Osteoporosis Defined

Osteoporosis is a bone disease in which bone tissue is normally mineralized, but the amount of bone is decreased and the structural integrity of trabecular bone is impaired. Cortical bone becomes more porous and thinner. This makes the bone weaker and more likely to fracture.

Via Dexa Bone Density Tests (World Health Organization Criteria via “T” Score)

• Normal - T score above –1
• Osteopenia - T score between –1 to –2.5
• Osteoporosis - T score lower than –2.5
• Severe Osteoporosis - Associated with prior fracture

Osteoporosis Risk Factors

1. Female gender
2. Thin or small frame (low body mass index)
3. Advanced Age
4. Family history
5. Caucasian or Asian
6. Poor diet
   1. low calcium and magnesium intake
   2. low intake of other important nutrients
   3. excessive intake of certain nutrients
      1. Caffeine
      2. Sugar and Salt
      3. Excess animal protein (sulphur based amino acids cause acidification)
      4. phosphoric acid in soda pop
      5. Unhealthy fats
7. Inactive lifestyle
8. Smoking
9. Excess alcohol intake
10. Low testosterone levels in men (role in women is unclear)
11. Premature menopause & menopause
12. Associated Medical Conditions (Secondary Osteoporosis)
    1. Hereditary skeletal diseases: osteogenesis imperfecta, rickets, hypophosphatasia
    2. Endocrine and metabolic: hypogonadism, hyperparathyroidism, hyperthyroidism, Cushing syndrome, acidosis, Gaucher's disease
    3. Anorexia and Bulimia
    4. Malabsorption
    5. Cystic Fibrosis
    6. Marrow diseases: myeloma, mastocytosis, thalassemia
    7. Renal insufficiency
    8. Hypercalciuria
    9. Hepatic disease
    10. Depression
    11. Spinal cord injury
    12. Systemic Lupus and Rheumatoid Arthritis
13. Associated with use of certain Medications
    1. Corticosteroids, Dilantin, gonadotropin releasing hormone agonists, loop diuretics, methotrexate, thyroid, heparin, cyclosporin, depot-medroxyprogesterone acetate

Risk of Fractures (Hip, Vertebral, Wrist)

• Bone Density + Bone Quality = Bone Strength
• Falling Risk + Force of Impact = Trauma Risk
• Bone Strength + Trauma Risk = Risk of fracture

RISK FACTORS FOR FRACTURE (these are significant regardless of bone density)

1. Falling and Force of impact  (falling to side increases risk 6X)
2. Anticonvulsant use
3. Prior fracture
4. Hyperthyroid
5. On feet less than 4 hours daily
6. Inability to rise from chair
7. Resting pulse above 80
8. Benzodiazepine use
9. Advancing age
10. Poor eyesight & depth perception
11. Height
12. Caffeine intake

Important Nutrients

Acid-Alkaline Balance

An alkaline internal environment may reduce bone loss. 
An acid internal environment may increase bone loss.

THIS IS A VERY COMPLICATED SUBJECT!!!

THEORY:

Blood pH decreases slightly with aging (becomes more acid).  This activates  osteoclasts to break down more bone.

Postmenopausal women given bicarbonate show a slight increase in blood pH (more alkaline) and improved calcium balance indicating reduced bone breakdown.

Bone salts are mobilized to balance (buffer) the endogenous acid generated by metabolism of acid-producing foods.  Over a lifetime this contributes to progressive bone loss.  Use of Potassium bicarbonate in postmenopausal women may improve calcium/potassium balance, reduce bone resorption and increase bone formation. 

Osteoporosis is mainly the result of osteoclasts over-activity.  It may be beneficial for older people (or all people) to avoid excessive dietary acid.

A major source of acid in the diet are animal proteins which yield sulphuric acid residues when metabolized.  Phosphoric acid in soda-pop is another major source of acid in the American diet.

