There is something particularly alarming when we realise that the structures upon which we instinctively rely to conduct our lives are in fact crumbling away, and there is nothing we can do about it. We tend to think of this in terms of societal or political structures but nowhere is this more frightening than when it is happening within our own frame. That our bone structure, the thing that allows us to defy gravity and walk erect in this world, is compromised and ebbing inexorably away.
Osteoporosis is a silent disease. Just as a heart attack is often the first clue to the existence of atherosclerosis, a bone fracture is usually the first indication that a person's bones have become dangerously weakened. Osteoporosis is responsible for over 1.5 million fractures a year in America alone and incurs medical costs of more than $38.0 million a day. An estimated 30 million Americans have already lost enough bone mass to be at serious risk of a fracture without knowing it. Half of all women over 50 and 1 in 8 men over 50 will suffer an osteoporotic fracture in their lifetime. And, when the fracture involves the hip, as it does with 300,000 Americans a year, it is fatal in 20% of cases. In fact, the chance of a woman having an osteoporotic fracture is greater than her chances of getting breast, cervical & ovarian cancer combined.
The disease is a modern one, greatly related to lifestyle, by which I mean diet & exercise (or rather, lack of it). It is easy to prevent but hard to treat. It is just as prevalent in the rest of the developed world as it is in the US. It is already a serious & fast growing problem in Asia. The WHO estimates that there will be more than 900 million sufferers in Asia by 2050 with more than 3.2 million hip fractures a year.
Nor is osteoporosis a concern for the elderly only. Bone loss starts around the ages of 30 to 35, and in women who do not take hormone replacement, that loss accelerates rapidly in the first 5 or 6 years after menopause. By age 65, bones can be so weakened that even the best available remedies cannot prevent them from breaking. According to a recent US survey 71% of women with osteoporosis did not know they had it and 86% of them were not being treated.
Get a DEXA
Regular X-rays are not able to detect bone loss until it is well advanced. A bone-density test is the only way to determine the health of your bones and the most exact testing method is the DEXA scan (dual-energy X-ray absorptiometry). It accurately measures bone mineral density in the spine, hip & wrist, takes only a few minutes fully clothed & involves only a tiny amount of radiation (1/10th that of a standard chest X-ray). All women over 50 & men over 65 should have one.
Normal aging causes a loss in bone density and this occurs in healthy people. This decline does not necessarily induce bone fractures. In the prevalent medical model osteoporosis is explained as the result of too little calcium, the cessation of estrogen production (in women), or just the process of growing older. However, the evidence shows that these factors are only sometimes the cause of osteoporosis. Like coronary heart disease, adult-onset diabetes, hypertension, obesity, colon diseases, and many cancers, osteoporosis is a degenerative disease and most often the real culprit is unhealthy living. Causes other than aging & bad lifestyle include major surgery, glucocorticoid (anti-inflammatory steroid) drugs, liver cirrhosis, Crohn's disease, cystic fibrosis & hormonal deficiencies.
Use it or Lose it
As already noted bone loss can mostly be prevented by exercise & good diet, so let's look at that. You've got to move it or lose it. If you want strong bones you've got to exercise. Bone mass increases or decreases directly in proportion to the demand put on it. Lean body mass has been shown to be the best indicator of bone density in many studies. In fact our bones weaken and thin at about the same rate as our muscles atrophy. Weight-bearing exercise or other resistance training is the most effective type for building bone mass & also enhances longevity by building muscle mass.
Dietary factors
A diet high in processed foods, carbonated soft drinks, caffeine, too much protein, sugar and salt consumption all contribute to osteoporosis. One way or another they all lead to a loss of calcium & finding the means of absorbing calcium is the name of the bones game. Unfortunately calcium is hard to absorb & easy to piss away. Don't think for a minute that gulping down pints of cow's milk is going to help one bit, whatever the dairy folks would have you believe. It may be rich in calcium (1,200mg per quart) but it's phosphorus content actually limits calcium uptake. There is also ample evidence that fluoride found in drinking water & toothpaste may contribute to bone loss.
