An A-Z Woman's Guide to Vibrant Health
Our bones are in a constant state of regeneration as bone is being broken down and
rebuilt. Hormones and our liver, kidneys and immune system all work together to
ensure that bone is maintained. Osteoporosis, meaning "porous bone," arises when
bone is broken down faster than it can be rebuilt. Over time a gradual decrease
in bone mass causes the bones to become porous, brittle and fragile, increasing
the risk of fracture. Bones of the hip, spine, wrists and ribs are the most common
fracture sites. Osteoporosis affects almost 30 million people; over 80 percent of
those are women. One in four women has osteoporosis and one in eight men. Hip fracture
is a dangerous result of osteoporosis. Over a quarter million hip fractures occur
each year, and over 50 percent will result in some form of disability, with many
patients never getting out of long-term care facilities. Hip fractures result in
death in up to 20 percent of cases.
If you have several of the risk factors mentioned below, have a dual-energy absorptiometry
DEXA scan performed to determine bone status.
Major risk factors for osteoporosis
- Family history
- Low Stomach Acid
- Thyroid disease (low thyroid or hyper-thyroid)
- Corticosteroid therapy (prednisone)
- High-stress lifestyle or type A personality
- Northern European or Asian descent
- Thinness, small build
- Early menopause
- Sedentary lifestyle
- No pregnancies
- High caffeine and sugar intake
- High-protein diet
- Depo-Provera (the birth control shot)
Bone loss occurs silently and often symptoms are not noted until a fracture occurs.
Warning signs include: back pain around the bottom of the shoulder blades. The pain
is relieved with heat, but aggravated by lying flat on the back. Teeth may become
loose, there is a loss of height and a rounding of the upper back known as dowager's
hump. Bones can fracture with little stress and collapsing vertebrae can pinch nerves,
If we believe what the media have been telling us, we would think that calcium loss
is the only cause of osteoporosis and that simply taking doses of calcium would
solve the problem. Unfortunately this is not true - calcium alone will not reverse
or halt bone loss in most suffering osteoporosis. Actually, studies using calcium
alone have shown bone loss, not bone gain. Hormones, our immune system, stress and
nutrition combine to maintain proper bone health.
Those with low stomach acid will have a difficult time absorbing calcium carbonate,
the most common calcium used in supplements. Less than 10 percent of calcium carbonate
is absorbed in those with low stomach acid. Calcium citrate, aspartate and orotate
are much better absorbed. Calcium concentration is controlled by several hormones
(including calcitonin secreted by the thyroid gland) and is influenced by our immune
Vitamin D also plays an important role in the formation of bone. Vitamin D interacts
with the cells of the immune system by reducing the inflammatory cytokines, specifically
interleukin-1 and interleukin-12. Carl Germano, RD and William Cabot, MD state in
The Osteoporosis Solution that, "In some research circles, osteoporosis
is thought to be a type of autoimmune disease."
The inflammatory cytokines of the
immune system, specifically IL-1 and IL-6, can cause calcium to be pulled from bone.
When we are under stress, our stress hormone cortisol is secreted. Cortisol release
signals the T-helper-2 cells to secrete IL-6 and IL-6. As well, when cortisol levels
go up, our anti-aging and immune regulating hormone DHEA decreases. The body is
designed to deal with short-term stressors, but when they become a regular occurrence,
the cortisol/interleukin-1 and-6 connection causes a breakdown of bone faster than
it can be rebuilt.
Osteoporosis can also be influenced by an overactive immune system. When macrophages
eat invaders in the course of their daily surveillance, they release nitric oxide
and IL-1. Nitric oxide in small amounts protects against bone loss. But when the
immune system is fighting infection, macrophages release nitric oxide in large amounts,
promoting the breakdown of bone. The drug Fosamax is designed to reduce nitric oxide,
although with some terrible side effects. As mentioned earlier, we know that IL-1
also promotes bone loss so not only does vitamin D have to be available to control
the secretion of IL-1, but our macrophages have to be kept in balance as well. Nitric
oxide, like vitamin D, is key to regulating bone.
Estrogen protects the body from excessive secretion of IL-1 and IL-6. Lack of healthy
estrogen in women with adrenal exhaustion or those who have had hysterectomies,
or top-level athletes with suppressed menses, is associated with abnormally high
levels of IL-1 (which promotes bone loss) and low levels of interferon gamma (which
prevents bone loss).
The thyroid hormone thyroxin activates bone breakdown, so long-term elevated levels
of the hormone for a prolonged period either through hyperthyroidism or too high
a dose of medication for hypothyroidism also results in bone loss. Sub-clinical
low thyroid function, where not enough thyroid hormone is available, also promotes
Use of medications can also contribute to osteoporosis: corticosteroid drugs decrease
absorption of calcium, and antidepressants have been linked to increased risk of
hip fractures. Drugs such as diuretics, antacids, anticonvulsants, warfarin and
lithium can also contribute to bone weakening.