1. See list of acid and alkaline producing foods
   1. Fruits yield alkaline residues from their metabolism.
   2. The Wolfe Clinic: www.thewolfeclinic.com/acidalkfoods.html
2. Calcium Carbonate is a buffer and good source of dietary alkali
   1. Coral calcium is calcium carbonate

OSTEOPOROSIS PREVENTION & TREATMENT           

1. This is a lifelong process of ‘creating health’ through a healthful life style.
2. Optimal diet, exercise and supplementation for our daughters and granddaughters!
3. Proper attitude is achieved through education and understanding
   1. Appropriate use of information to dictate good decision making (i.e. do not over-read Dexa Bone Density Scans)
4. Evaluation & Treatment must be INDIVIDUALIZED
   1. Should include appropriate medical evaluation
5. Primary prevention is EXERCISE
   1. How can this be supported for each individual?
6. Supplementation (www.consumerlab.com)
   1. Multivitamin & Mineral
   2. Calcium Citrate 1000 (normal)/1200(Osteopenia)/1500(Osteoporosis)mg daily
      1. With Magnesium 250-750 mg
      2. With Vitamin D  400 IU
      3. Trace minerals available
   3. Adequate B Complex
   4. Mixed source omega-3 fatty acids
      1. Fish oil, Flax seeds, Borage oil, Evening Primrose oil
   5. Mixed source antioxidants
   6. Specific other supplements
7. Diet
   1. More fresh whole foods of all types
   2. Consider alkaline diet
   3. These foods promote bone health
      1. Fish oils and Flax Seeds: Omega-3 fatty acids & lignans
      2. Avocado: good vegetarian source vitamin D
      3. Cabbage: rich in boron
      4. Dandelion: rich in boron, calcium and silica
      5. Garlic and onion: Source of sulfur bearing amino acids
      6. Parsley: rich in boron
      7. Pigweed: 5.3% calcium; A small serving of steamed leaves (1/3 ounce or 1/10 cup) provides a hearty 500 milligrams of calcium.
      8. Green tea, yogurt
   4. The No-No’s
      1. No Caffeine
      2. No excess animal protein
      3. No soda pop
      4. No excess alcohol
8. Fall Prevention
   1. Occupational therapy – activities of daily living
   2. Padding
   3. Tai Chi and movement therapy
   4. Maintain adequate weight
   5. Eyesight correction
   6. Medication minimization
9. Natural Progesterone Skin Cream
   1. Over the counter
   2. Prescription
10. Estrogen Replacement Therapy
    1. Bioidentical
    2. Lowest effective dose
    3. Plan of usage with reevaluation
    4. Benefits > risks
    5. Balanced with Progesterone
11. Pharmacy Medications
    1. Biphosphonates (Fosamax, Actonel)
    2. Calcitonin (Miacalcin nasal spray)
    3. Reloxiphene (Evista)
    4. Thiazide Diuretics

Resources:

• Better Bones Better Body; Susan E. Brown, Ph.D., CCN; (Keats 2000)
• Hyperhealth Pro; www.hyperhealth.com
• Supplement Quality Control: www.consumerlab.com
• Website for Susan Ott, M.D.   http://courses.washington.edu/bonephys/ophome.html
• The Osteoporosis Education Project   http://www.betterbones.com/index.htm
• The Wolfe Clinic; http://www.thewolfeclinic.com/acidalkfoods.html (information on alkali diet)
• Strong Women, Strong Bones; Miriam Nelson, Ph.D.
• Women’s Bodies, Women’s Wisdom; The Wisdom of Menopause; Christianne Northrup, MD
• Bone Physiology Graphics; http://www.medes.fr/Eristo/Osteoporosis/BonePhysiology.html

The following statements and/or supplements have not been evaluated by the FDA. The FDA suggests that you consult with a health care professional before using any dietary supplement. This product is not intended to diagnose, treat, cure or prevent any disease.

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