A decade ago, most women had never heard of osteoporosis. Now, as the baby boomer generation approaches menopause and doctors have analyzed the statistics, articles about osteoporosis are appearing everywhere. Osteoporosis presents a health danger because as bones age they absorb less calcium. This leaves them thin and pitted, and more liable to fracture easily. With a third of all post-menopausal women suffering some degree of bone deterioration, this translates into a lot of hip, spine, and wrist fractures. Sadly, a third of all elderly women who suffer a hip fracture die within six months.
At WholeHealth Chicago we strongly feel that osteoporosis is both preventable and reversible, and we often suggest a wide variety of conventional and supplemental therapies. Even better, with one or two simple tests, you can even track your progress as you improve.
What is Osteoporosis?
Osteoporosis (Latin for “porous bones”) is a progressive condition in which bones gradually lose their strength and density. Because bone is a living tissue, it continually “remodels” itself, both releasing stored calcium to the body and absorbing fresh calcium from food or supplements to form new bone. For much of a person’s adult life, this complex process preserves a delicate balance, building up and also maintaining bone mass at healthy levels. Sometime between the ages of 40 and 50, however, the balance begins to shift in both men and women, although much more so in women. New calcium is not absorbed as fast as old calcium is lost, making newly formed bone tissue less dense.
As this deficit continues and bones lose more of their strength, the risk of fractures rises. Each year an estimated 1.3 million older Americans suffer broken bones because of osteoporosis. Wrists, hips, and spinal vertebrae are the most susceptible areas, and women are the most vulnerable group, suffering about 80% of the injuries.
There is currently no cure for osteoporosis, but it can be slowed or limited with medications, lifestyle changes, and nutritional supplements.
Osteoporosis is a “silent disease,” producing no symptoms until it is already at an advanced stage. Therefore, unless found by chance during a routine X ray, the first sign of its presence is usually dramatic: a broken wrist or hip, or a severe backache caused by a fractured vertebra.
Other symptoms of osteoporosis are a gradual decrease in height and a progressive curving of the spine known medically as kyphosis, or commonly as dowager’s hump.
Osteoporosis can sometimes be detected early by dental X rays that reveal a loss of bone mass in the jaw.
What Causes Osteoporosis?
The primary factor leading to osteoporosis in women is a sharp decline in the levels of the hormone estrogen after menopause. Estrogen plays a major role in helping the body preserve calcium in the bones, as well as absorb calcium and other minerals essential to bone formation. Without estrogen, calcium reserves can rapidly become depleted.
In men, this function is performed by another sexually linked hormone, testosterone, which also declines with age and so can trigger the onset of osteoporosis. Because testosterone generally begins to decline later and more gradually than estrogen, the impact is less severe in men. At age 65, men have lost 9% of their bone mass, on average, while women have lost 26%.
Other factors can increase the risk for osteoporosis, including:
- Having a genetic predisposition (osteoporosis tends to run in families).
- Being Caucasian, small boned, light complexioned, and slender.
- Having 50% of your hair turn grey before age 40.
- Consuming insufficient amounts of dietary calcium (principal sources include milk, cheese, and other dairy products, as well as dark green leafy vegetables).
- Being physically inactive, which can accelerate bone loss.
- Smoking cigarettes, which can lower estrogen levels in women.
- Drinking more than two cups of coffee, or 24 ounces of carbonated soft drinks, per day. Coffee increases the urinary excretion of calcium. Soft drinks contain phosphoric acid (phosphorus), which leaches calcium out of bone and hastens its urinary excretion.
- Eating a lot of red meat and other high protein foods, which are also high in calcium-leaching phosphorus.
- Drinking two or more alcoholic beverages a day,which tends to diminish bone strength in both men and women.
- Long-term use of medications such as corticosteroids (for asthma or rheumatoid arthritis) or high doses of thyroid hormone (synthetic and natural).
Treatment and Prevention
As women advance into their forties and men into their sixties, their doctors often suggest various self-help measures to prevent osteoporosis. Chief among them are a calcium-rich diet and weight-bearing exercise (such as walking and weight training) to keep bones healthy. Since bones stop growing around the age of 35, a conscientious physician often encourages a bone-building diet and exercise as a matter of course from an early age. If you’re at high risk of osteoporosis, your doctor may advise a bone density test to gauge bone health.
After menopause, hormone replacement therapy (HRT) may be suggested to prevent bone loss, which accelerates at that time. However, long-term use of HRT is not suitable for all women. For example, women at risk for blood clots or breast cancer probably should not use it. A newer alternative to HRT for women at risk for breast cancer is raloxifene (Evista), which acts like HRT on bone but not on breast tissue; no studies assessing long-term risk or comparing it to other drugs are available yet, however.
If tests and an examination reveal evidence of osteoporosis, your doctor may prescribe a recently approved drug, alendronate (Fosamax), which slows bone loss and builds bone mass. To avoid esophageal irritation, however, alendronate must be taken first thing in the morning, with a full glass of water, and you must then stay in an upright position for 30 minutes before eating or drinking.
Another drug, calcitonin (Miacalcin), can also slow bone loss and may add bone mass. But 10% to 20% of the people who take it suffer from side effects, chiefly nausea, appetite loss, and flushing; in addition, calcitonin is expensive.
