Our bones are in a constant state of regeneration as bone is being broken down and rebuilt. Our hormones and our liver, kidneys and immune system all work together to ensure that bone is maintained. Osteoporosis, meaning “porous bone”, arises when bone is broken down faster than it can be rebuilt. Over time a gradual decrease in bone mass causes the bones to become porous, brittle and fragile, increasing the risk of fracture. Bones of the hip, spine, wrists and ribs are the most common fracture sites.
Osteoporosis affects almost 30 million people; over 80 percent of those are women. One in four women and one in eight men have osteoporosis. Hip fractures are a dangerous result of osteoporosis. Over a quarter million hip fractures occur each year, and over 50 percent will result in some form of disability, with many patients never getting out of long-term care facilities. Hip fractures result in death in up to 20 percent of cases.
If you have several of the risk factors mentioned below, have a dual-energy absorptiometry (DEXA) scan performed to determine bone status.
Bone loss occurs silently and often symptoms are not noted until a fracture occurs. Warning signs include: back pain around the bottom of the shoulder blades. The pain is relieved with heat, but aggravated by lying flat on the back. Teeth may become loose, there is a loss of height and a rounding of the upper back known as dowager’s hump. Bones can fracture with little stress and collapsing vertebrae can pinch nerves, causing sciatica.
If we believe what the media has been telling us, we would think that calcium loss is the only cause of osteoporosis and that simply taking doses of calcium would solve the problem. Unfortunately this is not true – calcium alone will not reverse or halt bone loss in most cases. Actually, studies using calcium alone have shown bone loss, not bone gain. Hormones, our immune system, stress reduction and good nutrition combine to maintain proper bone health.
People with low stomach acid will have a difficult time absorbing calcium carbonate, the most common calcium used in supplements. Less than 10 percent of calcium carbonate is absorbed in those with low stomach acid. Calcium citrate, aspartate and orotate are much better absorbed. Calcium concentration in the body is controlled by several hormones (including calcitonin secreted by the thyroid gland) and is influenced by our immune system.
Vitamin D also plays an important role in the formation of bone. Vitamin D interacts with the cells of the immune system by reducing inflammatory cytokines, specifically IL-1 and IL-12. Carl Germano, RD, and William Cabot, MD, state in The Osteoporosis Solution that, “In some research circles, osteoporosis is thought to be a type of autoimmune disease.”
The inflammatory cytokines of the immune system, specifically IL-1 and IL-6, can cause calcium to be pulled from bone. When we are under stress, our stress hormone, cortisol, is secreted. Cortisol release signals the T-helper-2 cells to secrete IL-1 and IL-6. As well, when cortisol levels go up, our anti-aging and immune regulating hormone, DHEA, decreases. The body is designed to deal with short-term stressors, but when they become a regular occurrence, the connection between cortisol and IL-1/IL-6 causes bone to break down faster than it can be rebuilt.
Osteoporosis can also be influenced by an overactive immune system. When macrophages eat invaders in the course of their daily surveillance, they release nitric oxide and IL-1. Nitric oxide in small amounts protects against bone loss. But when the immune system is fighting infection, macrophages release nitric oxide in large amounts, promoting the breakdown of bone. The drug Fosamax is designed to reduce nitric oxide, although with some terrible side effects. As mentioned earlier, we know that IL-1 also promotes bone loss so not only does vitamin D have to be available to control the secretion of IL-1, but our macrophages have to be kept in balance as well. Nitric oxide, like vitamin D, is key to regulating bone.
Estrogen protects the body from excessive secretion of IL-1 and IL-6. Lack of healthy estrogen in women with adrenal exhaustion, who have had hysterectomies, or top-level athletes with suppressed menses, is associated with abnormally high levels of IL-1 (which promotes bone loss) and low levels of interferon gamma (which prevents bone loss).
