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How huge our parents appeared to us
when we were children, yet when we are grown, they seem so
much smaller . It is not just that we have grown, very likely they
are smaller now.
This is because with age the body's
frame can shrink as we lose cartilage, the padding between the bones
of the spine. For some people this process remains within acceptable
bounds, but for others it can become a major heath hazard as not
only is the cartilage affected, but the bones themselves become
brittle and start to erode . This bone loss happens to men as well
as women, but is more common and a greater health risk in
women.
Bone loss in women usually starts
imperceptibly around the age of 30, increasing rapidly with the
onset of menopause, then slowing down again about 5 years after the
"change" to the earlier rate. The point is that the better the
foundation of bone laid down in youth, the further you have to
decline in age to be in trouble. As with so many health problems,
prevention is so much easier than cure.
Risks are higher for some women than
for others, and the following factors are extremely relevant:
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ethnic origin
-
frame size
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activity levels
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smoking
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heavy coffee drinking
-
family history
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Step 1.
Hormonal Balance is crucial to
healthy bones. In Dr. John Lee's book,
Natural Progesterone, The Multiple Roles of a Remarkable Hormone,
he points out that if estrogen were the only hormone involved in the
accelerated bone loss of the menopausal years, then there would be
no bone loss when hormonal levels of estrogen are high, as is the
case certainly after age 30 and even into the later childbearing
years.
The fact that the rate of bone loss
accelerates when estrogen levels fall suggests a partial
involvement, but the hormone that is lower during both these
times in a woman's life is
progesterone. The evidence we have at the moment suggests that
estrogen's role in bone loss is limited to increased bone resorption
in its absence.
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In other words, when levels
of estrogen are low, it can no longer inhibit the rate at
which bone is broken down: but we have no real
evidence
of receptor sites for estrogen in the bone building
process.
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On the other hand, there is evidence
that such sites do exist for progesterone. In fact, Dr. Lee's
studies show that untreated post menopausal women will lose bone
mass, that estrogen supplementation will maintain bone mass, but
that supplementing with natural progesterone will increase bone
mass, effectively reversing the osteoporotic process.
Remember, all hormones have
cholesterol as a base, and the hormone-like vitamin D is also
dependent on cholesterol. Regulation of cholesterol and LDL is
dependent on the presence of the correct fatty acids. Because of the
hormone connection to bone health, I urge you to balance your
essential fatty acid intake to make sure you are getting a healthy
ratio of Omega 3 to Omega 6. Think fish 3 times a week, or
a supplemental source of Fish Liver Oil.
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Researchers measured bone
density at several skeletal locations
in 130 anorexic women in their mid 20s.
92% had substantial bone loss in at least one site: 38%
had bone loss severe enough to qualify as osteoporosis. "Bone
mineral density did not differ by history of estrogen use at any
site," the study authors reported.
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While estrogen use was not related to
bone density, several other factors were:
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Weight
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Age at first period
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Amount of time that had elapsed since women had their last
menstrual period
were all associated with bone density.
Interestingly, this study found that calcium and
vitamin D supplements did not improve bone density in these women
either. I would be interested to see a study investigating the
connection between low stomach enzyme levels and anorexia:
lack of hydrochloric acid is one cause of zinc deficiency, which has
been linked to eating disorders.
HCL is necessary for the absorption of both calcium and zinc.
Annals of Internal Medicine November
21, 2000; 133: 790-794
Step 2
Proper diet. For women, this involves careful balancing of
nutrients, heavy on the green leafy vegetables (such as kale,
spinach, broccoli, cabbage), and low on animal fats. The Nurses'
Health Study looked at this question of diet, and Dr. Diane
Feshkanish, M.D. of Harvard Medical School found that the 20% of
women who consumed less than 109 mcgs. of Vit. K (found
primarily in your green leafies) had a 43% higher risk of hip
fracture.
There are numerous studies that show
bone mass in vegetarians is much denser than that of meat-eaters
when they reach their fifties, and the reason appears to be that
high animal protein promotes the excretion of calcium. The main
dietary enemies of proper calcium balance are sugar, caffeine and
alcohol, all of which cause calcium to be lost from the body, and
drinking carbonated pops, where the excess of phosphoric acid is
thought to interfere with calcium uptake. I theorize it also causes
an acid body pH, which affects calcium balances.
