“Diggin’ on Bones”

By: Dr. Jeanne Greisen, RPh, PharmD

Get out your shovel- we are “diggin” bones today! The “diggin’ on bones” has nothing to truly do with physically diggin’ on bones. Our “diggin” is a dive into an alternative perspective on osteoporosis and bone health. We are shoveling out the old paradigm of thinking and transitioning to a new way of looking at the condition called osteoporosis. We will dig into the current pharmaceutical treatments, provide natural alternatives, discuss what the research says, talk about dietary consideration, and discuss information about “the shots”. However, we won’t do a deep dive into “shots” as that’s a big topic for another day.

What is osteoporosis?

Osteoporosis is a defined by the Merck Manual as having a “generalized, progressive diminution of bone density, causing skeletal weakness.” In other words, the bone turnover is greater than bone formation. The bone turns over every 7-10 years with the body eliminating the old and making new.

Having the proper nutrients for removal and building bone components is the key to the strong, healthy bones. The word “osteoporosis” means porous bones. If left unaddressed, osteoporosis can progress silently causing fractured bones and broken hips. The bones most affected by osteoporosis are the hip, spine, and wrist. Osteoporosis affects postmenopausal women more often than men. During menopause, women see a decline in estrogen and progesterone resulting in a decrease of bone formation. Decreased estrogen levels in women and testosterone in men, insufficient vitamin D, calcium and phosphorous are all associated with age-related bone loss as stated in the Merck Manual.

New research has brought a new perspective to bone health beyond hormones and calcium. Keep reading to learn about these vitamins and minerals.

How prevalent is osteoporosis?

It is estimated that 54 million people in the United States have osteoporosis, and 200 million word-wide. Some estimate 1 in 2 women and 1 in 4 men will have osteoporosis after the fourth decade of life. With numbers like these, osteoporosis alone will generate billions of dollars for the Pharmaceutical Industrial Complex if no other alternative is offered.

Treatments for osteoporosis

To date, the mainstay of treatment for osteoporosis is:

1. a calcium supplement at a minimum of 1200 mg per day

2. vitamin D

3. a pharmaceutical drug, which seems to be Prolia as of late.

The current pharmaceutical products available for treatment include bisphosphonates (which include Boniva, Actonel, Fosamax), biologics (Prolia), and anabolic agents (Evenity and Forteo). Aside from bisphosphonates, all others are in the form of injectables that come with very high price tags, lack of ease for the patient, and risk of infection due to bypassing all defensive mechanisms of the body. As with all medications, there are side effects, some more severe than others. These medications are no different. Side effects occurring in trials with these pharmaceutical drugs include fractures upon discontinuation, infection, bone and muscle pain, hypertension, and abdominal pain to name a few. Although not in the mainstream news, natural alternatives for bone health exist with more information

becoming available. The vitamins and minerals that play an interconnected role in healthy bones include magnesium, Vitamin D with K2, strontium, DHA (fish oil), and dietary sources of calcium. Although only calcium and vitamin D have traditionally been mentioned as necessary minerals when talking about bones, magnesium and K2 play a key role in the absorption of calcium by the bones.

Vitamin K

Vitamin K consists of K1 and K2, which are essential for maintaining blood homoeostasis, optimal bone formation and smooth arterial function. Vitamin K2 has a pivotal role in the regulation of calcium deposition in the bone. Vitamin K2 deficiency has been recognized as a key component in the development of blood vessel calcification and osteoporosis. Historically, Vitamin K has been mentioned only when talking about coagulation, but its role is so much larger. While K1 is obtained in the diet through green leafy vegetables, K2 is acquired in the diet from cheese, curd, and natto. Junk food is nearly void of any vitamin K, with little vitamin K being consumed in the Western diet. Although K1 is present in green leafy vegetables, only 10% of the total amount is absorbed in the diets of people in

industrialized countries. Japan is the exception due to a portion of their population consuming high amount of natto, which is high in vitamin K. Outside of food sources, K2 is either synthesized in animals or by bacteria. Adequate intake of K2 has been shown to lower the risk of vascular damage from calcification as well as keep calcium in the bones.

