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Osteoporosis generally
affects women more than men
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Porous
bones. That’s what the word osteoporosis means. While we’ve come to
associate it with the aged, especially women, osteoporosis affects men, women,
even children, in all age groups.
This
decrease in bone density leads to bone fragility- they tend to break more
easily!
Most
people believe that bones are static. That, once you physically ‘grow up’,
your bones are formed and don’t change. Nothing could be further from the
truth! Your bones are always changing.
Bones
are Dynamic
There
are three types of bone cells. The
first are called osteoblasts and
they are the bone- forming cells. The second type, osteocytes, maintain bones as a living tissue. They make up about 90% of
the adult skeleton. The third kind, osteoclasts
dissolve bone, breaking down calcium and
phosphorous, and causing it to be reabsorbed. Lots of factors are involved in
this interplay of building and tearing down, especially hormones. So, your bones
are dynamic, being built up and broken down all the time.
Generally,
up to about age 25, more bone mass is being built than broken down. At about age
30, the process begins to reverse and bone matter begins to be lost at the rate
of about 0.3%-0.5% per year. However, women after menopause, can lose from 2%-3%
per year!
But, about half of bone mass is lost even before
menopause!
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There are three types of bone cells: osteoblasts, osteocytes and osteoclasts
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Such
a decrease leads to height loss, back and leg pain and more importantly,
fractures! They can occur as the result of very minor trauma and are frequently
in the vertebra. Known as compression fractures, they usually occur in the mid
and lower back and can be due to just plain old gravity. There can also be
numerous microfractures and about 35 percent of vertebral fractures are not
painful. However, they can
accumulate and cause pain and disability. Also, once a vertebral fracture has
occurred, the risk for further fractures becomes much higher.
Fractures
can and do occur in other parts of the body, like the wrist. But the most common
fracture associated with osteoporosis is the hip fracture, with often
devastating consequences. In the first 12 months after a hip fracture, one
person in five will die, one in two will not be able to walk or perform the
tasks of daily living without assistance and one in four will need extended aid
in a long term care facility like a nursing home.
Overcome
Osteoporosis by Preventing It
The
key to overcoming the dire consequences of osteoporosis is PREVENTION, and that
well before the time of menopause. And the single most important factor in
prevention is exercise, particularly
weight training. Putting a stress on the bones, like with weights, causes the
body to respond by increasing bone density (or, at the minimum, reducing the
rate of its dissolution). It also stimulates the release of hormones that have
positive influences on bone growth. While
nobody is suggesting you take up bodybuilding, a well-rounded exercise program
that includes weight training is an essential component in deterring
osteoporosis. Sedentary lifestyles, coupled with poor nutrition, are the
absolute worst things for your bones, not to mention your other body systems!
Other lifestyle changes that will also help include quitting smoking and
reducing your caffeine and alcohol intake.
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Calcium is by far the most
important of minerals needed to prevent osteoporosis
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But
nutrition is really the other part of the equation. A healthy diet of green
leafy vegetables (like kale and dandelion leaves), seaweeds (like nori), milk,
cheese (particularly goat’s cheese), yogurt and kefir, tahini, fish
(especially sardines and salmon) and grains, like oatmeal, all with as little
added chemicals and preservatives as possible, constitutes the absolute barest
minimum standard. Yogurt and kefir are especially utilizable by the body.
Some
greens however, need to be avoided. They are mostly those high in oxalic acid
and include swisschard, beet greens, spinach and rhubarb. Phosphorus-rich foods,
including carbonated drinks, processed white flour products as well as many
other processed foods, inhibit calcium uptake and utilization, and should be
avoided. Those who down lots of soft drinks are four times more likely to break
a bone!
Healthy
bones need minerals, including calcium, phosphorus, potassium, manganese,
magnesium, silica, iron, zinc, selenium, boron, sulphur, chromium, and a couple
of dozen others. In order to adequately assimilate these minerals, we also need
proteins, high-quality fats like fish oil and vitamins!
Calcium,
however, is by far the most important of the minerals. Most adult women should
be getting 1,000 mg a day or more before menopause and more afterwards. While
milk has been promoted as the best source of calcium, it’s really not the
case. An 8 oz. glass of milk does
contain about 300 mg of calcium. But it’s not only how much you get but how
much is used and the calcium in milk isn’t well absorbed. It’s the same
problem with a lot of calcium supplements.
Important
Supplements
Unfortunately,
with today’s hectic schedules and over-filled lives, relying solely on diet is
unrealistic and supplementation becomes necessary.
