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Better Health Update #42 - Monte Kline, Clinical Nutritionist

Osteoporosis

Osteoporosis refers to a loss of bone mass, which in turn leads to increased bone fractures. It affects 15 - 20 million Americans, resulting in over one million bone fractures per year and costing ten billion dollars in hospitalization, acute care, and long-term care expenses. With the rapid aging of our population, the incidence and cost of osteoporosis are expected to rise dramatically. Of women 65 years or older one third have had spinal vertebrae fractures. In extreme old age one in three women and one in six men will have had a hip fracture, the most serious of all osteoporotic fractures. More women die from the complications of these fractures annually than from the combined deaths from cervical and breast cancer. Unfortunately, osteoporosis is usually symptomless until the first fracture is experienced.

Like most conditions, osteoporosis is far easier to prevent than it is to treat. Yet few medical doctors do any osteoporosis screening of susceptible patients. Diet and nutritional supplementation offer help for osteoporosis, as do drug approaches, both for the prevention and the remediation of bone loss.

RISK FACTORS

Though men also get osteoporosis, women have the greater incidence of it due to having less bone mass to begin with. The more dramatic hormonal changes in women also make this condition more common than with men. Some risk factors (for women) include:

Family history of osteoporosis
White or Asian
Small body frame
Postmenopausal
Hysterectomy
Inadequate calcium intake
Excess protein in diet
Inadequate exercise
Smoking
Excessive alcohol consumption
High caffeine intake
Long-term corticosteroid drug usage
Long-term use of anticonvulsants or antacids
Hyperparathyroidsm or thyrotoxicosis
Addison's Disease or Cushing's Syndrome
Type I Diabetes

BONE BUILDING AND RESORPTION

Bone tissue is not just a collection of calcium and other crystals. Rather it is living tissue that is constantly rebuilding itself. Two kinds of cells are involved in this process: osteoblasts, which form new bone tissue, and osteoclasts, which break down old or damaged tissue (referred to as resorption). Remedies for osteoporosis can therefore focus on either encouraging osteoblastic activity or suppressing osteoclastic activity.

MENOPAUSE AND BONE LOSS

Bone loss in women begins prior to menopause at ages 35-45, though a significant acceleration of bone loss occurs for about 5-10 years after menopause. From that point on bone loss remains basically stable. Conventional medicine views estrogen deficiency resulting from menopause as the primary cause of postmenopausal osteoporosis, and therefore views synthetic hormone replacement therapy (H.R.T.) as the answer. Unfortunately, all drugs have side-effects.

In 1984 the Consensus Development Conference on Osteoporosis of the Natural Institutes of Health issued a statement that the risk for endometrial cancer increased with the use of estrogen therapy. They justified continued estrogen therapy with the statement:

"Estrogen-associated endometrial cancer is usually manifested at an early stage and is rarely fatal when managed appropriately."

In other words, "you may get cancer from this treatment, but we can probably keep it from killing you, so don't worry."
There is a question, though, as to whether estrogen therapy really helps with osteoporosis. An extensive 14 year study demonstrated no significant difference in hip fracture incidence between women who had estrogen therapy and those who didn't ("National Institutes of Health, Consensus Conference: Osteoporosis," Journal of the American Medical Association 252 (1984):799).

The reason for this problem may relate to how estrogen supposedly helps osteoporosis. Estrogen reduces osteoclastic activity, the bone resorption process I spoke of earlier. Thus your hanging on to more old bone, resulting in a higher bone density, but with your bones being more brittle - the quantity goes up but the quality goes down! Fortunately there are other answers.

DIET AND OSTEOPOROSIS

Diet has a significant effect on the development of osteoporosis. Factors include:

1. Refined Sugar - In recent generations sugar consumption has increased almost astronomically. A couple hundred years ago 10 or so pounds per year was the per capital consumption of this substance, using it as a condiment. Today sugar consumption is closer to 150 pounds per year per person with sugar amounting to nearly 20% of all calories consumed. Since refined sugar has no nutrients, that means a 20% reduction in vitamins and minerals, many of which are key to bone health.
Sugar is also known to deplete the body of calcium. One study showed that administering 25 teaspoons of sugar to healthy people caused a significant increased in the amount of calcium excreted in the urine. Since over 99% of the calcium in the body is in the bones, that urinary excretion is coming from the bones.

Research done by sugar authority, John Yudkin, M.D., indicates that sugar increases the cortisol hormone, which in excess, causes osteoporosis. In effect eating too much sugar, like most Americans do, is like taking a small amount of prescription cortisone daily. The result - thinner bones. Yudkin notes that in a study that hamsters fed a 56% sucrose diet developed osteoporosis, in spite of their having adequate calcium intake.

2. Refined Grains - Refined grains like white bread, white flour pastas, white rice, and most breakfast cereals do not have the bran and germ portion of the grain - the part where most of the vitamins and minerals are. In addition to this nutrient deficiency aspect, refined grain products quickly turn to sugar, producing the results noted above.

