Osteoporosis

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Osteoporosis

Osteoporosis is a reduction of the total mass of bone, with the remaining parts being left as fragile or “brittle”.  Osteoporosis is primarily a disease of the aged, usually beginning at about age 50.  After the age of 30, the normal cycle of bone remodelling is interrupted. Over a complete lifetime, women may loss 30% to 50% of cortical bone thickness. Post -menopausal women lose a significant amount of bone mass; possibly as a part of the changing hormonal environment, however some elderly men suffer the same condition.

Osteoporosis and bone fractures

One in every two women over the age of 70 suffers a fracture related to osteoporosis.  One in 10 of those who suffer hip fractures die soon after.  More women die from the consequences of fracture of the hip than from cancer of the breast, cervix and uterus combined.  Osteoporosis can also cause a loss of height, a hunched back and back pain.

Osteoporosis and mineral levels

Osteoporosis is a disease in which minerals are being depleted more rapidly than they can be replaced, but with treatments such as diet, hormones, and exercise, quality of life can be improved.  Medical intervention usually involves increasing calcium intake as well as supplementing with the hormone estrogen.  However we now know this approach is of very limited value and does not consider the very complex nature of the problem. 

Osteoporosis and calcium

Many illnesses predispose an individual to calcium loss.  These include a hyper-active thyroid, maldigestion/malabsorption problems, athletic amenorrhoea, chronic alcoholism, renal disease, hyperparathyroidism, anorexia nervosa, bulimia, steroid therapy, liver disease, diabetes, hormonal problems and adrenal exhaustion.  These diseases must be corrected before calcium supplementation is effective.

Osteoporosis and genetic factors

There are a number of developing factors in osteoporosis. Genetically speaking, ethnic background, age, body build and a family history all play a significant role.  Lifestyle also affects the bone building cycle in our body.  Factors such as lack of exercise, smoking, crash dieting, vitamin and mineral deficiencies and a high protein diet are all implicated in the pathogenesis of osteoporosis. 

Osteoporosis and hip fractures in women

There are 1.3 million fractures from osteoporosis each year, with 250,000 of those being of the hip.  Some 80% of those occur in women 65 and older who have osteoporosis.  One quarter of those will die from complications like pneumonia and blood clots within the first year, and another third will be impaired to the point where they are no longer self-sufficient.  Besides bone fracture, osteoporosis is responsible for gum and jaw loss, dowager’s humps, back pain, wrist fractures, and loss of height.  These fractures and conditions come about under circumstances in which there is not undue strain exerted or not circumstances where fractures would normally occur.  Some may happen when there is no trauma history, lifestyle, natural early menopause, childlessness, and removal of the ovaries.  Women who are sedentary or small boned, have a fair complexion, and present no known health condition are also at risk.

Osteoporosis and our diet

A diet adequate in protein with less carbonated soft drinks, coffee, sugar, salt, is recommended for those with osteoporosis.  Nutrients have been shown in various studies to be of extreme benefit in supporting bone remineralisation.  The essential nutrients for bone building are firstly

Calcium, for its ability to positively impact bone formation.  Some evidence points to this mineral’s ability to slow down bone reabsorption.  Research indicates a calcium rich supplement containing

Microcrystalline Hydroxyapatite Concentrate has been useful in preventing bone thinning and increasing cortical bone thickness.

Magnesium, a mineral in which less than two thirds of New Zealanders may not be getting enough through dietary sources.  Deficiency is common in women with osteoporosis and appars to be associated with abnormal bone mineral crystal formation.  It is estimated that it may only take 24 days for an individual to deplete bone stores of Magnesium on a sub-optimal diet, while it will take approximately 2-3 years to deplete Calcium stores from bones on the same diet.  Magnesium converts

Vitamin D to its active form and supports the absorption of Calcium.

Vitamin K is a cofactor in the synthesis of osteocalcin, a unique bone protein which attracts calcium to the bones.  The mineral

Boron promotes the synthesis of bone health related compounds.  These are estrogen, testosterone, DHEA, and vitamin D.  Further evidence suggests the need for manganese, Vitamin D, folic acid, zinc, copper, silica, and possibily vitamin C and B6.  At Ideal Health we have a number of bone health supplements which contain many of the above nutrients. Here is a link to those we use for bones

Osteoporosis and hormones

Hormonal therapy has always been controversial in regards to osteoporosis.  Estrogen replacement therapy inhibits bone resorption, and reduces the incidence of osteoporotic fractures. HRT has been predicted to reduce heart disease in postmenopausal women and this has been a major reason for starting his therapy.  Although conventional treatment is proven to slow the rate of osteoporosis, an increase in bone mass may be limited.  The use of synthetic estrogens and progestins is probably the biggest flaw in conventional treatment.  These hormones have been implicated in promoting the late stages of carcinogenesis among postmenopausal women and in facilitating the proliferation of malignant cells (Journal of National Cancer Institute 1998;90:814-23).

Hulley and co workers published the results of the Heart and Estrogen/progestin Replacement Study (HERS) in the JAMA, No7, Vol 280 in 1998.  This study is of particular importance as it was the first randomised trial proving that hormonal replacement therapy (HRT) does not prevent or reduce heart disease in postmenopausal women.  Previously observational studies had found lower rates of coronary heart disease in postmenopausal women who take estrogen than in women who do not, but this potential benefit had not been confirmed in clinical trials.  HRT has been predicted to reduce heart disease in postmenopausal women and this has been the major reason for starting this therapy.  Interestingly, natural progesterone reverses the bone loss in ageing women to increase bone density (Lee.J Int Clin Nutr Review, July, 1990 Vol. 10, No3), and has an anti-tumour effect on the endometrium (Amer Soc for Repr Med, Feb Vol. 65, No2 1996).  Progesterone appears to enhance new bone formation in contrast to estrogen which merely inhibits resorption of old bone.

