the things that it produces, which I'll be getting over going over here in a second. So I'm just going to blow this up. So what you're looking at right here, you're looking at the hip bone, the femur right there. And you're looking at the femur right here. I just want to give you a good diagram. So you can actually see what this actually looks like inside your body. So you have some reality and what's actually happening. So in here we have this right here which is called trabecular bone. Or for purposes of this webinar I'm just going to say this is the spongy bone right. So that's number four right here. And then we have number three right here which is what we call the hard bone right here the cortical bone. And then you can see that we have these blood vessels that are feeding into the tip of your hip bone right here, which is called the spongy bone. Now, I like this diagram right here because this kind of shows you how much vascular, how much blood flow is in the spongy bone in your entire body. So let's take a look at this. So what we're looking at right here is this part right here. So you can see here it's called the spongy bone. Right here we have the spongy bone. And look at how red that is. Right. That's really red because that's the spongy bone. And that's where all that vasculature is. That's where the blood supply is. That's where the veins come in. So we're talking right in here. And this right in here. This is where life happens. If you have poor bone, if you have weak bone, if you have osteopenia, if you have chronic inflammation, all this stuff that we'll be talking about in a second that's made by the spongy bone does not get made. And what does that mean. That means you are going to be chronically ill. You're going to have chronic, some kind of chronic long term illness that people have. So I see all day long people that have chronic illness and chronic disease. Now what I want to do is I want to blow this up. You see this right here? That's the trabecular bone. That's just a fancy word for saying that's the spongy bone, right? That's the spongy bone. So we're looking at this femur right here. The hip bone. Now this is under a microscope. You know, you see right here that's the trabecular bone. And then right here we have the bone marrow. This is where God designed us. Where all your immune system comes from is actually the bone marrow that's in the bones, in particular the long bones. And when you have osteopenia, when you have chronic inflammation, guess what happens to this bone marrow. It goes down, which is bad news bears. So now let's just take a look at this. And here we've all seen this picture in here. And you can see here this is where all that vasculature. This is where the bone marrow is being made. When you have osteopenia, osteoporosis, or chronic systemic inflammation, if you have a chronic disease, you have chronic inflammation. This is what's happening here. It's hindering this body your your your body's ability to make the bone marrow. It's not very strong. The spaces are much larger. And it's just it's not it's just not healthy bone to produce good bone marrow. So that's the bone marrow. So let's just clear up a couple different words here. Here's another here. You can just see that vasculature. It's nice and deep and rich and full of blood. And you can see the the how how deep it is full that blood in the arteries. And then this is a really quick glimpse right here. This is the bone marrow. And it makes your entire immune system. All right. So let me just read this right here. So stem cells. So what we're going to be talking about here is stem cells. That is life. Now if you have chronic inflammation, if you have osteopenia, if your hormones are all out of whack, if you have a bad gut, it goes. It goes on and on and on. And the things that can hinder your bone marrow and within the bone marrow, this is where the stem cells are located. So let's just get back to this graph right here. This is the bone marrow. And within the bone marrow right in here, this area right in here. This is where your stem cells are produced. Right. So what the heck. Um, okay. So stem cells are made in the bone marrow, which is the soft, spongy tissue found inside certain bones, in particular the hips, ribs, spine, and the ends of long bones. So the ends of the long bones. This is what we're concerned about right here. This is the ends of the long bones. Okay, so this is the ends of the long bones right here. So that's what we're really primarily concerned about is the ends of the long bones like the femur, the femur or the hip bone. Now in here what you can see is what's happening here. This right here, that's a stem cell that comes from the bone marrow right in here. Now, what does the stem cell produce? In adults this is particularly in adults. This is going on every single second of your entire life. Is these things are being produced right in here. So all these things in here are being produced by the stem cell every single day. So you can see right in here is this is your immune system. Immune system right here. All this right here. This is your NK cells, your immune system, the T cells, B cells. All this right here is your immune system. So everything right in here? Your