The best treatment for osteoporosis is to take preventive measures to forestall bone loss–and supplements, along with diet and exercise, can help strengthen bones. The earlier in life you begin working to increase bone density, the better you can deal with bone loss later in life. By the time a woman reaches menopause, it’s harder to compensate for bone loss–though there is still plenty of reason to try to slow bone loss. Men, too, can benefit from bone-strengthening measures.
Just a reminder: If you have a serious medical condition, it’s always a wise idea to talk to your doctor before you begin a supplement program.
How Supplements Can Help
Calcium, the basic bone-building mineral, is essential for preserving bone mass and strength. Calcium supplements alone have little effect, however, when the hormones involved in calcium uptake are not at high enough levels. Better results are obtained when the calcium supplements are combined with vitamin D, which acts as a hormone and helps the body absorb calcium.
Adding calcium and vitamin D may impair the absorption of another mineral, magnesium, which is also necessary for good bone structure. Boron is needed to enhance the absorption of both calcium and magnesium as well as control the urinary loss of these minerals.
Vitamin C may help maintain greater bone density, researchers believe, and it also seems to enhance the production of the protein collagen, which is where the calcium is stored.
Zinc and manganese encourage good mineral absorption and overall bone health. (Note: if zinc is used for more than a month it should be taken in combination with copper.)
An adequate level of vitamin K is needed for proper bone formation. Individuals with osteoporosis are often found lacking in this vitamin.
More than 50 human clinical trials have demonstrated that the soy extract ipriflavone enhances the body’s ability to absorb and utilize calcium.
Do regular weight-bearing exercise. This includes any activity in which the legs or other parts of the body meet resistance. Important for maintaining bone density, this type of exercise can include walking, riding a bicycle, dancing, lifting weights–even doing housework or mowing the lawn.
Pay attention to your calcium intake: A calcium-rich diet includes low-fat dairy products. dark-green leafy vegetables, and canned salmon or sardine, with the soft bones.
In addition to containing calcium, dark green leafy veggies contain B vitamins, which will lower the body’s levels of homocysteine, a substance found to increase risks of heart disease and osteoporosis.
Try to limit your red meat intake to one or two servings per week.
Women should eat foods rich in plant estrogens, especially tofu and other soy products.
Take a good bone-building supplement daily, one that contains all the bone building elements listed above.
If you smoke, stop. Cigarette smoking affects the ovaries and lowers both estrogen and progesterone levels and thereby accelerates loss of bone mass. Obviously giving up cigarettes also promotes generally better health in both sexes.
Reduce your intake of coffee and alcohol, both of which increase calcium loss. Reduce carbonated soft drinks; they are high in phosphorus which depletes calcium from bones.
When to Call a Doctor
- If you notice you’ve been losing height.
- If you think you’ve broken a bone.
- If you feel a sudden and very severe back pain; it could indicate a fractured vertebra in the spine.
- If you feel any serious pain in or around the spine, ribs, hips, or feet after an injury.
- If you have major risk factors for osteoporosis, even with no symptoms, consider asking your doctor for a quick and painless bone-density test.
From David Edelberg, M.D. at WholeHealth Chicago: As a woman, you should begin to strengthen your bones by taking bone-building supplementation in your thirties. And you may need to start even earlier if you don’t routinely get enough calcium in your diet. By the time you reach your forties, all the nutrients in the WholeHealth Chicago list are valuable for preventing osteoporosis.
If you are over age 50 and have a high osteoporosis risk, you may also want to consider hormone replacement therapy (HRT), which you’ll need to discuss with your doctor. While all of the supplements are safe to use with HRT, it’s especially important to take them if you decide not to use HRT.
If you’re reluctant or can’t use hormones and you’re showing any signs of bone loss, there are nonhormonal prescription drugs (Fosamax, Miacalcin, Evista) that can be effective in reversing bone loss. The supplements listed here are safe to use with these drugs, too.
How to Take the Supplements
These supplements should have a strengthening effect on your bones after six months or so.
Calcium, of course, is mandatory for bone health, but needs some vitamin D to be absorbed. The mineral magnesium is also vital to healthy bone structure and function.
Soy holds great promise as a builder and maintainer of bone strength. Try incorporating such products as tofu, tempeh, soybeans, soy powder, or soy milk into your diet. If you don’t like soy, include the supplement ipriflavone, a soy-derived hormone mimic, instead. Vitamin C has been linked to greater bone mass as well.
Add the trace minerals manganese, boron, and zinc for bone health and mineral absorption (and when using zinc long term, take it with copper, since copper stores can become depleted). The combination of your daily multivitamin-mineral combination plus a good bone-building product will cover all these vital trace minerals just fine.
Vitamin K also contributes to building strong bones, and is also found in most good multiple vitamins or bone-building supplements. However, if you are taking the blood thinner warfarin (Coumadin), talk with your doctor as this vitamin will lessen the effect of the warfarin.
Some studies have shown that taking the herb black cohosh, normally used to relieve menopausal symptoms such as hot flashes, may have a positive effect on the bones as well.
To recap: Begin with a high-potency multiple vitamin. As an added benefit, the B-complex vitamins in your multiple supply B6, which seems beneficial in strengthening bones, and these nutrients also help lower levels of a chemical called homocysteine. (High levels of homocysteine contribute to heart disease and osteoporosis.)
Then, you need to add a good calcium-magnesium supplement and a bone-building combination product for trace minerals and vitamin K. If you wish, you can always take some black cohosh for hot flashes and an extra daily 400 IU of vitamin E as additional protection against heart disease.
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.
For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700 ext. 2001.
David Edelberg, MD