by Dr. Laura Korman, DC 

 
Nearly one in two women and one in four men over age 50 will suffer a fracture due to osteoporosis at some point in their lifetime. 24 percent of both men and women over age 45 who fracture a hip due to osteoporosis will, on average, die within 12 months of their injury. That's a serious statistic. Across the globe, osteoporosis causes more than 8.9 million fractures annually, resulting in an osteoporotic-related fracture every three seconds.  

As with all chronic diseases, osteoporosis takes years to develop, often without significant symptoms. Therefore, the most effective treatment approach, should focus on early, preventive lifestyle and nutritional strategies, rather than late-stage medical interventions. In this article, I will discuss what osteoporosis is, how it develops, and how we can prevent—or even reverse—this devastating bone disease. 

The word osteoporosis literally means “porous bone.” It occurs when the bones become increasingly porous due to a decrease in the quality or density of bones, making them more prone to fracture. From the time we are born, through our mid-20s, our bones continually build and strengthen until they reach their maximum density or peak mass between ages 25 and 30.   

After this point, our bones undergo a process of remodeling, which involves a synergy of building new bone and removal of old bone. When the breakdown of bone occurs at a more rapid rate than the building bone, osteopenia (early osteoporosis), and eventually osteoporosis, occurs. An osteoporosis diagnosis will result from a DEXA (dual-energy X-ray absorptiometry) scan, which measures the density of bone.   

This scan is scored based on the amount of deviation away from the T-score that a healthy young adult would be given. A T-score between -2.5 and -1.0 indicates osteopenia, and a T-score of -2.5 or lower indicates osteoporosis. This test is static, meaning that it takes a snap shot measurement of the density of bone, but it fails to inform if or how the bones are abnormally remodeling (either building too slowly or breaking down too quickly).  

The other limitation to this DEXA scan is that it is performed every one to two years, meaning the response a person could have to any given prescribed treatment is withheld for a 12–24-month period of time. This can result in delaying a crucial change to treatment protocol if the follow-up DEXA scan fails to improve—or worsens. As a result, the person will miss out on valuable time to halt, slow down or reverse bone loss. 

The positive news is that a simple blood or urine test can assess the rate at which bones break down, a process known as resorption. This test is the N-telopeptide (NTx) test, which provides a dynamic measurement of what actually occurs inside the bone at any given time by measuring the by-products of bone breakdown. The real benefit to this test is it can be re-run every three to six months to assess the patient's response to treatment, allowing for any adjustments to be made, as necessary, aiding in a quicker recovery.   

As I discussed earlier, we have a limited opportunity during our youth and young adulthood to build our bone reserves and make contributions to our healthy “bone bank” before our peak bone mass is reached. This is why we should start preventing osteoporosis early in life through intentional lifestyle and nutritional strategies to achieve maximum bone strength by our mid- to late-20s, so we can maintain optimal bone density as we age. 

The most effective way to build healthy bone and minimize breakdown at any age is to follow an ant-inflammatory diet. Starting in childhood, a diet high in sugary foods or beverages, as well as processed carbohydrates, depletes the body of bone-building nutrients like calcium, magnesium, chromium and copper. Soda consumption includes an extra note of caution, as it contains high levels of phosphoric acid, which removes vital calcium from our bones.  

Other inflammatory foods to eliminate include vegetable and seed oils, like canola, corn, soybean, peanut, cottonseed, sunflower and safflower oils, found in nearly all snack foods, salad dressings and condiments. These foods are too high in omega-6 oils, causing an increased rate of bone loss. It’s also important to avoid farm raised fish.  Instead, look for wild caught, cold water fish that’s low in mercury such as salmon, mackerel, sardines and herring, which increase essential omega-3 oils to improve bone mass. Increase consumption of whole, nutrient-dense, organic, pasture-raised, local food, if possible.  

Other causes to poor bone health starting in childhood include a lack of exercise and a lack of sunshine, causing a deficiency in Vitamin D, needed to build strong bones. As we age, our risk for osteoporosis increases, especially in post-menopausal women. A woman's bone mass can decrease by 10 percent in the first year of menopause due to the drop in sex hormones. Risk factors—especially for women of this age group—include medications like corticosteroids, antidepressants, and antacids including Nexium, Omeprazole and Prilosec, which cause a depletion in bone building nutrients.  

Exposure to toxins in herbicides, pesticides, plastics, and household or personal products, will rob us of many nutrients we need to build bone, in order to be detoxified from the body.  Unmanaged stress and chronic sleep deprivation are also bone nutrient-robbing lifestyle factors, common among post-menopausal women. Inadequate intake of the essential and synergistic nutrients required for optimal bone remodeling become an even more important factor contributing to bone loss after menopause.  

Let's look at some of the treatment options available. Classic medications to treat osteoporosis are called bisphosphonates like Fosamax and Boniva. These drugs work by slowing the breakdown of bone, but they also decrease the formation of healthy new bone. This can cause the bones to appear denser on future DEXA scans, but they leave them bones brittle, increasing the likelihood of fractures in the future. Bisphosphonates can also interfere with the absorption of essential nutrients like calcium. However, there are many natural, effective strategies to promote the healthy remodeling of our bones at any age. 

In addition to eating an anti-inflammatory diet, taking a hydrochloric acid supplement with one or two of your largest meals will help improve the absorption of bone-building minerals. Most of us think we have too much acid produced in our stomachs when, in fact, as we age, our natural production of hydrochloric acid decreases. This can cause indigestion, heart burn, GERD and poor nutrient absorption.  

There are many nutrients other than calcium required to build healthy bones such as magnesium, phosphorus, Vitamins D3, K2, C, B12, Boron, Silica and Glutathione. As I have mentioned, many of them are depleted due to poor diets, lifestyle, medications, stress and toxins. In order to identify deficiencies, test—don’t guess.  

A blood test might be adequate to identify inflammatory markers like Vitamin D, CRP(hs), SED rate, Homocysteine, HgA1c, Insulin and Ferritin, but will fall short in identifying the levels of key nutrients needed for optimal bone remodeling. A Spectracell test measures, not only the levels of micronutrients, but also how vitamins and minerals work in the body to determine if the levels supply what the body actually needs.   

Another beneficial test would be to run an Omega Check. This will give you a ratio of omega-6 and your omega-3 levels to identify excess inflammation, which will show you which changes to make in your diet or supplementation needs. Hormone levels, including estrogen, progesterone, testosterone and DHEA, should also be tested, as these hormones play an important role in bone health and optimal function of both the heart and brain.   

I cannot emphasize enough the importance of weight-bearing exercise to help build new bone. Weight-bearing exercise that puts a load on the bones is essential. The greater the load, the stronger the bones. This is why a lifetime of consistent exercise is so important for optimal bone health. Exercise should start our gently based on your current health and bone mass, then gradually increase over time. If you are new to exercise, ask your doctor before starting and consider hiring a trainer to make sure you do the exercises safely.  

Finally, when choosing supplements to improve health and bone mass, avoid those with artificial colors, binders, fillers, and nutrients that are not bioavailable or poorly absorbed. Look for supplements in a reputable health food store rather than a drug, grocery or department store. This is not a purchase to be cheap with—especially if you have been diagnosed with osteopenia or osteoporosis already.  

Osteoporosis is a serious health issue, increasing worldwide but not given as much attention as it needs, in my opinion. The best defense against this disease starts in childhood, but it is never too late to make the necessary changes in diet and lifestyle to start building optimal bone mass again. If you have questions about testing or supplementation, please call my office, Korman Relief & Wellness Center, at 941-629-6700.