your red blood cells. This right in here. This line right here. This is all your white blood cell count right down in here. So this is all your white blood cell count in here. And this right here. This is your red blood cell count right down in here. So this is very, very critical. If you have any kind of chronic systemic inflammation, what's happening right now with your bone marrow. It's hindering those functions. It's hindering the white blood cell which is immune system. And it's hindering the red blood cells which gives you oxygen to the different tissues. Now this is a really great paper here. And this is the, um, the link right here. Now what I want to do here really quickly, What I want to do quickly is I'm just going to show you this research article right here. So I pulled it up. This is the article. Uh, basically it's bone marrow adipocytes, which is the fat is a key player in vascular niches, which just means your bone marrow aging and diseases. Now I just want to show you this. You can see look right over here and how long this article is. Right. This thing is massive. I'm quickly scrolling. This thing is a huge long article. And then these are the references. And it has over 200, I believe 213, uh, references. So what I'm talking about is this is scientific research in here. It actually has 223 research articles in there. We scroll all the way up to the top. This literally just came out. This is like new research just came out just a few months ago. Right. So this is really, really critical how your body works. Now, what I want to show you right here is it's going to compare healthy bone to a bone that has osteoporosis or osteopenia or inflammation. Right. So that's what you're going to be looking at is a before and after picture. So look at this right here. So this is an adult. And you can see this is like the hip bone. And you can see all that vasculature the blood vessels coming in. And this right here, that part right there that you're looking at right there. That is the stem cells. Now you have one little cell of fat. That's that's a fat cell. Now when you have age cells you can see right here those age cells. What's happening. Just compare the bone. Right. This bone over here you can see this bone is a lot thinner. This bone is going through osteopenia, osteoporosis. It has chronic inflammation. And this is very very critical. This part is very very critical. What you're going to be looking at right here is this right here that is fat. So what the research shows is when you start to have chronic inflammation when you have bone loss, the bones where the bone marrow is that is replaced with fat, and when it's replaced with fat, that causes that causes systemic global inflammation in your body. Now and this is the research article that shows us right down here. So you have a lot more fat. When you have a lot more fat you have a lot more inflammation. You have a lot more inflammation. You're going to you're going to cause more bone loss, more inflammation. So it's a spiral. It keeps on getting worse and worse and worse. This is the research article right in here. Now what you can see this is a great visual I like visuals. So what you're looking at here is this is a young cell. So this is the red bone marrow. Remember that's the spongy bone. We're talking about this part right in here right there. Now you can see when you have young you have a lot of this spongy bone. The red the red bone marrow. That's where life is made. Life is made is right in here. Then you can see we all have the yellow fat, right? The yellow bone marrow. Now, look what happens when we start to age right in here. What happens is. Look what happens to the amount of fat that we have in the bone. Way less. This is actually the amount of bone we have down in here. Here's as we as we age. Osteoporosis. The amount of fat that we have is way more. And this causes huge problems. When you have all this fat chronic systemic inflammation then you have red bone marrow. That's also decreased. So one thing that you have to realize when it comes to bone marrow. Osteoporosis is that the amount of bone marrow you have as an adult, like in your 50s, is substantially less. Than when you're a kid. So when we talk about, you know, a 10%, 15% decrease in bone marrow. This is drastically massive because you don't have a lot of that red bone marrow floating around in your body. So what does bone marrow do in our body? It creates the stem cells. Right? So I just love this picture right here. This right here is the bone marrow. The bone marrow produces the stem cell. So the bone marrow produces the stem cells. Um, so this is what happens when you're when you're over 50, right. So stem cells the number decreased slightly. Now if you have more inflammation you have osteoporosis. If you have mold if you have heavy metals this is going to accelerate. Stem cell function declines fat content increases. Immune system becomes more pro-inflammation. They call this inflammaging. Inflammaging. This is the term inflammaging is where diseases are caused by chronic systemic inflammation. Every disease that's chronic has some kind of component of some kind of chronic inflammatory process, and recovery slows down. Here's another great quote