Osteopenia and osteoporosis are prevalent in modern society. They are best remedied with nutrition, lifestyle changes, herbs, and supplements. Prevention and treatment are both discussed in this article.
What Is Osteopenia And Osteoporosis
Osteopenia – Getting rid of more bone than you are creating. If it continues, it leads to osteoporosis.
Osteoporosis - "porous bone" - Thinning of the bones, leading to bone fragility and susceptibility to fracture. The condition often results in broken bones, especially of the hip, wrist, and spine.
Prevention Is Key
Osteoporosis is something you want to prevent rather than treat. It takes time to create and treat osteoporosis, therefore it is better to prevent it. Often people first find out they have osteoporosis when a bone breaks, so don't wait for this to happen before taking steps to prevent osteoporosis.
The density of bone is due to a balance between the activity of two types of cells. Osteoblasts (the builders of bone), which are involved in producing bone, and osteoclasts (the destroyers of bone), which are the cells that degrade bone. Together these two cell types work to "remodel" bone on a continual basis. Kind of like remodeling your house.
Bone mass grows most quickly during adolescence. The prevention of osteoporosis should ideally start at this time by adhering to a healthy diet and getting exercise. It is important for a young individual to realize this body they are using needs to be taken care of and maintained if they want to live a long and healthy life.
The way to maintain bone structure is to get the 12 minerals and 64 trace minerals in bones. This can be done by eating high mineral foods and salts.
Diagnosis Of Osteoporosis - Less Invasive Methods
I won't go into detail here, but do want to let you know about a low risk (no ionization x-rays), less expensive screening method that will help you decide if you should be concerned about osteoporosis. Usually diagnosis is with dual-energy X-ray absorptiometry (DEXA). However, a recent small study has suggested that ultrasound of the heel bone could be a reasonable, low cost alternative to DEXA to distinguish individuals with low bone mineral density (BMD). This is a great screening tool for those who shy away from x-rays, or can't afford the current expense of DEXA. In the future it will probably replace x-rays as a screening tool to initially evaluate for osteoporosis.
Earlier Screening Methods: Tests To Follow Bone Loss And Treatment
Additionally, there are some screening tools that are great. There is bone resorption (breakdown of bone) testing that is an inexpensive, and non-invasive method that measures rate of bone loss. Collagen makes up the majority of the non-mineral tissue of the bone, and forms the matrix that the mineral portion of the bone is layed down upon. Testing for peptides that make up this collagen is being used by practitioners that want to know of Osteoporosis risk earlier, or want to follow their patients progress on treatment. One of these tests is called pyrilinks-D (deoxypiridinoline or DPD). DPD is only found in bone, and DPD in urine is a good measure of accelerated bone breakdown and can be used to predict the probability of bone loss. General range is 3-7.4, but may differ with labs. This test appears to be useful in predicting future fractures, which allows an individual to get on top of this issue well before fractures start. Read more about this test at Universtiy Health News.
There are a couple more bone resportion tests that are also being used. They measure carboxy-terminal (CTX) (in the serum) and amino-terminal (NTX) (in the urine) telopeptides of type 1 collagen. Read more about this testing again at University Health News.
The thing about these tests is that they are not common place practice yet, and labs may differ slightly in how they test. So, stick to one Dpractitioner, with one type of test, that is from the same lab. Otherwise you will not be able to compare the testing.
Factors That Cause Osteoporosis
Osteoporosis is more likely to occur if there is a family history of osteoporosis.
Health Conditions Associated With Osteoporosis:
- Celiac disease
- Inflammatory bowel disease
- Congenital bone disorder
- Anorexia nervosa or other eating disorder in the first 20 years of life.
- Cushings syndrome
- Cystic fibrosis
- Kidney failure
- Rheumatoid arthritis
- Estrogen or androgen deficiency
- 677C_T polymorphism - genetic studies show an association between the common MTHFR 677C_T polymorphism and the risk of osteoporosis.*
- Low Stomach acid - decreases the ability to absorb minerals
- Low diversity of intestinal microbes
- A diet of high oxalate foods - oxalate binds calcium, magnesium and other minerals decreasing their absorption. Oxalates are really high in soy, and next would be spinach.
- A diet of high phytates such as found in grains, beans, nuts, and seeds will also chelate minerals and decrease calcium/magnesium absorption as well as interrupt vitamin D metabolism, unless they are pre-fermented by a soaking regime or other fermentation method.
* 677C_T polymorphism is the gene encoding the folate metabolizing methylene tetrahydrofolate reductase (MTHFR) enzyme. This polymorphism can lead to high levels of homocysteine which may be related to osteoporosis. This can be treatedwith diet or supplements. See further on in this article for healing methods.
Age & Sex:
- Osteoporosis happens over time, so as you age, the occurrance becomes more likely.
- Osteoporosis is more common in women
- Osteoporosis-related fractures will develop in half of all women older than 65. One out of three postmenopausal women has osteoporosis to some degree.
- Osteoporosis-related fractures will develop in one-fifth of all men older than 65 years.
Late onset of menstruation or early menopause
Being very thin/low body weight
High homocysteine levels - may be high homocsteine or may be lack of B vitamins as seen in conjunction with high homocysteine. (May be related but not causal.)
