Osteoporosis is the decrease in bone tissue leading to structural weakness and increased risk of fracture. The bones that are most commonly affected are the spine, hips and the ribs.
Symptoms are usually absent until osteoporosis is severe, when backaches or structural changes such as a decrease in height or ‘hunchback’ deformities occur. Spontaneous fractures, or breakage following minor accidents, are the result of osteoporosis.
The density of bone will decline in all of us, both male and female, generally after the age of about 40. This is partially because of a decrease in exercise, which maintains bone integrity, but also because of the loss of oestrogen levels in women and of calcitonin – a calcium-level-controlling hormone made in the thyroid glands -in both sexes. Decreasing levels of stomach acid, and skin and bowel membrane changes all lead to diminished blood levels of calcium, magnesium, boron and vitamin D, all of which are essential to the production of bone. A diet too high in protein can encourage loss of calcium through the urine and is probably one of the major causes of the condition in the Western world. Other dietary factors are undoubtedly relevant, as is borne out by the fact that osteoporosis is very much a condition affecting the West, as opposed to in Africa and Japan where the incidence is negligible. The ageing process is by far the most common cause of osteoporosis but other conditions must be ruled out before age-related osteoporosis is treated.
Alcohol, steroids and a few prescribed drugs can all cause osteoporotic conditions. Paralysis or other causes of decreased movement, such as arthritis, lung or heart disease, will also reduce bone density. Certain congenital conditions, malnutrition and a variety of glandular diseases can all cause osteoporosis.
Postmenopausal osteoporosis is not, as the pharmaceutical industry would have us believe, solely created by a diminution in oestrogen. In fact oestrogen has a very small role to play in maintaining bone density, whereas other hormones such as progesterone and dehy-droepiandrosterone actually help build bone. Several trials show categorically that weight-bearing exercise is as beneficial, if not more so, as oestrogen replacement. This is borne out by the fact that the risk of fracture in a male is equal to that of a female after the age of 70. A good diet containing all the necessary supplements is also essential.
Most of us make the assumption that bone density is governed by the levels of calcium, and to an extent this is true. However, calcium is trapped in the bone on a network or matrix of protein fibres. Osteoporosis is as much due to a deficiency in this matrix as it is due to mineral deficiency. Interestingly, high animal protein diets have an adverse effect whereas vegetarian diets, which are heavy on vegetable protein, seem to be protective.
One important factor has come to light recently. It appears that osteoporosis is more profound in individuals who underwent malnutrition before the age of the menarche . It would appear that the foundation of bone density is laid at this early age. This has led to the suggestion that cow’s milk is a must for children. This is incorrect since milk is not a good dietary source of absorbable calcium and is a food that many humans are actually allergic to .
The orthodox medical world is quick to promote the use of X-ray investigations of the spine and hip to measure bone density. Whilst the levels of radiation are low, bear in mind that three per cent of the population carry a gene that is sensitive to radiation and may become cancerous. There may be times when X-rays are necessary but as a routine screen, non-invasive and simple tests are available.
Urine testing for two proteins called pyridinium and deoxypyridinium – principal proteins involved in the bone matrix that trap the calcium – should be carried out because an increase in levels of these proteins may suggest an osteoporotic tendency.
An ultrasound of the heel bone has been shown in comparative studies to be as effective as radiological investigation. Ultrasound is harmless and is therefore preferable.
Densitometry scan of a normal lumbar spine. This technique measures the density of the bone and is used in the assessment of osteoporosis.
Minerals as trace elements can be analysed by a simple blood and hair analysis and deficiencies of calcium, magnesium, zinc, copper, silicon and boron can be established, all of which are known to be integral in the formation of strong bones. Orthodox sources may suggest that increasing these minerals in the diet will have no effect and they are absolutely right if one takes an artificial form of any of these and gives it to an individual without the others. Many trials have shown that natural forms of mineral supplementation, especially those in a combined form, will be absorbed rapidly not only in the bloodstream but also effectively into the bones themselves.
Vitamins B6, C, D and K are all essential for bone growth and stability. These levels can be tested in the blood. The absorptive capacity of these and all the necessary minerals and proteins is dependent on an intact bowel. Low stomach acid, poor pancreatic function and bowel bacterial integrity are all very important.
Bowel conditions such as coeliac disease or the less severe gluten sensitivity, Crohn’s and other inflammatory conditions, and the leaky gut syndrome must all be considered as possible causes of osteoporosis. These may all be tested for.
The levels of phosphorus and its derivative phosphate are balanced in the bloodstream by the kidneys. Phosphorus encourages the kidneys to eliminate calcium. Phosphates are found in most foods but especially in carbonated drinks and meat products. Is there a correlation, I wonder, between the high incidence of osteoporosis in developed countries and their intake of fizzy drinks and burgers?
There is much press at this time discussing the use of natural progesterone . Dr Lee, a gynaecologist from the USA, has spent over a decade studying the effects of progesterone on osteoporosis and other menopausal problems. His conclusions are that progesterone, not oestrogen, is more effective in maintaining bone density. His work needs more study but theoretically he is correct. The use of natural progesterone is becoming more popular and studies over the next few years should help to decide if this is a preferred method of maintaining bone density and avoiding osteoporosis.
Prevention is the best form of cure. Ensure, especially in children, a good source of calcium and other relevant minerals. Soya, fish, nuts and deep-green vegetables such as spinach, collard greens and broccoli are all excellent sources.
Milk and milk products such as cheese are not necessarily a good source although yoghurt is excellent.
Orthodox hormonal replacement therapy should be avoided, as should your GP whose first-line treatment will be HRT, unless all other avenues under the guidance of a complementary medical specialist have failed.
Increase proteins from vegetables rather than animals and if osteoporosis is noted, switch to a predominantly vegetarian diet.
Meat products are particularly high in phosphorus, which increases calcium excretion and should therefore be reduced. Carbonated drinks contain a marked level of phosphates and must be avoided.
Ensure an adequate intake of calcium each day.
Avoid excesses of protein, alcohol, tobacco and caffeine. Specific osteoporosis formulae are available, all of which combine the necessary co-factors needed for good calcium absorption. A nutritionist would recommend particular brands.
Remember that calcium is directly linked to vitamin D and up to 200iu should be taken on a daily basis if there is any sign of bone thinning. Higher doses may be necessary via your complementary practitioner.
Use of DHEA may be prescribed under medical supervision along with natural progesterone creams to increase bone density.
Increase weight-bearing exercise. Thirty to forty minutes of walking each day is a minimum for those with osteoporosis but 20min of work in a gym or as a racket sport three or four times a week is good for maintenance.
Supplementation of the following may be beneficial but it is best to check your levels before self-prescribing. Overdosing is not possible on the recommended dosages but the supplementation is not necessary if levels are not proven to be deficient. The following supplements should be considered and taken in divided doses per foot of height throughout the day: calcium , magnesium , copper , manganese , silicone , boron and zinc .
The following vitamin supplements should be taken in divided doses per foot of height with food throughout the day: vitamin B6 , folic acid , vitamin D and phylloquinone , 200ug.
Blood and hair analysis for mineral deficiencies, phosphorus, fluoride and strontium toxicity and calcitonin should be taken as the baseline and monitored on a yearly basis or treated as required. Please note that strontium, whilst toxic in excess, is necessary for good bone strength and deficiencies should be remedied.
Plant oestrogens , natural progesterone and specific herbal treatments should be considered in osteoporosis but prescribed by a complementary medical practitioner.