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 The word “Osteoporosis” means “porous bones”. It is a silent
disease that makes bones brittle. If not prevented or left
untreated, osteoporosis can progress painlessly until a bone
fractures.
There are approximately 1.5 million
osteoporosis-related fractures occurring annually in the United
States, and over 500,000 of these cases occur in post-menopausal
women. Over half of the women over age fifty will have an
osteoporosis related fracture in their remaining
lifetime.
Any bone in the body can be affected, but fractures
typically occur in the hip, spine, and wrist. A hip fracture almost
always requires major surgery as well as hospitalization. More
significantly, one in four hip fracture patients over the age of
fifty will die within the year following their
fracture.
Millions of Americans are at risk for
osteoporosis. An estimated ten million Americans today have
osteoporosis and are not even aware of it. Among those, eight
million are women, and two million are men. Risk factors of
osteoporosis include alcoholism, gastro-intestinal disorders, kidney
stones, smoking, lack of physical activity, low exposure to
sunlight, age of menarche, overweight, as well as prolonged use of
steroids such as cortisone or prednisone.
Men versus Women
 Osteoporosis targets more women that
men, because of the hormonal cycle. In fact, women are four times
more likely than men to develop and suffer from the disease and can
lose up to 20% of their bone mass from the first five to seven years
following menopause.
During menopause, bone loss
accelerates due to an absolute drop in estrogen levels in the body.
This leads to an increase in the resorption (teardown) of the
existing bone in the body. There is also at the same time a even
more severe drop in the body’s production of progesterone, and
without an adequate level of progesterone, there is a reduction of
new bone formation. This imbalanced state is often termed estrogen
dominance, where the relative amount of estrogen in the body
post-menopausally is actually higher than before menopause due to
the severe reduction in progesterone.
For decades, women
have been told that taking synthetic hormone replacement therapy
(HRT) such as Premarin or Pempro post-menopausally would help to
reduce the risk of fractures and slows down the aging process. In a
study published in the Journal of American Medical Association,
(June 13th, 2001,) a review of 22 previous studies shows that HRT
does not bring any benefit to the bones.
Men are also at
risk for osteoporosis, although the incidence of fractures is less
than that in women. More than two million men in the US have
osteoporosis and it is estimated that another three million are at
risk.
Men over age 50 have a greater risk of developing
osteoporosis than they do with prostate cancer, even though prostate
cancer is much more publicized.
While women are four times
more likely to get osteoporosis than men, men are more likely to
develop an extreme form of the disease, which can result in the loss
of height by several inches.
Conventional
Approach
Osteoporosis is often diagnosed by x-ray or bone
density tests. The conventional choice of treatment is the use of a
class of drugs called biphosphates and other “designer” variations
of this class of drugs. One such drug in this class is Fosamax®.
Fosamax® is made from the same type of chemicals that are used to
remove soap scum in your bath tub.
The bone is a living
structure, and a constant break down and rebuilding of bones is the
key to healthy bones. The Osteoclasts are cells that remove old
bones, and they work in conjunction with osteoblasts, which are
bone-building cells. When this process is in balance, normal bone
density is maintained. Fosamax® kills the osteoclasts, so only
the osteoblasts are left.
When the bones are not being
broken down, bone density will show an apparent increase. However,
as times goes on, this will back fire. As bones become denser due to
the lack of break down, they actually become weaker, as they have
not been allowed to remold themselves and readjust to the constantly
changing forces that are applied to the bones. Over time, the
rise in bone density slows down, while the risk of fractures
actually increases as the bone becomes more brittle.
In
addition, the bisphosphonates drugs may also cause serious
inflammation in several regions of the eyes. In a study reported in
the New England Journal of Medicine in March 20th, 2003, researchers
reviewed thousands of cases in which patients were prescribed
bisphosphonates and tracked 314 patients who had also reported to
have eye problems. Although side effects were rare, several types of
inflammation did occur, leading to the loss of vision and blindness.
Other side effects included nausea, heartburn, abdominal pain,
muscle cramps, irritability, pain when swallowing, and diarrhea.
Aspirin and other non-steroidal, anti-inflammatory drugs such as
ibuprofen may also increase the damage to the stomach if taken with
Fosamax®.
Osteoporosis Prevention
Protocol
1. Diet
A. Meat
There is little doubt that there is a strong correlation
between dietary habits and osteoporosis. As far back as 1968,
research has shown that the amount of minerals in the bones varies
with the diet. An excessively high protein diet (particularly
animal protein) leads to a negative calcium balance. In other words,
there is a net loss of calcium from the body resulting in reduced
calcium storage in bones. This is a serious risk for osteoporosis.
