Osteoporosis Management
Osteoporosis is a condition where bones become thin and porous. This reduces their strength and puts the bones at risk of fracture. Treatment once this starts to happen is elusive, so prevention is the most important aspect of management! Bone mass peaks at 30 years of age and then starts to decline after 40. There is a natural process of mineral balance that the bones play a major roll in. Many different hormones play and interactive roll with either bone growth or decay. 15% of bone turns over each year, so it is very important to give your body what it needs to maintain a healthy spine and skeleton!
Testing Points:
Types of testing to determine bone density
DEXA scan
Heel and hand X-rays
CT scans
Ultrasound density measurements
Osteopenia is between 1-2.5% lower than the mean
Osteoporosis is >2.5% below the mean
Current recommendations are that women over 65 get tested and younger patients get tested if they have a medical condition that puts them at risk
Causes:
Genetic predisposition
Major Medical conditions
Cancer
Stroke and neurologic conditions
Liver and kidney disease
Medications
Steroids
Some anti-hypertensives, sedatives and others
Nutritional deficiencies
Absorption problems
Inflammatory Bowel Disease
Gluten sensitivity
Leaky gut syndrome
Dietary considerations
Inadequate dietary intake of fruits and vegetables
Acidifying diet
Diet high in animal products
Inflammation and Auto-immune diseases
Thyroid disease
Lupus
Arthritis
Hormonal issues
Testosterone deficiency
Estrogen deficiency in women
Thyroid insufficiency
Parathyroid diseases
Prevention – the MOST important of strategies!
Nutritional strategies
Anti-Inflammatory diet
Alkalinizing diet
Eat the rainbow to get the vitamins and minerals needed
Foods with high Omega-3 fatty acids
Adequate protein (0.8gm/kg)
Supplements
Vitamin D
High quality multi-vitamin and minerals
Vitamin K
Magnesium
Hormonal balance
Estrogen
Thyroid
Exercise
Moderate strenuous activity
Mild use of free weights
Helps stimulate bone growth
Balance training exercises
Reduces risk of falls
Avoid the following
Very high protein diet
Damages kidneys and alters calcium and phosphorus balance
Animal proteins
Smoking
Excessive alcohol
Excessive Vitamin E
Excessive Caffeine consumption
Antacids
High sodium diet
Soda
Treatments
Prescription Medications
Usually started after there is considerable bone loss
Bisphosphonates
Stimulate bone growth
Estrogen receptor blockers
Antibodies to bone absorption proteins
Calcitonin
Strontium and others
Hormonal balance
Maintain optimal Vitamin D levels
Estrogen and testosterone replacement
Thyroid and parathyroid hormone support
Calcium and bone health
Calcium is important as 99% of the calcium in our body is in our bones and the bones are 38% calcium!
No real correlation between high or low calcium intake and bone health
Important to increase calcium absorption from our diet and limit its excretion through the kidneys
Increase absorption by:
Plenty of essential fatty acids (fish oils)
Vitamin D levels in optimal range
Limiting animal products
Increasing fruits and vegetables
Avoiding simple carbs
Decrease excretion by:
Avoiding high protein diets
Limiting sodium intake
Limiting caffeine
Be careful regarding calcium supplements as they are associated with increased heart and vascular disease. Best to get your calcium through your diet
Milk is NOT a good way to get calcium as it acidifies the blood and increases leaching from the bones. Yoghurt – the good kind – and hard cheeses are a good way to get calcium