Osteoporosis

Osteoporosis – Treatment Options

Osteoporosis is the reduction of bone density

Please read this entire document regarding osteoporosis.  There are a variety of factors involved in bone density.  These factors include more than calcium, and are often neglected in osteoporosis treatments.

Osteoporosis is a loss of bone mass resulting in fragile bones and increased risk of fractures.  Osteoporosis can lead to loss of height, stooped posture, humpback and severe pain.  It can affect both men and women, however women are at higher risk, especially after menopause.

Bone density increases until about 25 years of age.  The best-case scenario is to increase bone density at a young age and then maintain your bone density level, as you get older.  If you have osteoporosis in your family or have risk factors for osteoporosis, treat yourself earlier and your outcome will be better.

Tips for reducing bone loss:

  • Eat a significant amount of protein (at least 30-50g/day)but be sure to include sources other than meat protein, which can increase calcium loss.  Other sources of protein include soy, tempeh, beans, nuts, seeds, dairy and fish.
  • Avoid carbonated beverages entirely!
  • Increase calcium in your diet and through supplementation.
  • Get enough vitamin D each day, including at least 15 minutes of direct exposure from the sun each day on hands and face.  Note: sun block with SPF 8 or higher will block the necessary vitamin D activation.  Supplemental vitamin D may be necessary in northern climates.  400-800IU of vitamin D may not be enough for specific people, ask your doctor about vitamin D testing (25-OH vitamin D blood testing.  Do not be happy with the bottom range of normal, you must be middle to high range).  Lack of vitamin D increases parathyroid hormone excretion, which causes a loss of calcium.
  • Make exercise part of your daily routine, especially weight bearing exercises like aerobics, jogging, walking, Jazzercise® or weight lifting.
  • Don’t smoke.  Quit now!  Don’t smoke.  There are heavy metals and chemicals in smoking!  Don’t smoke!  Quit now!  If you don’t smoke, tell someone else to quit now!
  • Keep alcohol consumption to a minimum.

 

Minerals Supplementation

Not all supplementation for osteoporosis are created equal.

Calcium

The easiest forms of calcium to absorb are:

Calcium Microcrystalline Hydroxyapatite (calcium MCHA).

Calcium MCHA is made from cow bone.  It is prepared using a special process of re-suspending bone matrix into an easily absorbable crystalline structure.  Calcium MCHA is bone so it has the appropriate ratio of minerals such as magnesium, boron and silica.  

It may be necessary for those who are deficient to supplement more magnesium.  Signs of magnesium deficiency are restless leg, leg cramps, muscle tension and muscle spasm.  Use additional magnesium with all of you calcium sources if you have these symptoms. You can use up to 1000 milligrams of magnesium per day, with your calcium. 

Protein and Vitamin D should also be used additionally when using MCHA.

Calcium MCHA is bulky, so it is often necessary to take 4-6 capsules to achieve a dose of 1000mg/day-1500mg/day.

The normal Calcium MCHA dose is 1000mg/day of calcium (which is about 3-4 grams of the entire MCHA complex)

Note: Not all Calcium MCHA is created equal!  It is easy to make a bad batch of calcium MCHA, and quality matters!  Do not find the cheapest version of Calcium MCHA, because you are most likely buying bone meal with very low absorption potential.  Bone meal is not the same as Calcium MCHA!

 

Calcium Citrate is another version of easily absorbed calcium.  Calcium citrate is not dependant on stomach acid for absorption.  Those on acid blockers can still use this form of calcium.

Calcium citrate is not a complete mineral supplementation for bone density.  Supplementation should also include magnesium, trace minerals, vitamin D & C and protein.

Calcium citrate is an excellent choice for those with constipation, because one of the side effects is to loosen stools.  Find a calcium citrate that doesn’t have propylene glycol.

Calcium citrate dose per day is 1500mg/day

Chelated calcium such as calcium glycinate, calcium aspartate or calcium malate are also easily absorbed versions of calcium.  These forms of calcium supply the body with amino acids or nutrients that are used to create energy, as well as calcium.  They do not cause loose stools normally.

These forms of calcium are not complete mineral supplementation for bone density.  Supplementation should also include magnesium, trace minerals, Vitamin D & C and protein.

The dose of calcium glycinate/aspartate or malate is 1500mg/day

Calcium carbonate is difficult to absorb in individuals with low stomach acid, a common problem in post-menopausal women and those on acid blockers due to reflux or ulcers.  Calcium carbonate blocks stomach acid.  Stomach acid helps acidify calcium and improve its absorption.  Stomach acid is also necessary for digestion, especially digestion of protein.  Protein is also necessary for bone density.

All calcium supplementation should be divided throughout the day, to increase absorption.

I do not recommend calcium carbonate to anyone because of the long-term risk of damaging digestion.  Calcium carbonate is the cheapest and smallest version of calcium, so it is most often used and recommended by MDs.  I do not believe the convenience of “one pill” can outweigh the fact that “one pill” doesn’t give you anywhere near the benefit of the other calcium types mentioned.

Calcium carbonate also is not a complete bone food.  If you are taking calcium carbonate, you still need to use protein, vitamin D, Vitamin C, magnesium and trace minerals.

Calcium Oxide is also used commonly.  It is not easily absorbed but not as poorly absorbed as calcium carbonate.  Oxides are small and difficult molecules to digest.  I do not recommend this type of calcium either.

 

Magnesium:

Half of the magnesium in our body is stored in the bones.  It is a necessary mineral in the structure bone.  High dose calcium supplementation can lower magnesium levels, making it necessary to eat or supplement magnesium. 

Most processed foods are low in magnesium and the standard American diet tends to lead to magnesium deficiency. 

Symptoms of magnesium deficiency are cramps, twitches, restless leg and muscles spasms.