When excessive amounts of meat, refined carbohydrates,
and fat are consumed into our diet over a long period of time, our
body becomes more acidic. The body is not used to this and prefers
to be in an alkaline environment most of the time. As a compensatory
mechanism, the body directs calcium and other minerals to be removed
from the bones and transported to the rest of the body in an attempt
to buffer and neutralize this acidic environment. Some of this
calcium goes into the kidney and is excreted out. As a result, there
is a net loss of calcium from the body.
In addition to the
loss of calcium from the bones, animal proteins, due to the high
sulfur content, alter the kidney's re-absorption of calcium, so that
more calcium is excreted. Those on high protein diets such as
meat and dairy products can lose about 100 mg of calcium a day.
In one study, individuals who consumed excessive amounts of protein
were found to have a negative calcium balance of 137mg/day. This
translates into approximately 50g/year and a potential skeletal mass
loss of 4% per year.
Milk Promotes Calcium
Loss
A major concern of those who have been advised to
stop drinking milk is, "What will happen to my teeth and bones?" The
answer is astoundingly simple, "They will
improve."
The majority of the world's population takes
in less than half the recommended daily calcium intake of 800 mg a
day and yet they have strong bones and healthy teeth. The notion
that continuous ingestion of high amount of calcium is needed in
order to maintain strong bones and prevent osteoporosis must be
dispelled. Studies have repeatedly shown that strong bone is due
more to a function of optimum amount of magnesium and a low acidic
environment in the body rather than calcium from a nutrient
perspective.
While milk provides calcium, it is
ironic that milk also promotes calcium loss in the body. This
is because the consumption of the excessive proteins found in cow's
milk increases the need for minerals found in the body to neutralize
the acid formed from digesting the animal protein in cow’s milk.
Such minerals include calcium and magnesium and 99 percent of the
body's calcium and 60 percent of the body's magnesium is stored in
the bone. As mentioned before, calcium is removed from the bone to
the blood in order to neutralize the acid, resulting in the loss of
calcium from the bone. In fact, calcium excretion and bone loss
increase in proportion to the amount of animal protein consumed.
In short, milk and diary products are acid forming
substances. Acidic byproducts that accumulate in the body is also
one of the primary reasons of accelerated aging and cancer. It is
best that our body be bathed in a slightly alkaline environment. A
diet high in milk, meat, and poultry means that, more protein is
ingested, and the more acidic the body becomes. Vegetarians, for
example, need about half as much calcium as meat eaters as they lose
much less calcium from their bones.
Cow's milk also contains
phosphorous. When calcium and phosphorus reach the intestine at the
same time, they compete for absorption. The more phosphorus there
is, the less calcium will enter the body. Some phosphate compounds
form insoluble calcium salts in the intestine. In addition, excess
phosphorus triggers the release of parathyroid hormone, which sucks
calcium out of the bones. When combined with calcium, phosphorus
also competes with and prevents calcium absorption in the intestine.
The higher phosphorous level found in animal food (as
compared to plant food) may also interfere with calcium absorption.
Phosphorous is an important component in a balanced nutritional
program, but it may bind with calcium and therefore reduce the
amount of calcium that is absorbed by the body. Plant based foods
have protein, but contains a lower calcium –phosphorous
ratio.
Not all calcium in food enters the body. Many
components of food such as phosphates, vitamin D, fiber, proteins,
and hormones alter the absorption of calcium in our diet. For
example, Cow's milk contains 1,200 milligram of calcium per quart;
human milk contains only 300 milligrams. But the total calcium
absorbed in breast-fed babies is higher than in babies fed cow's
milk. This is because the phosphates and palmitic acid in cow's milk
reduce the absorption of calcium by the body.
The optimum
calcium/phosphorus ratio is important for bone building. The ideal
ratio is 2.5 to 1. Too much phosphorus consumed will upset the
balance, and will lead to progressive bone loss in the body. The
ratio in cow's milk is only 1.3 to 1.
In addition, milk
consumption is not helpful in improving bone density for those over
30 years old, because the milk has been pasteurized. The
pasteurization process causes a severe destruction of essential
nutrients.
Low-carb diet
As more
Americans turn to the low-carb, high protein diet to lose weight
quickly, some research studies are reporting that such diet can
increase the risk of kidney stones as well as the risk of
osteoporosis. In a six week study reported in the American
Journal of Kidney Disease in 2002, ten healthy adults consumed a
regular diet for two weeks, followed by a low-carb, high protein
diet for two weeks, and finally followed by a moderately restricted
carbohydrate diet for four weeks. It was found that while the
volunteers lost nine pounds on average, most developed ketones.
