Do gut problems play a role in poor bone formation?

Yes, the gut demonstrably influences bone health. Your gut microbiome, the collection of bacteria living in your intestines, affects bone remodelling through several pathways at once. Beneficial gut bacteria produce short-chain fatty acids that inhibit bone-breaking cells (osteoclasts) and stimulate bone-building cells (osteoblasts). They also improve calcium absorption and keep certain immune cells in check that would otherwise drive bone breakdown.

When the balance of bacteria in your gut is disrupted, researchers call this dysbiosis. Both in animal studies and in clinical research we see that dysbiosis is associated with lower bone mineral density and a higher risk of osteoporosis. In humans the association is clearly present, but it has not yet been fully established that the imbalance in the gut is the direct cause of bone loss. The two most likely influence each other in both directions.

Whether this can be reversed with probiotics or prebiotics is the question occupying many researchers. In animal studies, bone density visibly improves after such interventions. In humans there are promising signals, but the studies are still small and the results sometimes contradict each other. It is too early to recommend probiotics as a proven remedy for poor bone formation.

Two other factors that influence bones through the gut: eating a lot of salt is associated with lower bone mineral density, partly because sodium unfavourably alters the composition of gut bacteria. And there are early indications that regularly skipping breakfast may reduce bone density, possibly through calcium metabolism and the microbiome. That evidence is weak and not free of confounding factors, however, so no firm conclusions can yet be drawn from it.