Table of Contents:
- What is Osteoporosis
- What is bone density loss?
- Who is at risk of bone density loss?
- Support normal bone density as you age
- Optimize Protein Intake
- Stop Drinking Coffee???
- Why Taking Calcium Supplements Might Not be the Best Idea
- Lift Weights and Exercise
- Eat Less Sugar
- Decompress and Relax
- Get Vitamin D
- Have Your Hormones Checked
- Add Strontium and Magnesium Supplement
- Try Melatonin
What is Osteoporosis?
Osteoporosis and Osteopenia are degenerative diseases that cause bone density loss to the point that bones become very weak and brittle. This process can progress to a stage where bones become so fragile that a mild fall, or even small stresses such as getting up out of a chair or laughing, can cause a fracture. These osteoporosis-related fractures most commonly occur in the hip, wrist, or spine (vertebrae). If you look at the structure of bone under a microscope, you’ll see that it looks much like a honeycomb.
What doesn’t occur to most people, is that bone is living tissue much like our muscles. It’s not concrete. It’s constantly being remodeled. To keep bones strong, your body breaks down old bone via the osteoclasts and replaces it with new bone tissue by way of osteoblasts. However, around the age of 30, the body slows the rate of increasing its bone mass. As people enter their 40s and 50s, bone tissue can be broken down more quickly than it is replaced.
(Image courtesy of openstax.org (1))
As the osteoporosis, or osteopenia progresses, the hollow spaces in between the “comb” get much larger, and the actual structure begins to get thinner, less dense, more brittle, and weaken. This bone density loss, whether your doctor calls it osteopenia or low bone mass, is a warning. Bone loss has started, but you can still take action to keep your bones strong and possibly prevent osteoporosis later in life. That way you will be less likely to break a bone in your wrist, hip, or your spine as you age. Osteoporosis is called a “silent disease” because you may not notice any changes until a bone breaks. All the while though in reality, your bones have been losing strength and durability for many years which is why it is imperative to have your bone density checked as much as possible.
Typically, doctors will prescribe a class of drugs called bisphosphonates. These drugs will increase the density of bone, but they don’t create pliable bone with tensile strength. Think about a glass versus a plasticware dinner plate. The former is nice and dense but as soon as you bump it into your counter, or drop it on the floor, it shatters. The rubbery plastic flexes. Your bones are no different. You want a strong, pliable, resilient dinner plate.
What is bone density loss?
Bone density loss occurs when your body breaks down old bone structure through resorption more quickly than the osteoblasts are able to lay down new bone to replace it. This results in osteopenia and osteoporosis, the diseases of bone density loss. The milder form of the two is typically called osteopenia.
There is a myriad of factors that can contribute to bone density loss, such as family history, certain medicines or conditions, and not developing good bone mass while you’re young. It should be noted however, that there are many things that we do unknowingly that contribute to bone demineralization:
Drinking too much caffeine
Consuming too much sugar
Lack of exercise
Vitamin D deficiency.
Through Dr. Clarke’s work with his patients in his clinic, he regularly orders blood tests for his patients to find out where they stand with their hormones, inflammatory markers, and vitamin levels. He has concluded that almost everyone is vitamin D deficient.
Who is at risk of bone density loss?
Women are certainly more at risk of developing osteopenia or osteoporosis from bone density loss. Approximately one in two women over the age of 50 will develop bone density loss and experience a fracture. This could be due to women having lighter and thinner bones than men. Menopause can also increase the speed at which women break down bone.
However, men are susceptible to bone density loss and osteoporosis as well. Approximately one in four men will experience a fracture due to osteoporosis, a surprising statistic even to most physicians.
Research suggests that family history can play a role in bone density loss as well. If either of your parents suffered from osteoporosis, you are more likely to be predisposed to bone density loss.
People whose diets consist of excessive amounts of the wrong type of proteins, sugar, and carbohydrates are at increased risk of developing bone density loss.
Inactive lifestyles or people who don’t regularly engage in weight-bearing exercises are at risk, because just as pressure turns coal into diamonds, increasing the load on your bones stimulates them to absorb the minerals they need to stay strong.
Some of the medical conditions that may cause bone density loss are those with autoimmune disorders, such as Lupus and Rheumatoid Arthritis. These disorders are typically managed by taking steroid medicines, which contribute to bone density loss leading to osteoporosis and osteopenia.
Hormonal disorders are typically suspected when bone density loss and osteoporosis begin to present. Bones need hormones like estrogen, progesterone, testosterone, and thyroid hormone to build strong, pliable bones. Hyperthyroidism (too much thyroid hormone) can lead to weak muscles and fragile bones. Low testosterone in men may lead to bone density loss, as well as low estrogen in women. When women begin to go through menopause, their estrogen levels drop precipitously. Because women have smaller, lighter bones than men to begin with, this is the contributing factor to the high rates of osteoporosis and osteopenia in their gender.