These ketones raise the acid level in the blood, and some volunteers
had their acid level increased by 90%. There is also an increase of
calcium being lost in the urine by the volunteers. Protein is a
source of acid and produces an acidic environment in the body. The
body simply does not like this. When exposed to a high acidic
environment, the body tries to buffer or neutralize the acid by
withdrawing minerals such as calcium from the bones. As such, the
body’s calcium stored in the bones is therefore
reduced.
Vegetables
The kind of
vegetables that is good for osteoporosis prevention include leafy
vegetables, legumes, raw nuts ( that have been pre-soaked overnight
in water), and seeds. All these contain plentiful amounts of
calcium. It has been shown that the average African women only
consumes only 500mg of calcium a day, and mostly from plant sources.
However, they have a positive calcium balance because they retain
their calcium much better.
The key is to control the protein
level and thus maintain an environment that is not overly acidic in
the body. When protein intake is reduced to a modest level, and
especially if the protein can be derived from plant sources,
excessive calcium intake to compensate for the calcium lost is not
necessary. The level of calcium intake can further be reduced if it
is combined with magnesium and strontium, both facilitators of
calcium transport.
Soy
 Soy is high in phytoestrogen, a plant estrogen
precursor. The effect of soy in the body is still controversial, but
many experts believe that soy blocks excessive estrogen from being
absorbed and acts like estrogen when it is deficient, thus providing
the best of both worlds.
Interesting studies have been
conducted, including one from Italy involving 90 women age 53-65. It
was found that ipriflavone and calcium supplementation was able to
increase bone mineral density by 2% after 6 months and 5.8% after 12
months with the added bonus of significant decrease in pain-45% in 6
months, and 62% at 12 months. However, it should be noted that soy
does have a dark side. Excessive amounts of unfermented soy
intake such as tofu can lead to thyroid disturbances. Women who are
in post-menopausal period should therefore be careful when using soy
as a supplementation for osteoporosis. Fermented soy products
such as miso or tempeh do not have this problem and can be taken
liberally.
Fluids
Avoid
stimulatory drinks that contains caffeine which acidifies the body
and cause calcium to be withdrawn from the bone. Avoid coffee and
tea. Distilled water should also be avoided. Decaffeinated
coffee and decaffeinated tea is acceptable in moderate amounts.
Herbal tea is acceptable.
2. Exercise and
osteoporosis
 Weight bearing exercises is as close as one can get when
one is searching for a magic bullet in the prevention of
osteoporosis. The positive effect of exercise on bone density is
greatest in adults who have been sedimentary and just started
exercising. Studies have shown that even elderly adults over age
80 who have done active exercise and weight bearing programs can
significantly increase their bone density over a shot period of
time. Weight bearing exercises such as walking, running,
jogging, dancing, are especially important. While swimming is a
great exercise for cardiovascular diseases, it is not as good for
bone health when compared to walking and jogging.
Bone is a
live tissue and it responds to stress placed upon it. In a positive
way when a person becomes sedimentary, the normal stress placed on
the bones is removed. The bone will lose its density and become
brittle over time. It comes as no surprise that a patient with
spinal cord injuries will have significant loss of bone density if
proactive steps are not taken. The opposite is also true; athletes
have stronger bones than the average adult.
Exercise is a
life long activity. Its effect on bone mass will decrease when one
stops to exercise. Therefore, exercise needs to be done on an
ongoing basis. 30 minutes of weight bearing exercise daily will
improve bone density, heart health, muscle strength, coordination,
and balance. The good news is that studies have now shown that
the 30 minutes of exercise can be broken down into ten-minute blocks
without sacrificing results.
Remember to warm up and
cool down always. It is also wise to combine several different kinds
of weight bearing exercises. Incorporate exercises that build
strength, and increase resistance in weight to the program. Lastly,
drink plenty of water to prevent dehydration.
3. Nutritional Supplement
Considerations
Fifty years ago, nutritional
supplementation for bone building involves primarily around the
single element calcium. Later, it was found that magnesium and
vitamin D are important components as well. The latest nutritional
research now points to three other important team players –
strontium, vitamin K, and collagen.
Bone building is no
longer about any one single nutrient. The best program consists of a
cocktail with all six nutrients working concurrently.
A.
Calcium
Calcium is a basic building block of bones. The
average adult has about 3 lbs of it in their bones, teeth, and
blood. The use of calcium supplementation to treat post menopause
osteoporosis has increased significantly since 1987, which is the
year the National Institute of Health increased the recommended
daily intake of calcium to 1500mg for the prevention of primary
post-menopausal osteoporosis (PPMO). There is significant
controversy surrounding this recommendation because working it was
made despite the conflicting conclusions research by some clinical
studies presented to the NIH. Some of the studies show no
significant effect of calcium intake on mineral density on the
trabecular bone and only a slight effect on the cortical bone. Since
PPMO is predominantly a condition due to the demineralization of the
trabecular bone, there is no justification for calcium mega
dosing for postmenopausal women. In fact, soft tissue
calcification can be a serious risk factor arising from calcium mega
dosing under certain conditions. Most research and trials using
calcium in the prevention of post-menopausal osteoporosis also
involve the use of vitamin D and this makes it difficult to
attribute the benefit to calcium alone.