I also recommend that women limit
their dairy intake (unless they have access to raw milk
products), except for yoghurt and kefir (see
RESOURCES at right) and replace some
dairy with soy products. As previously stated, studies are
suggesting that soy promotes proper hormonal balance, essential for
bone-building, and it is a fact that countries where dairy
consumption is high tend to have higher levels of osteoporosis.
Interestingly, tea (even caffeinated) is associated with
higher bone density. This is probably because tea contains many
positive elements, flavonoids such as catechins, and now research
has discovered that an amino acid in Green Tea, called
L-Theanine, counteracts the effects of caffeine giving the
drinker the benefits of both relaxation and stimulation!
A caveat here: if you cannot
handle dairy, and/or are lactose intolerant, be very careful to
supplement with enough calcium. See RESOURCES
at right for a study connecting dairy
intolerance with osteoporosis.
Another reason diet is important is
that calcium is very sensitive to acid conditions, and relies on a
combination of the proper acid environment in the stomach - i.e.
enough hydrochloric acid - and a more or less neutral pH in
the blood for absorption. A diet high in veggies will take care
of the latter part of this equation, but those of us who have
digestive problems had better be SURE they are due to too MUCH acid
before taking antacids! It is likely that regular and habitual
use of antacids will be directly connected to poor calcium
absorption.
Unfortunately, so may chocolate!!
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It is much more common as
we age to have too little acid in our stomach which can
mimic the same symptoms of discomfort: addressing the
situation with antacids, however, will mean adversely
affecting calcium status. See below, step 3, for more
information on that.
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High homocysteine levels are now suspect
in osteoporosis, which is not a surprise, given the
connection between pH, methylation and homocysteine.
The study's authors state:
"An increased homocysteine level appears to be a
strong and independent risk factor for osteoporotic
fractures in older men and women," while
recommending that this risk be confirmed in other
large population studies. "Proof of a causal
relationship between increased homocysteine levels
and bone disease could be established by
intervention studies aimed at lowering the serum
homocysteine level. Whereas randomized, controlled
trials have shown that folic acid–based vitamin
supplements can effectively reduce homocysteine
levels and reduce the rate of coronary restenosis,
additional studies are needed to assess whether the
use of such therapy will reduce the risk of
fracture." |
Step 3
Exercise of almost any kind: including
walking, swimming, yoga, jogging, but most effective is working out
with light hand weights. One of our foremost holistic doctors
has suggested, only half in jest, that we levy a tax on video games,
television programs and other couch potato type occupations that
keep our young people inactive, and set it aside in a fund for all
the hips that will be fractured in the year 2030!
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As
little as 1 hour of exercise 3 times a week has been
shown
to help reverse bone loss. Even just brisk
walking.
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The importance of
exercise is high-lighted by a 2002 study at the University of
Connecticut (Ilich-Ernst, et al) that showed pretty conclusively a
direct connection between lean body mass (LBM) and bone mineral
density (BMD):
Results: The
results showed significant reduction of both total body BMD and lean
body mass (LBM) of 13% and 12%, respectively, with age. LBM was the
strongest determinant of BMD in various skeletal sites in the entire
cohort and groups. Ca was positively associated with BMD of various
regions of hip in the entire cohort and in the youngest and oldest
subjects (r ranging from 0.32-0.56, P < .05, in simple
regression), but not in perimenopausal and early postmenopausal
women. Past activity (sports and recreation) was positively
associated with BMD in total body, spine, hip, and forearm (r
ranging from 0.26-0.37, P < .05). Various modes of present
walking were positively associated with BMD in regions of femur and
forearm.
Conclusions: These results reveal the importance of lean
tissue acting independently on bone at different skeletal sites in
women across age groups as well as the positive effects on BMD of Ca
in the youngest and oldest women and life-long engagement in
physical activity in older women.
