Osteoporosis: Debunking the Myths

By: Dr. Kimberly Oxbro, Nov 09, 2015
  Article
weakening, bones

The weakening of bones caused by an imbalance between bone building and bones destruction

Osteoporosis:

This is “the weakening of bones caused by an imbalance between bone building and bones destruction” (Harvard School of Public Health). The Merck Manual defines it as “a systemic skeletal disease characterized by low bone mass and micro architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture”.

Osteopenia:

Translated from Latin meaning “bone” (osteon) “poverty” (penia) – it is a “mild thinning of the bone mass, but not as severe as osteoporosis. Osteopenia results when the formation of bone (osteoid synthesis) is not enough to offset normal bone loss (bone lyses). Osteopenia is generally considered the first step along the road to osteoporosis” (MedicineNet.com).

Osteomalacia:

Translated from Latin meaning “softening” (malacia) of the bone (osteon) – it is a “softening of bone, particularly in the sense of bone weakened by demineralization (the loss of mineral) and most notably by the depletion of calcium from bone (MedicineNet.com).

  • Contrary to popular belief, as you will see in the above definitions, osteoporosis is not a disease
    of calcium deficiency. Osteomalacia, the softening of the bones, is greatly affected by calcium
    deficiencies, but osteoporosis is a decrease in bone mineral density, which results in fragile (not
    soft) bones. Several minerals are required to form the bone‟s inner structure (or density) –
    calcium is only one.
  • Osteoporosis is a weakening of the „trabecular‟ bone (the inner matrix) – most calcium deposit in
    „cortical‟ bone (the outer shell) 
Who is at Risk of Developing Osteoporosis?

In general, those who fail to attain sufficient bone mass within the first 30 to 35 years of life and those
whose bone reabsorption is greater than their bone deposition during their adult life.

  • Post-menopausal women.
  • Individuals with a small frame and body mass index.
  • Individuals with a family history of osteoporosis.
  • Individuals with a sedentary, inactive lifestyle.
  • Women who have not had children.
  • Long term use of corticosteroids (Prednisone etc.) and glucocorticoids.
  • Smokers.
  • Those consuming alcohol.
  • Those consuming caffeine (cola as well as coffee) – the famed Framingham Osteoporosis
    Study found that older women who drink cola every day have lower bone mineral density
    (Am J Clin Nut 2006; 84: 936-42).

Conventional Options for Osteoporosis Treatment

Hormone Replacement Therapy:
  • Despite the on-going suggestions that HRT will “treat” osteoporosis, consider the following:
    HRT does not build new bone density – it only offers some benefit in slowing down bone
    loss – and numerous options can do the same, without the serious risks of breast cancer,
    stroke, heart attack and blood clotting.
  • The medical journal Bone (Sep. 29, 2001(3):216-222) stated “conventional HRT acts by
    preserving bone, but can not restore lost bone in women with established osteoporosis.
  • The medical journal Human Reproductive Update (Sep, 2000;6(5)) published a review of
    ALL trials on HRT and osteoporosis from 1995 – 2000 and concluded “the
    recommendation to use estrogen for postmenopausal osteoporosis … is not well
    supported.”
  • In 2002 the U.S. government‟s National Institutes of Health stopped an 8 year study on
    HRT after only 5 years because it was deemed too dangerous for the women to stay on
    HRT given their findings of risks. These risks included a 41 per cent increase in strokes, a
    29 per cent increase in heart attacks and a 24 per cent increase in breast cancer” (Journal
    of the American Medical Association 2002;288:49-66) 
Popular Pharmaceuticals
  • Remember that osteoporosis is an imbalance between new bone development and the breakdown
    (reabsorption) of existing bone? Well, ALL of the existing drugs for osteoporosis – including
    bisphosphonates (like Fosamax), S.E.R.M.s (like Evista) and calcitonin (Calcimar) – work only
    by slowing down the breakdown (reabsorption) of the bone. NONE of them actually increase the
    body‟s ability to build new bone density.         
Side Effects:
  • Bisphosphonates (Fosamax, Actonel, Didronel): bone and joint pain, flu-like symptoms,
    constipation / diarrhea, fatigue, kidney damage, osteonecrosis of the jaw.
    S.E.R.M.s (Evista): hot flashes, leg cramps, blood clots.
Heartburn Medication
  • The popular drugs Prilosec, Nexium and Prevacid were found, in a study published in the
    Canadian Medical Association Journal (August, 2008), to almost double the risk of a hip fracture
    – because they decrease the stomach acid required to absorb the needed minerals
Calcium Supplementation
  • The Harvard School of Medicine examined their own, as well as several other medical studies,
    and found no association between calcium intake and fracture risk (Am J Clin Nutr 2007;86:1780-
    90). Study has shown that only calcium supplements taken with a variety of trace minerals results
    in improvements in spinal bone loss in post-menopausal women. Calcium alone does not produce
    significant changes in bone density – it is only one of several minerals inside the bone.