It is also
interesting to note that the bone density increase found in the
first two years of calcium supplementation may not substantially
increase over a long period of time. In contrast to most clinical
data, a great number of studies did not find a significant
association between calcium intake and a reduced risk of bone loss
fracture. It is well known that calcium at low or moderate doses is
largely dependant on the action of vitamin D for active support.
Sufficient amount of Vitamin D are important for the prevention of
post-menopausal bone loss. Insufficient vitamin D leads to less
calcium absorption, elevated blood concentration of parathyroid
hormone, as well as an increased rate of bone absorption. All these
can eventually lead to a bone fracture if not corrected in time.
The conventional wisdom and recommendation taken for granted
is that a high dose of calcium is necessary for the prevention of
post menopausal osteoporosis, as well as for the building of strong
bones for children and elderly. Long term studies however have
not been able to confirm that calcium alone can get the job done
without the help of other nutrients especially in the case of
PPMO.
RDA
Current
Recommended Dietary Allowance (RDA) is 1000 mg of calcium for
younger adults, and 1200 mg for people over the age of 50.These
numbers reflect the total calcium needed for a diet that is high in
protein and fat (typical of the young American diet). Such diet
also produces a body that is acidic and as a result, calcium is
drawn out of the bones to neutralize this acidic environment in
order to return the body to a more alkalized state. A high
calcium intake of more than 1000 mg or more is suggested for anyone
who falls into this demographic group that takes in a diet high in
protein.
This
recommendation of 1000 to 1500 mg calcium is not suitable in
the case of postmenopausal osteoportic women whose diet is likely to
be high in green leafy vegetables. In this type of diet, the
amount of calcium required in terms of supplementation is much
reduced. If you have a high calcium intake from food source, then
less supplemental calcium will be needed. As well, a diet
high in green leafy vegetables leads to an alkaline internal
environment. The body will not have a need to withdraw calcium from
the bone required. As a result, only 500 mg is required if
accompanied by the right dose of magnesium.
Mega-dosing of
calcium in excess of 1000 mg per day has little correlation with
increase in bone density. In fact, taking too much calcium can
inhibit the absorption and utilization of other important bone
nutrients, such as zinc and copper. In fact, mega-dosing of calcium can be detrimental to your
health, leading to the extra cellular deposit of calcium and
eventual formation of bone spurs. Excess calcium also can serve as a
cardiac irritant and can lead to cardiac arrhythmias.
Multiple studies
have shown that calcium supplements - such as calcium gluconate,
calcium citrate, calcium carbonate, and even calcium citrate-malate
- slow, but do not halt or reverse, menopausal bone loss, whether
taken alone or with vitamin D. Even a total daily calcium intake of
3000 milligrams of calcium alone isn't enough to stop bone loss.
The bone will not be able to take in more calcium than it is capable
of if other supporting nutrients are not present. An osteoporosis
program focusing largely on calcium intake is a recipe for
failure.
Calcium can be found in vegetables and milk.
Traditionally, milk is consumed, but it is not helpful in improving
bone density as it is pasteurized. Raw milk on the other hand, is
very different and beneficial, but not everybody has access to this
however.
You can get an ample supply of calcium from green
leafy vegetables. Supplementation with calcium is an easy and
inexpensive way to assure that you get enough. About 500 mg of
calcium a day is all that is needed for strong bones, provided that
you also take 500 mg of Magnesium and follow a diet ample in green
leafy vegetables. The ratio of magnesium to calcium should be one to
one (1:1) or even two to one (2:1) for strong bones, according to
many researchers who are in the forefront of anti-aging medicine.
Over 80% of adults in America do not consume even the 300 mg of
magnesium recommended. While there is no harm in excessive amount of
magnesium being consumed, some people do develop a harmless
diarrhea.
How Much to
Take?
A recent study by the National Institute of
Health supports the notion that, starting at childhood, an adequate
amount of bone reserve needs to be built up in order to have it for
the future. As such, a high dose of calcium intake of 800mg for
children from years 3-8 and 1300mg for those between 9-17 is
suggested.