Step 4
Supplementing: this is a complex subject , certainly not as
simple as just taking Tums, made from calcium carbonate, an
inefficiently absorbed form of calcium to start with, and one that
ironically requires the stomach acid it is designed to suppress
to be absorbed at all!
In fact, Max Motyka, who holds an MS
in Pharmacy, wrote in an article in October 1999 that clinicians are
reporting a rise in a problem called Milk-Alkali Syndrome.
Sufferers present with irritability, nausea, headache, vertigo,
weariness, hypercalcemia, metabolic alkalosis and renal failure. All
of the cases were attributable to the use of a popular calcium
carbonate antacid formula as a calcium supplement.
Unfortunately, too, whatever calcium
is absorbed from Tums , when combined with the highly alkaline
carbonate, greatly increases the risk of kidney stones.
This is what I suggest you look for
in a calcium supplement, together with some of the reasons:
Calcium in an absorbable form,
such as citrate, or there are studies suggesting MCHA calcium, from
actual (organic bovine) bone is also a very positive choice for
absorbable supplementation.
If you have an acidic pH, consider
adding Coral Calcium as part of your calcium supplementation.
I aim for between 500 and 1500 mg
depending on the individual’s dietary level of calcium.
A recent NIH study makes it clear that starting in
childhood, reserves need to be built up and that this early approach
to bone building pays off in later life. Yet the figures are
far from encouraging:
- Daily calcium intakes of 800 mg for children
aged three to eight years and 1,300 mg for children and
adolescents aged nine to 17 years are suggested by the Institute
of Medicine. Only about 25% of boys and 10% of girls aged nine
to 17 years meet these recommendations.
- Daily calcium intake for older adults should be
maintained at 1,000 to 1,500 mg, yet only about 50%-60% of this
population meets this recommendation.
Magnesium - at least 50% of
the calcium level, perhaps more. Many people (women in particular)
are seriously deficient. Boron - a trace mineral that has an
estrogenic effect on calcium absorption.
L-Lysine - important in
calcium absorption and connective tissue strength.
Vitamin D - Essential
for calcium uptake. Look for D3, calciferol, and consider doses of
up to 2000 i.u.
Vitamin K - essential for bone
formation, and found chiefly in green leafy vegetables. A Japanese
food called
Natto is an excellent source of
Vitamin K.
Silicon/Silica - difficult to
find enough in the diet, and a nutrient found in high concentrations
anywhere bone is being built.
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Additionally, the process of bone
adsorption and formation is at all times dynamic. Osteoporosis
occurs when the rate of bone breakdown by osteoclasts outpaces the
rate of bone building by osteoblasts. A 1993 study done in Paris by
Dr. Marie dealt with Silicon
supplementation in estrogen deficient rats. The ovaries were removed
surgically, and true bone loss was observed both as loss of bone
volume, and an increase in osteoclasts as compared to controls. One
finding was that Silicon supplementation significantly reduced the
rate of bone loss, from 48% in unsupplemented rats to 34% in those
receiving Silicon. (Animal model for
osteoporosis Hott et al, 53, 174 1993.)
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Melatonin -interesting new
research is linking age-related Melatonin deficiencies to
osteoporosis. For some, this might be a helpful addition, but I
recommend
measuring the level of the hormone through a saliva test
before supplementing .
It is also really important to take
your calcium in divided doses throughout the day, with some being
taken last thing at night. Measurements of uptake show 29%
efficiency for 500 mg taken once a day, versus 40% efficiency for
500 mg divided into three daily doses with an all time low of 14%
uptake for 2000 mg taken in one dose!
Strontium -
here is an expert opinion. Strontium is demonstrably present
in bone when it is actively building.