Magnesium

Magnesium balance is crucial to health. While most Americans are deficient in magnesium, magnesium deficiency directly contributes to osteoporosis and can cause calcium deposits on the arteries. Magnesium deficiency is a significant risk factor for post-menopausal osteoporosis since magnesium alters calcium metabolism and the hormones that regulate calcium. Magnesium shuttles calcium to the bones and works as a natural “calcium channel blocker” for those with hypertension. Magnesium taken at bedtime is also beneficial for a more relaxing sleep.

Strontium

Strontium is the 38th element on the periodic chart. Research has suggested long ago that strontium is necessary for strong bones. Strontium has a structure like calcium and can replace calcium to a certain extent. Strontium is a strong mineral that adds strength to calcium due to its charge and can facilitate movement of calcium into the bones. There are different salt forms of strontium with the citrate salt form showing to be effective for bone strength. A radioactive form was available in the 1940’s and since, removed from the market. Studies have shown strontium to be effective for osteoporosis as well as building strong teeth.

Vitamin D

Vitamin D has long been a mainstay of treatment for osteoporosis with calcium. However, the

recommended dose was much lower than where it needs to be. The “covid” epidemic has

been beneficial to bring to light that most of the population in the United States is Vitamin D deficient. Increasing Vitamin D levels has aided in the health of many with chronic diseases. Maintaining vitamin D levels over 50 ng/ml is essential for optimal health. Coupled with Vitamin K, Vitamin D supplementation has kept many from hospitalization and improved their overall health. It is worthwhile to note the best, inexpensive vitamin D is available to everyone by simply going outdoors for 30 minutes in the sunshine without sunscreen and exposing large amounts of the skin.

Calcium

Calcium supplementation has been the mainstay for osteoporosis for the past 20+ years. In the past 20 years, we have seen cardiac events increase, calcification of arteries, and the health of the population remain stagnant or decrease. The question remains: have we been wrong about calcium this entire time? Calcification of the arteries is a real problem. Moving the calcium to the correct location, i.e., the bones seem to be the key. Calcium deficiency, unless a patient’s lab results show differently, may not be the cause of bone loss. Research is showing that the previously mentioned vitamins and minerals that are necessary to transport the calcium to the bone tissue are more than likely the cause of bone loss. Calcium is readily available in the foods that we eat. Calcium should only come from dietary sources and choosing foods high in calcium- seeds, cheese, yogurt, beans, almonds, leafy greens, tofu,

should be consumed to obtain good amounts of calcium.

Fish Oil (DHA)

Lastly, it is of no surprise that DHA, or fish oil is a key to bone health. Fish oil provides a good source of omega 3 fatty acids. DHA is important in the early mineralization of bone. Not only is DHA beneficial for bones but provides anti-inflammatory properties. Good food sources of DHA include salmon, flax, walnuts, chia seeds, and hemp seeds/hearts.

Important of Exercise

Exercise is not only good for maintaining weight but is essential for strong bones. Weight bearing exercise is key for bone strength and turnover. With the sedentary lifestyles that have come to plague society, it is taking its toll on bone health. 30 minutes of weight bearing exercise daily, such as walking, jogging, and jumping are the key to strong bones. In addition to bone strengthening, exercise boosts mood, cognition, and helps to maintain a healthy weight. Couple exercise with the 30 minutes of natural sunlight and your mind, body, and bones will thank you.

You Decide

The new data available on natural treatments for osteoporosis is a valid solution for bone health. A regimen of Vitamin D with/K2, strontium, magnesium, DHA, calcium from food sources and physical exercise is a “root cause approach” by supporting bone health with the building blocks that are required for healthy bone turnover. This regimen has shown positive results on bone density with a side effect profile negligible compared to Big Pharma products and a price tag at a fraction of the cost. What bones ultimately need are the building blocks (vitamins and minerals) to make the structure, not“modifications” (pharmaceuticals) to manipulate the process. There is a difference and knowing the

difference will change our perspective on how we treat “diseases”.

To find out more, click on the links below.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566462/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3775240/

https://www.semanticscholar.org/paper/Effects-of-dietary-DHA-and-%CE%B1-tocopherol-on-bone-and-Izquierdo-Scolamacchia/46486b59e7aabc4a43ad8ca5808ab058cfd641ce

https://www.hindawi.com/journals/jeph/2012/354151/