From age 18 onwards, the use of high dose
calcium above 1500 mg is only indicated if the diet is high in meat
(leading to an acidic body). Only 500 mg is required if the diet is
high in vegetables (leading to a alkaline body), and excessive
calcium intake can in fact cause more harm than good. The blanket
recommendation of high doses of calcium (over 1000mg )after
adulthood regardless of diet or metabolic type, should be
abandoned.
Nutritional Consideration : 500 mg
of calcium in a diet high in green leafy vegetables. The calcium
intake should be increased up to 1500 mg a day if the diet is high
in meat and protein.
B.
Magnesium
Magnesium acts as a balancer of calcium
in our body, much like progesterone balances the effect of
estrogen, and omega-3 balances omega-6 fatty acids.
Magnesium balances the body's calcium supply and keeping it
from being excreted. Without magnesium and other trace minerals,
calcium ingested, especially if excessive, will be deposited not in
the bone but perhaps in the wall of our arteries.
It is
interesting to note that human autopsy studies have shown a close
correlation between osteoporosis and abdominal aortic calcification.
Since magnesium deficiency can promote osteoporosis and calcium
deposit in aorta, logic dictates that magnesium is likely to be the
primary factor and that calcium is secondary when it comes to the
prevention of bone loss.
Magnesium regulates the active
calcium transport. It has been shown that magnesium has fracture
prevention effect, and is able to increase bone density when taken
on an ongoing basis. Magnesium deficiency has been shown to be a
significant risk factor for post-menopausal osteoporosis, and this
may due to the fact that magnesium deficiency alters calcium
metabolism and the hormones that regulate calcium.
Magnesium
has been shown to prevent the formation of calcium oxalate crystals,
the most common cause of kidney stones. Studies have shown that
500 mg a day of magnesium is able to reduce the recurrence rate of
kidney stones by as much as 90%. Magnesium is also nature's
"calcium channel blocker", preventing the entry of excessive calcium
into the cell resulting in contractions, chest pain, hypertension,
and arrhythmias. Magnesium deficiency can cause various
abnormalities of calcium metabolism, resulting in the formation of
calcium deposits in arteries. Osteoporotic women who were deficient
in magnesium had abnormal calcium crystals in their bones, whereas
osteoporotic women with normal magnesium status had normal calcium
crystals in their bones.
One researcher, Dr. Guy Abraham,
postulated that a dietary program emphasizing magnesium as well as
calcium would be more effective in preventing bone loss. His
concern for low magnesium for osteoporosis is similar to his concern
for women with premenstrual tension syndrome. To test Dr. Abraham’s
hypothesis, 19 post-menopausal women on hormone replacement therapy
were given a supplement consisting of 500mg of calcium (50% of RDA),
and 600mg of magnesium (200% of RDA). Studies were conducted every 3
months. Subjects receiving the treatment showed an 11% increase in
bone density versus 0.7% in the untreated group. Results also showed
that in post-menopausal women on hormone replacement therapy, the
magnesium emphasized program was able to produce calcaneous bone
density 16 times greater than that of the dietary advice alone. At
the start of the study, 15 subjects were below the fracture
threshold. After a year of treatment with magnesium supplementation,
in conjunction with calcium supplementation, only 7 of them were
below the fracture threshold.
Researchers such as Dr.
Abraham postulate that PPMO is predominantly a skeletal
manifestation of chronic magnesium deficiency facilitated by
estrogen withdrawal during the post-menopausal period. He suggests
raising the RDA of magnesium to 1000mg a day and lowering the RDA of
calcium to 500mg a day. This suggestion is more in line with the
World Health Organization” (practical allowance)”.
Nutritional Consideration: 500mg
magnesium.
C. Vitamin K
Vitamin K is an
essential nutrient, best known for its role in blood clotting. There
is significant emerging evidence that vitamin K plays a protective
role in fighting age related bone loss.
There are three
types of Vitamin K. The primary source of Vitamin K is
phylloquinone, and can be found in green vegetables and certain
plant oils. Vitamin K2, also called menaquinone, is made by the
bacteria that line the gastrointestinal tract of our body.
Osteocalcin is a protein that is produced by the
osteoblast. This chemical is utilized within the bone and is an
integral part in the process of bone formation. Before osteocalcin
can be used, it has to be carboxylated and Vitamin K functions as a
co-factor for the enzymes that catalyzes the carboxylation of
osteocalcin.
Numerous studies have now shown that people with
the lowest intake of vitamin K have a higher chance of hip fractures
than those who have higher intakes of vitamin K. This was the
conduction of the “nurse health study” conducted by Harvard Medical
School. Another study involving 800 elderly men and women followed
the Framingham Heart Study for 7 years found that people with the
highest vitamin K intake only has 35% of the risk of hip fracture
experienced by those with the lowest dietary intake of vitamin K. In
fact, vitamin K has been approved for the treatment of osteoporosis
in Japan since 1995.