here. Poor bone marrow function can lead to serious health problems such as increased risk of infection, severe anemia and bleeding could be chronic infections in here could be anemia, bleeding, fatigue, organ dysfunction, and bone issues. Right. So these are all bad things that we don't want to happen. What does bone marrow do in humans. We kind of went over this. Every second millions of new cells, millions of new new blood cells are made every single second. So just imagine that God designed us. Where every second there's millions of red blood cells made coming from the bone marrow. Right? So if you have poor bone marrow, you're eventually going to have poor health. That's your immune system. So bone marrow, this is where red blood cells are made. White blood cells. Right. So white blood cells fight infections. Platelets. They actually help with blood clotting after an injury. What does bone marrow do in humans? It houses the stem cells. Bone marrow contains some bone marrow. Contains stem cells which develop into blood cells, bone cells, fat cells, and the immune system. These are the master cells. These are the master cells that keep your body renewing itself. So this is really critical. This is what keeps your body renewing itself. If you have chronic illness and chronic disease, your immune system can't fight whatever disease this is. So this keeps your body functioning and moving forward and rejuvenating itself so you can function at a high degree. What does bone marrow do in humans? We talked about this more supports bone and immune health stores fat and nutrients. Now this section here. What I want to go over in here is exploring how inflammation drives bone loss during perimenopause and menopause. Now there's a lot of research with women, with ladies. Obviously when they go through menopause, they have, uh, higher risk of osteoporosis and bone loss. And I really like this graph because this sums this graph up. Here we have men. Okay. So first of all we have bone mass right. We have bone mass over here. Then we have men. We have women and then we have the hormones. Now in men, you can see here that this line doesn't go down as quickly. Right. So once they hit a certain age we're just going to say ballpark 50 right in here. It doesn't go down as quickly. Then we have women. Let's go. Women right here. See the women. And then what happens as soon as women hit menopause? What happens around, uh, you know, perimenopause, which is the beginning stages of menopause. Menopause can start as early as your late 30s, and it can go on until you're 52. Generally, the average woman in the United States is menopausal at 52. Now, what's the definition of that? It means that you haven't had a cycle for 12 months. So if you haven't had a cycle for 12 months, you're considered menopausal. Right. Officially. Now look at the hormones right here. You can see the hormones as you go through menopause. Now women, it drops off drastically, right? This is a major problem in here when it comes to the hormones. And going through menopause is with men. With men. Men don't have that decline. Women all of a sudden boom. They have drastic change in hormones. And this can lead to osteopenia, osteoporosis, chronic inflammation and chronic illness over a period of time. Now, one of the things is when when I look at things, I believe that, you know, God designed us to be healthy. I actually believe that genetically we are programed to live to be like 120 years old. So if you really optimize your health, you can leave. I believe you can. You can live to be 120 years old now. I'm not talking 120 years old as a vegetable. I'm talking about a healthy, vibrant human being. Now, one of the things is I want you to pay attention to right here. I did some research, and this research was, um, you know, in the 1950s, a woman in the United States was expected to live to be about 43 years old. So that's pretty crazy. The average person in the United States, female in 1850, was going to live to 43 years old. Now, if you would take out any of the childbirth, um, deaths. Right. Because that's where this number really went down. So if you would take out any of the of the the people that lived that passed away five years or younger, the average age in the United States was 51 years old. So you can see that if we're living to be 80, 90, 100, 110, 120, you have many, many years of declining hormones or naw, naw, naw or no hormones at all, which is is going to cause more inflammation, more osteoporosis, more osteopenia. So what are some key lab signs that can indicate chronic inflammation and accelerated bone marrow decline? So these are basic labs that I run on every single client. So one of the things when people come to me you have to do a comprehensive metabolic panel and look at all these different inflammatory markers because this is where you find problems. It's like the fishing net. If you've gone to the conventional system and they ran 1 or 2 vials of blood, that's not enough. That is shortcomings of the medical system. When clients come to me, I'm running about 1112 vials of blood. The bigger your fishing net, the more you're going to catch. So you want to look at all these different inflammatory markers. So this is a key summary