Dietary deficiencies: Lack of minerals used to form bone tissue is associated with osteoporosis, as is vitamin D and K. However other minerals and vitamins are also needed to make strong, flexible bones and prevent osteopenia and osteoporosis. The list includes these nutrients below:
- Vitamin D
- Vitamin K
- B vitamins (folate, b6, b12 specifically)
Excess phosphorus - Soft drinks or other carbonated beverages with phosphorus will decrease calcium levels.
Excess salt (sodium) - associated with osteopenia
Coffee - associated with osteopenia - Two or more cups per day associated with accelerated bone loss.
B vitamin deficiencies
- Thyroid medications or overactive thyroid
- Exposure to radiation
- Steroids such as hydrocortisone, prednisone,
- Anti-seizure drugs such as carbamazepine, gabapentin, or phenytoin
- Aromatase inhibitors
- Vitamin A
Lack of Exercise - especially weight bearing
Other Lifestye Factors
- Smoking - An individual can minimize the loss of bone from smoking by quitting in later life although it is better to quit earlier in life.
- Fluoride may be an issue if you have high fluoride water - see data below
- Alcohol - People who drink alcohol are more prone to fractures.
Vegetarian Or Meat Eater Debate & Acid/Alkaline Food
There have been some studies in the past that appeared to show vegetarians had less chance of osteoporosis as they aged in comparison with meat eaters. However, it appears that the real issue with the meat eaters was a lack of getting enough vegetables and fruit. They lacked necessary nutrients to build healthy bones. It appears that the elderly who are more inclined to have osteoporosis are more likely to be deficient protein rather than have too much, and low protein is shown to be associated with osteoporosis. So, the key appears to be getting adequate protein from either vegetable or meat sources as well as adequate vegetables and fruits in the diet.
It has also been though and widely stated that meat or acid producing foods will remove calcium from the bones in an effort to re-establish the bodies acid-base balance, but this has been found to be untrue.
Several recent human studies have shown that there is no relationship between nutritionally induced variations of urinary acid excretion and Ca balance, bone metabolism and the risk of osteoporotic fractures.
It has been demonstrated that, in subjects in good health, that meat eaters are not more acidic than vegetarians and do not extract calcium from their bones to buffer the acid.
Fluoride And Bones
Since some water has naturally high fluoride in it and many U.S. water supplies have fluoride added to water supplies, I think we should look closer at the affect of fluoride on bones. Fluoride accumulates in bones, just like lead. Fracture risk and bone strength have been studied in animal models. The weight of evidence indicates that, although fluoride might increase bone volume, there is less strength per unit volume.
In a 2006 scientific committee review report prepared for the EPA regarding fluoride in drinking water, there was consensus among the committee that there is scientific evidence that under certain conditions fluoride can weaken bone and increase the risk of fractures. The majority of the committee concluded that lifetime exposure to fluoride at drinking-water concentrations of 4 mg/L or higher is likely to increase fracture rates in the population, compared with exposure to 1 mg/L, particularly in some demographic subgroups that are prone to accumulate fluoride into their bones (e.g., people with renal disease).
They did not know the effects under 4 mg/L ( 4 mg/L is the most allowed in drinking water by the EPA) and said more studies of communities with drinking water containing fluoride at 2 mg/L or more are needed to assess potential bone fracture risk at these concentrations.
Skeletal fluorosis is a bone and joint condition associated with prolonged exposure to high concentrations of fluoride. Fluoride increases bone density and appears to exacerbate the growth of osteophytes present in the bone and joints, resulting in joint stiffness and pain. Whether the EPA’s maximum fluoride level allowed of 4 mg/L in the water supply protects against these precursors to more serious mobility problems is unclear.
Factors That Lower Risk Of Osteoporosis
Nutrition For Your Bones
All living tissues require essential nutrients. The skeleton requires nutrients for development, maintaining bone mass and density. If the skeletal nutritional requirements are not met, the consequences can be severe including osteoporosis.
Bones get nutrients from the bloodstream. So, what you are eating or getting from sunshine (vitamin D) is quickly made available to your bones.
Stomach acid: First and foremost you need adequate stomach acid to absorb minerals. Read more on this below.
Intestinal Flora: You need a diverse gut microbial community. Read more on this below.
Hydration- Need to stay hydrated, yes even your bones and joints need water.
Dietary Factors: I suggest most people use nourishing, high mineral foods and high density nutrient teas to get adequate nutrition. Please be aware that consumption of vitamins and minerals when not needed can have deleterious effects. Although many studies show positive results as far as prevention of osteoporosis and fractures with intake of calcium supplements, there are studies also showing the opposite. This makes it confusing. However, what is healthy and not confusing is the use of nutrient dense foods to prevent osteoporosis and fractures. Therefore, I suggest including high mineral/nutrient foods and herbs in your daily diet.
Needed In The Diet For General Bone Formation/Support:
- B vitamins (folate, b6, b12 specifically)
- Phosphorus - usually plenty in diet
- Vitamin D - works synergistically with vit. K
- Vitamin K - works synergistically with vit. D
- Vitamin A
- Vitamin C
How To Supply Bone Healthy Nutrients - Diet & Sun:
- Dark green leafy vegetables (1 serving per day, compared to 1 per week, cuts your risk of a hip fracture in half.) They are high in calcium magnesium and vitamin K.