Support normal bone density as you age
Bone density loss, osteopenia, and osteoporosis can be effectively managed. Bones are living tissue and require all the right chemistries and lifestyle changes to support normal bone density as we age.
1. Optimize Protein Intake
Research has indicated that consuming too much of the wrong type of protein can have a negative effect on bone density. Animal sourced protein is associated with higher serum levels of IGF-1, which has a positive effect on bone density with increased mineralization and fewer fractures. Soy-based protein was associated with lower serum IGF-1 levels, and has been found to be detrimental to bone density.
“Several studies have observed a positive association between dietary protein intake and increased bone mineral content or decreased risk of fracture (15–17). One study found that among premenopausal women, there was a significant positive association between protein intake and bone mineral content, suggesting that dietary protein intake actually may be a determinant of the peak bone mass (15). Among a group of 59 elderly patients hospitalized for femoral neck fractures, those given an oral nutrition supplement providing 20 g/d of protein had significantly better clinical outcomes (lower rates of complications and shorter hospital stays) compared with those not receiving the protein supplement (18).”
2. Stop Drinking Coffee???
Having moderate amounts of caffeine each day from coffee and tea should not harm bone health. The key here is moderation. The majority of research papers point toward caffeine not having a negative effect on bone health. It was thought that caffeine inhibited calcium absorption, however this alone does not seem to be the case.
3. Why Taking Calcium Supplements Might Not be the Best Idea
This is the most common, “advice” from physicians for people to support bone health and normal bone density. However, recent studies suggest that this approach should be avoided. These findings are similar to science finally demonstrating that blood-letting in the 1800’s didn’t rid someone of their diseases. We now know that taking calcium can be counterproductive and can, in fact, do more harm than good. Excess calcium can be precipitated into the arteries as a result of inflammation, compounding problems of atherosclerosis. In fact, there is now a scan called an EBCT (electron beam computed tomography) which is a machine that detects calcium build-up in the arteries. This can be thought of as sort of a way to check the clock on a ticking time-bomb. It would be unwise to risk adding more into the already problematic atherosclerosis equation.
According to a new study published in Live Science, older women with certain health conditions who are taking calcium supplements may be linked with an increased risk of dementia. “Researchers found that women who had previously had a stroke and who regularly took calcium supplements at the start of the study were seven times more likely to develop dementia over the five-year period than women who had had a stroke but who did not take those supplements.”
This research suggests that we may already be getting the necessary calcium through diet alone.
4. Lift Weights and Exercise
When you exercise, walking up hills, lifting weights, and doing jumping jacks, you are putting pressure and stresses on your skeletal structure.
Bones absolutely need to have pressure put upon them in order for them to absorb the minerals required to rebuild. Here in Houston, we are very close to NASA Space Center. Astronauts are prone to bone demineralization when they have an extended mission in zero gravity. If you take the Space Center tour through the astronaut training building, one of the machines that you’ll see is a treadmill with bungee cords attached to a vest. The point of this odd contraption is for the astronauts to strap themselves in, and go for a run. The bungee cords pull the jogger down onto the treadmill and cause pressure on the bones.
(Image credit: https://www.nasa.gov/mission_pages/station/multimedia/gallery/iss036e005384.html)
And by the way, it is also worth noting that water exercises don’t count when discussing bone density exercises. They certainly have their place for cardiovascular health, but without the exertion of pressure on the skeleton, you will not rebuild bones.
5. Eat Less Sugar
Inflammation is a definite contributor to bone loss, and it should be no surprise that sugar is also an inflammatory substance in and of itself. But, sugar also feeds yeast, and yeast is also inflammatory. For example, beer breweries add sugar, yeast and water to make their beer. The sugar feeds the yeast and the byproduct is the alcohol that can then be turned into beer. Because of the high sugar American diet, we are primed to have problems with yeast that is thought to be a root cause of a large number of inflammatory diseases. It is, of course, best known as the cause for the common “yeast infection.”
When sugar is consumed, it increases the glucose in your cells. Excessive glucose levels result in your body becoming more acidic. The body does not like that at all and it mobilizes calcium and magnesium from the bone matrix to decrease the acidity of your blood, ultimately excreting these minerals in the urine. So the body sucks out calcium from the bone to serve as an antacid. Two main components of strong bone, calcium and magnesium are sacrificed into the urine, the result of high sugar in the body.
Sugar also lowers your vitamin D levels. Vitamin D is a key element in the heterodimer of A, D, K2, and thyroid that stimulate the DNA to make osteocalcin, the sticky substance in bone that binds the calcium. Without osteocalcin, the osteoblasts (bone-building cells) cannot complete their construction project.
There is also an adrenal problem that results from too much sugar. Sugar boosts the production of cortisol which is a stress hormone that inhibits calcium absorption and slows down the osteoblasts.
