Bone Loss With Aging

Stats:
Over her lifetime, a typical woman will lose 42% of her spine and 58% of her femur.  In the U.S. an estimated 34 million people are at risk for developing bone loss, and 80% are women.  Fractures result in 800,000 emergency room visits, 2.5 million office visits, and 180,000 nursing home placements costing an estimated $14 billion.  20% of women die within the first month of their femoral fracture.  Sadly, most screenings for bone loss do not begin until age 65 when a significant amount of bone loss has already happened. 

Anti-Aging Bone Health
It is imperative that young women have regular menstrual cycles, adequate Vitamin D levels, and adequate calcium and protein during the ages of 15-25.  This is an important time of bone maturation, strength, and density.  I encourage young women to be on a supplement that contains Vitamin D, calcium, and multivitamins because this time in life is so important.

Biphosphonates
This class of medication was first developed for Pagets Disease in the 1960's. They were not intended for the treatment of osteoporosis, but in the 1990's we saw marketing for these agents come about to help with bone density loss. 

~Reversible side effects of this drug class: Kidney toxicity, join pain, muscle aches, fever, musculoskeletal pain, gastritis, low calcium (wow!!), eye complications, asthma (aspirin-sensitive), altered taste, and central nervous system side effects.

~Irreversible side effects with chronic use
Osteonecrosis of the jaw.  (Awful!!)  Have you ever wondered why dentists offices want to know if you are on Fosamax, Boniva, etc?  This is why.  Look up information about the mini-epidemic called "phossy jaw" related to factory workers with jaw necrosis after continuous exposure to phosphorous fumes. 

Spontaneous femoral fractures.  Even though some might consider this a rare side effect, when one considers that 190 million prescriptions are written worldwide for osteoporosis, this could translate into millions of men and women with the risk of potential fractures.

Hormones and Bone Health
Vitamin D is a steroid hormone and along with parathyroid hormone, and calcitonin, carefully control calcium metabolism. Limited sun exposure, skin pigmentation, and geography are well recognized causes for low Vitamin D.  I suggest 10-30 minutes (at least) in the sun each day.  It's a natural way to obtain Vitamin D.  In the winter months, it might be advisable to increase your Vitamin D supplement regimen due to less exposure to the sunshine.  D essentially drives calcium into the bone. It's important to have both in your vitamin regimen.

Sex Hormones
~Estrogen deficiency accelerates bone loss. 
~Progesterone deficiency is connected with reduced bone growth.  Women who have consistent low progesterone and those who do not have menstrual cycles are at risk.  It is important to supplement progesterone in young women especially who have PCOS (polycystic ovary syndrome).
~Androgens (DHEA and Testosterone) are important for bone health in both sexes.  Low free T is associated with increased hip fractures. DHEA levels directly correlate with bone mass. 
Plain and Simple: IT IS IMPORTANT TO ASSESS AND ADDRESS HORMONE DEFICIENCIES!!

Melatonin
Melatonin has positive effects on bone.  It directly stimulates osteoblasts (bone builders) and increases collagen production.  It also enhances sleep which indirectly raises growth hormone levels.

Vitamin K
Specifically K2-of the 3 forms of Vitamin K, this one is made by bacteria in the gut, ensures calcium is deposited in the bone and not into the arteries. 

Here's a good protocol to follow:
Vitamin D3: 2,000-5,000 units/day
Vitamin K2: 50-150mcg/day
Vitamin C: 1000-4000mg/day
B Complex Vitamin
Vitamin E: 200-800 units/day

Magnesium
This is one of the most common mineral deficiencies in adults.  High doses of calcium, without magnesium, can worsen magnesium deficiency. 

Potassium Citrate
Oral supplementation has shown an increase in bone density of postmenopausal women. 

Diet and Exercise
An alkaline diet rich in fresh fruits and vegetables, with limited protein and avoiding dairy, artificial sweeteners, and preservatives promotes an alkaline environment leading to improved bone health.

Exercise two times a week helps to maintain bones, and three times a week (or more) has been shown to increase bone.  Get out and exercise!

To your good bone health,
Dr. Sonja