- A special mention goes to Kale which is high in calcium, magnesium and Vitamin K and easy to grow.
- Fresh fruits and vegetables - 9 servings or more - focus on brightly colored ones - colored to their core, not just a colorful skin
- A variety of dried fruits are great out of season.
- Broccoli and other mustard family plants (high in vit. K and minerals)
- Dried beans - good supply of protein, calcium and magnesium - avoid kidney beans and soy generally, all beans must be pre-sprouted and cooked well.
- Dairy foods for those who can ingest them- I suggest finding a local farmer if you want "real milk" and making fermented dairy products. Fermented milk is the safest way to get dairy.
- Salmon and other cold water fish - sardines are inexpensive and have small edible bones that supply nutrients in just the correct amounts - Omega 3 fatty acids such as found in cold water fish reduce inflammatory and degradation markers in chondrocytes and synoviocytes.
- Variety - although I mention some high powered nutrient sources for your bones here, variety is important.
- Meat - There is debate on the whole acid/alkaline situation that I went into previously. If you are eating meat, I suggest organic or grass fed only. The meat industry has really made it hard for a meat eater to get quality food.
- Bone Broths - Great for bone and joint health - make them the old fashioned way. The gelatin in broth contains chondroitin sulfate a main building block of bone matrix, cartilage, ligaments, tendons and connective tissue in general.
- Consider Plants/Herbs High In minerals/vitamins/isoflavone phytoestrogens - see details below
- Celtic Salt - many minerals
- Seaweed - many minerals
Check You Stomach Acid
A person may have enough minerals and other nutrients in your diet, but if you don't have enough stomach acid, you may not be absorbing your protein and minerals. An individual needs acid to help them absorb minerals from food and supplements so they can build better bones.
As we age, the production of gastric acid decreases. Some research has shown it decreases by 50% or more in people over 60 years old. Low gastric acid/pepsin means food is not digested and can lead to reflux (stomach contents refluxing into throat) and dysbiosis (intestinal bacteria out of whack and causing illness). Low acid can be measured with radio telemetry via a Heidelberg capsule. Symptoms of low gastric acidity are bloating, belching, gas, burning, gastroesophageal reflux and a feeling of food sitting in the stomach and not digesting after meals. There may also be broken fingernails and thinning hair.
Low acidity leads to decreased absorption of nutrients. This includes inadequate protein absorption and decreased absorption of minerals and can lead to osteoporosis. If you think you have low gastric acid, see your practitioner right away. You can read more about this here. Also, you can give a copy of this research article to your practitioner.
Bitter foods and herbs will stimulate stomach acid as well as other digestive juices. Some people have trouble stimulating them though. So, if you tried bitters and they don't work, your practitioner may decide you need to replace your stomach HCL and/or pancreatic enzymes to assimilate the protein, oils and minerals necessary for supporting your bones/joints.
We know that diversity of intestinal microbes can be protective against osteoporosis. Research has shown a correlation between the diverse number of bacterial species and the bone mineral density. The same study showed the proportion of Firmicutes bacteria was significantly higher and Bacteroidetes was significantly lower in samples from people with osteoporosis than that in "normal" samples.
This simply tells us what most research keeps telling us in regard to our gut microbes and that is diversity of gut microbes is key. Additionally, as with other research we find Bacteroidetes too low and Firmicuties too high. We see this scenario in various disease processes, however the research is in the beginning stages and sometimes contradictory. So, what to do about it?
Increase Diversity of Intestinal Microbes
This is the one thing, all studies seem to agree upon. Diversity of the gut population is key. To get diversity I do not suggest taking a gut flora capsule although if you do, make sure there is diversity of the microbes in the capsule and you may want to take a few brands. However, you usually get better diversity by eating live fermented foods such as sauerkraut, live pickled beets, or kimchi. In fact if you like fermented foods, try fermenting your own. I have fermented almost everything in my garden at one time or another. My favorite fermented beverage is beet kvass. I would recommend the book "Wild Fermentation" by Sandor Katz as he has basic easy to use recipes that will give you good results.
Luckily if you do not want to make your own, there are live fermented vegetables available at local health food stores nowadays.
You can also feed your healthy gut bacteria by providing inulin to them. You can spend a lot of money on it as a supplement, or you can eat herbs that are high in inulin. Examples are dandelion root, and burdock root. These two herbs are also slightly bitter, so they will stimulate your digestion which will help you assimilate your nutrients better.
Vitamin K2 And The Fermentation Connection
We also know that vitamin K2 is important for proper bone growth. More importantly, K2 has been shown to completely reverse bone loss in Japanese trials, and in some cases even increase bone mass in people with osteoporosis. Additionally there has been shown to be a 60 percent reduction in vertebral fractures and an 80 percent reduction in hip, and other non-vertebral fractures. K2 is made by our gut bacteria from K1, but thought not to be absorbed, since it is made in the colon. (We are finding some things are actually absorbed in the colon more so than previously thought. Perhaps K2 is one of them, but we can't bet on it.) However, we can eat animal products that have K2 in them such as "grass fed butter, or grass fed egg yolks" or natto which is very high in K2. Alternatively, we can ferment vegetables high in K1, and get K2 that way. During fermentation of vegetables K1 is turned into K2. So ferment your cabbage, broccoli, brussel sprouts and kale. Even cucumbers have vitamin K1, although not as much as most of the Cruciferae family vegetables. Kale has 4 -8 times more K1 than other vegetables consumed for higher K1 content, so be sure to include kale in your ferments.
