OSTEOPOROSIS:                            What do we need to know about it??

By Vasanta Irina Lidanova, DOM

I thought I was strong and invincible until I was not. This past winter while skiing in Taos, I took a fall shortly after getting off the chair lift, not even skiing. However, the result was a fracture of my femoral neck, aka hip fracture. Because I was fit, active, ate real food and lead a healthy lifestyle, I could not believe the result of my x-ray. What did I do wrong?

 In retrospect, I should have done a DEXA scan, the bone density scan to determine if there was osteoporosis creeping in or full-blown.

That is why I decided to educate myself first, and then my patients, or whoever has bones 😊 

What is osteoporosis? Osteoporosis is a disease characterized by the thinning and deterioration of one’s bones. Some of the causes in a bit, but first I wanted to preface this with some statistics. According to the Surgeon General’s 2004 report, “…about half of all women and 20% of all men will sustain an osteoporosis-related fracture in their lifetime.”

“By the time women reach age 60, their lifetime risk of having osteoporosis is 44%.” (Cawthon PM, Clinical Orthopedics & Related Research).

Most fractures occur in the spine, hip, or forearm. Spinal (vertebral compression) fractures are common. In one study, “66% of compression fractures went undiagnosed either because they didn’t cause pain or because doctors failed to detect them.” (Ross PD, American Journal of Medicine).

And one more piece of disturbing statistics on mortality. According to Bone Health and Osteoporosis foundation, “24% of patients age 50 and over die in the first year, following a hip fracture.”

OK, enough of doom and gloom. We’ll talk about prevention and important actionables.

Most people think that osteoporosis is a normal result of aging. It is common, but not normal. There is a physiological process called ‘remodeling’ that takes place within our bones: osteoclast cells break down old brittle bones, whereas osteoblast cells build new and strong bone. When the former exceeds the latter, the remodeling process goes out of balance.

So, let’s look at some of the causes that may tip this balance:

Low estrogen:

One of the significant causes of bone loss is a dramatic decline in estrogen, either at menopause or after hysterectomy. Estrogen, among other functions, is required for inhibiting the osteoclasts (the bone-breaking) activity, so a decline produces an increased risk for fractures.

Nutrient deficiencies: calcium, magnesium, vitamin D3, K2, boron, among others.

Gastrointestinal health is crucial for keeping bones strong and supple. The GI tract is home to 70-80% of one’s immune system and is inseparably linked to bone health.

Our gut is like soil: when there is a sufficient population of beneficial microbes, we, the whole organism, thrive. However, if there are more pathogenic bugs in the gut than ‘good guys’, there will be dysbiosis, which will lead to systemic inflammation (leaky gut, for example) and nutrient malabsorption. Disruption in the intestinal flora produces  proinflammatory cytokines that will lead to osteoclastic (bone breaking) activity. There is a branch of science called osteomicrobiology that studies bones and the gut microbes. Fascinating! How do we know if our microbes out of balance? Well, if we regularly experience one or more of the following symptoms—bloating, gas, belching, heartburn, constipation, diarrhea, or even fatigue. Dysbiosis will raise gut pH, making it difficult to absorb minerals. Probiotics, on the other hand, will facilitate calcium and mineral absorption.

Other causes (not a complete list): smoking, excessive alcohol intake, some medications, family history, sedentary lifestyle and lack of exercise.

Osteoporosis signs and symptoms include back pain, forearm pain, loss of height, stooped posture, excessive tooth decay, premature graying of the hair (50% by age 40).

What can we do to prevent a fracture or mitigate one:

First, I highly recommend that you ask your doctor to order a DEXA (DXA) scan. It would be useful to have it done to create a baseline for women who are beginning to experience signs of menopause. There are other specific labs which will have to be tailored to the individual. So, your low hanging fruit, so to say, is a DEXA scan in addition to checking your serum vitamin D.

Remember, men are not immune to this. They should get their DEXA scan at the age of 55-60. But if they have persistent pain in the above-mentioned areas for over 3 months, it’s a wise idea to have the scan done then.

SUPPLEMENTS:

Since 80% of our top soil is depleted of minerals, we need to supplement. I myself am now taking a comprehensive bone formula, Bone Builder by Metagenics. There is another one called Bone Up by Yarrow, both of which are available at our clinic.

DIET:

A diet rich in calcium—but not necessarily through dairy products that are usually recommended and can be problematic for most people—consisting of broccoli, bok choy, collard greens, sardines (with bones), fish, bone broth, grass-fed lean meat, as well as some nuts and seeds. Beans are another good source of protein, but please soak them over night to reduce phytic acid. If you are not allergic to dairy, have some unsweetened yogurt or kefir. By the way, people in Asia hardly consume any dairy, and, interestingly, have a low incidence of osteoporosis.

EXERCISE:

Exercise is essential for the bone health, in particular weight training, whether with weights or body weight resistance. Exercise increases the secretion of a thyroid hormone called calcitonin, which inhibits the osteoclasts (bone breakdown).

STRESS:

Keep your stress low by having more ‘me’ time: establish regular meditation/prayer time, and schedule acupuncture tune-ups!

By no means is this article a comprehensive overview of osteoporosis. Instead, my purpose is to increase awareness of this epidemic that needs to be addressed. I hope that you will put in practice some of the actionables and make it part of your daily routine.