Strong Bones For A Lifetime
Enclosed are scientific references to allow you to make more informed health care decisions. Please share them with your family and friends.
Table of Contents
- Osteoporosis Myths and Reality
- Fosamax May Damage Liver
- Chiropractic and Osteoporosis
- Osteoporosis: The Fractured Truth
Osteoporosis Myths & Reality
Osteoporosis is a scary name for many people. Women know about this process because they have been told for decades that they are most at risk. An entire generation has been brought up on concepts about building strong bones and fearing osteoporosis. But the myths about osteoporosis often do not match the reality.
Consider that we have always been told that osteoporosis was caused from a lack of calcium in our diets. In fact, there is data available that shows this is not the case. Take, for example, Singapore, where calcium consumption is approximately 600 mg/day compared to the U.S. where calcium is approximately 1000 mg/day. In spite of this, Singapore has only 10 percent of the hip fracture rate as does the U.S. People of Hong Kong consume about 400-500 mg/day, yet they have 30 percent the fracture rate of the U.S. In Finland, they consume 1400-1500 mg/day of calcium and have 50 percent less hip fractures compared to the U.S. From this data, it is obvious that increased calcium consumption does not by itself mean a decrease in hip fractures. Yet the dairy industry, antacid manufacturers, vitamin companies, and many health care practitioners continue to push people to consume more calcium.
An article from "Medscape" offers exercise as a possible answer to preventing osteoporosis. Since the body reacts to exercise by strengthening areas used, using the bones through exercise can prevent bone loss. When asked what type of exercise to do, experts suggest that it be an exercise that the person enjoys. This way they are more likely to continue.
From a chiropractic standpoint, we also understand that it is the innate healing ability of the body that has to adapt and strengthen the bones. With this in mind, we also understand that a properly functioning nervous system is essential for both function and adaptability. It is, therefore, a good idea to keep your spine free of nervous interference (subluxation) and give your body the best chance to adapt normally and healthily.
Fosamax May Damage Liver
Doctors from Israel describe a 71-year-old woman who developed liver damage 2 months after starting Fosamax, the popular bone-resorption inhibitor, used in the prevention and treatment of osteoporosis and they feel strongly that the drug was the cause or a major contributing factor.
Some of the known side effects of Fosamax are gastric and esophageal inflammation, but renal failure, ocular damage, skin reactions, and hypocalcemia have also been reported.
A case of hepatitis that developed after treatment with alendronate was recently reported in a 77-year-old woman.
The authors admit that the mechanism by which alendronate may cause liver damage is not known, although one possibility is that the fosomax inhibits the synthesis of cholesterol in the liver, which may alter liver function.
Regardless of the mechanism, physicians treating patients with a fosamax or related drugs should be alert to the possibility of liver dysfunction and monitor properly for it.
The New England Journal of Medicine August 3, 2000;343:365-366.
COMMENT: lthough this is only a case report and it is likely that the 71 year old woman was highly compromised from other factors, it does illustrate the fact that Fosamax is NOT something that should be used. The report does maintain validity though because the target market for this drug really is 50-70 year old women.
Bone building is a fine balance of a number of factors. Fosamax is very similar to estrogen's mode of action. Estrogen inhibits osteoclasts while Fosamax actually KILLS them. Osteoclasts cells in the bone that actually remove the bone so it can be rebuilt. If these cells are damaged the bone gets much denser. The fallacy in medical thinking though is that a denser bone is a stronger bone.
This is just not true. Even though the bones are denser they are actually weaker because they have not been allowed to remold
themselves and readjust to the constantly changing forces that are applied to bones. This will actually increase the risk of fracture over time.
NATURAL Progesterone is normally required to stimulate the osteoblasts or the bone rebuilding cells. The synthetic version, or Provera, does not provide this benefit.
I had previously recommended the cream version of natural progesterone but for most people I cannot recommend this approach any more. As it will in some people cause abnormally high levels of progesterone in the body that actually cause a reverse effect and stop it from working at all.
The optimal solution is to normalize the adrenal glands through a variety of techniques. If a woman still has ovaries they can normally be encouraged to produce appropriate amounts of estrogens and progesterone to build strong bones.
The important tools for normalizing the adrenal glands include an optimal diet. getting to bed by 10 PM and a mechanism for coping with the stress in one's life. Salivary hormone testing is a useful tool to monitor the effectiveness of the interventions.
