Osteoporosis

Osteoporosis is the continual breakdown of bone. It can cause fractures deformity and death. Osteoporosis affects over 25 million people each year; 80 percent of them are women.

Signs and Symptoms

• Periodontal disease
• Hunched back
• Loss of height
• Back pain

What Causes It?

Osteoporosis occurs when bone breaks down faster than it is formed. Lack of estrogen in the body causes 95 percent of all cases of osteoporosis. Other causes include glucocorticoid and heparin use hyperthyroidism and calcium deficiency. Osteoporosis may be hereditary. Women approaching or experiencing menopause are at increased risk.

What to Expect at Your Provider's Office

Ask your health care provider about having a bone density test to determine if you have begun to loose bone mass. Your provider will talk to you about preventative treatment options.

Treatment Options

Treatment Plan

Hormone replacement therapy is the most commonly used treatment for osteoporosis. It helps to slow bone loss. A healthy diet supplements and exercise are essential to treatment plans and to slowing bone loss.

Drug Therapies

Prescription

• Estrogen—slows bone loss and decreases the number of fractures; it cannot increase bone growth; should be taken at the lowest dose possible as higher doses may increase your risk of getting breast cancer abnormal blood clotting or gallbladder disease
• Conjugated equine estrogen pills are frequently prescribed by providers; do not use if you are obese a smoker have high blood pressure high cholesterol or varicose veins
• Estradiol—a type of estrogen that brings the estrogen directly into your blood stream; available in a patch or gel
• Progesterone—slows bone loss; stops estrogen from causing bleeding in menopausal women; prevents uterine cancer that can occur with estrogen therapy
• Bisphosphonates—alternatives to estrogen; increase bone density and reduce fractures (take upon rising with 8 oz. water; do not lie down or eat for 1/2 hour); side effects include inflammation of the esophagus especially with overdose abdominal pain heartburn nausea
• Selective Estrogen Receptor Modulators (SERMS)—estrogen-like effects with reduced breast cancer risk; side effects: hot flashes or blood clotting (uncommon)

Over the Counter

• Calcium—1 000 mg a day for postmenopausal women on estrogen and 1 500 mg a day for those not on estrogen; if taken early in life it aids prevention; better absorbed if taken with meals; no known adverse effects up to 2 500 mg a day
• Vitamin D—increases intestinal absorption of calcium; 800 IU a day; take with calcium

Complementary and Alternative Therapies

Nutritional and herbal support aid the absorption of essential vitamins and minerals. Include exercise and stress management in any treatment program.

Nutrition

• Eliminate refined foods alcohol caffeine tobacco sugar phosphorous (carbonated drinks and dairy products) aluminum-containing antacids and high amounts of sodium chloride (table salt) and animal proteins. Sea salt soy sauce tamari or kelp granules are preferable to table salt.
• Increase intake of complex carbohydrates essential fatty acids (cold-water fish nuts and seeds) legumes and soy. Isoflavones found in soy may slow bone loss and increase bone building activity. Studies suggest 30 to 50 mg per day of soy to maintain bone mass.
• Dark berries (blueberries blackberries cherries and raspberries) contain anthocyanidins which help stabilize collagen found in bones.
• Mineral-rich foods especially nondairy sources of calcium should be increased. Although these are lower in actual calcium content they provide calcium that is easier for your body to use. Particularly beneficial are almonds blackstrap molasses dark leafy greens sardines sea vegetables soy tahini prunes and apricots.
• Calcium citrate or aspartate (1 000 to 1 500 mg per day) are the preferred forms of calcium.
• Magnesium (200 mg two to three times per day) enhances calcium uptake is necessary for hormone production and protects the heart. Magnesium may actually increase bone density and may be a more important mineral than calcium for preventing osteoporosis.
• Vitamin K (100 to 500 mcg per day) helps increase calcium uptake. Foods high in vitamin K include dark leafy greens.
• Boron (0.5 to 3 mg per day) helps calcium absorption. Women at high risk for breast cancer should use boron with caution.
• Manganese (5 to 20 mg per day) helps produce the collagen foundation for calcium.
• Zinc (10 to 30 mg per day) aids normal bone growth. Copper (1 to 2 mg per day) is needed with long-term zinc supplementation.
• Chromium (200 to 600 mcg per day) should be used in patients with unstable blood sugars.
• Essential fatty acids (1 000 mg twice a day) aid hormone production.
• B-complex (50 to 100 mg per day) reduces the effects of stress. Elevated cortisol levels from stress increase bone loss. Take folic acid (1 to 5 mg/day) B₆ (100 mg/day) and B₁₂ (1 000 mcg per day).

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers; 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

Some herbs have phytoestrogen or progesterone properties and women may choose to take them instead of or in addition to conventional hormone replacement therapy. Natural progesterone may be more effective at increasing bone density than synthetic progestins. It is important to note that natural progesterone may not be strong enough to offset the risk of uterine cancer posed by conventional estrogen replacement therapy. The following are examples of herbs that can help treat osteoporosis.

• Black cohosh licorice (Glycyrrhiza glabra) and squaw vine (Mitchella repens) help balance estrogen levels. Do not take licorice if you have high blood pressure.
• Chaste tree wild yam (Dioscorea villosa) and lady's mantle (Alchemilla vulgaris) help balance progesterone levels.
• Kelp (Nereocystis luetkeana) bladderwrack (Fucus vesiculosis) oatstraw (Avena sativa) nettles (Urtica diocia) and horsetail (Equisetum arvense) may also help support a sluggish thyroid.
• Milk thistle (Silybum marianum) dandelion root (Taraxacum officinalis) vervain (Verbena hastata) and blue flag (Iris versicolor) support the liver and may help restore hormone ratios. Taken together as a tea before meals they enhance digestion.
• Topical applications of natural progesterone. Your provider should check your progesterone levels periodically.

Homeopathy

Some of the most common remedies used for osteoporosis are listed below. Usually the dose is 12X to 30C every one to four hours until your symptoms get better. A combination of homeopathic tissue salts such as Calcarea fluoricum and Silica may be helpful.

Acupuncture

Acupuncture can help hormone imbalances and poor blood sugar control.

Massage

Massage may enhance circulation.

Special Considerations

Osteoporosis may take root during the teen years. Adequate calcium and magnesium intake and proper nutrition and exercise are the primary preventative measures for osteoporosis.

Supporting Research

Chapuy MC Arlot ME Duboeuf F et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med. 1992;327:1637–1642.

Chesney RW. Vitamin D. Can an upper limit be defined? J Nutr. 1989;119:1825–1828.

Fauci AS Braunwald E Isselbacher KJ et al eds. Harrison's Principles of Internal Medicine. 14th ed. New York NY: McGraw-Hill; 1998.

Feskanich D Weber P Willett WC Rockett H Booth SL Colditz GA. Vitamin K intake and hip fractures in women: a prospective study. Am J Clin Nutr. 1999;69:74–79.

Gaby AR. Preventing and Reversing Osteoporosis: Every Woman's Essential Guide. Rocklin Calif: Prima Publishing; 1995.

Goroll AH ed. Primary Care Medicine. 3rd ed. Philadelphia Pa: Lippincott-Raven; 1995.

Werbach M. Nutritional Influences on Illness. New Canaan Conn: Keats Publishing; 1988:331–340.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.