 

The type of calcium dictates what you absorb and what is excreted Check your supplement label –most use calcium carbonate. This is the worst absorbed form of calcium at about 10% absorption. Calcium citrate has better absorption, but requires adequate stomach acid – and approximately 40% of post-menopausal women have low levels of stomach acid – others are taking antacids like Tums, Prilosec, Nexium, Losec etc. Calcium hydroxyapatite is a synthetic form of calcium and is very poorly absorbed, while ossein microcrystalline hydroxyapatite complex is VERY well absorbed and consider the best form of calcium by far.

The density of the inside of our bones is made up of several minerals – calcium is included, but is NOT the primary. If you want to provide your bones with minerals to slow, prevent and reverse bone loss, you need them all. They include:

  • Magnesium: 1/2 of the magnesium in your body is actually inside your bones. One study showed that while magnesium deficiencies were associated with an increased risk of osteoporosis fracture, calcium deficiencies were not (Int J Epidemiol 1995, Aug 24(4):771-82).
  • Vitamin D: Most have heard of the critical role this vitamin plays in bone health. The amount is key – 1000 IU per day is required to reduce fracture risks.
  • Vitamin K: Low levels are associated with low bone density. Studies show supplementation can reduce hip fractures by 30% to 50% (Nurses Health Study, Framingham Heart Study).
  • Zinc: Involved in the formation of osteoblasts (the cells inside bones that MAKE new bone) and enhances the activity of Vitamin D.
  • Manganese: Increases the production of mucopolysaccharides – which provide a structure for calcification.
  • Boron: Reduces the urinary excretion of calcium and magnesium, increases blood levels of estrogen and testosterone and helps activate Vitamin D.
  • Strontium: N.B.: A multivitamin and / or calcium-magnesium supplement will NOT give you these minerals in the dosages required. You need a specific formulation, for bone health, that focuses on these minerals and vitamins.
Dairy and Bone Health

The Harvard Nurses‟ Health Study of 80,000 women showed that the women who consumed the most calcium from dairy products had almost double the rate of hip fractures as compared to women who consumed the least dairy. The United States is a world leader in dairy consumption and has one of the highest rates of osteoporosis. The medical journal Pediatrics (2005; 115(3):736-743) concluded that “scant evidence supports nutrition guidelines focused specifically on increasing milk and other dairy product intake for promoting child and adolescent bone mineralization”. Diets high in dairy products disrupt the calcium / phosphorus balance – evidence indicates that this accelerates the loss of calcium from bones.

 

Are there any problems or risks in consuming dairy?

The answer depends on the individual – rather than the blanket assertions made by the milk marketing boards or the government food guides. Consider the following:

  • Dairy Allergies: Recent medical studies have shown that dairy allergies are increasing in North America – and people are no longer „out growing‟ these allergies.
  • High Saturated Fat Content: Dairy is high in saturated fat – a contributing cause of heart disease. Leafy green vegetables have no saturated fat……
  • Crohn‟s Disease Linked to Dairy: The CBC reported in July, 2008 that 90% of Crohn‟s patients are positive for a bacteria found in dairy that causes an intestinal disease in cows called Johne‟s Disease. It is believed these same bacteria can induce Crohn‟s Disease in human.
  • Possible Increased Risk of Ovarian Cancer: A study published in the journal Cancer Epidemiol Biomarkers Prev. (2006;15:364-72) examined 12 medical studies (with 500,000 women) on the role milk consumption plays on ovarian cancer. They found that those women who consumed the most milk had the highest rates of ovarian cancer. Alternative Options to Bone Health Maintenance
1. Non-Dairy Sources of Calcium

Leafy green vegetables and legumes are a richer source of calcium and the varied minerals used in bone developments than are dairy products. More over, your body has the enzyme capacity to digest and absorb the calcium and minerals found in leafy greens. Current Rheumatology Reports acknowledged that “diets high in fruits and vegetables contribute nutrients such as magnesium associated with bone health and may also produce an alkaline environment, reducing calcium excretion and thus improving bone density” (2007; 9(1):85-92). The American Journal of Clinical Nutrition stated “our findings associating bone resorption with dietary factors provide further evidence of a positive link between fruit and vegetable consumption and bone health” (2000 Jan;71(1): 142-51).

2. Strontium

As mentioned, the prescription drugs on the marker, as well as Vitamin D and calcium, do NOT actually build bone at all. What they do is slow the destruction, or breakdown, of the old bone. Contrast this with a natural mineral, essential to bone health and absolutely safe: 99 % of strontium in the human body is in the bones. A lack of strontium in the body will cause defective mineralization of bones. Studies at McGill University showed that Strontium supplementation increased osteoblasts (bone making cells) by 120.8% and increased the rate of new bone formation by 172.4% (Trace Subst Environ Health 1985;19:193-208). The New England Journal of Medicine published data on Strontium in 2004 (Jan 29; 350(5):459-68) on 1,640 women with postmenopausal osteoporosis. The study showed that strontium supplementation increased bone mass by 14.4% over three years – as compared to Fosamax (the most powerful of the bisphosphonate drugs) which yielded only a 5.5.% increase in bone mass. In the same New England Journal of Medicine study, strontium accounted for a 41% reduction in new vertebral fractures – with no side effects. Strontium does what no prescription drug does – it both increases the activity of bone forming osteoblasts and decreases the activity of bone-dissolving osteoclasts (Metabolism 2002;51(7):906-11).