There
are many calcium supplements on the market today. Most commonly use calcium
citrate, calcium carbonate and calcium from oyster shells in their formulations.
But recent studies suggest that the best type of calcium supplement is a
concentrate of microcrystalline
hydroxiapatite (MCHC). They
have shown that the MCHC type can increase bone density by more than 6%, even
where there is advanced bone loss. It also helps in healing fractures.
In addition to the calcium, MCHC also contains protein
and over 25 other required minerals.
Also
high on the list of minerals is magnesium, necessary for the chemical reactions
that form new bone, and manganese, needed to increase bone resistance to
fractures.
Herbs
& Vitamins
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Stinging nettle is rich in calcium
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Herbs
can play a big role in bone health as well. Many herbs are rich in minerals,
including calcium, and are extremely
well absorbed. They include stinging nettle (Urtica dioica), oatstraw (Avena
sativa), red clover (Trifolium pretense), dandelion (Taraxacum
officinale), Irish moss (Chondrus crispus) and especially horsetail (Equisetum
arvense), which is high in silica and both strengthens bone and aids in
healing fractures. However, if you have kidney problems, it is best to stay away
from horsetail as it can be hard on the kidneys.
Vitamins
are a crucial component of both bone growth and bone health. In particular, Vitamin
D, which is so necessary for calcium absorption that it is added to milk, and
Vitamin K, necessary to form osteocalcin,
a protein found only in bone and required for bone formation.
A
recent Netherlands medical study determined that a minimum of 400 IU of Vitamin
D and 80 micrograms of Vitamin K were necessary for optimum bone health in
menopausal women.
The
B vitamins are also very important for bones. Folic acid and Vitamin B6, for
example, are necessary for the fibrous collagen framework onto which minerals
deposit to make up the bone, while a vitamin B12 deficiency negatively impacts
on proper osteoblast (the cells that form bone) functioning.
Allopathic
Medications
On
the allopathic side, the treatment of choice in menopausal women has been
estrogen or hormonal replacement therapy. That’s because bone density
decreases with the reduction of estrogen associated with menopause. But
interestingly, a study done by St George’s Hospital
Medical School at
the University of London
revealed that as the level of estrogen is reduced, the antioxidant level in the
bone is also decreased. When they introduced the antioxidants Vitamin C and
N-acetyl cysteine, a form of the amino acid (the building blocks of proteins)
cysteine, bone density began to increase! They had discovered the mechanism by
which estrogen protects against osteoporosis and suggested an alternative to its
controversial use.
Other
medications commonly prescribed for osteoporosis include Fosamax (Alendronate)
and Didronel (Etidronate) for both prevention and treatment. Also, Evista
(Raloxifene), a relatively new drug that aids in preventing bone loss
particularly in the spine, and Miacalcin (Calcitonin-salmon) which increases
bone density up to 3% but appears to have little impact in reducing fractures.
The
big problem with these drugs is the negative side-effects they can exhibit.
Estrogen has been shown to increase the possibility of breast cancer by as much
as 40%. Fosamex can cause esophogitis (inflammation of the esophagus) and even
esophageal bleeding. Evista can have the relatively mild side effect of hot
flashes but in some, the more serious complication of deep vein thrombosis (a
blood clot in the deep veins).
Osteoporosis
is reaching epidemic proportions. In fact, the World Health Organization (WHO)
has classified osteoporosis as the second leading
health care problem after cardiovascular disease. Because of its usual
long-term, asymptomatic onset, it is frequently referred to as the “silent
epidemic”.
In
the United States, some 6 million women over the age of 50 suffer from
osteoporosis, while up to 17 million have low bone mass. Men do a little better
with the statistics a little better than half that of women, probably because
they have more bone mass to begin with.
Because
it comes up on you slowly, take early heed. Put into action the suggestions
outlined here and put yourself on the course to preventing what could otherwise
be a debilitating life in the years that should indeed be golden!
*Lev
G. Fedyniak, MD
began his medical career in alternative medicine, studying acupuncture, herbs
and other healing traditions in China, Hong Kong, Canada,
Ukraine
and other parts of the world. Recognizing that the allopathic tradition was a
necessary component in treating illness, he trained in allopathic medicine to
obtain the Doctor of Medicine (MD) degree.
Dr. Lev makes his home in Ukraine
and continues to study new approaches to treating illness and optimizing health
from traditions all over the world. He publishes articles and books in the hopes
of bringing such information to all who need it.
He
can be reached at DrLev@IntegrativeMedicineOnline.com.
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