3. Caffeine - Studies suggest that caffeine intake increases urinary excretion of calcium, and that overall caffeine intake correlates with decreasing calcium retention in the body.

4. Alcohol - Excess consumption of alcohol is known to correlate with osteoporosis. A study of 96 alcoholic men ages 24 to 62 showed that 47% had osteoporosis.

5. Protein, Phosphorus, and Sodium Excess - Excessive dietary protein has been shown to cause osteoporosis. Urinary excretion of calcium increases with high protein intake as the body draws calcium out of the bones to buffer the acidic products of digesting protein. High phosphorus tends to go along with high protein. It tends to displace calcium in the body. Similarly, high sodium intake, which often goes along with high meat intake, increases urinary excretion of calcium.

6. Trace Mineral Deficiencies - Bones are more than just calcium. Other minerals and trace minerals like manganese, vanadium, and boron have a significant role in bone health too. Unfortunately, modern chemical agriculture doesn't replace these trace minerals, but only synthetically replaces N, P and K - nitrogen, phosphorus, and potassium. Our trace mineral deficient food is yet another cause of osteoporosis.

EXERCISE EFFECT

Lack of exercise significantly contributes to osteoporosis. We learned this from the space program. Astronauts in weightlessness for several weeks showed bone loss on return to earth. Similarly, lack of "weight bearing" exercise, like walking decreases bone density. Conversely, regular (preferably daily) weight bearing exercise can reverse bone loss.

NATURAL HORMONES FOR OSTEOPOROSIS

A number of plant derived hormones are now available which can benefit osteoporosis without carrying the side effects of drugs. Estrogen and progesterone come in cream forms for application on the skin. Since oral hormones may be destroyed by stomach acid, skin absorption makes a lot of sense. I particularly like to use natural progesterone cream. While estrogen slows bone resorption, progesterone increases bone-building. John Lee, M.D. of Sebastapol, California is one of the leading advocates for progesterone therapy. In his study women who on average would have had a 4.5% bone loss over a three year period had a 0% bone loss using a progesterone cream.

DHEA (dehyroepiandrosterone) adrenal hormone is another valuable tool. DHEA can turn into estrogen, and indirectly cause an increase in progesterone. It is believed that DHEA both slows bone resorption and increases bone building.

NUTRITIONAL SUPPLEMENTS

1. Chelated Multi-Mineral - This is our foundation. Chelated minerals (those combined with an amino acid) have been shown to have a 40% or better assimilation, as compared to often only a 4% assimilation for calcium carbonate - the kind of calcium most people are taking and most doctors are recommending. A multi-mineral with the whole range of minerals and trace minerals essential to bone health is my usual choice.

2. Microcrystalline Hydroxyapatite Concentrate - Also known as microcrystalline calcium or MCHC, this form of calcium has been shown to not only prevent bone loss, but also restore bone density. It is derived from whole bovine bone, including the complete organic matrix and minerals as found in healthy bone. In one study calcium carbonate reduced the rate of bone loss by one-half, while MCHC nearly stopped it altogether. In another study it actually increased cortical bone thickness by 6.1%.

3. OstivoneTM (Ipriflavone) - Ipriflavone is derived from soy and is perhaps the single best non-prescription remedy for osteoporosis. It has shown in studies similar bone density improvements as calcitonin drugs, yet without side-effects. It probably needs at least a year of usage (like the drugs) before reevaluating bone density.

4. Digestive Aid - Hydrochloric acid and pancreatic enzymes are essential for the digestion and assimilation of the minerals needed for bone. The multi-minerals we usually use include hydrochloric acid to aid assimilation.

5. Vitamin D - Vitamin D regulates calcium absorption. Vitamin D3 has been shown to significantly increase calcium absorption and reduce bone loss. Again, this is normally included in our multi-mineral and multi-vitamin/mineral products.

6. Vitamin K - Vitamin K deficiency may be a major contributor to osteoporosis since it is required for osteocalcin production. Osteocalcin is a protein in the bone matrix that binds calcium, thus maintaining healthy bone density.

7. Manganese - This trace mineral (likewise normally included in our chelated multi-mineral), is essential to the organic matrix upon which calcification takes place in the bone.

8. Boron - A good osteoporosis-oriented multi-mineral will contain this trace mineral. Boron appears to affect the action of the parathyroid hormone, which in turn affects mineral metabolism. Boron deficiency depresses ionized calcium and calcitonin, and elevates urinary excretion of calcium.

BONE DENSITY TESTING

I highly recommend having a bone density test done, preferably a DEXA scan. It's considered the most accurate bone density test, and can be prescribed by your medical doctor or chiropractor. I would suggest all women have their first test prior to menopause to establish a baseline, and then monitor every two to three years.

DISCLAIMER: The information contained in this publication is for educational purposes only. It is not intended to diagnose illness nor prescribe treatment. Rather, this material is designed to be used in cooperation with your nutritionally-oriented health professional to deal with your personal health problems. Should you use this information on your own, you are prescribing for yourself, which is your constitutional right, but neither the author nor publisher assume responsibility.