of lab markers that hinder bone marrow function, meaning that if you have these that are abnormal, this is going to cause bone marrow malfunction, stem cell malfunction. It's going to cause your bones to degenerate and go through osteopenia, osteoporosis. And you become chronically, systemically inflamed. So you want to check CRP, which is an inflammatory marker, ESR, which is an inflammatory marker, ferritin, which is an inflammatory marker. And fibrinogen, which is a inflammatory marker. Metabolic health, fasting insulin, a1-c and homocysteine. So really you want to really do a comprehensive protocol and figure out how healthy your internal organ is, like your internal internal organ health. Like if you have chronic systemic inflammation, you got to handle that. What's your B vitamin D status? What's your B12 folate iron zinc to copper. And then you also want to do some immune panel. Like do you have any compromised immune system? White blood cells and white blood cells. There's a variety of different white blood cells that you want to look at. And that all comes from the stem cells. Right. Now there's also a really significant important test that's come to market. And this is called what we call this the the C telopeptide right here. The C Telopeptide. Now what this is, is this is a new marker on the market. That's a blood test that you can actually check to see how your bone is breaking down. Because what we know is we know that bone here's here's more of a detailed explanation of it. We know what bone looks like. Bone is a collagen, right. So when it breaks down it has a certain look to it. So this right here the the C-telopeptide is abbreviated CT, right. So what does the CT measures. And basically simple terms the CT blood test shows how quickly your bones are breaking down. This is critical right here. When your body removes old bone tissue, tiny pieces of a protein called collagen get released into your blood. And these pieces are called the C high. Ck means your bones are breaking down too fast. A sign of bone loss. A low CK means bone breakdown is slower and more balanced. A healthier state. Now guess what? Check this last part out. Doctors use this test to detect bone loss early, often before it shows up on bone density and a Dexa scan. So why is this test so significant? This test is so significant because you can get a baseline, and then you can check this baseline in eight weeks or 12 weeks or six months to see if you've slowed this progress down. So you don't need to wait two years or three years or five years for your next Dexa scan. You can check this right away. So when you're going to use a CCT, what do you want to do? You want to use it for tracking osteopenia osteoporosis. You want to monitor response to a functional medicine program or a nutritional therapy. So when patients come to me like we do all these labs, we do the assessments. And then you want to do post checks, right? So you want to see post checks to see exactly how well you are doing. And this can be done every 3 to 6 months after starting a program. So then, you know, like is your therapy working? Are you moving in the right direction? This is all really, really critical information. So this would be a simple basic protocol. Right. So how to track. So you're going to measure the CDT day zero right. You're going to do an intervention between 8 to 12 weeks. You can recheck it and then 3 to 6 months later you can also recheck it as well. But at the same time you also want to be checking these other markers in here as well, because it's just not about one lab marker. It's globally. Like when clients come to me, it's like, what's a polytherapy approach? Meaning many. What are the many things that we can do to increase your health from here and take it to here? This is what I specialize in when it comes to my clients and getting better. So you want to do a full evaluation, then you want to recheck to see how well you're doing and what's happening. Okay. So this is one of my clients right here. So this is a standard blood work that anyone can get from their doctor's office. So this is actually going to show before and after. Progress here. Now you can see here. So this is the blood work. So what you're really looking at right here. So this is when we initially did the blood work right in here. So this was done. On June 13th right June 13th 2025. These results were done October 23rd 2025. So we're we're talking this is a four month difference. Now this is a four month difference. So this is the current labs what's being shown right here right now. And these are the ones that we did prior. Oh these are the ones that we did prior right in here. Now I just made a really quick graph here which I think is much easier to understand instead of looking at all those things. So what this is showing us in this lab, specifically, this is showing us that her bone marrow is like a thousand times better. And let me show you. So bone marrow recovery before and after functional medicine. So this is a summary. So the bone marrow is clearly stronger and more active. And I'll show you that producing healthier red blood cells and white blood cells. This shows improved immune defense uh oxygen delivery and reduced inflammation. So I've