A Scientific Approach to Treating Osteoporosis
The human body weaves bone from many different minerals. Although
it looks white and solid, it is in fact a porous material that
is made from lots of minerals other than just calcium. The body
needs to have just the right minerals, as well as particular vitamins
and other nutrients, in order to build your bones. Bone mass is
gained and lost every day. Your bones act as a mineral reserve.
If you don't get enough of certain minerals in your diet, the
body is able to borrow from your bones to replace them.
Osteoporosis is an end-stage disease affecting about 1 in 10
Americans -- some 20 million women, and 5 million men. It is responsible
for about 1.5 million bone fractures per year, and can also cause
premature tooth loss. Surprisingly, the disease is almost unknown
in poorer countries like China.
Conventional medicine has a straightforward approach to osteoporosis
in women: estrogen replacement therapy, a drug called Fosamax,
weight-bearing exercise, calcium in pill form, and sometimes fluoride.
The estrogen and Fosamax are normally considered to be required
for the rest of your life. Unfortunately, the conventional approach
has not been very successful at treating this disease.
Luckily, the world-wide scientific research community has actually
come to understand osteoporosis fairly well. The biochemical reasons
for bone loss are now pretty well understood. This research has
led to alternative treatment plans that are slowly starting to
be used by doctors who have come to understand the science. Conventional
medicine has been reluctant to adopt these new findings, partly
because there are no drug companies willing to put millions of
dollars of marketing muscle behind them, and partly because medical
school textbooks seem to take a least a generation to catch up
to current basic scientific research.
How can you tell if you have osteoporosis?
Your doctor can prescribe a diagnostic test called a DEXA scan.
This is a type of low-dose X-ray that can be used to determine
the past history of your bones. Although it can tell you if your
bone density is too low (which makes you susceptible to fractures),
it can't tell you whether or not you are currently losing bone.
The most sensitive test to find out if you are currently losing
bone is called the NTX Bone Loss test (MetaMetrix,
800-221-4640). The Osteo-Risk Panel is also good (Great
Smokies Laboratory, 800-522-4676). Both of those tests require
a doctor's prescription. Great Smokies also has a non-prescription
(and less accurate) test called the Bone Check test, that is available
for $39. These tests all measure certain amino acids in your urine
that are increased when your body is using up your bone reserves.
They can be easily done at home, with a kit mailed to you by the
The advantage of doing the amino acid tests before the scan
is that they are cheaper, and they do not involve any radiation
at all. If you find that you are losing bone, then a scan may
be warranted to see how far advanced it is, and therefore how
careful you need to be to avoid putting extra stress on your bones.
Later on, you can use the amino acid tests to tell you if your
diet and nutrition plan is working or not.
What should you do if you have osteoporosis?
First of all, self-treatment in this area is risky. You should
be sure to consult a qualified health professional before undergoing
any treatment, including nutritional supplements. However, based
on conventional medicine's poor success rate, you may want to
consider finding a health care professional who has become educated
in 21st century biochemically-oriented medicine. One good place
to start is the American Academy of Environmental Medicine.
To give you a better understanding of the condition, and to
help you discuss your situation more clearly with your doctor,
it would help if you understood the basic causes and possible
treatments, when approached from a scientific perspective.
It helps to think of the body as a large barrel of water. When
the water level is near the top, we are functioning at peak health.
If the barrel overflows, we get sick, and if it gets too low,
we also get sick. Now as we age, it turns out that our barrels
(bodies) develop leaks. The water (nutrients) starts seeping out
through the cracks. If we don't adjust our diet accordingly, our
water level can drop, and we can become ill with diseases like
osteoporosis. If we don't fix the leaks, then it doesn't matter
how much water we add to our barrel, it will never be full again.
So one of the first steps in getting better is to slow down
or stop the leaks. In the case of osteoporosis, some of the most
important ways this can be done are:
- Stop consuming caffeine. Caffeine, in all forms (coffee,
chocolate, sodas, etc) increases calcium loss in urine.
- Decrease salt intake. A high salt diet also increases urinary
excretion of calcium.
- Eliminate phosphates from your diet. Phosphates are chemicals
added to many processed foods as stabilizers and flavor enhancers.
Sodas are especially high in phosphates. The problem is that
phosphates prevent calcium from being absorbed by your body.
- Cut down on acid-forming foods. When your body becomes slightly
acidic, a little bit of your bone is dissolved to keep the balance.
This is one reason why people with osteoporosis sometimes have
high calcium levels on their blood tests. The calcium is coming
from dissolved bone. Acid-forming foods include sodas, carbonated
beverages (including carbonated water), sweets, junk food, alcohol,
meat and cigarettes. High protein diets are acid forming (the
proteins break down into amino acids). Stress can also make you
- Stay away from NSAID drugs, including things like aspirin,
Relafen, Naprosyn, Aleve and Motrin (acetaminophen is OK). These
medications can damage the lining of your gut, and impair your
ability to hold onto nutrients that you take in.
You should also be aware that prednisone, cortisone and other
adrenal hormones can interfere with bone metabolism. However,
changing your dose of these medications can be dangerous, and
should only be done with the help of your doctor.