6. Decompress and Relax
Stress causes a litany of health problems, however the topic of this discussion is bone health. The stress hormone cortisol targets the collagen in bone, pulling amino acids away and inhibiting the osteoblasts from proliferating and repairing or building new bone tissue. If you stay in a state of constant high stress, your cortisol levels will continue to inhibit your osteoblast formation, and no amount of vitamin or mineral supplementation will prevent this catastrophic process.
Take time out of your day to practice breathing and mental relaxation methods. Avoid foods that contribute to inflammation, and focus on dark colored fruits and vegetables, and healthy fats like avocado, coconuts, and nuts that grow on trees.
Get plenty of sleep. 7 – 8 hours of solid sleep will do wonders for your stress levels.
Find something that gives you purpose and brings you joy. Finding a hobby that allows you to escape from the mundane and compounded stress of your work or job can go a long way to re-centering oneself.
7. Get Vitamin D
Vitamin D has long been established as a building block for optimal bone health. It was mentioned before that in Dr. Clarke’s clinical practice, the overwhelming majority of patients are vitamin D deficient. He discovers this with the blood tests that he orders for every one of his patients. Your optimal vitamin D level should be between 75 and 100, however Dr. Clarke regularly receives reports on people showing levels in the single digits or in the teens. These are alarmingly low levels!
Vitamin D is actually a hormone that we get from milk, mushrooms, and fortified dairy products, as well as the sun. Vitamin D helps your body absorb calcium and phosphorus from food, the raw minerals for bone-making. In addition, vitamin D is required by the body to support the immune system production of cathelicidins which serve a critical role in our innate immune defense system.
Vitamin D deficiency is common in those who live in northern climates, the obese, those who use sunscreen heavily, people over the age of 60, and those who have more melanin in their skin.
The best way to increase your vitamin D levels is to supplement your diet with vitamin D. Dr. Clarke likes 50,000iu at least once per week, along with weight loss, as this hormone is sequestered in your fat cells. In addition, spend 30 to 60 minutes outside in the sun when your shadow is shorter than you are tall, as this is when you absorb the most UV light, the key generator of vitamin D in the skin.
8. Have Your Hormones Checked
Our hormones are the general contractors of our body’s building. They regulate everything from metabolism, cardiac function, suppression of cancer, cellular output, stem cells, and of course building major structures like bone. They are indeed the major catalyst for bone-making.
Women who enter menopause are at very high risk for bone density loss, as their estrogen levels drop precipitously once they stop menstruating. Hysterectomy or removing the ovaries initiates menopause instantaneously in younger women not quite at menopausal age by dropping their estrogen levels drastically, as this hormone is produced in the ovaries.
In men, testosterone also regulates the osteoblasts and osteoclasts. Men with declining testosterone are at risk for bone density loss, just as women are. One in four men will experience a fracture due to osteoporosis in their lives, compared to one in two women; so this is not gender specific problem.
9. Add Strontium and Magnesium Supplement
Strontium is a misunderstood supplement. Scientists aren’t exactly certain how it works and there is much debate about which form of strontium is ideal for bone density loss. Back in the 70’s everyone knew of Strontium 90, the radioactive isotope that settled in your bones, causing horrible and painful bone cancer. Strontium carbonate and citrate are the stable forms of strontium that accumulate in bone; especially where active remodeling is taking place. These strontium compounds are NOT radioactive! Researchers have found that strontium promotes cartilage metabolism by stimulating production of proteoglycan (structural components of cartilage such as glucosamine and chondroitin). Strontium also suppresses the activity of the ‘osteoclast’, the cell that dissolves bone so it can be remodeled. That is precisely what is needed in a bone and cartilage normal remodeling process: to stimulate the bone maker, the osteoblast, and inhibit the bone dissolver, the osteoclast. That is the mechanism by which strontium directly supports bone density.
Magnesium helps the body absorb calcium and stimulate calcitonin, which is a hormone that draws calcium from the blood and deposits it where it needs to be, in the bones. Magnesium also activates vitamin D for calcium absorption and it’s also a relaxation mineral, alleviating heart palpitations, eye twitches, anxiety, and high blood pressure. Remember the importance of relaxing and breathing on stress levels and bone loss? Magnesium can help you relax, especially your muscles and brain.
10. Try Melatonin
Most people think of melatonin as a vitamin that helps you fall asleep. Melatonin is actually a hormone that regulates your circadian rhythm. However, new data suggests that melatonin can actually increase bone density in rats. The researchers concluded:
“These compelling results are the first evidence indicating that dietary melatonin supplementation is able to exert beneficial effects against age-related bone loss in old rats; improving the microstructure and bio-mechanical properties of aged bones.”
With that said, research in humans is necessary before we can conclude that melatonin helps support healthy bone density.
With all of the recommendations to alleviate stress, eat anti-inflammatory foods, getting your hormones checked and adjusted, and begin an exercise program, supporting bone health and normal bone density is possible through lifestyle changes.