Recent studies on
Vitamin K have been impressive. 72 osteoporitc women taking a
first-generation biphosphonate drug called Didronel for two years
was compared to those taking vitamin K for the same period of time.
There was no difference found in the bone fracture rates between
women taking vitamin K and those taking the biphosphonate drug for
osteoporosis.
In fact, vitamin K has the additional benefit
of being a protector of our cardiovascular system as well as
fighting cancer. One study published in the September 2003 issue of
International Journal of Oncology found that lung cancer patients
treated with vitamin K2 was able to show the growth of cancer cells.
Vitamin K can be found naturally from a variety of foods
including collar greens (440mcg/100g), spinach (380mcg/100g), salad
greens (315mcg/100g), Kale (270mcg/100), broccoli (180mcg/100g),
Brussels sprouts (177mcg/100g), olive oil (55mcg/100g) green beans
(33mcg/100g), and lentil (22mcg/100g). Unfortunately, you have to
eat more than a pound of green leafy vegetables per day just to get
enough vitamin K into your diet.
Vitamin K
supplementation should not be taken by those on blood thinner,
pregnant or nursing mothers beyond the RDA recommendation of 65mcg
unless monitored by a health care professional.
Those
who have experienced strokes and cardiac arrest, as well as those
who are on blood thinning medication should also consult their
physicians first before taking vitamin K. Those living in the
modern day world may already have a vitamin K deficiency brought on
primarily by environmental as well as lifestyle factors and not
knowing it. Many prescription drugs and antibiotics such as
penicillin, tetracycline, warfarin, deplete this valuable vitamin.
Other causes of vitamin K deficiency include smoking, excessive use
of alcohol and caffeine, chemotherapy, x-rays, frozen foods,
aspirin, air pollution, lactose intolerance. Unfortunately, most
multi-vitamins do not contain any vitamin K at all.
Both
Vitamin K1 and K2 are safe, natural, and needed for strong bones.
Vitamin K3, or menadione, is a synthetic form that is manmade in the
laboratory. Only Vitamin K1 and K2 are recommended from a
nutritional supplementation perspective.
Nutritional
Supplement Consideration: K1 and K2 blend: 1000 mcg day. Take
with food is best.
D. Vitamin D
Vitamin D,
calciferol, is a fat soluble vitamin. It is found in food and can
also be made in the body after exposure to ultra-violet rays from
the sun. If you are exposed to the sun for more than 40 minutes a
week, your body is able to produce the needed Vitamin
D.
Vitamin D prevents rickets in children and osteomalacia in
adults. In the US, fortified food is the major source of Vitamin D.
Exposure to sunlight is an important source. Sunscreen with sun
protection factor (spf) of 8 or greater will block the UV rays that
causes the body to produce vitamin D. Vitamin D supplementation is
therefore recommended.
Season, latitude, time of day, cloud
cover, smog, and sunscreens affect UV ray exposure. For example, in
Boston the average amount of sunlight is insufficient to produce
significant amount of vitamin D synthesis in the skin from November
through February.
Vitamin D supplements are often
recommended for exclusively breast-fed infants because human milk
may not contain adequate vitamin D.
Fortified foods are the
major dietary sources of vitamin D. Prior to the fortification of
milk products in the 1930s, rickets (a bone disease seen in
children) was a major public health problem in the United States.
Milk in the United States is fortified with 10 micrograms (400 IU)
of vitamin D per quart, and rickets is now uncommon in the
US.
Vitamin D actually exists in several different forms
and each has its own activities. The main biological function of
vitamin D is to maintain normal blood levels of Calcium and
Phosphate. Vitamin D helps the absorption of Calcium, and without
the proper amount of it, calcium is not able to do its job.
Having a normal level of vitamin D in the body helps the
bones to be strong. Vitamin D deficiency has been associated with
greater incidences of bone fracture, and severe deficiency leads to
rickets and osteomaliacia. . Vitamin D deficiency has also been
associated with obesity, auto-immune disease, fatigue, depression,
arthritis, heart disease, as well as metabolic syndrome. Steroids
may impair the vitamin D metabolism, further contributing to the
loss of bone and the development for osteoporosis.
Nutritional Supplement
Consideration: 600
IU/day.
E.
Strontium
Strontium is
an essential element with an elemental number of 38 in the periodic
table. It was discovered in 1808 and is one of the most abundant
elements on earth. In fact, there is more strontium in the earth
crust than there is carbon. It is also the most abundant trace
mineral in seawater. Strontium is not a new element to us. In
the body, strontium tends to accumulate in bones where the
remodeling process is actively taking place.