Fecal Transplants To Enhance Gut Microbe Diversity
Sounds scary, hugh. Well, not really, but for most people they are squeamish about this next subject. When someone tries everything available to get their gut flora back to a happy state, but they just can't seem to do it, there is always a fecal transplant. It is really quite simple and something you would want to talk to your practitioner about. It is mostly naturopaths and functional medicine M.D.s that do this or know about it. You basically take feces from a healthy person (It has to be a healthy person with great digestive flora.) That healthy sample is then transplanted into the individual in a manner similar to being given an enema. If the transplant is a success, which it often is, the person will immediately notice a difference in their body.
The Low Down On Milk
There are contrary reports as to if milk is protective or may even cause fractures. From reading the research here is what I would say the take home is on the situation.
- The role of dairy foods for hip fracture is controversial.
- Recent evidence indicates that fermented milk in comparison to non-fermented milk exerts a protective effect on hip fracture rates and bone mineral density.
- Many people are sensitive to milk due to an inability to make appropriate enzymes such as lactase to digest milk sugar or enzymes to digest milk protein. They cause inflammation in the body when they drink milk and this can cause collateral damage.
- Accumulating evidence supports the view that persistent ingestion of pasteurized dairy milk and bioactive exosomal miRNAs (in the milk) after the skeletal growth period activate cells that break down bone and impairs cells that build up bone. It appears that much of the negative effects from milk exosomes disappears when the milk is fermented. So think yogurt or cheese if you are a dairy eater.
For details on Exosomes and epigenetic signaling from milk (Yes, the milk that mammals make and babies drink transfers genetic information to the baby that is necessary for that individual to be healthy.) read more about it here.
Lowering High Homocysteine
Individuals with hyperhomocysteinuria exhibit numerous skeletal defects, including reduced bone mass density, osteopenia and a higher risk of fractures in the elderly. How does this happen? Well, animal studies have shown that a deficiency in folic acid and Vitamins B6 and B12 can lead to increased levels of homocysteine and, consequently, an increased production of free radicals and oxidative stress, which lead to endothelial dysfunction, decreased bone blood flow and, eventually, osteoporosis. (This is the theory any way.)
High homocysteine is associated with certain low B vitamins and increasing foods with B vitamins such as dark green leafy greens or taking them as a supplement (active Bs, for example - an individuals needs to use folate and not folic acid) will decrease the homocysteine level usually.
High homocysteine can usually be lowered with a mix of betaine (trimethylglycine, riboflavin 5' phosphate, 5-MTHF (folate), methylcobalamin(B12), and Pyridoxal 5' phosphate (b6). A persons practitioner would usually advise them of what would best work for them. You will usually see these mixes sold as Methylation Formulas. There is one called Methyl Guard Plus by Thorne that I like, but there are many decent formulas on the market.
B12 is one of the vitamins used to lower homocysteine and vegetarians are often low in this vitamin to the point of being symptomatic. Some people have trouble absorbing it, especially the elderly (usually the same folks that are low in stomach acid). A common symptom of B12 deficiency is megaloblastic anemia. Folate deficiency also causes megaloblastic anemia and both can be low in the person with high homocysteine. Usually both folate and B12 are given together for reasons we won't go into here, but don't use folate without B12 unless you know the person has enough B12 for sure.
The neurologic symptoms of Vitamin B12 deficiency include: numbness and tingling of the hands and, more commonly, the feet; difficulty walking; memory loss; disorientation; and dementia with or without mood changes.
To Add Minerals To Your Daily Diet, Consider High Mineral, Nutrient Dense Herbs
They are best made as overnight infusions. I once measured the magnesium content in an overnight infusion of Nettles in comparison with a 25 minute decoction and there was the tiniest bit more magnesium in the decoction, but so tiny that it was not worth the loss of the beautiful taste you get with the overnight infusion. I was surprised as I thought the decoction would have had much more magnesium in it by comparison. Since overnight infusions usually taste better, and are a great way to ingest minerals, I usually choose this method. It is also a very easy process that takes little time. Learn how to make infusions, decoctions and overnight infusions here.
Stinging nettles - Urtica dioica
Nettles contain calcium, magnesium, silica, iron, potassium, boron, manganese, cobalt, selenium, chromium, and sodium as well as protein, vitamin A, B (no b-12)C, K (lots of K),
Stinging nettle has a better amino acid profile (protein) than most other leafy vegetables. This green leafy plant is high in most amino acids except leucine and lysine. By dry weight it is comparable to beans and chicken for quantity of amino acids supplied according to one research review.
This plant needs to be harvested in the spring when fresh and succulent if eating it as a food. If making a tea out of it, you can harvest it anytime before it starts to make flower buds.
