Osteoporosis Part II
Bisphosphonates are the most common drugs prescribed for osteoporosis under common names such as Fosamax or Actonel. These drugs inhibit the activity of osteoclasts so that bones are broken down and resorbed at a much slower rate than usual. The idea is that this gives the cells that create bone, osteoblasts, the ability to catch up and form new bone faster than it is recycled. While this is great in theory, this results in thicker but more brittle bones. So, while more bone is being packed on to existing bone, the natural turnover process of bone has been altered and weaker bones form as a result. Bisphosphonates do their job of creating denser bones, but the results leave patients no better off or even worse off than where they were originally.
The number one thing you can do to slow osteoporosis is weight bearing exercises. Bones abide by Wolff’s law which states that they will adapt to the loads under which they are placed. This means that if bones face no resistance, there is no need for them to be strong. But, if the bones must resist against certain loads or forces, they will remodel themselves to become thicker and stronger to be able to handle those forces. We can apply this to osteoporosis where we need to speed up the bone building process to match bone breakdown. While we have already discussed organ health and nutrient availability, adding weight bearing exercises to this will have a great impact on bone health. Weight resistance exercises must exert resistance against the body. Examples of non-weight bearing exercises that will not help osteoporosis are swimming, bicycling, or stretching. Examples of good weight bearing exercises include squats, pushups, deadlifts, running, certain sports, rebounding, and at the minimum, walking.
Estrogen and Progesterone
As women age and enter menopause, they have a natural drop in estrogen and progesterone as they no longer release eggs to be fertilized each month. While estrogen and progesterone play a part in healthy bone formation, it is not as large a factor as people think. While the ovaries are no longer producing these hormones, the adrenal glands take on the brunt of the responsibility, so estrogen and progesterone are still being produced even after menopause. Many women turn to hormone replacement therapy (HRT) to combat this drop in hormones, but this often leads to further complications. Synthetic hormones disrupt the body’s chemistry and the ratio of estrogen to progesterone is often not correct with estrogen usually being too high. The goal after menopause, as it is even before menopause, is to balance the estrogen and progesterone ratio in the body, with it often being necessary to reduce estrogen levels. This is done by supporting estrogen detoxification in the liver through the sulfation or glucuronic acid pathway. Nutrients such as vitamin B6 (P-5-P), vitamin B9 (5-MTHF), the amino acid cysteine, or the herbs artichoke and rosemary are commonly used to detox estrogen. This along with supporting the adrenal glands will help keep estrogen and progesterone levels where they need to be to support bone health.
While calcium and phosphorus must always be in balance, so must all the minerals in our body. They all affect each other at some level and here I will list the most important nutrients that either directly or indirectly affect bone health: calcium, phosphorus, vitamin D, magnesium, manganese, zinc, chromium, silicone, copper, boron, potassium, iron, vitamin A, vitamin C, vitamin K, vitamin B6 (P-5-P), vitamin B12, folate (5-MTHF), essential fatty acids, hydrochloric acid, parathyroid tissue, and glutathione. Some of these must be taken together such as calcium and vitamin D or magnesium and phosphorus in order to be utilized correctly. Parathyroid tissue can have a huge impact on parathyroid health as it can provide the proper minerals in ratio that are already present in the organ. While all these vitamins and minerals are needed to form healthy bone, there is no reason to supplement for every single one. The goal is to figure out if there is a deficiency in a specific nutrient and to potentially supplement for this to restore proper balance. There may also be certain offenders that are causing organ dysfunction which indirectly lead to decreased bone health such as common nutritional deficiencies, infections, improper supplementation, certain medications, ammonia toxicity, uric acid, caffeine, heavy metals, and trans fats. Sometimes correcting the problem affecting an organ, such as an infection, will allow that organ to function optimally and no nutritional supplementation is needed.
Bloodwork is a poor indicator of osteoporosis since the body must maintain a very specific level of calcium in our blood to keep our heart beating, and this task takes precedent over maintaining bone health. This can lead to osteoporosis going unnoticed for long periods of time before it is eventually discovered due to a bone fracture and confirmed by a DEXA scan – the gold standard of measuring bone density.
As you can see, there is much more to bone health than calcium. All the nutrients mentioned are needed at various stages of bone formation and each organ must be functioning well to use the nutrients appropriately. Reach out to a professional in your area to get started today.