Its
properties are quite similar to those of calcium, and in fact,
strontium is located in the same column as calcium in the periodic
table. Research has long suggested that it may be an essential
nutrient required for the normal development of bone structure and
skeletal system. Like calcium, strontium has 2 positive charges in
its ionic form. Because of its structural similarity to calcium, it
can replace calcium to some extent in various biochiemical processes
in the body. A small portion of calcium in hydroxyapatite crystals
of calcified tissues such as bones and teeth can be replaced with
strontium.
Strontium is a very strong mineral. Not only does
it add strength to the calcium, it also is able to draw extra
calcium into the bones and thus facilitate the movement of calcium
into the bones.
Clinical trials on the use of strontium and
osteoporosis have been conducted since the 1940s. Unfortunately,
there was a significant amount of bad press given to this mineral in
the late 50s. At that time, it was confused with another form
called strontium-90, which is a very dangerous and radioactive
component of nuclear fallouts produced during the testing of nuclear
weapons in the mid 50s. Strontium-90 is radioactive and has cancer
causing abilities. Stable elemental strontium, on the other hand, is
non radioactive and non toxic even when given in large doses over a
long period of time. In fact it is one of the most effective
substances for the treatment and prevention of osteoporosis.
Interestingly, the non-radioactive form of strontium can compete
with the radioactive form and in fact displaces the radioactive form
of strontium in the bodies of those who have an overload of
radioactive strontium.
One of the most significant studies
was conducted in 1959. Researchers administered a dosage of 1.7g of
strontium lactate a day to 32 osteoporosis patients. It was found
that 84% of the patients reported significant relief of bone pain.
The remaining 16% reported moderate improvement. There were no side
effects. Due to the rudimentary and crude measurement of bone mass
back in the late 50s, extensive objective data was not able to be
carried out. Numerous studies have been done since with the
administration of strontium to rats. In1986, it was shown that an
administration of 0.27% strontium to mice in their drinking water
resulted in an increase rate of bone formation, and a decrease in
the bone resorption. Dr. Stanley Skoryna of McGill University in
Montreal conducted a small-scale study in 1985 in the use of
strontium for the treatment of humans with osteoporosis. A total of
6 subjects, 3 women and 3 men, were given 600-700mg of strontium
carbonate. Bone biopsies were taken before and after 6 months of
treatment. The study showed a 172% increase in bone formation
after strontium therapy. There is no change in the bone
absorption. Interestingly, the patients receiving strontium reported
a reduction in bone pain.
Recently, the use of strontium in
the form of strontium ranelate for the prevention and treatment of
post menopausal osteoporosis was carried out. One study had 353
osteoporosis women with at least 1 vertebral bone fracture and low
lumbar bone density score. The subjects received a placebo or
strontium ranelate in doses of 170, 340, 680mg a day for 2 years. It
was shown that there was a significant positive change in bone
metabolism and a reduction of vertebral fracture in the second year
of the group receiving 680mg a day. There is little doubt that
strontium ranelate therapy is able to increase hipbone mineral
density and reduce the incidence of vertebral fracture.
Another large study of 1649 osteoporotic, post menopausal
women showed that those receiving 2gram a day of strontium renalate
(providing 680mg together with calcium and Vitamin D) suffered fewer
fractures of up to 49% risk reduction in the first year of treatment
and 41% over the 3 year period. There was an average increase in
bone density of 14.4% in the lumbar zone as well as an 8.3% increase
in the femoral neck area.
Strontium has also been used
to treat patients with a metastastic cancer that has spread to the
bones, using a dose as low as 274mg a day. In addition, Strontium
has reduce the incidence of cavities. In a 10-year study, the United
States Naval conducted an examination of 270,000 naval recruits and
found that only 360 were completely free of cavities. Curiously, 10%
of those came from a small area in Ohio, where the water has an
unusually high concentration of strontium. There have also been
studies done in animals showing that the administration of strontium
reduces the incidences of cavities.
Strontium in doses of
up to 1.5g a day appears to offer a safe and cost effective approach
in preventing and reversing osteoporosis. Most of the studies
done involved dosage of 680mg per day. Although most of the
recent studies use strontium renalate, early studies used other
forms of strontium including strontium carbonate, strontium lactate,
and strontium gluconate. It is clear that the active
ingredient is strontium and not the salt. The salt used is not as
important when compared to the amount of actual strontium
consumed.
Because of the similarity in structure and
physical properties of strontium and calcium, a few researchers
question whether strontium should be administered together with
calcium to avoid the possibility of both calcium and strontium
competing for the same bone building sites. While this appears to be
a theoretical possibility, clinical data have not been able to
conclusively demonstrate such problem. Furthermore, the presence of
strontium may actually facilitate the transport of calcium into the
bones. Research in this area is still ongoing. Suffice to say that
from what we know at this time, strontium is an important part of
any bone-building program.