The Ideal ratio of calcium: magnesium is somewhere between 2 calcium: 1 magnesium to 1 calcium: 1 magnesium. 

For instance: if you take 1000 mg of calcium, it’s necessary to take in 500mg-1000mg of magnesium.  People with constant muscle pain, restless leg, fibromyalgia or polymyalgia should use the 1:1 ratio.

The ratio of magnesium when supplementing Calcium MCHA can be less, do to the nature of MCHA.

 

The body best absorbs chelated forms of magnesium.

Magnesium glycinate or Magnesium aspartate are the best versions of calcium.  They are easily absorbed and tend to have less stool loosening effects.

 

Magnesium Citrate is another option and tends to make stools looser.

Magnesium citrate is an excellent option for those who have constipation and/or those who don’t experience complete bowel evacuation at least daily.

Please see the section about constipation.

 

*Note: All magnesium has the tendency to make stools looser, so use caution and divide the doses throughout the day.  If you have loose stools or normal stools, use the glycinate or aspartate versions.

Magnesium oxide is another type of magnesium widely used.  It is harder to absorb and is not recommended.

 Vitamin D *

Vitamin D increases calcium absorption.

Vitamin D can be supplemented.  The recommended dose of vitamin D is 400 IU/day.  Supplementation can be up to 5000iu/day.  This should be done under medical supervision and using appropriate laboratory diagnosis.  Vitamin D can be toxic.  Replacement doses may be up to 10,000/day or 50,000IU/week.  The vitamin D that should be used is vitamain D3.

Getting 15 minutes of unprotected sun exposure daily can also increase Vitamin D production.  Your vitamin D levels can be assessed with a blood test.  Talk to your treating physician about blood testing.  Your levels of 25-OH vitamin D should be in the middle to higher range of normal.  A low-normal vitamin D level isn’t enough vitamin D and will cause bone loss due to the increase of parathyroid hormone.

Foods high in vitamin D are: butter, cheese, egg yolk, fish liver oil, fortified cereals and bread, fortified milk, herring, mackerel, oysters and salmon.

*TOXIC Vitamin D is toxic in high doses, and caution should be used not to exceed 2000 IU (units) a day without lab evaluation.  The recommended dose is 1000IU without appropriate testing.

Excess vitamin D can cause seizures, nausea, vomiting and death.

Vitamin K*

Vitamin K is necessary to bind calcium to bones. 

The bacteria in your intestines normally produce Vitamin K, but with constipation, irritable bowel symptoms or malabsorption disorders, vitamin K levels can become low. 

Vitamin K can be supplemented safely at a dosage of 100-150 micrograms/day.

Food sources of vitamin K are: broccoli, brussel sprouts, cauliflower, garbanzo beans (aka chick peas), dairy products, eggs, kale, seeds and olive oil.

*TOXIC Vitamin K is toxic and doses of 150 micrograms/day is the maximum recommended limit.  Early symptoms of toxicity are flushing and sweating. 

If you are taking warfarin (Coumadin), do not take vitamin K without speaking to your doctor.

Trace minerals

Other minerals are necessary in smaller concentration for healthy bones. 

Boron*

Boron is used to metabolize calcium and to activate vitamins and minerals.

Do not exceed a dose of 5mg/day.

Food sources of boron are: apples, beet greens, broccoli, cabbage, cherries, grapes, legumes, nuts, peaches and pears

* Toxic Side effects of overdose include nausea, vomiting, diarrhea, insomnia and fatigue. 

Silicon

Silicon helps with the growth and protection of skin, hair, ligaments, tendons and bones.  Silicon is found in whole unprocessed foods.  Often the herb horsetail is added to osteoporosis supplements to add silicon and other trace minerals. 

The suggested dose for silicon is 25-50mg/day.

Silicon food sources include: asparagus, horsetail, cabbage, cucumbers, lettuce, mustard greens, mustard greens, olives, parsnips, radishes, white onions, whole grain rice and oats

Zinc/Copper

Zinc deficiency can lead to bone loss, loss of connective tissue formation, and decreased immunity. 

Copper is used in the normal growth and developments of bones.

Copper and zinc must be taken together, because use of just one can lead to a deficiency of the other.  For every 30mg of zinc you need about 1mg of copper.  They don’t have to be taken at the same time, but they should be taken in the same day.   Take copper with food.

You should not take doses of Zinc greater than 90mg/day for more than a few months at a time.  Higher dosages may be used for immune function, but only for short-term. 

Zinc foods:

Copper foods include: buckwheat, crab, liver, mushrooms, peanut butter, seeds, nuts, split peas and olive oil

Vitamin C:

Vitamin C has many functions in the body.  It is an antioxidant, it helps build connective tissue, increases immunity, regulates the use of minerals and increases bone density.
A typical dose of vitamin C is 500mg 3X/day.  Buffered vitamin C is not recommended for bone density because it can reduce the absorption of calcium (it’s an acid blocker like calcium carbonate).

Vitamin C can be found in chili peppers, guavas, red cabbage and citrus.

Vitamin C can be dosed to “bowel tolerance”.  This means dosages of vitamin C can be slowly increased until stools become loose, and then decreased to normal bowel movement consistency.

Prescription options:

Your MD (allopathic doctor) may recommend certain prescriptions for the treatment of osteoporosis.  Please consider taking these medicines in concert with the above supplemental options.  Bone density is called a “silent problem”.  It can worsen over time without any symptoms.  The better the effort and treatment applied, the better the outcome.

Some prescription options have side effects.  It is best to work with your doctor if the side effects become a problem for your health and happiness.

Other problems to consider if you have osteoporosis are:

Adrenal fatigue

Hypothyroid

Pituitary insufficiency