Exercise and larae amounts of veaetables are likely to be more important the mineral replacements. Most people automatically assume that calcium is the most important factor to address bone density. I have seen a large number of women consuming calcium supplements that did not have good bone density as these other issues were not addressed.
Vitamin D is also essential to the formation of strong bones. There is an article that will likely go in next week's newsletter that provides some interesting conjecture that vitamin D should not even really be called a vitamin but is more appropriately identified as a precursor to a steroid hormone. A good mineral replacement however is probably wise.
Magnesium, manganese, zinc, silicon and boron are also important nutrients that should be in the supplement.
If you do decide to take Fosamax, be sure to ask your doctor to check your liver function at regular intervals.
If you decide to do something more natural, consider using a Doctor of Chiropractic to assist you in your choices.
Osteoporosis: The Fractured Truth
Awareness Magazine - July/August 2002
By Alex Strande, N.D., Ph.D.
Osteoporosis, the very word strikes fear into people's hearts, conjuring up images of frail hunched-over little old ladies with ribs so fragile they can fracture from coughing, and hips that break when they step off a curb. Calcium is the first thing most people think of when osteoporosis is mentioned. HRT is probably the second. But the standard view of osteoporosis prevention and treatment is largely founded on myths. One myth is that osteoporosis is caused by calcium deficiency.
Open any medical textbook and you will find that osteomalacia is a disorder resulting from under-calcification of bones. Osteoporotic bone is normal in quality but reduced in quantity: all the minerals as well as the protein matrix that holds those minerals in place have been leached away. Osteoporosis is emphatically not a calcium deficiency disorder. Rather, it is an imbalance between the intake/absorption and the excretion of bone building materials including calcium that occurs with increasing age.
Another myth is that osteoporosis is an estrogen-deficiency disease, so hormone replacement therapy (HRT) is an effective therapy for it. Age-related bone loss begins to occur in people following standard Western dietary and lifestyle patterns, at about 40 years of age. The hip-fracture rate for white women begins a steep climb between 40 and 44, as her levels of estrogen have not significantly dropped, although progesterone production is often falling. So it is clear that declining estrogen levels are not the primary trigger of the bone-thinning process.
Interestingly, women living in Asian and African cultures with low osteoporosis rates, tend to have much lower estrogen levels throughout their lives than do Western women. They begin menstruating several years later, and go through menopause several years earlier. These differences are related to their high physical activity level, low calorie and fat consumption, and high fiber intake, which lead to lower body-fat levels than those of Western women and markedly different bowel flora composition.
Body fat is a major site of estrogen production. In addition, the Asian and African women excrete far more estrogen in their bowel movements than do Western women on high-meat, high-fat diets.
Since calcium is the major mineral in bone, however, it's metabolism has been studied more thoroughly than that of magnesium, phosphorus, zinc, boron and the other minerals contained in bone. Calcium balance refers to the interplay between the intake, absorption and excretion of calcium. Our bodies selectively absorb only a small fraction of the calcium we consume. If
we absorb more calcium in a day (from food and/or supplements) than we excrete, we will be in “positive calcium balance”. If we excrete more than we absorb, “negative calcium balance” results. It is not deficient intake of calcium that causes osteoporosis, but rather being in negative calcium balance day after day, year after year.
The Recommended Daily Intake (RDI) of calcium is 800 mg for adults, and 1000 mg for postmenopausal females. Yet most of the world’s population consumes only 300-500 mg of calcium per day, and osteoporosis and fractures in such countries are significantly lower than in Western countries with high daily recommended and actual intakes. Maintaining an adequate calcium intake is easily accomplished on a diet of fresh and dried fruits, vegetables, (especially green leafy vegetables including sea vegetables like dulse, kelp and nori), nuts, seeds (particularly sesame seeds), whole grains and legumes.
Our bodies absorb on average only 20%-30% of the calcium we consume. The higher the amount of calcium consumed, the lower the percentage absorbed. As we get older, however, decreased production of stomach acid reduces our ability to absorb calcium (and other minerals). Drugs that neutralize stomach acid or inhibit its production lower calcium absorption even further. Alcohol and the oxalic acid in tea, coffee, chocolate and some other foods reduce calcium absorption.
Some fat must be present in the intestines in order for us to absorb calcium from foods (so skim milk is next to useless as a calcium source). Raw unsalted nuts and seeds and avocado are excellent sources of healthy fats that help boost calcium absorption.
