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LRP5 and Bone Health: What Your rs3736228 Genotype Means for Osteoporosis Risk

Osteoporosis is a condition in which bones become weaker and more likely to fracture. Bone strength depends on a balance between bone breakdown and formation. The LRP5 gene helps regulate that balance by producing a protein important for building and maintaining bone mineral density. Certain variations in LRP5 can influence how well that protein works, and that can change your lifetime risk for lower bone density and fractures.

This article explains how the rs3736228 variant in LRP5 relates to bone health, what lifestyle and dietary steps can help reduce risk, and practical monitoring and supplement options. PlexusDx does not provide medical advice. This information is educational only. Always consult with your healthcare provider before starting supplements, changing medications, or making significant lifestyle changes.

How LRP5 affects bones

LRP5 is part of a signaling pathway that controls bone formation. When LRP5 protein function is reduced, the body may form less new bone or fail to maintain existing bone, leading to lower bone mineral density. Genetics accounts for a large portion of bone density differences between people, so knowing your LRP5 status can help you plan prevention and monitoring.

General steps to support bone health (for everyone)

  • Nutrition: Aim for consistent daily intake of calcium, vitamin D, and vitamin K. Include adequate high-quality protein to support bone matrix and muscle mass.
  • Weight-bearing and resistance exercise: Walk, jog, hike, dance, lift weights, or perform resistance band work at least 3 times per week to stimulate bone formation and preserve strength.
  • Avoid smoking and limit alcohol: Smoking accelerates bone loss and lowers bone repair. Keep alcohol moderate — excessive use increases fracture risk.
  • Maintain a healthy body weight: Very low body weight increases fracture risk; obesity can also impair mobility and bone quality.
  • Control inflammation: Eat an anti-inflammatory variety of fruits, vegetables, whole grains, fatty fish, nuts, and seeds. Manage chronic conditions that cause inflammation.
  • Fall prevention: Improve balance and strength, remove trip hazards at home, and get vision and hearing checked regularly.

Diet, supplements, and monitoring to consider

  • Calcium: Aim for recommended daily intake based on age and sex (discuss targets with your provider). Get calcium from dairy or fortified plant milks, leafy greens, and calcium-set tofu where possible.
  • Vitamin D: Many adults need supplements to maintain optimal vitamin D levels. Check 25(OH)D blood levels and work with your provider on dosing.
  • Vitamin K2: Supports bone mineralization and may help direct calcium into bone. Talk with your clinician before starting, especially if you take blood thinners.
  • Protein: Target 0.8 to 1.2 g/kg body weight daily depending on age and activity. Higher protein supports bone and muscle, especially in older adults.
  • Omega-3 fats: Include fatty fish or omega-3 supplements to help manage inflammation.
  • Bone density testing: Discuss dual-energy X-ray absorptiometry (DEXA) screening timelines with your provider. Genetics plus risk factors may influence when to begin screening.
  • Medication review: Some medicines reduce bone density. Ask your clinician to review chronic prescriptions and discuss bone-protective strategies if needed.
Two effect alleles (TT) — increased osteoporosis risk

If your genotype is TT at rs3736228, you carry two copies of the effect allele linked with higher risk of lower bone mineral density. This suggests your LRP5 protein function may be reduced relative to the common genotype, which can predispose you to weaker bones over time.

What this means for you

  • Higher lifetime risk for lower bone density compared to people without this variant.
  • Genetics is an important factor but not destiny. Lifestyle and monitoring can greatly influence outcomes.

Actionable steps

  • Get baseline and periodic bone density testing (DEXA) sooner rather than later and follow your provider's schedule for re-testing.
  • Ensure adequate calcium and vitamin D intake; verify vitamin D levels with a blood test and supplement as needed.
  • Consider vitamin K2 after discussing safety with your clinician, especially if you take anticoagulants.
  • Engage in progressive resistance and impact-loading exercise to maximize bone stimulation. Work with a trainer or physical therapist if needed.
  • Avoid smoking and minimize alcohol intake.
  • Review medications that affect bone with your healthcare provider and discuss bone-preserving therapies if your provider recommends them.
  • Optimize protein intake and maintain a nutrient-dense, anti-inflammatory diet.
One effect allele (CT) — likely increased osteoporosis risk

If your genotype is CT, you carry one effect allele and one non-effect allele. This is associated with a likely increased risk of lower bone mineral density compared with people who have no effect alleles.

What this means for you

  • You may have a modestly higher predisposition to lower bone density, though lifestyle and other genes also matter.

Actionable steps

  • Talk with your provider about bone density screening timing and frequency based on family history, age, and other risk factors.
  • Prioritize calcium, vitamin D, and vitamin K in your diet and consider supplementation if blood tests show deficiency.
  • Follow a regular program of weight-bearing and resistance exercises to support bone strength.
  • Maintain adequate protein intake and an anti-inflammatory dietary pattern.
  • Avoid smoking and limit alcohol. Discuss medication interactions and long-term bone risks with your clinician.
Zero effect alleles (CC) — typical genotype

If your genotype is CC, you carry two copies of the non-effect allele. This is the typical genotype for rs3736228 and is not associated with increased osteoporosis risk through this specific marker.

What this means for you

  • This particular LRP5 variant does not increase your risk for lower bone density; however, bone health is influenced by many genetic and lifestyle factors.

Actionable steps

  • Continue standard bone health practices: balanced diet with calcium and vitamin D, regular exercise, and avoidance of smoking and excessive alcohol.
  • Follow routine screening recommendations for bone density based on age, sex, and clinical risk factors.
  • Address other risk factors such as early menopause, low body weight, chronic steroid use, or family history of osteoporosis with your healthcare provider.

When to talk with your healthcare provider

  • To interpret your genotype in the context of personal and family medical history.
  • If you are considering supplements like vitamin D or K2 so dosing and interactions can be evaluated.
  • To decide on the timing of bone density testing and whether prescription therapy is appropriate.
  • If you have other risk factors such as early menopause, chronic corticosteroid use, or previous fractures.

PlexusDx provides education about genetic predispositions but does not provide medical advice. Use this information to guide conversations with your healthcare provider, who can recommend testing, treatment, and monitoring tailored to your full health picture.