After you've plugged the leaks, the next step is to start adding
nutrients. It is very important to realize that no single nutrient
will cure you. Your body needs many different vitamins and minerals
in order to be able to lay down new bone. If you are deficient
in any one of them, your ability to produce bone is impaired.
It turns out that if you have excesses of these nutrients,
bone production can also be impaired. For example, all cells have
an active "pump" that moves calcium from the inside
of the cell to the outside of the cell. This is important because
calcium is actually a cellular poison. Too much calcium inside
a cell will kill it. So if the calcium pump stops working as well
as it should, the calcium level inside cells can rise, and the
cells can begin to malfunction. One theory behind the cause of
osteoporosis in some people is that the calcium level in the cells
that make your bone (called osteoblasts) rises, and the cells
become "drunk". There is plenty of calcium in the body,
but the machinery to use it is broken. For these people, it may
be that decreasing the calcium in the body through diet and other
therapies may be the right long-term solution.
What else can happen if you take too much calcium, without
the "supporting cast" required to use it correctly?
One place the body puts excess calcium is in the walls of your
blood vessels. That's why they call it "hardening of the
arteries". It can also be turned into kidney stones or gall
stones. It can contribute to calcification of cancer sites. It
can also lead to osteoarthritis, calcification of the pancreas
(leading to diabetes) and calcification of the cell membranes,
possibly leading to some forms of cancer.
This is one reason why people attempting to cure serious medical
conditions with nutrition should really do so under medical care
if at all possible. Too much of a nutrient can be as bad or worse
than too little. To this end, one of the first things your doctor
should do is to order a detailed blood mineral assay. The most
accurate ones use "red blood cell" levels, but "packed
cells" or even "whole blood" can also be useful.
The test most people get at their annual physical only looks at
your serum - the liquid that surrounds your cells - so it tells
you very little about what's happening inside them. Good laboratories
to use include MetaMetrix
at 800-221-4640 and Doctor's
Data at 800-323-2784.
Something else that your doctor should look at is your vitamin
D level. Vitamin D is required in order for your body to be able
to use calcium. If you stay indoors a lot, or if you live in the
far north, or if you don't drink a lot of milk, you may not be
getting enough vitamin D. You need at least 30 to 60 minutes of
sunshine every day to make the vitamin D your body needs. Vitamin
D is a crucial bone builder that has been measured to be low in
57% of the patients in a recent study. If your vitamin D is low,
it may be because you don't have enough magnesium. Magnesium is
required for vitamin D metabolism, and if you don't have enough,
it can result in an uncorrectable vitamin D deficiency.
You should also consider having a comprehensive digestive stool
analysis done (Great Smokies Laboratory,
800-522-4676). This test can help your doctor determine whether
impaired digestive secretions are putting you at risk. These secretions
are required for proper mineral absorption.
Only after your mineral status has been determined should you
begin taking supplements. Although calcium is important, it should
always be taken with an equal amount of magnesium. This is because
the calcium can't be used unless enough magnesium is present.
The form of calcium you take is also important. The most common
form, calcium carbonate, works like an antacid. In spite of much
recent advertising to the contrary, adequate stomach acid is required
for proper mineral absorption. As we age, the amount of stomach
acid we have tends to decline. If anything, many older people
should be taking stomach acid supplements, not using antacids
(if you are older, you may want to consider being tested for adequate
stomach acid). You may also want to avoid the forms of calcium
called dolomite and bone meal. They have recently been shown to
contain lead and other heavy metals. Although the levels of these
toxic contaminants are small, they still have no place in a nutritional
support program. One good form of calcium is calcium aspartate.
Another very bioavailable form is called Coral Calcium. A good
form of magnesium is magnesium taurate.
If you do take calcium supplements, it's best to take them
with meals, so that adequate stomach acid is available for absorption.
One study also showed that taking calcium supplements before bedtime
is helpful, since growth hormone, which also plays a large part
in calcium absorption, is highest when you are sleeping.
If you also take iron supplements, don't take them at the same
time that you take your calcium. They interfere with each other,
and taking them together means that neither one will be well absorbed.
The best source of calcium, of course, is from your food. Many
people mistakenly believe that milk is the best food source. The
problem with milk, as stated above, is that although it's high
in calcium, it doesn't have proportionately enough magnesium.
Milk is also a mild antacid. So the calcium that's there can't
be used very well by the body. It's better to eat foods like broccoli.
Two cups of broccoli has as much calcium as a cup of milk, with
matching magnesium and without the antacid. Other greens are even
better. Or consider brown rice or corn. Millet is especially high
Other minerals that are needed by the body in order to build
bone include copper, zinc, boron, manganese, selenium, silica
and chromium. Certain vitamins are also important, including vitamins
B6, C, D, K and folic acid. The amino acid arginine is also needed.
Being too low in any of these nutrients can impair your body's
ability to lay down new bone. Although targeted supplementation
is best, you may want to consider a "many-in-one" supplement
targeted at bone health, such as Tyler's Osteo Complex (available
from NEEDS at 800-634-1380).