Osteoporosis, Testosterone and DHEA

Other hormones related to osteoporosis are testosterone and dehydroepiandroterone (DHEA).  Although these have been considered in the past as male hormones, small quantities are in fact produced in the ovaries.  Each of these hormones has been shown to  enhance new bone formation.  Various studies outline the need to support normal testosterone levels, in fact Simerjot et al reported in the ‘Journal of Bone and Mineral Research’ (Vol. 10, No 4, 1995) that reduced testosterone action in menopausal women is a more important factor than estogen in osteporosis.  At Ideal Health we have a number of supplements for increasing testosterone synthesis in women but the main one is Tribulus.

Osteoporosis and Vitamin D

For those who use a lot of sunscreen, vitamin D may be a problem since, without it, bones cannot harden.  Calcium should be taken along with vitamin D in such cases preferably at night and more if it should be taken if diuretics, thyroid pills, or blood-thinning drugs are being taken.  Thiazide diuretics may be responsible for kidney stones and should not be taken with calcium and vitamin D.  Trace amounts of fluorides from foods or drinking water (1 milligram per litre) also protect against bone decomposition. 

Some food sources of nutrients

Reasonable calcium and magnesium intake guards against fractures.  The best food sources are yoghurt, fortified soy milk, sardines, salmon bones, almonds, broccoli, sesame seeds or tahini.  Some green vegetables have readily absorbable calcium like dandelion and mustard greens, turnip and beet greens, kale, bok choy, and broccoli.  Figs and prunes are dried fruits with useable calcium and boron.  Other boron foods are apples, grapes, dates, raisins, pears, and peaches.  Soybeans, molasses, and honey are also sources.  Boron in the diet may explain why fewer cases of osteoporosis are found in vegetarians.  Estrogenic foods like soy foods, flax seeds and chickpeas are high in boron.  Pineapples protect strong bones because they contain manganese.  These sources are by no means close to being able to supply the needed calcium per day, so a well balanced diet concentrating on calcium rich foods and decreasing calcium antagonists (coffee, sugar, meat etc) is essential.

Complex carbohydrates like whole-grain breads and cereals, rice, pasta, and potatoes are recommended for prevention of osteoporosis but should not be consumed at the same time as calcium. 

Osteoporosis and alcohol

Beer not alcoholic drinks are the bones worst enemies, because they directly interfere with the absorption of calcium.  Coffee, soft drinks, and nicotine are also not recommended, because they too interfere with absorption.  Salt robs calcium from the body.  Herbs that may help are horsetail, angelica bark, shavegrass, licorice, feverfew, birch (osteoarthritis pain), seaweed, oatstraw, and eucomia bark.

Osteoporosis and exercise

Exercise is vitally important for bone health.  Evidence pointing to the value of exercise to the bone structure is overwhelming.  It appears that the beneficial stress or weight bearing put on the bones encourages them to thicken.  It has also been found that weight lifting benefits the bones in areas where the muscles attaches to the bones.  Those who cannot do certain kinds of exercise may still benefit by  engaging in any kind of activity, since it seems that some is better than none.  Many exercises are recommended to maintain all the areas of the body.  Walking, running , aerobics, and weight lifting are good areas.  Racquet sports are also recommended.

Nutritional and herbal support for osteoporosis includes;

Ethi-Cal Hi Strength Tablets and Ethi Cal Bone Building Vitamin D Powder - Contain a source of calcium from hydroxyapatite, which may assist in the prevention and treatment of osteoporosis, strengthen bone in children and older adults, enhance bone mineral density, reduce bone loss in postmenopausal women and reduce the risk of bone fractures in the elderly. Suitable for all the family. Each 6 gram serve provides 1000mg of calcium with the co factors Vitamin D, Boron and Vitamin K. A Professional strength formula.

Super Calcium Complete – An excellent calcium supplement containing the clinically proven microcrystalline hydroxyapatite form of calcium, providing an excellent source of calcium and specialised growth proteins/synergistic trace minerals.

Boron caps – enhances hormonal synthesis, needed for bone health.

Some interesting points on bone health.

• Increase intake of calcium rich foods including sesame seeds, nuts, oats, tofu, vegetables, wheatgerm, yoghurt and tinned fish with bones.
• Weight bearing exercises are essential for increasing bone mass.
• Having a cup of coffee for up to 1 hour after eating has been shown to interfere with calcium absorption.  Even avoid coffee altogether.
• People with gall bladder and thyroid problems may have lower calcium levels as problems with these organs interferes with proper calcium absorption
• Reduce the foods in your diet that are ‘acid’ forming.  These are meats, sugars, refined flours, alcohols, and large amount of grains.  These foods once metabolised cause blood pH levels to drop, causing Calcium to be drawn from bones to compensate for the pH change.
• Lower the level of proteins in your diet, that are sourced from animals.  Whey powder is an excellent source of protein, that produces more of an alkaline effect during digestion
• Reduce any medication that may cause changes in bone mass if possible.