If eating it as a food, you can use it much like spinach. However, watch out for the stingers. Know how to collect and prepare it by reading this article on Nettles.
To make a tea, I suggest an overnight infusion or if in a hurry a 25 minute decoction. I will warn you that the decoction is not as tasty as the overnight infusion. The decoction in fact tastes a bit bad when compared to the overnight infusion. Fill a quart jar with 1/8-1/4 full with the Nettles, pour hot water over it all, nearly filling the jar, screw on a tight fitting lid and let infuse all night. In the morning strain it and begin drinking. Refrigerate any of the tea you do not immediately drink.
Parsley - Petroselinum crispum/sativum
This plant contains a lot of vitamin K and along with kale is a great way to get vitamin K. 1/4 cup has twice the amount of vitamin K recommended per day. It also has vitamin C, A, folate, iron, a small amount of calcium, magnesium and potassium. I suggest adding it to casseroles, soups, frittatas or anything you are eating. A little goes a long ways.
Oatstraw or milky oats - Avena sativa
This plant is rich in many minerals such as magnesium, calcium, phosphorus, chromium, iron, selenium, sodium and silica. It contains lesser amounts of cobalt, manganese, potssium, tin and zinc. It also contains high amounts of B vitamins ( B6, folic acid, niacin, riboflavin, and thiamine), vitamin A and C and less amounts of vitamins E and K. It also contains many amino acids (arginine, histadine, leucine, lysine, phenylalanine, and tryptophan).
This herb works great as a tea. The taste is quite mild. You can make an overnight infusion by adding the herb to a quart jar. If using the Oatstraw, I usually fill up 1/4 of the jar with the Oatstraw and then fill the jar with hot water and put the lid on tightly. The next morning the tea is strained and can be enjoyed through-out the day. Put it in the refrigerator to preserve it. Treat it as you would any other food. If you forget it and find it next week in the refrigerator, it needs to be thrown out.
Horsetail- Equisetum arvense
Horsetail has 5-10% dry weight silica which is the most I know of in any plant we use as food or medicine. Only the young actively growing somewhat supple male stems should be collected. Do not use older horsetails. Silica helps normal bone growth as well as repair of fractures. Silica is hard to extract from plants. Use young plants and an overnight infusion. I realize that silica in rice hulls and other such material is easier removed with water treated with an alkaline solution such as sodium hydroxide. Although I can't find the research on silca extraction from horsetail, I assume it would be better extracted in an alkaline water medium too. Herbalists have always collected the young shoots feeling the silica is in a form at this time that is more conducive to extraction, but additionally is better utilized by the body during the plants early growth phase. However, Ryan Drum has a yummy way of extracting silica from horsetail that uses a slightly alkaline medium. Dr. Drum says silica tends to be insoluble at pH below 7.2-7.4. He suggests using honey as an extracting medium as it has a pH of 7.4-7.8. He uses the young stems and cuts these fresh, green stems up and places them in honey that is heated to 100-110 degrees F. Use 1 part horsetail and 3 parts warm honey and keeping it at 100 degrees for a few days stirring as you think of it through-out the day (every 4 hours while awake). The sugar content in the honey will both help extract the silica by breaking open the cell walls as well as preserve the product. Some people leave their herbs in honey after extraction, but with Horsetail, I suggest you strain it out and save the lovely honey. Do this while the mixture is still warm or it will be impossible to strain.
Alfalfa - Medicago sativa
Alfalfa has high amounts of protein, Vitamin A, B (biotin, folic acid, niacin, pantothenic acid, pyridoxine, riboflavin, and thiamin), C and moderate amounts of vitamin D, E and K. Also contains calcium , chromium, cobalt, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, silicon, sodium, and zinc.
This herb tastes a bit like grass and it is nice to add something to your overnight infusion such as another good tasting tea or a spice to make it more pleasant to drink.
It is best to mix up the teas, so you are using different teas from time to time. You may find yourself attracted to one of them more than others at different times. You are also not limited to these high mineral herbs. These are just a few suggestions. To enhance the taste of these teas, you can add other high mineral spice herbs such as basil (high in calcium and vitamin K), Ginger (great at reducing inflammation), Sage (provides a lot of vit. K), Kelp, Oregano. You can also simply add any other tea or spice that you like that will make the tea more pleasurable to drink. The point is to enjoy it so you will want to drink it.
Sun For Vitamin D - 15-20 minutes per day - Besides sunshine you will find it in cold water fish like salmon, beef liver, cheese, egg yolks. Cod liver oil also has vit. D
Sleep: A study in the Journal of the American Geriatrics Society found those over age 50 who got less than six hours of sleep a night, they had a higher risk of osteoporosis than their peers who slept longer.
I would additionally suggest getting restful and deep sleep. Melatonin can be helpful, especially in the elderly who usually make less of it.
Especially resistance exercise which is any form of exercise that forces your skeletal muscles to contract.
Weight lifting is commonly thought of, but any weight bearing exercise works. You can use dumbbells, barbells, your body weight, bottles of water, bricks, rocks, anything that resists your muscles. Even pushing against your house wall is a good exercise.
Other exercises that are useful are dancing, high-impact aerobics, jumping rope, walking, hiking and climbing stairs, playing tennis.