Nutrients & Supplements
The problem is calcium is a strong binding agent that is difficult to break down in the digestive tract, so taking calcium caps as opposed to tabs makes sense. But calcium is only one part of an osteoporosis program & it requires quite a number of other things to aid absorption. The most absorbable form of calcium anywhere is microcrystalline hydroxypatite, which is derived from cow bone. If you use this form, make sure it comes Australia or NZ so you don't get strong bones & a weak brain. If you prefer a plant-based source, the next best option is calcium citrate. For bone maintenance & replacement between 1,000 to 2,000mg of elemental calcium is needed along with 600 to 1000mg of elemental magnesium every day. The addition of between 400 to 1000 IU of Vitamin D3 is mandatory to ensure optimal absorption. Other minerals important for healthy bone metabolism include at least 30mg a day of elemental zinc, 3mg a day of elemental manganese, and 2mg of elemental boron a day. You won't find such these quantities of all this in any multi but there are a number of good formulations on the market specifically for the purpose. However a really good multi is sufficient for maintenance & preventative purposes for those not really at primary risk of the disease.
Vitamin K, a little known but powerful nutrient, is needed for the production of osteocalcin, a protein found only in bone & preventing it becoming soft & weak. It reduces the calcium lost to urination & has been shown to reduce calcium loss by one third. For preventative purposes a Vitamin K supplement of 10mg a day is recommended. Vitamin K also has helps fight various cancers & Alzheimer's, regulates blood sugars, helps prevent cardiovascular disease & is generally an all-round good thing. But those on anti-coagulant drugs should seek advice. Studies have found that essential fatty acids (Omegas 3 & 6) and antioxidants influence bone formation & reduce the effect of diseases causing bone-density loss. Daily supplementation with Perilla Oil (6 x 1000mg caps) or a tablespoon of flax seed oil provides Omega 3 & Omega 6 can be obtained from borage or blackcurrant seed oils. Vitamin E was reported to increase bone formation & restore collagen synthesis. Vitamins B6 & folic acid reduce levels of homocysteine that contributes to osteoporosis & heart disease. Vitamin C is used to make collagen, which keeps bones flexible, yet strong.
Osteoporosis & Hormones
The primary cause of osteoporosis is hormonal imbalances that interfere with bone-forming cells. The major bone-building hormone in a women's body is progesterone, which dwindles as women approach menopause. Natural progesterone supplementation has been shown to rebuild substantial amounts of lost bone. Pre- & post-menopausal women should start with 1/4 to 1/2 a teaspoon a day applied transdermally. Those with severe osteoporosis should take 1/2 teaspoon morning & night. Synthetic progestin drugs are best avoided. The use of supplemental DHEA 15 mg and melatonin 1 - 3mg per day will also stimulate osteoblast activity & help prevent bone loss.
Beyond this, hormonal modulation therapy is a complicated & individual business & while it can & does help against osteoporosis, professional advise must be sought. Estrogen replacement therapy can help slow bone loss but there are known dangers of breast & endometrial cancer after prolonged use. Of these estrogens Triest is probably the safest but none should be used without progesterone. Testosterone levels are also important but supplementation with it must also be considered with care.
Plant-based phytoestrogens, in particular the protective action of bone formation from genistein found in soy protein, have been found to stimulate bone growth with none of the dangers of estrogen, and which acts by suppressing bone resorption. Soy isoflavone supplementation of 110mg per day has been shown to be effective in maintaining bone density.
All of the above is largely directed at preventing osteoporosis. The people who are traditionally most at risk are women whose parents suffered the disease & those who are fine-boned and slim. However, all women will start losing bone sometime in their 30's & this will accelerate rapidly with menopause. They need to take the necessary steps to prevent bone loss. Especially at risk are those women who have undergone surgically-induced menopause at an earlier age than would otherwise be normal. And, of course anyone whose diet & lifestyle are bad, will accelerate the process of bone loss.
Those who already have osteoporosis must also consider some of the new drugs on the market like Evista & Fosamax, which have been shown to increase bone mass. However they do have side-effects and nobody knows in the long term what effect they will have, or even if they will continue to work over time. Possibly more effective & less harmful is the bisphosphonate drug clodronate, which safely protects & restores bone density and is often prescribed by European doctors.
Moreover a key component for women, the whole hormonal aspect as it relates to osteoporosis, is tied in with overall health & wellbeing and is a very complex subject. Anyone wishing to inform themselves on the subject could not do better than to read the book "Hormone Replacement Therapy - Yes or No?" by Betty Kamen, Ph.D.
We tend to see our bones as solid & unchanging but they are living tissue and astonishingly every atom in our skeleton is replaced within a 3-month period. It is an amazingly strong but delicate mechanism. If you are to continue defying gravity treat it with respect.
"
The chances of a woman having an osteoporotic bone fracture are greater than her chances of getting breast, cervical & ovarian cancer combined. Bone loss starts in your 30's but is easily preventable. Absorption of calcium is the key........"