A good multivitamin, such as Tyler's Multiplex-1 without iron
can also be helpful for some people. Be careful about taking too
many vitamins, though. Excess vitamin C, for example, has been
shown to promote calcium loss.
Each of these micro-nutrients is important in its own way.
As an example, boron has been shown to decrease urinary excretion
of calcium by 44%, while also increasing natural estrogen production
to levels comparable to women on estrogen therapy.
Here are a few interesting facts about the nutritional status
of people in this country:
- 68% of adults consume less than 2/3rds of the RDA of zinc
- The average diet provides only 40% of the RDA of magnesium
- 80% of us are low in copper and chromium
- 54% of hospitalized people are low in magnesium
Other supplements that can be helpful are Glucosamine Sulfate
(by Tyler), and Bovine Cartilage (Pure Encapsulations). Both are
available from NEEDS (800-634-1380).
These nutrients actually directly help rebuild connective tissue,
cartilage and bone. In addition to osteoporosis, they are also
helpful for various arthritic conditions. Studies going back 25
years show that glucosamine produces better results than NSAIDS
like Naprosyn or Relafen. It is actually the only known substance
that has been shown to build new bone.
What about traditional therapies?
Weight-bearing exercise, such as walking or tennis, for 30
to 60 minutes, 3 to 5 times a week, has been shown to help encourage
bone growth. However, this can only work if the proper nutrients
are present. Be careful not to exercise too heavily until you
have had your mineral status measured. Strenuous activity can
lead to excessive mineral loss through sweating, which can actually
make you worse instead of better.
There has recently been much discussion about estrogen supplementation.
One issue here is that most estrogen supplements do not mimic
the natural types or amounts of estrogen found in the body. Measured
levels of women on therapy are much higher than normal - which
is one reason why it increases cancer risk. The most popular form
of estrogen supplementation, Premarin, is made from pregnant horse
urine. It actually has 14 different ingredients, including shellac
on the outside of the pills. Side effects can include mood swings,
poor libido, increased appetite, weight gain, breast swelling
and tenderness, abnormal uterine bleeding, increased blood clotting
in your extremities, nausea, hair thinning and loss, excessive
facial hair, and body swelling.
Instead of estrogen you may instead want to consider trying
a plant-derived progesterone cream such as Progest Cream. This
form closely matches what is normally found in the human body,
and because it can be applied topically, the circulating hormone
levels are lower than with the pill form. Recent studies (such
as the one by Jerilynn Prior, MD, in NEJM 1990) have shown a higher
correlation of calcium loss with progesterone levels than with
The new drug Fosamax has been shown to reduce the incidents
of fractures in people with osteoporosis. It works by blocking
the osteoclast cells that normally attack and break down bone.
Unfortunately, it doesn't cure the disease. It also takes the
body 10 years to eliminate it from the body after you stop taking
it. And the side
effects can include severe and possibly fatal hemorrhage from
ulcers in your esophagus.
Why don't they have osteoporosis in China? Because they aren't
rich enough to be able to afford the kinds of processed, mineral-depleted
foods we eat. Instead, they eat a low-meat, high-vegetable (non-acid
forming) diet. It's also interesting that they drink almost no
milk in China.
Only you can decide the approach that's best for your body.
The majority of Americans choose the conventional route, and look
where we are today. Fortunately, there are now viable alternatives.
21st century medicine is here today! Now you have a choice about
whether to go after the root cause of your health problems, or
to cover them up with prescription medications. In the end, the
decision is up to you.
You might be interested in the following book about osteoporosis,
Nicar MJ, Pak CYC, Calcium bioavailability from calcium carbonate
and calcium citrate, J Clinical Endocrinol Metab, 61:39-393, 1985
Recker RR, Calcium absorbtion and achlorhydria, N Eng J Med,
Brechner J, Armstrong WD, Relation of gastric acidity to alveolar
bone resorption, Prov Soc Exp Biol Med, 44:98, 1941
Frithrof L, et al, The relationship between marginal bone loss
and serum zinc levels, Acta Med Scand, 207:67-70, 1980
Leach RM, et al, Studies in the role of manganese in bone formation,
J Nutr, 78:51-56, 1962
Carlisle EM, Silicon localization and calcification in developing
bone, Fed Proc, 28:374, 1969
Nielsen FH, et al, Effect of dietary boron on mineral, estrogen,
and testosterone metabolism in postmenopausal women, Found Adv
Sci Exp Biol J, 1:394-397, 1987
Biochemical effects of calcium supplementation in postmenopausal
osteoporosis, Eur.J.Clin.Nutr 42:775-778, 1988.
Magnesium deficiency: Possible role in osteoporosis associated
with gluten-sensitive enteropathy, Osteoporosis International
(United Kingdom), 6/6:453-461, 1996 (see full abstract).
Abraham GE, The importance of magnesium in the management of
primary postmenopausal osteoporosis, Journal of Nutritional Medicine,
2, 165-178, 1991.
Copyright (c) 2001, All rights reserved.
the information here is presented for educational purposes only. It is not intended
to replace the services of health professionals, or to diagnose any medical
condition or prescribe treatments.