There are 1.4 million Canadians diagnosed with osteoporosis and one in four women over 50 and one in eight men over 50 has the disease. With the increased intake of sugary drinks in the North American diet over the last few decades we will be seeing an even greater increase in the next few decades in the younger population, not just the baby boomers. Phosphorous in soft drinks and in meat will increase the rate at which calcium is excreted in the urine. Another cause of osteoporosis in young women is the use the birth control injections that are administered every 3 months. As an alternative I would suggest monthly birth control pills rather than the injection for a maximum of 5 years use, then consider other forms of birth control such as Cervical Caps.

The first step in osteoporosis treatment is prevention! If women can get a baseline DEXA scan while they are still in their forties then they have time to treat the beginning stages (osteopenia). If their doctor won’t order it, so that MSP will pay for it, then it costs approximately $120.00 with an MD’s referral. The DEXA scan is not the most accurate test for bone strength but it is all that is available at this time. It measures the mineral matrix which makes up 70% of the bone. The other 30% consist of a protein matrix made up of collagen, for which there is no measurement, but it is well known that nutrients such as vitamin C, copper, zinc, manganese are important for its optimal formation.

Hormone replacement therapy was often the treatment of choice, however this is no longer recommended due to the increased risk of heart disease and breast cancer. The drug therapy of choice now are the bisphosphonates (Didronel and Fosamax) which inhibit bone resorption or bone breakdown. Bone is a very active material that needs to be constantly remodelled, ie building up and breaking down, for optimum strength. When the breaking down of bone is stopped, supposedly, the bone density will increase, which is indicated on subsequent DEXA scans, and lower fracture rates of the spine are seen. However many patients cannot take these drugs due to their digestive side effects.

Sally, age 48, came to me asking for help regarding her osteopenia. Her father and paternal grandmother had osteoporosis and she wanted to begin nutritional treatment to halt the progression. Her doctor had no other suggestions than exercise and taking calcium in the form of Tums!

I began by explaining that her bones not only needed calcium but a good quality one, along with other minerals such as magnesium, manganese, copper and zinc. The calcium I prefer is the (MCHC), microcrystalline hydroxyapatite, a whole bone concentrate that contains the natural ratios of bone minerals as well as the protein matrix and collagen factors. This is provided in a combination called Bone Basics. Tums, on the other hand, is a calcium carbonate only that is not only difficult to absorb but also lowers stomach acid impeding the absorption of important nutrients.

Other well researched nutrients important for improving bone health include boron, strontium, vitamin D, ipriflavone (soy flavone), vitamin C and vitamin K.  Vitamin K is found in foods such as green leafy vegetables and legumes.

I recommended that we do a complete blood chemistry including homocysteine which is implicated in osteoporosis indicating the need for vitamin B6 and B12 and folic acid. An optimal calcium phosphorous ratio of 1:1 and normal levels of BUN and creatinine are other indices to look for on the blood test.  Low functioning thyroid and subsequent treatment with the thyroxine hormone is well known to lower bone density. Sally had been on thyroxine for 5 years and during a serious Crohn’s disease episode she had to take prednisone for 6 months both of which have lowered her bone density.

The other test I like to do is the salivary hormone test to evaluate progesterone, estrogen, cortisol, DHEA and testosterone. I found her estrogen, progesterone, DHEA and testosterone were all low and her cortisol was too high. I explained that by taking a natural progesterone her estrogen levels might normalize along with her peri-menopausal hot flushes, and that there is mounting research indicating the efficacy of progesterone on bone density. Her supplemental boron will increase endogenous estrogen and testosterone both helping bone density. Elevated cortisol is linked with decreasing bone density so controlling stress is an important aspect of the treatment protocol.

I encouraged Sally to have her DEXA scan repeated one year after her treatment program was initiated to look for changes. She was very happy that she had so many options in taking charge of her osteopenia and she was pleased that in one year her DEXA result was better by 1.5%.