Submitted by: Barbara M.

Q: Besides calcium, what else can I do for osteoporosis?

A: First of all, osteoporosis is not a calcium-deficiency disease. If it were that simple, there would probably be no osteoporosis because everybody would just take calcium. The concern is, therefore, what the body does with the calcium once it is in the body.

Osteoporosis is the most common bone disorder in America. More than 50% of healthy American women age 30-40 are likely to develop vertebral fractures as they age due to osteoporosis. In bones affected with osteoporosis, new bone formation does not keep up with bone removal, leaving the bone progressively brittle. In the United States, more than 300,000 hip fractures occur each year due to osteoporosis and with the aging baby boomers this number will quickly rise to more than 500,000 each year.

Back to the calcium issue. One important factor is to know that not all calcium supplements are created equally. Calcium bound to citrate or lactate, fumarate, malate, and aspartate appears to be the best for absorption and assimilation. Calcium carbonate (chalk) is the least likely form of calcium to be absorbed. This is probably because calcium carbonate requires the greatest amount of stomach acid to be solubilized. Furthermore, in postmenopausal women, it has been shown that about 40% are severely deficient in stomach acid. At this point you may be wondering why Tums (an antacid) is promoted as being a good source of calcium (calcium carbonate, by the way)? Good question. Taking a medication that lowers stomach acid is very unlikely to provide an environment to absorb a poorly absorbable form of calcium. In short, do not take Tums as your source of calcium.

Another important supplement to consider for maximum calcium assimilation is essential fatty acids (EFAs). EFAs (especially EPA, DHA, and GLA) can increase calcium absorption from the gut and reduce its loss from the body. To put it simply EFAs are the bus that carry calcium to the tissues. They also have the capability of inhibiting the synthesis and secretion of cytokines, such as interleukin-1, interleukin-6, and tumor necrosis factor-alpha and inhibit nuclear translocation of NF-kB, which seems to play a major role in the pathophysiology of osteoporosis.

Vitamin D, which is actually closer to a hormone than a vitamin, is well known to stimulate the absorption of calcium. Vitamin D is produced in our bodies mainly through the action of sunlight on our skin.

Magnesium supplementation has been shown to be just as important as calcium in the prevention and treatment of osteoporosis.

You also must consider vitamins B6, B12, and folic acid. Increased homocysteine concentrations in the blood have been demonstrated in postmenopausal women, and are thought to play a role in osteoporosis by causing a defective bone matrix. Vitamins B6, B12, and folic acid are necessary for homocysteine metabolism and elimination.

Eat lots of green leafy vegetables (kale, collard greens, parsley, spinach, turnip greens, lettuce - with the exception of ice berg). Also consider supplementation with vitamin K, boron, manganese, and soy isoflavinoids.

You need to eliminate soft drinks and milk because they contain high amounts of phosphates that pull calcium from the bones. People in countries with the highest dairy intake have the highest rate of hip fractures per capita. Yes, dairy. The marketing campaign by the wealthy dairy industry would have you believe differently. The Nurses' Health Study, a study involving 77,761 women, researchers found that women who drank two or more glasses of milk per day had a 45% higher risk for hip fracture compared with women consuming one glass or less per week. Also creating a negative calcium balance are high meat diets, refined carbohydrates, coffee, alcohol, and smoking.

Aside from nutritional supplementation and dietary factors, you need to exercise, exercise, and exercise. Walking, running, tennis, aerobics, and weight lifting are the most effective for building and maintaining bone mass.

As a final note, I am reluctant to discuss hormone replacement therapy. Hormones have a very sensitive balance in the body and need to be discussed on an individual basis. But because there is a lot of misconception I will mention this. Estrogen replacement therapy (ERT) inhibits bone resorption and reduces the incidence of osteoporotic fractures. Unfortunately, ERT also increases the risk of certain forms of cancer. Therefore, in some individuals with late-stage osteoporosis, ERT benefits may outweigh the risks. In this case at least consider a medication called Tri-estrogen, a safer alternative to standard ERT. In contrast to estrogen, which merely inhibits resorption of old bone, progesterone appears to enhance new bone formation, and is not carcinogenic.

Again, I will emphasize that these factors be considered in conjunction with the advice of a qualified practitioner.

For a comprehensive, individualized assessment, please feel free to set up a consultation. All of the above laboratory indicators can easily be evaluated and a treatment protocol can be determined without ever having to come into the office.

We live in bodies where all the systems are very interrelated in a web-like balance of interactions. We cannot just listen to one instrument when addressing the human body but rather have to respect and consider the entire symphony. As usual, I would recommend a consultation for an individualized, comprehensive assessment.

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