Recently, some extremely encouraging
research has been done on a supplement called Ipriflavone,
which shows promise for restoring bone mass: it was first discovered
back in the 1930s, but has recently been reintroduced along with new
evidence of its benefits. This substance, which is found naturally
in Alfalfa and Bee Propolis, has been shown not only to
prevent bone loss ( even in patients with Paget's disease and
thyroid problems) but to either maintain, or improve, bone density
in post-menopausal women. The interesting thing about Ipriflavone is
that it achieves this by exerting an estrogen-like influence on the
body, but absolutely without affecting hormonal levels at all: in
other words, it appears to carry with it none of the risks of
Hormone Replacement Therapy, even for women susceptible to
estrogen-induced forms of cancer. (Source:
Osteoporosis Int (1997) 7: 119-125)
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One Italian study (Moscarini
- Gynecol Endocrinol 8:203-207, 1989) of 90 women aged
53 to 65 found that Ipriflavone and Calcium supplementation
increased bone mineral density by 2% after 6 months, and
5.8% after 12, with the added bonus of a significant
decrease in pain - 45% at 6 months, and 62% at 12. While
this was not a placebo controlled study, subsequent better
designed studies have confirmed these results. |
Recent research at the Universities
of Purdue and Indiana has turned up a connection between bone health
and Vitamin E. Working with chickens, Drs. Watkins and
Seifert found that supplementing the birds' feed with natural
D-Alpha Tocopherol along with the naturally occurring companion
mixed tocopherols not only resulted in leg bones that grew
longer, stronger and denser, but also inhibited the effects of free
radicals on existing bone, shielding the bone-forming cells (osteoclasts)
and allowing them to continue with their job of producing new bone.
This has definite implications for osteoporosis, say the two
doctors. Let me point out here that I have been saying for many
years how inferior the activity of synthetic Vitamin E is to the
natural: now comes a study in the American Journal of Clinical
Nutrition that unequivocally show the rate of absorption of
synthetic is far less than that of natural, perhaps as little as one
half as much.
On another interesting note, studies
in Sweden suggest that women ingesting more than 1.5 mg of
Vitamin A daily had almost twice the risk of hip fractures. Some
experts have data that suggests making sure you are getting
enough vitamin D mitigates this risk.
What this translates to is that if a
woman is drinking 5 glasses of milk per day, or the equivalent in
other dairy foods and foods high in Vitamin A, she should make sure
she is not taking a multivitamin with Vitamin A. Even 5000
i.u. is enough in combination with a diet high in A to increase risk
for bone density loss. Beta carotene is NOT a villain here, since it
is only converted to Vitamin A if the body needs it.
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Ongoing research continues to
emphasize the importance of Vitamin D:
I feel that once again reaction has gone overboard on the strength
of inconclusive evidence, and I worry about the harm being done to
bone health by recommendations that we avoid the sun entirely:
as you all know, sunlight synthesizes Vitamin D in the body.
When you consider that D
is not only essential for the absorption of calcium, but
also protects against falls by improving the ability of
the cell to contract, thereby improving muscle strength:
well, as you age you are not only going to fall, but
you'll be sure to break a bone as well!
See the research here.
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A study by Dr. Schurch (with WHO in
Geneva) has demonstrated that protein plays an important role
in proper bone growth: his double blind, randomized study showed
that not only did it slow bone loss and help heal existing
fractures, but it also supported immune function. (Ann
Intern Med1998 / 128 (10) / 801-809.)
Confirmation of this information
comes from an Australian study published in the Am. Journal of
Clinical Nutrition (vol 81, no 6, pp1423-1428)
in 2005: results showed a positive correlation between protein
intake and both heel and hip bone mineral density, even after
adjusting for age, body mass index, and other nutrients. Levels of
protein below 66gms per day were problematic, over 87 gms
protective.
This would seem to give double
validity for the regular daily use of soy or whey protein
shakes, particularly for women who not only are at greater risk for
bone loss and consequent fractures, but who also benefit in other
ways from the beneficial phytoestrogens in soy. I have used a shake
made from soy protein for breakfast for nearly 20 years now, and
every day it appears I find out a new reason why!
See RESOURCES
at right for the connection between protein and Osteoporosis. This
is part of the
pH
Factor, without which
calcium cannot be absorbed. As is so often the case, balance
is the key.
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It seems to me conclusive that a
combination of Ipriflavone and natural Progesterone, along
with soy and possibly other phytoestrogenic herbs, and the necessary
vitamins and minerals, would be an effective approach both to
combating existing osteoporosis and to preventing its occurrence in
the first place for women who wish to avoid the possible risks of
hormone replacement therapy.