The calcium in green leafy vegetables is absorbed about twice as well as the calcium in milk and other dairy products. Exposure to sunlight stimulates the body to produce vitamin D, which increases calcium absorption to the same degree.
Men are seven times less likely than women to suffer clinical effects of osteoporosis, because apart from having heavier bones to begin with, they tend to perform more exercise—especially muscle-strengthening exercise—than women.
Disuse of muscles causes rapid weakening of bone. In the weightless environment of space, astronauts suffer profound loss of skeletal mass despite vigorous physical activity.
High protein intake is also a factor. Daily protein intake, and particularly animal-protein intake, is clearly correlated with fracture risk in different populations. Plant proteins do not carry the same risk. A US study, the largest of its kind ever conducted, measured the bone density of vegetarians and non-vegetarians, and found that by the age of 65: male vegetarians had lost an average of 3% of their bone mass, male non-vegetarians had lost an average of 18%, female vegetarians had lost an average of 7%, female non-vegetarians had lost an average of 35% of their bone mass. Excessive sodium (salt) consumption increases calcium excretion. This compromises the kidney’s ability to return calcium to the bloodstream. We need less than 500 mg of sodium per day, yet many Americans eat from 4 to 8 grams per day. Caffeine has similar effects to sodium. Researchers at the
Chiropractic & Osteoporosis What Can Your Doctor of Chiropractic Do?
While there are no known cures for osteoporosis, there are many things that your chiropractor can do to prevent or slow its progress. Your chiropractor will advise you to discontinue unhealthy habits that contribute to osteoporosis such as excessive drinking and smoking. While studies show that large quantities of alcohol can contribute to bone loss, light drinking such as drinking one glass of red wine per day can actually be a benefit. Chiropractors can identify medications that you are taking that contribute to osteoporosis. Chiropractors are not licensed to give advice on medications but we can advise you to get second and third opinions as to the benefits of the medications you are taking. Your chiropractor can advise you on the amount and type of calcium you should take each day to help your body fight bone loss. He or she will also teach you about other nutritional supplements and dietary changes that can help slow the disease, such as vitamin D and others. Your chiropractor may also instruct you to begin a gradual increase in the level of exercise you are getting. It is not recommended that you jump right in and start exercising hard right away. If you already have osteoporosis any twisting or high impact exercises can cause a fracture and increase your problems drastically. Always consult a health professional before starting any exercise program. It doesn't hurt, so why worry?
Risk Factors for Osteoporosis
- Being female—especially thin, Caucasian or Asian
- Having family history of osteoporosis
- Being older
- Being physically inactive
- Taking corticosteroids, thyroid medications, anticonvulsants, anticoagulants, Dilantin, diuretics, antacids with aluminum, and drugs that alter digestion, such as Ranitidine
- Heavy consumption of alcohol
- Heavy consumption of carbonated beverages, coffee
- Low intake of calcium and vitamin D
- Chronic diseases of the kidney, lung, stomach, and intestines
- Hormonal changes because of menopause or hysterectomy
- Lactose intolerance, low stomach acid
We associate osteoporosis with older people whose backs are bent—from those with a mild "dowager's hump" to those who can no longer stand up straight. The truth is that 20 million American women have osteoporosis. And 80 percent of them don't even know it! Osteoporosis is a chronic, progressive condition that steals bone from the body, often leading to fractures of the hip, wrist, and spine. Many older people suffer disability and even death from osteoporosis-related fractures. While one in two women will suffer from an osteoporosis-related fracture in her lifetime, one in eight men will, too! Apparently, many people confuse osteoporosis with arthritis, and wait for swollen joints and pain before going in for testing. Even though osteoporosis is painless (until you suffer a bone fracture), it is extremely important to find out how healthy your bones are—and to make lifestyle, dietary, and sometimes other changes.
What You Can Do To Prevent Or Slow Osteoporosis?
