Mary, age 51, came into my office wanting a check up. She was beginning menopause and wanted to be proactive as she went through this normal chapter of her life. She was not having a lot of symptoms at the moment but she was hearing stories from other women her age and how much trouble they were having. She wanted to avoid as many symptoms as possible so she was seeking out my expertise on the subject.

During a review of symptoms I learned that there was no heart disease in the family, nor was there any osteoporosis or age related dementias.  Her mother went through menopause in her mid fifties and she had very little trouble. I told Mary that in order to have a complete assessment I wanted her to have a comprehensive blood chemistry panel, a bone density scan (DEXA), a physical exam and salivary hormone testing. Naturopathic physicians order all of these tests not to look for pathology necessarily but to look for optimal ranges that reflect a healthy aging process. Mary had to ask her MD for the DEXA as MSP does not allow naturopathic physicians to order this test.

I warned Mary that her MD would probably not pay (through MSP) for the DEXA, so she needed to be prepared to request that she pay for it out of her pocket which would be around $120.00 and performed at the Campbell River hospital. Subsequent DEXA scans should be performed on the same machine to be statistically relevant. In order for MD’s to send patients for DEXA scans and have MSP pay for them they must have several risk factors including family history, history of bone fractures and or history of medication that depletes bone density such as steroid and thyroid medications

One month later Mary returned with her DEXA scan result in hand along with some lab test results. Her MD sent her for the DEXA scan but Mary ended up having to pay for it. Mary did not have many risk factors other than her slight build. It turned out that Mary had severe osteopenia and was very close to being diagnosed with osteoporosis. How could this be, Mary questioned? Well during her teen age years she had very poor teeth health, a wrist fracture and she frequently consumed soft drinks. These are all risk factors that her MD had not asked her about. Now that Mary knew about her osteopenia at the age of 51, she had time to do something about it for which she was very happy. If she had waited for her MD to order it in her 60’s she would have been full blown osteoporosis and more severe by this time. She did not want to take the drug that her MD said would have to be prescribed inevitably, because of the reported side effects.

Naturopathic medicine offers a very effective treatment protocol for the treatment of osteopenia and osteoporosis resulting in improved DEXA scans within 12-18 months. Many of my patients are asked by their MD what they are doing to produce this change.

With mounting research that vitamin D status and homocysteine are both risk factors of osteoporosis I am performing these tests routinely.   I want the 25(OH) Vitamin D level to be 100-120 nmol/L and the homocysteine to be 5-6 umol/L. Mary needed help in both of these areas so I increased her vitamin D intake as well as her B12, folic acid, betaine and B6 intake. Her salivary hormone test revealed that her progesterone and testosterone levels were low. Jerrilynn Prior M.D. at UBC, has shown in her research that progesterone does improve bone density. Dr. John Lee author of “What Your Doctor Don’t Won’t Tell You” series also demonstrated this in his work over a 20 year period.

I have found with my patients, as did Dr. Lee, the multidisciplinary approach of treating osteopenia and osteoporosis to be very effective. This includes optimizing the vitamin D status, lowering homocysteine, using progesterone topically or orally and optimizing certain minerals. These include MCHC (microcrystalline hydroxyapatite complex) from bone source, magnesium, boron and strontium in therapeutic doses.

Strontium is one of the most important minerals to appear in the research lately. It is one of the few minerals which will actually build and create new bone. Bones are living tissues, constantly being built up and broken down or remodeled. Calcium and vitamin D will keep the calcium from leeching out of the bones but they don’t actually build bones. When antiresorptive drugs such as Fosamax are taken they don’t build new bone, they prevent bone from being broken down. This results in a net increase in the DEXA scan result and according to statistics a lowered fracture rate however it is well known that the bone quality and integrity is decreased.  It is also disputed how long the patient can take the antiresorptive drugs to maintain this effect. 

Mary followed the program I outlined, which included diet changes, to perfection and within 18 months her DEXA scan had improved close to 2% in the both the hip and the spine. Her doctor was pleased with the result and her DEXA will continue to be monitored every 18 months by her MD. What is so wonderful for Mary is that, when she follows such a program, she is also treating and preventing any inflammation in her body thus helping to prevent the onset of cancer as well as arthritis.