3. Natural Hormones

In an era when everyone wants to continue to put hormones into their body, one hormonal substance stands out regarding its safety and its role in bone health. Dehydroepiandrosterone (DHEA) is not a „real‟ hormone and it certainly is not an anabolic steroid – it is a „pro-hormone‟, made by your adrenal glands and used to make estrogen or testosterone only as your body requires it. As you age, you produce less of it. As such, you have less of the hormones needed to keep your bones strong.

  • The medical journal Treatment Endocrinology stated “emerging evidence from these studies shows that DHEA may significantly enhance bone mineral density. In fact, the improvements of bone mineral density are accompanied not only by suppression of bone resorption, but more importantly, stimulation of bone formation” (2002;1(6):349-57).
  • The medical journal Menopause International reported on a medical study that concluded “evidence has accumulated for the beneficial effects of DHEA on osteoporosis” (2007 June;13(2):75-8). N.B.: A patient must see a doctor familiar with DHEA, have her blood levels tested first and be supervised in using DHEA. It‟s safe, but it should be supervised by a professional to determine the right dose and length of use.
4. Ipriflavone

Ipriflavone is a naturally occurring substance, found in soy products like tofu, miso, soy protein powders (etc.), which has over 60 human trials demonstrating its positive effects in the treatment of osteoporosis. Like DHEA, it has been shown to increase osteoblastic (bone forming) activity.

  • The medical journal Maturitas (1997, Sep;28(1):75-81) published the results of a medical study that concluded “postmenopausal Ipriflavone administration can prevent the increase in bone turnover and the decrease in bone density”.
  • A 12 month comparison of Ipriflavone to Calcitonin (a „conventional‟ recommendation for osteoporosis) revealed that Ipriflavone increased bone mineral density by 4.3% compared to 1.9% for Calcitonin (Biomed Pharmacother 1995;49:465-468).
  • Ipriflavone appears most effective for those 65 years of age and over. In a study published in the medical journal Bone Mineral (1992;19:57-62), women aged 65-79 were given Ipriflavone for two years. Those receiving the Ipriflavone had a 4-6% increase on bone mineral density. Those NOT receiving the Ipriflavone had an average loss of 3% of their bone mineral density. These results require a specific, standardized amount of the Ipriflavone every day. Consumption of soy foods is not a means to achieve these results. A doctor familiar with Ipriflavone needs to be consulted for the right individual dose and frequency.
5. Body Alkalinity

Your body is an amazing machine. If it determines risk of harm, it will do what it needs to in order to mitigate the potential harm. This reality is particularly true for your bones. If the body is experiencing an acidic ph in the blood, it will literally pull calcium from the shell of bones to buffer the acidity and balance the blood pH. While this inherently naturopathic awareness (of basic human biochemistry) has been „debated‟ within medical circles, what isn‟t debated is the role of foods causing an imbalance between calcium and phosphorus in the body. Consumption of caffeine (coffee and sodas) has been proven to increase the excretion of calcium in urine. In the Framingham Osteoporosis Study, women who consumed caffeine every day had much lower bone density than those who consumed it less than once per month (Am J Clin Nutr 2006;84:936-42). This calcium / phosphorus imbalance can also be caused by diets high in dairy products.

6. Weight Bearing Exercise and Cardio

Physical activity that will benefit your bones puts strain on bones – which in turn makes the osteoblast cells in the bones (bone forming cells) more active. There needs to be this strain for this to occur. For this reason, swimming is NOT a desired exercise. Ideal „weight bearing‟ exercise includes activities such as walking (a decent distance), dancing, jogging, weightlifting etc. The frequency should be at least 5 days a week and duration should be in the 45 minute range. An often ignored strategy is developing muscle. With increased muscle strength, falls are greatly reduced. To develop a proper exercise program for osteoporosis – that you can do on your own – one needs professional counsel. Physiotherapists are most suited to design these programs for your specific needs.

Dr. Oxbro completed her undergraduate science degree in Biology and Psychology at Trent University and then completed a Masters of Science Degree in Pharmacology at Queen’s University in Kingston, Ontario. Upon completion of her Masters degree, Dr. Oxbro entered the 4-year Naturopathic Medical Program, obtaining her Doctorate of Naturopathic Medicine upon graduation in 2008. She currently treats patients, at her naturopathic medicine clinic Nova Health Naturopathic Centre in Kingston, Ontario