The thyroid hormone thyroxin activates bone breakdown, so long-term elevated levels of the hormone for a prolonged period either, through hyperthyroidism or over-medication for hypothyroidism, also results in bone loss. Sub-clinical low thyroid function, where not enough thyroid hormone is available, also promotes bone loss.
Use of medications can also contribute to osteoporosis: corticosteroid drugs decrease absorption of calcium, and antidepressants have been linked to increased risk of hip fractures. Drugs such as diuretics, antacids, anti-convulsants, warfarin and lithium can also contribute to bone weakening.
Other factors promoting osteoporosis include genetic predisposition (Asians and Caucasians are at higher risk), hyperparathyroidism, hypothyroidism, excessive alcohol consumption, leanness, never being pregnant, side effects of prescription medication, immobility or lack of exercise and not getting enough sunlight. Smoking increases inflammatory immune factors promoting bone loss.
Calcium to Magnesium Ratio: Research shows that the body requires twice as much calcium as magnesium. Taking more magnesium than calcium can actually suppress calcium levels and increase bone loss by decreasing the production of the thyroid hormone calcitonin. Magnesium in excess acts as a calcium blocker. There are times when we would want extra magnesium (e.g., for for restless leg syndrome, constipation, painful periods or heart palpitations) but we should then take the magnesium in divided doses and at a different time than the calcium supplement.
Ensures adequate nutrient status; contains all nutrients needed for optimal bone health
HEALTH TIPS TO ENHANCE HEALING
We are waiting far too long to take our bone-building nutrients. Most women do not start taking calcium until the age of 50. Young women need calcium, especially during the crucial bone-building years from ages 12 to 25.
Reduce consumption of caffeine (depletes calcium and magnesium), simple or refined sugars (also depletes calcium and lowers bone density), and alcohol (can lower vitamin D metabolism).
Include fermented soy in the diet from tempeh, miso, fermented soy powders and soy sauce.
Eat plenty of green leafy vegetables; they contain vitamin K, needed for proper bone mineralization.
Eliminate all soft drinks; they lower calcium levels and increase phosphate levels.
Reduce salt; it increases calcium loss.
Maintain a balanced daily intake of protein – 40 g for women (average body weight of 138 lbs), 63 g for men (average body weight of 174 lbs). Too much protein depletes calcium from the bones; too little prevents the formation of collagen and associated enzymes. Reduce animal protein by opting for vegetable-based protein such as legumes.
Develop an adequate exercise program that includes weight-bearing activities such as walking, hiking, stair climbing, dancing, weight training, jogging, skiing or low-impact aerobics. However, while regular movement and exercise is required to preserve bone mass and increase bone mineral density, excessive exercising can also lead to osteoporosis if menses are suppressed or the immune system is hyper-stimulated.
Eat calcium-rich foods including canned salmon with the bones, broccoli, sesame and sunflower seeds, dark leafy vegetables, organic cheese and yogurt. Take your calcium supplements before bed with a glass of orange juice. The blood’s calcium level is lower at night so the rate of calcium absorption is greater.
“Good fat” diets enhance bone density. High-saturated-fat diets promote bone loss.
If your medication increases the risk of osteoporosis, inquire if a more natural approache can be taken, or replace it with one that does not. (Prednisone, Depo-Provera, steroids, blood thinners and diuretics are examples of drugs that increase risk).
Take advantage of sunny days when you can and get at least 15 to 20 minutes of sunshine.
Avoid antacids – they lower the acid in your gut and inhibit the absorption of calcium.
Vitamin D is essential for the absorption of calcium into bone, and our bodies are capable of producing this vitamin when we are exposed to sunlight for about 20 minutes per day. You can see how this is a problem during the winter months. A Swiss study shows that supplementing with vitamin D also helps reduce the risk of falls for the elderly. Magnesium is essential to convert vitamin D to its active form, and yet magnesium deficiency is common in the elderly population as well as in those with osteoporosis. Symptoms of magnesium deficiency include muscle cramps and twitching eyelids.
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