One of the best lifestyle changes you can make is in the area of exercise. Weight-bearing activity for 20 minutes three times a week is helpful. Try walking, jogging, playing racquet sports, lifting weights, or doing aerobics. A healthful diet makes a big difference. Eat plenty of fresh vegetables and fruits. Enjoy nuts and seeds. Experiment with broccoli, kale, collard greens, cabbage, and turnip greens. Try tofu, salmon, sardines, grains and low fat dairy products, such as milk and yogurt (a glass of low fat milk and a cup of yogurt adds 600 mg of calcium to the diet a day). Drink eight 10-ounce glasses of water a day (herb teas, juices, or other liquids are not a substitute for water). Avoid caffeine, carbonated colas, alcohol, baked goods, and junk food. Watch your animal protein intake. Don't smoke. Include more calcium in your diet. Most Americans get only about 600 mg of calcium a day, but a recent report from the National Academy of Sciences says adults 51 and older need 1,200 mg/day. The National Institutes of Health's recommendations are 1,000 mg/day for post-menopausal women taking estrogen; 1,500 mg/day for postmenopausal women not taking estrogen, and 1,500 mg/day for men and women 65+. If you're in the market for a supplement, be sure you take one that's highly absorbable, such as microcrystalline hydroxyapatite concentrate (MCHC), or one of the malates, fumarates, succinates, glutarates, or citrates. But don't overdo. Taking more than double the recommended amount of calcium may put some people at risk for developing kidney stones. You may also want to supplement other nutrients, such as vitamin D, C, magnesium, zinc, and silica after talking with your doctor of chiropractic. The National Osteoporosis Foundation says that although weight-bearing exercise is generally recommended, people with osteoporosis should consult their health care practitioners before beginning a new exercise program. The Foundation cautions against sudden or excessive strain on the bones during exercise. People with osteoporosis need to be careful when lifting heavy objects—including grandchildren. Take steps to avoid falling. Talk to your doctor of chiropractic to see what else you can do to maintain and improve the health of your bones. Your doctor of chiropractic is a highly trained expert on helping you maintain good health. Studies show chiropractic patients are hospitalized less than the general population. And chiropractic health care ranks number one in patient satisfaction.
Instructions for Repairing Disc Injuries
Chiropractic Care for you disc injury is by far the safest and most effective form of treatment available today How to get the most out of your treatment, Follow these simple recommendations: Do your exercises. Lumbar retraction (top half of body push-ups) will help reverse spinal disc instability. Do at least 20 of these "push ups", 3 times each day, also (if instructed to do wall exercises), for 3-5 minutes 3 times a day. You can do more if you like (you can never do too many). *Note: Stop immediately if your pain begins to spread. It is ok for it to get more intense as the area of your pain gets more localized. - Drink plenty of water. It is all your body is ever thirsty for. You need to re-hydrate dried/degeneration joints and discs. - Take some form of nutritional supplementation. The easiest type is a complete multi-vitamin. Be sure to get the highest quality products as your health depends on it. A good Glucosamine product is also recommended. - Eat more of "God's" foods and less than "Man's." Highly processed (boxed, bagged, canned, or 'fast' foods) only slow your progress. Imagine putting contaminated sludge in your high performance vehicle vs. high octave fuel. - No Sitting. Stand or lay with a pillow behind knees while on your back. Equally bend both knees and place a pillow between them when lying on your side. - Be sure to switch your wallet. Clean it out and preferably do not sit on it for long periods at a time. - Keep all of your appointments. Treatment's 3 – 4 times a week is what is required to reverse disc conditions. Make sure you recover as fast as possible. - Understand your condition. Disc injuries occur largely from improper weight bearing and out of align vertebrae above and below the disc. Realignment of these vertebrae is crucial for a lasting and healthy recovery. Only quality Chiropractic Care can align a vertebrae. *If you feel the need to use ice or a heating pad, do not use for longer than 15 minutes within each hour. Heat increases the blood flow to the affected area while ice calms the inflammation.
Chiropractic & Osteoporosis What Can Your Doctor of Chiropractic Do?
While there are no known cures for osteoporosis, there are many things that your chiropractor can do to prevent or slow its progress. Your chiropractor will advise you to discontinue unhealthy habits that contribute to osteoporosis such as excessive drinking and smoking. While studies show that large quantities of alcohol can contribute to bone loss, light drinking such as drinking one glass of red wine per day can actually be a benefit. Chiropractors can identify medications that you are taking that contribute to osteoporosis. Chiropractors are not licensed to give advice on medications but we can advise you to get second and third opinions as to the benefits of the medications you are taking. Your chiropractor can advise you on the amount and type of calcium you should take each day to help your body fight bone loss. He or she will also teach you about other nutritional supplements and dietary changes that can help slow the disease, such as vitamin D and others. Your chiropractor may also instruct you to begin a gradual increase in the level of exercise you are getting. It is not recommended that you jump right in and start exercising hard right away. If you already have osteoporosis any twisting or high impact exercises can cause a fracture and increase your problems drastically. Always consult a health professional before starting any exercise program.