How to use nutrition and supplements to treat osteoporosis

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 labs.

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 acidic.
  • 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 in magnesium.

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 estrogen.

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.

 

Conclusion

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, from Amazon.com:

The Osteoporosis Solution

The Osteoporosis Solution, New Therapies for Prevention and Treatment

 

References

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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.

Disclaimer: 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.