Nutritional Supplement
Consideration: 1100 mg of Strontium Carbonate, yielding at least 680
mg of elemental strontium.
F.
Collagen
Collagen is the most abundant and most important
protein in the body. Protein is abundant in all living creatures. It
forms an integral part of the body’s organs. It is especially
important for bones and joints. Bone has a high amount of collagen.
Approximately 90% of the organic matrix of bone is Type I collagen,
cross-linked to increase strength and rigidity. Collagen derivatives
are formed by cross-linking lysine and hydroxyl-lysine residues in
mature collagen and elastin. Collagen acts as an external fiber that
wraps around the bone matrixes to increase the tensile strength of
the bone matrix. Without an adequate amount of collagen, bone
strength is weakened. Osteoporosis depletes both calcium and
collagen from the bones.
Nutritional Supplement
Consideration: 500 mg to 5,000 mg of mixed blend including Collagen
Type 1 and 3. Also take synergistic nutrients that enhances
collagen production including L-lysine, L-proline, citrus
bioflavonoids, pine bark extract, and
L-carnitine.
G. Natural
Progesterone
There is only one compound that we
currently know of that will increase bone strength and density by
promoting the growth of osteoblast, and this is natural
progesterone. The use of natural progesterone to treat
osteoporosis was pioneered by Dr. John Lee, who suggested that
osteoporosis in women is due to the decreasing level of progesterone
and not estrogen. Dr. Lee’s research points out that most women over
65 still have adequate estrogen to inhibits bone loss ( though not
enough to cause ovaluation). But at the age of approximately 35, the
body’s progesterone production decline drastically. That is also the
age of peak bone production in women. After that, it declines. By
age 50, the body’s progesterone level is extremely low.
His associate Jerilyn
Prior, MD found evidence of progesterone’s possible role in
countering the effect of osteoporosis in a study of 66
pre-menopausal women aged between 21and 41. All of these women were
long distance marathon runners. It was observed that after 12
months of therapy that their average spinal bone density decreased
by about 2%. However, women who developed ovulation disturbances
lost 4.2% of their bone mass in one year. While there is no
correlation between the rate of bone loss and serum level of
estrogen, there was a close relationship between the indicators of
progesterone status and bone loss. It appears that the progesterone
deficiency rather than estrogen deficiency is the major factor in
the pathogenesis of menopausal osteoporosis. Dr. Lee believes that a
transdermal method is the best way to get natural progesterone
safely into the body.
The efficacy of natural progesterone
is verified by a three-year study of 63 post-menopausal women with
osteoporosis. Women using transdermal progesterone cream
experienced an average 7-8% bone mass density increase in the first
year, 4-5% the second year, and 3-4%, the third year. The untreated
women in this age category typically lose 0.7- 2% bone density per
year.
Nutritional Supplement Consideration:
Women
(Postmenopausal): 20 mg of USP Natural Progesterone a day for 25
days a month
Women (Pre or Peri-menopausal): 20 mg of USP
Natural Progesterone a day for Day 14-28 of a 28-day cycle.
Men: 5 mg of USP Natural Progesterone a day everyday of the
month.
Conclusion
Osteoporosis is not a
debilitating disease if one starts on the prevention protocol
quickly, as early as age 35, the time when bone loss starts to
become significant. From a diet perspective, one that is high in
alkaline and base is preferred to an acidic body causes minerals to
be bleached out of the bones in most cases. Weight bearing
exercises have repeatedly been proven to be important for
stimulating osteoblasts and bone formation. From a nutritional
perspective, a cocktail consisting of the right balance of calcium,
magnesium, and vitamin D is important. Along with these foundational
building blocks, Vitamin K, strontium and collagen will
synergistically help the bone formation. Natural progesterone cream
should also be considered to round out the
program.
Based on a diet high in
above the ground vegetables , the key osteoporosis prevention
nutritional cocktail for those over 35 years of age should contain
the following and to be taken on a daily basis with meals:
Calcium
blend ( carbonate, hydroxyapatite, and citrate): 500 mg.
( Caclium may be increase to 1000-1500
mg if the diet is high in meat and protein)
Magnesium : 500
mg
Strontium
Carbonate : 1100mg (yielding 650 mg of elemental
strontium)
Vitamin K1 and K2 blend
: 1000 mcg
Vitamin D3: 600
I.U.
Vitamin C: 145
mg
Collagen Type 1 and 3 :
500 mg
L-Lysine: 150
mg
L-Proline: 50
mg
N-acetyl-cysteine : 100
mg |