Other factors promoting osteoporosis include genetic predisposition (Asians and
Caucasians are at higher risk), hyperparathyroidism, hypothyroidism, excessive alcohol
consumption, leanness, never being pregnant, side effects of prescription medication,
immobility or lack of exercise and not getting enough sunlight. Smoking increases
inflammatory immune factors promoting bone loss.
Calcium to Magnesium ratio: Research shows that the body requires
twice as much calcium as magnesium. Taking more magnesium than calcium can actually
suppress calcium levels and increase bone loss by decreasing the production of the
thyroid hormone calcitonin. Magnesium in excess acts as a calcium blocker. There
are times when we would want extra magnesium for restless leg syndrome, constipation,
painful periods or heart palpitations, but we should then take the magnesium in
divided doses at a different time than the calcium supplement.
PRESCRIPTION FOR BONE HEALTH
Multivitamins with minerals; (contains no iron)
MULTISMART contains all the bone nutrients you need to prevent
and treat osteoporosis
2 packets of Multismart powder daily provides all your needed daily nutrients plus special
bone nutrients including:
Elemental Calcium (glycinate/aspartate) 1000mg
Elemental magnesium (bisglycinate) 500mg
Vitamin D3 1000 IU
Silicon 4 mg
Ensures adequate nutrient status
Important for the formation of collagen in bone
Research showed 2% increase in bone strength over 12 months
Enhances osteocalcin, important for bone mineralization and increased bone strength
314 mg daily on an empty stomach
Supports osteoblasts (the cells that form new bone) while reducing the action of
osteoclasts that reabsorb old bone
Pharmaceutical grade fish oils
1000 mg three times daily
Inhibits inflammatory IL-1, IL-6, and proinflammatory prostaglandins, known to promote
HEALTH TIPS TO ENHANCE HEALING
- We are waiting far too long to take our bone-building nutrients. Most women do not start
taking calcium until age 50. Young women need calcium, especially during the crucial
bone-building years 12 to 25.
- See Menopause.
If you have osteoarthritis as well as osteoporosis see
- Rule out hydrocholoric acid deficiency. Low stomach acid impairs calcium absorption.
- Reduce consumption of caffeine (it depletes calcium and magnesium), simple or refined
sugars (also depletes calcium and lowers bone density), and alcohol (it can lower
vitamin D metabolism).
- Include more fermented soy in the diet from tempeh, miso, fermented soy powders
and soy sauce.
- Eat plenty of green leafy vegetables; they contain vitamin K needed for proper bone
- Eliminate all soft drinks; they lower calcium levels and increase phosphate levels.
- Reduce salt, it increases calcium loss.
- Maintain a balanced daily intake of protein - 50 grams for women (average body weight
of 138 lbs), 63 grams for men (average body weight of 174 lbs). Too much protein
depletes calcium from the bones; too little prevents collagen formation and associated
enzymes. Reduce animal protein by opting for vegetable-based protein such as legumes.
- Develop an adequate exercise program that includes weight-bearing activities such
as walking, hiking, stair climbing, dancing, weight training, jogging, skiing or
low-impact aerobics. However, while regular movement and exercise is required to
preserve bone mass and increase bone mineral density, excessive exercising can also
lead to osteoporosis if menses are suppressed or the immune system is hyper-stimulated.
- Eat calcium-rich foods including canned salmon with the bones, broccoli, sesame
and sunflower seeds, dark leafy vegetables, organic cheese and yogurt. Take your
calcium supplements before bed with a glass of orange juice. The blood's calcium
level is lower at night so the rate of calcium absorption is greater.
- "Good fat" diets enhance bone density. High saturated fat diets promote bone loss.
- If your medication increases risk of osteoporosis, inquire if more natural approaches
can be taken, or substitute it for one that does not. (Prednisone, Depo-Provera,
steroids, blood thinners and diuretics are examples of drugs that increase risk.)
- Quit smoking.
- Take advantage of sunny days when you can and get at least 15 to 20 minutes of sunshine.
- Avoid antacids - they lower the acid in your gut and inhibit the absorption of calcium.
- Vitamin D is essential for the absorption of calcium into bone, and our bodies are
capable of producing this vitamin when we are exposed to sun light for about 20
minutes per day. You can see how this is a problem during the winter months. A Swiss
study shows that supplementing vitamin D also helps to reduce the risk of falls
for the elderly. Magnesium is essential to convert vitamin D to its active form
and yet magnesium deficiency is common in the elderly population as well as in those
with osteoporosis. Symptoms of magnesium deficiency include muscle cramps and twitching