If you are frail low impact weight-bearing exercise is safer. This would include low-impact aerobics, stair-step machines, and fast walking.
Swimming is an interesting form of exercise. Swimmers present with lower bone mineral density than individuals who are involved in high impact sports and they have similar values to sedentary controls in studies. However, swimmers have a higher bone turnover than the controls resulting in a different bone structure which in turn results in higher resistance to fracture indexes.
To increase flexibility yoga, Qi Gong and Tai Chi are useful.
If you are considering medications with your practitioner, ask them about their efficacy and their side effects. Medications given for osteopenia can cause digestive problems and bone and joint pain as well as make people tired. A few of them have had some more serious issues including increasing bone breakage. We won't discuss these drugs here as you can get data on these treatments from many websites as well as your practitioner.
Newer Research Articles On The Use Of Berberine
Diabetes, Osteoporosis And Berberine
Diabetic related osteoporosis can result in an increased incidence of bone fractures and a delay in fracture healing. The constituent berberine (found in many herbal plants including Barberry - Berberine spp., Oregon grape - Mahonia spp., Goldenseal - Hydrastis canadensis, Gold thread - Coptis canadensis, Amur cork tree - Phellodendron amurense, Huang Bai - Phellodendron chinense) reduces blood glucose levels. Since high glucose causes dysfunction in the human bone marrow stem cells, researchers set out to see how bones of diabetic mice would be affected by berberine. It was shown to partially prevent damage to the mice leg bones (femurs) and restore the decreased bone formation. The dose given to the mice was quite large however.
Postmenopausal Osteoporosis And Berberine
Post menopausal osteoporosis is a risk factor for periodontitis and it has been shown that therapies used for post menopausal osteoporosis prevent alveolar bone loss of periodontitis in estrogen deficient women. Recent research has indicated that gut microbiota is a potential target for the treatment of estrogen deficiency-aggravated periodontal bone loss, and berberine through it's modulation of gut microflora appears to not only affect metabolic diseases such as obesity and diabetes, but also ameliorates periodontal bone loss through improvement of the intestinal barrier and regulation of the microflora. A recent study showed significant reduction in alveolar bone loss when berberine was given to rats who had their ovaries removed as compared to those not given berberine. The rats given the berberine were found to have higher levels of butyrate producing bacteria. They also had improved intestinal barrier integrity and lower levels of serum endotoxin.
Postmenopausal Osteoporosis And Other Herbs/Plants
Excerpt from my book "Herbal ABCs - The Foundation of Herbal Medicine" The main cause of postmenopausal osteoporosis is thought to be estrogen deficiency (there is a new theory that bone loss might be related to increased follicle stimulating hormone which may be stimulating osteoclasts) which increases bone resorption and accelerates bone loss. Hormone replacement therapy had previously been used to prevent hip and spinal fractures in menopausal women. However, it is no longer recommended since the 2002 Women’s Health Initiative study revealed estrogen replacement therapies increased risk of cancer, stroke and arteriosclerosis. In some cases practitioners will still recommend hormone replacement therapy and some may use bioidentical or natural hormones as an alternative to synthetic hormones. However, largely practitioners tend to shy away from use of hormones at all. This has lead to an increased interest and research on the use of phytoestrogens for osteoporosis.
Estrogen receptors alpha and beta are both found in bone cells including the osteocytes, osteoblasts, osteoclasts and chondrocytes.
Hops And Prenylflavonoids
Prenylflavonoids represent a class of plant flavonoids that will be studied more closer for estrogenic activity in the future. There are research studies showing osteoprotective effects from 8-prenylnaringenin (8-PN), which is a component of female hop strobiles (hop flowers) and is supportive of bone building.
As a beer maker, I like the fact that hops may help prevent osteoporosis. It has many medicinal uses in fact, but we will save that for another day.
Beans, Red Clover And Other Leguminous Plants
The plants in the bean/pea family (Leguminoseae) supply the well studied isoflavone constituents called genistein, daidzein and equol. Equol is technically made from genistein and daidzein by the microflora in our guts.
Genistein, one of the isoflavones abundant in soy, is one of the most well studied of the phytoestrogens. It has the ability to both inhibit bone resorption activity of osteoclasts (cells that break down bone) and stimulate osteogenic differentiation and maturation of bone marrow stromal progenitor cells and osteoblasts. (cells that build up bone) This assists in overall bone growth.
Genistein prevents bone loss in research rats inhibiting inflammation activating angiogenesis, enhancing bone formation and inhibiting bone resorption. Genistein has been reported to prevent the bone damage that often accompanies chemotherapy.
All three constituents , genistein, daidzein(supplied from the plant) and equol (formed from the plant isoflavones by gut bacteria) from legume herbs/foods are well known for their phytoestrogenic effects with equol being the most effective. However when compared with 8-prenylnaringenin (from Hops), 8-prenylnaringenin was the most effective as far as the osteoprotective effects.
Herbs/Plants High In Isoflavone Phytoestrogens
- Licorice - Glycyrrhiza spp.(make as decoction)
- Alfalfa - Medicago sativa (make as infusion)
- Red clover - Trifolium spp. (make as infusion)
- Soy - Glycine max - I would suggest fermented soy foods such as tempeh, tamari,and soy sauce only. Don't eat soy beans unless fermented. Simply not healthy. I did not list them here to tell you to eat them, but to warn you to be weary. I go into this in my last book.