just created a different graph right here. So this is before and here and this is after. And then what does this mean. So initially her white blood cells were 2.4. No they went up to 2.6. Are we knocking that out of the ballpark. Nope. But we just started this this four month program. It's gotten better. And that's the most important thing. Neutrophils which is the immune system that fights bacteria was 0.9. Now it's uh 1.3. So stronger front stronger front line infection defense. Hemoglobin which carries oxygen was 1.9 to start with or 11.9 now it's 13.3. So we have bone marrow more red blood cells that's producing more oxygen. Getting to her tissues. Guess what? That can fight infection. You need good oxygen delivery to fight infection. So in here, improved oxygen and energy delivery. Hemocrit. This is another marker. Right here was 37.8. Now it's 40.8. Better red blood cells. Um. You know, so this is red blood cells is another indication of red blood cells and one of the most significant ones in here. And I'll just show you right here. This one was lab high. This is the. Red right here. So this is the W in here was 13 or it is 13.5 was 17.1. That's lab high. This is really really super high. So in here we went down from uh it was 13.5. Now it's 17.1. What does this mean. More uniform healthy red blood cells. And this is all coming from the bone marrow. So we did a program and she's getting better and her health is completely better. She's way better. Her chronic pain is almost virtually gone. So what is this saying here? So the bone marrow, right. We're starting to regenerate bone marrow and immune system is better. Inflammation is better energy and oxygen oxygenation is much much better. Now when we look in the conventional system, like if you're going to try and go to the conventional system and get better, you're not going to get better. Like they have no tools, they are in a box, they can only do certain things, and if it's not within the box, they cannot get you better. You need to exit out of that system. That system is causing more disease, more chronic illness than I can even count. It's it's not going to work for you. So this is the approach, the medical system, the conventional medical system, what they're going to do is they're going to monitor your healthy bone. Then you're going to start getting osteopenia. And then when you get osteopenia somewhere around here it's going to progress to get osteoporosis and In severe osteoporosis. They might tell you to take some vitamin D or calcium when you're in this state right here. If this doesn't work, then guess what? They're going to put you on drugs, right? They're going to put you on drugs. And these drugs do not get to the root cause of the problem point blank. So the conventional model of osteoporosis management is heavily weighted towards pharmaceutical drugs support, and does not adequately address the management of the underlying risk factors. An effective functional medicine approach to halt chronic inflammation and restore bone health. Bone marrow. This is what it looks like. All these things that you're looking at right in here, all these things in here have been clinically shown in research papers to help osteoporosis. Now you can see up in here. So we're going to do bone remodeling things. Sunlight vitamin D vitamin D metabolism estrogen testosterone thyroid. You want to make sure that you have good thyroid hormone. Good hormone function. Right. So these are basic things. Then down here we have decreased osteoclasts. That's just a fancy word for saying all these things in here cause. Bone to break down. So we want to start to change these things right. So, you know, uh, are your antioxidants depleted? Do you have some kind of chronic inflammatory problem? Do you have a gut problem? Is your diet inflamed? Do you have dysbiosis? Is your gut messed up? Do you have intestinal intestinal permeability? Leaky gut? Do you have any metabolic syndrome? Do you have any high insulin, high homocysteine, low vitamin D, you know, a1-c that's high. All these things need to be looked at and evaluated. And then you can just really get better, right? So osteoblasts that's a fancy word for saying that's going to, uh, cause more bone to be laid down. So exercising. Exercising is critical. Getting muscle on your frame is critical. These are basic essential nutrients. And then finally right here pharmaceuticals to consider for osteopenia osteoporosis chronic inflammation. I really even hate to show this slide because you need to have all these other things in place. You just can't start taking these products right here and then expect things to turn around, because this is a more of a complex situation here. Just take this supplement here. Just take this product. Now I can tell you this right here, the strontium right here, strontium citrate. This is a very, very potent supplement that has tons of clinical research on how this can lay down more bone. But it doesn't matter if you're chronically inflamed. You have to handle the inflammation. You have to do a polytherapy approach. So if you've liked this video, I appreciate it. Give me a thumbs up. And if you're looking for any help, see my bio. And again this is Doctor Hugh. Take care. Bye bye.