Building Healthy Bones

Osteoporosis, a concern for a significant number of the women who come to my practice, conventionally has been thought of in two ways: a lack of calcium, and a deficiency of hormones as a result of aging.

Women affected by osteoporosis are given several pieces of advice: exercise (particularly weight-bearing exercises), hormone-replacement therapy and increase calcium intake.  On the front page of their website, Osteoporosis Canada has lots of information about calcium and vitamin D, but very little information on other factors equally important for osteoporosis prevention and treatment.

The role of exercise in osteoporosis

The strengthening of bones is best started in childhood and should continue through adolescence, when the body builds most of the bone that must sustain it for the remaining years of life.

Dr. Kirk Scofield’s article in “Current Sports Medicine” rightly stresses the need for certain type of physical activity more like a “stop and go” kind of sport like dancing, tennis, basketball, lacrosse, kick ball. “Repetitive stress can tear down bone and is not the best for increasing bone strenth,” Dr. Scofield said in an interview.  Read the whole article in NY Times Health here: https://well.blogs.nytimes.com/2013/08/05/to-ensure-bone-health-start-early/?partner=rss&emc=rss&_r=0

The role of antioxidants in osteoporosis

Interesting recent research has shown that antioxidant status in patients with osteoporosis is lower than in healthy controls (Sendur et al. 2009).  Other researchers have also concluded that oxidative stress plays a role in osteoporosis (particularly post-menopausal osteoporosis; see Maggio et al. 2003, Ozgocmen et al. 2007, Ke et al. 2009) and that supplementation of antioxidants and antioxidant vitamins may be very important in the prevention of the disease (Morton et al. 2001, Pasco et al. 2006).

High-dose calcium – the “gold standard” of treatment – may not be the best.  In 2008 a study was published which showed that women taking calcium citrate supplements were at much greater risk of having cardiovascular events such as MIs or stroke.  Many naturopaths, and even some medical doctors, argue that osteoporosis is less a deficiency of calcium, and more an overload of acids.

The role of acids in osteoporosis

The relationship between acids and osteoporosis is well-establish; several studies thus far in 2009 (Ceglia et al. 2009, Dawson-Hughes et al. 2009, and others dating as far back as 1989) have shown that supplementing with alkaline bicarbonates is very effective at reducing markers of bone loss and improving calcium status.  It makes a lot of sense: in an acidic environment, bone builder cells (osteoblasts) become inactive and cells that break down bone (osteoclasts) become active, thus resulting in bone loss.  The bone is a great source of buffers for the body, which considers bones to be expendable in the daily struggle to keep pH at a physiologically healthy level.

And just recently, Karp et al. found that calcium carbonate but not calcium citrate decreased bone resorption relative to control.

The role of minerals in osteoporosis

Minerals, both macro and trace, in addition to other nutritional cofactors are vital nutrients that maintain the density and architecture of our bones.

Lack of trace minerals can accelerate bone loss and osteoporosis.  Zinc is a cofactor in bone formation and in the activation of vitamin D3.  Boron reduces the urinary excretion of calcium by 44%. No quality vitamin-mineral supplement for the prevention of osteoporosis and fractures should be without vitamin D3 and magnesium.  Vitamin D3 enhances intestinal calcium absorption and vitamin D3 alone can reduce the annual rate of hip fracture from 1.3% to 0.5%.  Magnesium is essential for parathyroid hormone production which is necessary for the activation of vitamin D and therefore absorption of calcium across the gut wall.  Magnesium also influences both the matrix and mineral metabolism in bone and is necessary for proper calcium metabolism. Vitamin K2, a vitamin produced by a healthy gut, appears to regulate calcium deposition and therefore is a critical nutrient component .  ”Vitamin K2 helps maintaining bone strength at the site of the femoral neck in postmenopausal women by improving BMC [bone mineral content] and FNW [femoral neck width], whereas it has little effect on DXA-BMD.”
 https://www.ncbi.nlm.nih.gov/pubmed/23525894

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