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Now let's look at other factors, all
of which are well within our own control. I proved this last week
when my dog (all 140 lbs of him) barreled into me (all 63 years of
me) when I was running, and knocked me down two flights of concrete
steps. I landed on my arm, and thought I had broken it - an X-ray
showed that I had only bruised it badly. Now, if I can just control
my dog as well as I control my bones ...
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I feel it important that women should
know there is a possibility of an adverse effect on bone production
by synthetic thyroid hormone therapy: a reduction in
thyroid hormone is a fairly common occurrence in women over 60, and
a new study in the Journal Am. Board Fam. Pract.
13(6):403-407, 2000 shows a potential risk in older nursing home
residents because of the inappropriate use of thyroid hormone
therapy. " It is clear from several studies that excessive or
suppressive doses of thyroid hormone result in a decrease in bone
density. It is less certain, but an increasing body of evidence
suggests that even therapeutic doses of thyroid hormone contribute
to decreased bone density. Kung and Pun, in their study of 26
premenopausal women receiving physiologic doses of levothyroxine
compared with age-matched control women, found that femoral bone
density was between 5% and 15% less in the women on thyroid hormone
therapy. The mean duration of hormone therapy in these patients was
7.5 years, and the mean dose of thyroid hormone was 106 µg."
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This same study showed
that it was
possible to discontinue the use of the thyroid
hormone in half of the residents, because it had
either been prescribed inappropriately originally, or
the thyroid imbalance had corrected itself in the
meantime.
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To recap: we can keep our bones
strong through a combination of exercise, diet, supplementation, and
hormonal balance. The sooner in life we start, the better: but it's
never too late to start building stronger bones!
| Topic: |
Hyperhomocysteinemia May Increase the Risk of
Osteoporosis |
| Keywords: |
OSTEOPOROSIS, BONE HEALTH, BONE
DENSITY - Homocysteine, Hyperhomocysteinemia,
B Vitamins |
| Reference: |
"The role of
hyperhomocysteinemia as well as folate, vitamin B(6)
and B(12) deficiencies in osteoporosis - a
systematic review," Herrmann M, Peter Schmidt J, et
al, Clin Chem Lab Med, 2007; 45(12): 1621-32.
(Address: ANZAC Research Institute, University of
Sydney, Sydney NSW, Australia and Department of
Clinical Chemistry and Laboratory Medicine,
University Hospital of Saarland, Homburg/Saar,
Germany). |
| Summary: |
In this article, recent
epidemiological studies, randomized clinical trials,
and experimental studies examining the possible link
between hyperhomocysteinemia and osteoporosis are
reviewed. Results of epidemiological and randomized
clinical trials suggest that hyperhomocysteinemia
increases fracture risk. However, no clear
relationship has been found between
hyperhomocysteinemia and bone mineral density.
Results of animal studies suggest that bone
resorption is stimulated and bone quality is
diminished in hyperhomocysteinemic animals. Results
of cell culture studies suggest that bone resorption
is stimulated in the presence of
hyperhomocysteinemia, demonstrated by the
stimulation of osteoclasts but not osteoblasts in
the presence of Hcy. Furthermore,
hyperhomocysteinemia appears to disturb collagen
cross linking, adversely affecting the extracellular
bone matrix. The authors conclude their review by
stating that, "...Existing data suggest that HHCY
(and possibly B-vitamin deficiencies) adversely
affects bone quality by stimulation of bone
resorption and disturbance of collagen cross
linking." |
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| Keywords:
bone loss natural help, osteoporosis natural help, osteoporosis
hydrochloric acid, osteoporosis natural hormone replacement
therapy, osteoporosis natural HRT, osteoporosis progesterone,
osteoporosis natural progesterone, osteoporosis ipriflavone,
osteoporosis ipriflavones, vitamin E and bone health, vitamin A
and bone loss, osteoporosis protein, osteoporosis soy protein,
osteoporosis calcium and bones, osteoporosis calcium,
osteoporosis boron, osteoporosis silicon, the vitamin lady
writes about natural help osteoporosis, homocysteine
osteoporosis, vitamin d falls |
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