- Beans - Phaseolus vulgaris- this includes all dried beans - soak to begin sprouting and cook well to remove antinutrients.
- Kudzu roots - Pueraria lobata (make as decoction)
Up And Coming Prenylated Flavonoids
Another prenylated flavonoid, called Icariin, from the Chinese medicinal herb genus Epimedium (multiple species), has been shown to stimulate bone growth and decrease bone resorption. Icariin is more potent than genistein in promoting estrogenic differentiation and maturation of osteoblasts (cells that make new bone).
Some nine Epimedium prenylflavonoid compounds have been reported to target estrogen signaling and other bone creation pathways in osteoblast and osteoclast cell lineages. Epimedium prenylflavonoids can exert beneficial effects on bone health in estrogen-deficient and other models of osteoporosis animals.
The Flavone Chrysin & Plants Containing Chrysin
The flavone Chrysin, which is found in honey, propolis, and Passion flower (Passiflora spp.), has been shown to enhance the formation of bone through estrogen receptor mediation. It has the potential to enhance osteogenesis for prevention and treatment of osteoporosis.
A Few More Herbs To Mention
Research showed non-psychoactive cannabidiol or CBD in Marijuana was able to enhance the healing of mid-femoral fractures (broken leg) in rats. when used for 8 weeks. The THC was not shown to help, only the CBD fraction of the marijuana. You can by the way purchase low or non-THC and high CBD preparations of medical marijuana.
I am mentioning this herb specifically although it is in the list of isoflavone herbs above too. Osteoporosis is associated with inflammation in the body and Licorice helps in the process of decreasing bodily inflammation. Additionally, it helps support the menopausal woman as a phytoestrogen and it has been shown to contain constituents that have similar affects on bone metabolism, and osteogenic differentiation as does estradiol. I think this is an excellent herb for menopausal women with osteoporosis or who want to preven it, however it does have some precautions. It should not be used with high blood pressure or with edema. There are other reasons some people should not take this herb and I suggest you read through them all here.
Ashwagandha has been shown to protect menopausal mice from bone loss. Other research has also shown this herb to increase expression of the cells (osteoblasts) that help to grow and mineralize bone. It has decreased inflammatory cytokines associated with osteoporosis and shown ability to regenerate bone in damaged bone of menopausal mice. This is an herb that is considered to be an adaptogenic herb.
Supplements Are Not All Equal
Calcium is added to so many foods that it is not a common deficiency any more. One needs to evaluate their intake before they take a supplement of calcium or any supplement.
That being said, if you do take a calcium supplement you should know that the calcium supplements made from oyster shell and bone meal may contain quite a bit of lead which accumulates in your bones. So, I suggest you stick to calcium chelates which have lower levels of lead usually and are better used by your body. These would include calcium citrate, fumarate, succinate, and malate.
You should also know that calcium carbonate supplements have had the most side effects. The most common being constipation, but they also may cause flatulence (a nice way to say farting), and bloating. Plus calcium carbonate is chalk. Do you think using it might build bones that have a chalky consistency or at least less strength?
Vitamin D should be in the form of Vitamin D3. I suggest you also get D3 that has itamin K2 in it. You can find some liquid oil vitamin D3s that contain K2 levels listed on the bottle.
This should be in the form of K2. There are various forms of K2. MK7 appears to be more beneficial than some forms of K2. There is data showing K2 appears to be better than K1 for osteoporosis prevention, but I must admit a review of all the research showed much of the research was lacking in a variety of ways. Just basic data and techniques were often poor, so although I still use Vitamin K2 and usually in the base of a vitamin D3 oil emulsion, I am wondering if using K1 or K2 really makes so much difference. I write more about this below.
A Special Mention Of Magnesium
Calcium gets all the glory when it comes to preventing osteoporosis, but the fact is that magnesium is just as necessary and in fact is more likely to be deficient in an individual in the United States than is calcium. Magnesium is absolutely necessary for good bone growth and health. Consider that it is involved in these vital bone related activities.
- Bone growth - activates an enzyme needed for new bone to form
- Regulates calcium transport
- Involved in osteoblastic and osteoclastic activity
- Prevention of osteopenia and bone fragility
- Assists in calcium absorption
- Studies have shown it is involved in increasing bone density in the first year of supplementation.
- Norwegian study showed the less magnesium one had in their drinking water, the more likely they were to break a hip.
- In one clinical study, 32 post menopausal women took 250 to 750 mg of magnesium per day for two years. Bone mineral density increased by 1 to 8% in nearly 75% of cases.
When someone tells me that they have twitches, muscles spasms and awake at night with charley horses, I tell them to increase the magnesium in their meals or to take a supplement. Food is the best way, but supplements help too. Magnesium is involved in hundreds of activities in the body and you would be surprised what can go wrong when there is not enough magnesium aboard.
Luckily, the same food sources for calcium are usually high in magnesium. Supplements that I would suggest are magnesium glycinate, citrate, and if using in liquid form, plain old magensium chloride is quick to be absorbed and is used by some people with spasms to get quick relief.
