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Mechanistic insights implicate hypothalamic-pituitary-adrenal (HPA) axis dysregulation, sympathetic nervous system (SNS) overactivation, and chronic inflammation in disrupting bone remodeling. Additional risk modifiers include sex-specific biology, early-life adversity, and glucocorticoid sensitivity. However, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), anti-inflammatory agents, and emerging tools like exosomal profiling and microbiome modulation show promise in mitigating stress-related bone loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>PTSD contributes to skeletal fragility through complex, multisystem mechanisms. Trauma-informed care integrating bone health screening and personalized interventions may improve psychological and musculoskeletal outcomes. Future research should prioritize longitudinal, mechanistic studies to guide holistic management of trauma-related disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11914-026-00957-2","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T10:27:17Z","timestamp":1773656837000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The PTSD-Bone Axis: Evidence, Mechanisms, and Management"],"prefix":"10.1007","volume":"24","author":[{"given":"Olivia X.","family":"Jones","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten D.","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie K.","family":"Khoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan R.","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara J.","family":"Sidles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda C.","family":"LaRue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"957_CR1","doi-asserted-by":"publisher","first-page":"2487","DOI":"10.1007\/s00198-018-4644-0","volume":"29","author":"T Jiang","year":"2018","unstructured":"Jiang T, Veres K, Farkas DK, Lash TL, S\u00f8rensen HT, Gradus JL. 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