Osteoporosis is a major concern for most women over the age of 50. And women even as young as 40 may start to seriously consider taking action to ensure the health of their bones as they age. Although osteoporosis is a condition most often associated with an older population, the process of building strong bones and preventing osteoporosis starts at a relatively young age.
Peak bone mineral density in women occurs around age 30. This is the point where the bones have reached their strongest, densest point. After age 30, bone density steadily declines into old age. Between the ages of 16 and 30, it is crucial for women to practice habits that build strong bones. Adequate calcium intake from foods such as dairy products and green leafy vegetables, as well as from supplements, is vital to ensuring that the bones have plenty of building material around. An active lifestyle with ample exercise and optimal hormonal balance will also encourage the development of strong bones.
Pharmaceutical Treatment for Osteoporosis
Bisphophonate drugs are the most commonly prescribed medications for osteoporosis. While many women do very well on these drugs, some women cannot tolerate the side effects, which usually include moderate to extreme irritation of the stomach or esophagus. Mounting data is suggesting that these medications should be used with caution. In recent years, they have been correlated to osteonecrosis of the jaw bone, atraumatic fractures (bone fractures in the absence of a trauma or fall) of non-vertebral bones and heart arrhythmias. Early data from the FDA last year seems to suggest increased rates of esophageal cancer in certain predisposed individuals.
In the natural health community, there has been long standing concern regarding the mechanism of action of these drugs and how it relates to long-term bone health. The drug works by decreasing the breakdown of bone, thereby making bones denser in the short term. However, since healthy bone constantly goes through a process of breakdown and formation (often referred to as bone remodeling), reducing the breakdown of bone also inhibits the formation of new bone. It is speculated that this is the reason why these drugs are associated with osteonecrosis of the jaw after dental procedures, due to the fact that new bone formation is needed after an extraction or trauma. Atraumatic fractures are also thought to occur in bisphophonate users due to disruption of the bone remodeling process.
Some women may not want to start bisphophonate drugs because they are on the border of osteoporosis and are not yet ready to try a drug-based intervention. Although these drugs are effective at reducing fracture risk, another drawback is that their main area of benefit is the spine. Vertebral fracture is a serious problem, but even more troublesome are fractures of the hip. 20-40% of elderly patients die within six months of a hip fracture, making it by far the most devastating type of fracture. So even if you are taking a prescription drug for bone density, it is of vital importance to have a comprehensive nutritional plan to ensure the health of all of your bones.
Prescription Drugs that Increase Fracture Risk
Commonly prescribed medications for acid reflux can have a significant negative impact on bone health. The intestines can only absorb calcium if it has been ionized in the stomach by acid. Proton pump inhibitors like Nexium, Prilosec, Prevacid, Zoton and Inhibitol are prescribed for acid reflux because they block the stomach’s ability to manufacture hydrochloric acid. H2 blockers, another class of drugs, are prescribed for the same reason. However, as stomach acid dramatically decreases, so does the body’s ability to absorb calcium. Research suggests that taking these drugs for more than one year can increase fracture risk by as much as 44%! Higher doses and longer periods of time on these medications further increase this risk.
In addition, developing and mature women taking any type of steroid therapy for conditions like asthma, autoimmune disorders or injuries are also at a significantly higher risk for decreased bone density. Make sure to seek out nutritional guidance to ensure that you are doing everything possible to reduce the negative effects of these medications.
Supporting Your Bones with Vitamins and Minerals
Calcium: Although you probably already know that calcium is an important nutrient for bone health, you might not know how much you should be taking. People are often misguided about dosing when it comes to calcium supplementation. 1,000-1,200 mg per day is the dose required to support bone building. Calcium is a very large mineral, in terms of its molecular structure, so in order to get this large dose, it is often necessary to take anywhere from 3-6 capsules or tablets per day. Make sure to check the serving size recommendations on the bottle to make sure you are taking enough capsules or pills to equal 1,200 mg per day.
Vitamin D: Next to calcium, vitamin D is probably the nutrient most often associated with bone health. Without adequate blood levels of vitamin D, your body will not be able to absorb calcium from food and supplements. Although many people are now taking vitamin D, very few people actually know how much they should be taking. The only way to determine this accurately is to get a blood test to measure your vitamin D levels. Only at this point can it be determined how much supplemental vitamin D you will likely need to bring your levels up to optimal. The normal range of vitamin D levels is between 30ng/ml and 100ng/ml. It is thought that an optimal level is somewhere between 45ng/ml and 65ng/ml. Different people will require different protocols of supplementation to reach these levels. One person may need only 1,000 IU per day, while another might need 7,000 IU per day. Again, the only way to accurately monitor the situation is to have your levels tested and monitored. Because vitamin D is fat-soluble and can be toxic if taken excessively, it is important to determine what the most appropriate dose is for your individual health needs.
Vitamin K2: Vitamin K plays some important roles in bone health, particularly vitamin K2. Vitamin K1 is the form of vitamin K most relevant to blood clotting. Osteocalcin is a protein necessary for bone growth, and vitamin K2 plays a critical role in activating osteocalcin so it can contribute to bone formation. Scientific data has verified the correlation between high levels of inactivated osteocalcin and increased risk of hip and other bone fractures. Supplementation with vitamin K2 can increase levels of activated osteocalcin, thereby reducing fracture risk.
There is sufficient evidence pointing towards vitamin K2’s role in supporting bone health. Over the next five to ten years, emerging research will likely show it to be as important as other bone health nutrients, like vitamin D and calcium.
Note: Vitamin K2 should not be taken by anyone on blood thinning mediations. However, for people NOT on blood thinning agents, vitamin K2 DOES NOT raise the risk of developing blood clots.
Magnesium: Magnesium plays several important roles in bone health. Not only is it found abundantly in bone tissue, it is also critical for the absorption of calcium. A good calcium supplement should also contain adequate amounts of magnesium in a ratio of 2:1 (two parts calcium to one part magnesium). For example, a calcium supplement providing 1,000 mg of calcium per four capsules should also provide 500 mg of magnesium.
The Anti-Aging Bottom Line: Osteoporosis affects over half of all Americans over the age of 50, 80% of whom are women. Don’t wait until you have osteoporosis to do something about it. Start prevention early by getting the nutritional support you need for strong bones from supplements and calcium-rich foods.
Dr. Passero completed four years of post-graduate medical education at the National College of Naturopathic Medicine in Portland, Oregon after receiving a Bachelor’s Degree in Environmental Biology from the University of Colorado. Dr. Passero has trained with some of the nation’s leading doctors in the field of natural medicine. In his practice, Dr. Passero focuses on restoring harmony to both the body and mind using advanced protocols that incorporate herbal therapy, homeopathy, vitamin therapy and nutritional programs. Through education and guidance patients are able to unlock the natural healing power contained within each one of us. For more information, visit his website, Green Healing Wellness, or follow him on Facebook.