Osteoporosis has become the silent killer of our senior citizens. Many times a bone breaking for no good reason is the first sign indicating that osteoporosis is present.

Fortunately, public awareness of this disease has grown. I find, however, that many of my patients still have questions about the nature of this disease. Moreover, they have many questions about what to do about reducing their risks of getting osteoporosis or dealing with the impact of having this potentially devastating disease.

Well, what is osteoporosis? It is a bone disorder characterized by a reduction in bone mass which leads to increased susceptibility to bone fracture. In simpler terms, your bones become fragile and break easily.

We tend to think of our bones as permanent structures. Nothing could be further from reality. Bone is a dynamic tissue. Your body is constantly remodeling your skeleton through a process of breaking down old bone and the formation of new bone. During the first three decades of life your body increases bone mass. After the fourth decade bone mass starts to decrease.

Both men and women lose bone. Women, however, experience a greater loss of bone than do their male counterparts. This bone loss is especially pronounced for about 5-10 years following menopause. This is primarily due to the effect of lower estrogen levels experienced during this period. Estrogen inhibits bone loss.

Other factors, though, play an important part in this gender difference. Males tend to have larger and more dense bones than females. This is protective against developing the disease. Genetically, mothers with low bone mineral content tend to have daughters with low bone mineral content.

Other risk factors have been identified for osteoporosis in women and are summarized below.

• Family history of osteoporosis
• White or Asian
• Small body frame
• Postmenopausal
• Hysterectomy
• Inadequate calcium intake
• Excess protein in the diet
• Inadequate exercise
• Smoking
• Excessive alcohol consumption
• High caffeine intake
• Long-term use of antacids

If you are at risk for osteoporosis, what can be done? It is never too early or too late to think about preventing bone loss. Women in their 20’s and 30’s can greatly affect peak bone mass by maximizing calcium intake. A study reported in the New England Journal of Medicine by Reid et al. demonstrated a 43% reduction in bone loss in postmenopausal women who supplemented their regular diets with 1,000 mg of calcium for two years compared to women receiving sugar pills. In other words, woman taking calcium had better bone density.

Taking calcium is important. My recommendation for the type and amount of calcium to take can be found in the “What About Herbs & Vitamins” section of this newsletter. If you have been told to take TUMS for calcium, you have been given poor advice.

Other nutrients are also important for proper bone development. Vitamin D is important for calcium absorption from the intestines. Your body makes vitamin D from cholesterol through exposure to the sun, so soak up those rays (in moderation). If you do not get any sun or if you get very little, it is a good idea to supplement vitamin D each day.

Magnesium also plays an important role in calcium metabolism, as well as, bone metabolism. Magnesium is one of the minerals that is very deficient in our population. I would suggest supplementing with 150-300 mg a day.

Other trace minerals such as zinc, manganese, and copper may also be important. A good multiple vitamin will include these minerals. Listen to the Vitamin Answer Book for more information about finding a good multiple vitamin.

Along with nutrition, I want to stress the importance of exercise. Activity builds stronger bones. If you walk on a regular basis you will be doing yourself a world of good in regard to preventing the development of osteoporosis.

Please, do not wait to develop this horrible disease before doing something about your bone health. If you are 20-40 years old, increase your calcium intake now! If you are postmenopausal, increase your intake of proper nutrients and begin exercising. If you already have osteoporosis or are at high risk, there are many avenues to pursue.

Remember, this is a silent killer. Do not let it sneak up on you.

Herbs & Vitamins

Calcium supplementation has been shown to be important for the maintenance of bone density. Since it is important for osteoporosis, the question should be asked whether all types the same? What about taking TUMS for calcium? Which form is the best?

The active ingredient in TUMS is calcium carbonate. Calcium in this form requires adequate amounts of stomach acid to be present for proper absorption into the body. Studies have shown that a large portion of the population above the age of 50 are hypochloridic or have low amounts of stomach acid. Thus, calcium carbonate is a poor choice for the age group most affected by osteoporosis.

Additionally, taking calcium carbonate with a meal reduces the level of stomach acidity. This greatly increases your risk of bacteria survival into the intestines and decreases the digestion of proteins. Also, the ability of vitamin B12 to enter your body may be decreased with the reduction of stomach acid. These are not good things and thus, I do not like calcium carbonate as a daily source of calcium. If you have a Doctor who suggested taking TUMS, please give them a copy of this article.

My suggestions for calcium supplements are outlined as follows:

1. Calcium Citrate: Good
   • Well absorbed, reduced chance of calcium stones.
   • Not dependent on stomach acid for absorption
2. Microcrystalline Hydroxyapatite: Good
   • Contains many of the minerals needed for bone growth.
   • Well absorbed and shown to decrease bone loss.
   • BE CAREFUL: Get only from your doctor. Some sources contain high levels of LEAD!
3. Oyster Shell: Poor
   • May contain high levels of LEAD, MERCURY!

IPRIFLAVONE

Ipriflavone is synthesized from soy and holds great promise in the prevention and treatment of osteoporosis. It has been widely studied in humans as there have been 60 human studies completed in the last decade.

Ipriflavone comes from a family of phytoestrogens. It does not, however, possess estrogenic activity but appears to enhance estrogen’s effect. Ipriflavone has been found to be effective for inhibiting bone loss and enhancing bone formation.

The recommended dosage is 200 mg three times a day with meals. In general, ipriflavone appears to be quite safe and very well tolerated.

One of the best supplements I have found to support healthy bone density is Pro Bono.  If you have osteoporosis or osteopenia, I suggest you take this supplement.