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Lifestyle Medicine Solutions 36 Osteoporosis Building Better Bones (1 of 3)

By Hans Diehl, DrHSc, MPH & Wayne Dysinger, MD, MPH,
September 13, 2019 at 02:09pm. Views: 14

Gallant Gladiator?

Has ordinary, everyday calcium turned out to be the gallant gladiator that can deliver fair maidens from brittle bones, fractured hips and deformed spines? That is what the calcium manufacturers and the dairy industry would like us to believe. In reality, osteoporosis is far more complicated than that.

What is osteoporosis?

Osteoporosis (literally, porous bone) silently and painlessly weakens the bones of 25 million Americans. Previously sturdy bones gradually become thin and fragile, their interiors soft and spongy. As a result, bones break, giving rise to the term brittle bones.

Osteoporosis may cause as many as 1.3 million fractures a year. Hip fractures can be both disabling and deadly. Spinal fractures, on the other hand, are often painless, but can rob a person of two to eight inches of height. The resultant spinal curvature is the source of dowager’s hump.

How does osteoporosis develop?

Normal bones continue to increase in strength and thickness until around age 35. Then the process gradually reverses itself, and small amounts of bone density is being lost each year. This loss accelerates in women after menopause and can continue for 7 to 15 years. When risk factors are present, bone loss occurs even faster, and osteoporosis may develop. Although usually considered a disease of older women, 20 percent of victims are men.

How can I tell if I have it?

Without professional help, you can’t—not until you fracture a bone or start shrinking in height, and that’s quite late in the disease. Earlier diagnosis is best done by physicians at reliable medical centers. If you are middle-aged or older and you have two or more of the following risk factors, you should be tested:

  • Sedentary lifestyle
  • Early menopause
  • Chronic use of corticosteroids
  • Cigarettes, caffeine, or alcohol use
  • Standard American Diet high in animal protein, and salt.

What can be done to treat this disease?

Several treatments are being used:

1. Estrogen therapy. When used, it slows down bone loss, but increases the risk for uterine and breast cancer, thrombophlebitis (blood clots) and gallbladder disease. It may also aggravate diabetes and hypertension, and women sometimes face periodic uterine biopsies. Over the years, adding progesterone was designed to blunt some of these disturbing side effects. The results of the large Women’s Health Initiative, however, have raised so much concern about the use of these hormones that many physicians prescribe them now only for special clinical conditions, such as severe hot flashes, and even then, only for a short time.

2. Vitamin D. The body uses vitamin D to absorb calcium, but most Americans get more than they need if they have sufficient sun exposure. A 15-minute face-to-the-sun exposure may give you a jolt of 20,000 IU of vitamin D! The dietary recommendation is 600 to 800 IU/day.

3. Calcium. Various U.S. governmental agencies have recommended 1,200 to 1,500 milligrams of calcium a day. Until recently, the World Health Organization (WHO), however, recommended only 500 mg since calcium deficiency has never been documented anywhere in the world, even with calcium intakes of as little as 300 milligrams a day. With westernization of most diets, and the increase in osteoporosis, the WHO is now recommending 1,000 mg of calcium/day.

4. Exercise. Bones will not thicken and strengthen without regular, weight-bearing exercise, such as walking. To retain their minerals, bones need to be pressed, pushed, pulled, and twisted against gravity. The gravity factor was well demonstrated by the early astronauts. Even though they exercised faithfully while in space their bones showed startling osteoporotic changes on their return. While nearly all types of aerobic exercise are beneficial to the body what the bones need most is a good daily shake-up. 

Two more treatments to come next week!

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