Osteoporosis

Osteoporosis – Symptoms, Causes & Treatment

Osteoporosis is a progressive skeletal disorder characterised by a reduction of bone density which can cause bone fragility, thereby significantly increasing the risk of fractures.

It occurs when the body fails to form enough new bone, when too much bone is reabsorbed by the body, or both. The World Health Organisation defines osteoporosis as a bone mass density 2.5 standard deviations or more below an average bone mass density for a young, healthy adult.

Osteoporosis is the most common type of bone disease and affects mainly the spine and long bones of the arms and legs.

Causes of Osteoporosis

• The leading cause is increased bone resorption due to decrease in sex hormones following menopause and andropause: estrogen and testosterone play a fundamental role in maintaining bone strength
• Deficiency of dietary factors required to make new bone: calcium, magnesium, Vitamin D
• Metabolic diseases: e.g. Cushing‘s syndrome, hyperthyroidism, hyperparathyroidism, diabetes
• Medications: corticosteroids, anti-coagulants, diuretics etc.

Risk factors

• Impaired gut function, intestinal dysbiosis, SIBO
• Digestive disorders and low stomach acid – : occurs in 40% of post-menopausal women and is common with most adults as they age
• Age: women over 50 and men over 70
• Family history
• Poor diet / nutritional deficiency: especially calcium and vitamin D
• Sedentary lifestyle and lack of weight-bearing exercise
• Malabsorption syndromes e.g. coeliac disease
• Early or surgical menopause, late menarche, history of amenorrhea
• Low BMI
• Low exposure to sunlight
• Caucasian race, especially with fair hair and skin
• Smoking: depletes Calcium
• Excessive alcohol consumption (> 10 drinks/week): diuretic effect
• High phosphorus intake (excessive commercially raised red meat and soft drinks): pulls calcium from bones
• Anorexia nervosa, bulimia or frequent dieting
• Long-term medication use: diuretics, broad-spectrum antibiotics, anti-convulsants, corticosteroids, thyroxine (excess), oral contraceptives
• Heavy metal toxicity

Signs and symptoms of Osteoporosis

• Asymptomatic in early stages
• Fracture with little or no trauma: often the first sign of osteoporosis; mainly affects hip or wrist
• Bone pain or tenderness
• Loss of height over time
• Stooped posture or kyphosis
• Low back pain or neck pain

TREATMENT STRATEGY FOR OSTEOARTHRITIS

Prevention in the younger years is the best treatment with appropriate dietary and lifestyle measures.

• Support bone formation / prevent further bone loss
  • Support digestive function / improve absorption
  • Support estrogen in post-menopausal women

Diet plan guidelines that support Osteoporosis

• Emphasise foods high in nutrients essential for bone health:
  • Calcium: green leafy vegetables (broccoli, bok choy, spinach), nuts and seeds, tahini, tofu, bony fish, seaweed, yoghurt
  • Magnesium: green leafy vegetables, nuts and seeds, raw cacao
  • Vitamin D: cod liver oil, butter, egg yolks. Regular exposure to sunlight is essential
  • Boron: fruit and vegetables, nuts, legumes
  • Vitamin K: green leafy vegetables, especially Brassicas, parsley, watercress
  • Phyto-estrogens: fermented soy, linseeds, alfalfa, legumes
  • Adequate dietary protein intake is associated with a lower rate of age-related bone loss
• Reduce nutritional factors that alter calcium absorption or metabolism:
  • Phytates: mainly found in whole grains and legumes; soaking prior to cooking reduces phytate content
  • Phosphorus-containing foods: commercially raised red meat, soft drinks; can leach calcium from bones
  • Acid-forming foods: sugar, refined carbohydrates; pulls calcium from bones to buffer acidity
• Increase omega-3 essential fats: studies have shown significant decreases in bone resorption and a protective effect on bones
• Apple cider vinegar or lemon juice with meals to improve digestion

Nutritional considerations

• Calcium gluconate, citrate or hydroxyapatite
• Magnesium : needed for calcium and vitamin D regulation
• Vitamin D – depending on status
• Vitamin K – required for osteocalcin which holds calcium in the bones
• Boron
• Manganese
• Copper
• Omega-3 essential fatty acids
• HCL or digestive enzymes – improve digestion
• B6, B9, B12: to decrease homocysteine and assist with the balancing of the methylation cycle (contributes to osteoporosis)

Herbal considerations

• Nutritives – horsetail, kelp, alfalfa, nettles, oats, fennel
• Support estrogen production – black cohosh, wild yam, red clover, wild yam, chaste tree, fennel, sage, false unicorn root
• Support adrenals – withania, Siberian ginseng, rhodiola

Lifestyle / Physical measures

• Weight-bearing exercise: essential for maintaining bone strength; combination of weight-bearing endurance activity, resistance training, flexibility and coordination exercises has been shown to be the most beneficial regimen for people with osteoporosis
• Regular exposure to sunlight
• Quit smoking

FUNCTIONAL MEDICINE TREATMENT OF OSTEOPORSOIS

Osteoporosis is a common condition that is growing with prevalence in Perth and Australia wide.  Poor diet and lifestyle factors coupled with impaired digestion and gut dysbiosis are major contributors to the condition.  Patients that have had long standing gut issues that are unable to absorb nutrients effectively are at high risk, many people are often unaware that they have issues with their digestion or nutrient absorption.

Methylation and the MTHFR polymorphism (gene variation) are also contributing factors to the condition.  We commonly see patients with major imbalances in the related biochemical cycles with homocysteine levels often showing above 8.5mcmol/L. 

Are you or a family member suffering from Osteoporosis?  We would love to hear from you?  What interventions have assisted with you the most?  Have you identified gut and digestion issues and corrected these with great results?  Please leave a comment below.

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