Mention Of A Few Other Minerals
Manganese deficiency causes an increased susceptibility to fracture.
Boron supplementation has been shown to reduce the urinary excretion of calcium by 44 percent, reduce urinary magnesium excretion and markedly increase the serum concentration of 17 beta-estradiol and testosterone.
Zinc is essential for normal bone formation, supports the activity of vitamin D, and is required for the formation of osteoblasts and osteoclasts and is needed for the synthesis of various proteins found in bone tissue. Zinc levels have been low in the serum and bone of elderly people with osteoporosis during research studies.
Copper deficiency may be a related to osteoporosis. Copper supplementation has been shown in laboratory studies to inhibit bone resorption. Its considered necessary in women at risk or with diagnosed osteoporosis.
Remember zinc and copper should be ingested in a 8:1 ratio of zinc:copper.
Silica is integral to connective tissue like collagen. It has been shown in mice studies to support bone building by increasing osteoblast activity but suppress bone-resorbtion by decreasing osteoclasts. There was an increase in bone density and bone formation.
Vitamin K research suggests that vitamin K2 regulates bone remodeling, an important process necessary to maintain adult bone. Bone remodeling involves removal of old or damaged bone by osteoclasts and its replacement by new bone formed by osteoblasts. Vitamin K is in fact required for osteocalcin carboxylation that in turn regulates bone mineral mass. Put simply, it promotes formation of bone cells, and also limits the process that removes bone from the skeleton. This activation of osteocalcin by Vitamin K2 that binds calcium into the matrix of your bone also appears to prevent calcium from depositing into your arteries and therefore probably decreases atherosclerosis that has been noted in recent research with calcium supplementation. Clinically, vitamin K2 has been shown to sustain the lumbar bone mineral density (BMD), and prevents fractures in patients with age-related osteoporosis, prevents vertebral fractures in patients with glucocorticoid-induced osteoporosis, increases the metacarpal BMD in the paralytic upper extremities of patients with cerebrovascular disease, and sustains the lumbar BMD in patients with liver-dysfunction-induced osteoporosis. A Nurses Health Study suggests that women who get at least 110 micrograms of vitamin K a day are 30% less likely to break a hip than women who get less than that. Vegetables have vitamin K1 in them while animal foods have K2. It turns out that K1 is turned into K2 by healthy bacteria in our colon as well as in fermentation of foods with K1. It is thought that the K2 made in our colon is not well absorbed though. So, we need to get it from grass fed animal foods or foods high in K1 that have been fermented. Foods with lots of K2 are:
- Grass-fed cheese
- Pastured egg yoks
- Grass-fed butter
- Fermented food like sauerkraut & Kale
- Pastured meats
Vitamin D is also necessary for healthy bones and preventing osteoporosis. It appears to reduce the risk of hip and any nonvertebral fractures in both institutionalized and ambulatory elderly persons. We know it helps absorption of calcium and magnesium. We do want to be sure to take it with vitamin K2, as this will help keep all that extra calcium we are absorbing from from calcifying in the arteries, and make sure it gets to the bone matrix. Besides making vitamin D with sunshine you will find vitamin D in cold water fish like salmon and sardines, beef liver, cheese, and egg yolks. Usually, the same foods that have high vitamin D will also have high vitamin K in them. Vitamin D3 is the type to use.
Guidelines For Amounts of More Common Nutrients Used To Build Healthy Bones
Calcium: 1,000–1,500 mg/day of calcium (including food sources and supplements) is recommended (varies with age, weight, sex, etc.) by the National Academy of Sciences.
Magnesium: Supplementing with 250–400 mg a day of magnesium is usually recommended. Some people need much more than this to simply keep from cramping. Using epsom salt baths is a good way to get magnesium and it also supplies sulfur that your collagen needs to make cartilage.
Vitamin D3: 700–800 IU/day appears to reduce the risk of hip and any nonvertebral fractures. Some vitamin D oils also contain vitamin K. I use a liquid D3 emulsion that contains K2. Need to test levels. Want 60 ng/ml when you get a vitamin D test. Don't take supplementation without testing to see what your level is. Some people take up to 10,000 IU per day and this is not recommended unless under the guidance of a practitioner that suggests this based upon your test results and health.
Vitamin K2 is recommended at the RDA amount of 150–500 mcg/day. Vitamin K can interfere with some blood-thinning medications such as coumadin (warfarin). Seek guidance from your practitioner. Even dark green leafy greens can enterfere with coumadin activity. People usually take 150-300 mcg in a supplement. K2 has been thought by some to be safe with blood thinners, but studies show it can sometimes Counter-affect blood thinners. So be cautious.
Boron: A safe daily intake is estimated to be between 1 and 10 mg.
My Two Bits
I would like to add that in my opinion, inflammation is the key associated factor that causes osteoporosis other than lack of nutrients or poor nutrient assimilation. I believe this is not well addressed usually even though there are studies showing a relationship between osteoporosis and inflammatory cytokines. Studies also suggest that inflammation may increase enzymes that destroy collagen. Any inflammatory body burdens must be identified and attended to. This should be done in a preventive manner as well as in those who already have osteoporosis.