Osteoporosis: the bone loss disease

Osteoporosis is one of a small number of common metabolic diseases that show no symptoms until there’s a crisis. What’s the crisis? Bone fracture. How common is it? Fifty percent of all women and 21% of all men 50 years or older experience one or more osteoporosis-related fractures in their lifetime. While the condition is generally four times more prevalent in women, that doesn’t mean men can afford to ignore it.

What exactly is osteoporosis?

First, don’t confuse it with osteoarthritis, a different musculoskeletal condition that occurs when there is gradual deterioration of the cartilage that protects the ends of your bones, resulting in swelling, stiffness, loss of movement and pain. Joints most affected are hands, knees, hips and spine.

Osteoporosis, which literally means “porous bone”, also occurs over a long period but involves a gradual reduction in bone density until bones become fragile and can break easily. There are usually no symptoms until a fracture occurs, which is frequently at the hip, spine or wrist. But those with advanced osteoporosis have often lost height and can also have a stooped posture.

How can bone density reduce over time? Like other tissues in the human body, bone tissue is constantly being dissolved (resorption) and regrown. For people who have osteoporosis, resorption, or “bone loss”, occurs faster than new growth, resulting in bones that look like the picture above on the right.

Are you at risk?[i]

A condition like osteoporosis that is largely “silent” with devastating consequences, but has a high prevalence in the population certainly prompts us all to know our risk factors:

·        Age (especially women who are postmenopausal or who have had a partial or full hysterectomy)

·        Family history (I have worked with families where 8 members have osteoporosis)

·        Smoking

·        Heavy alcohol consumption

·        Those who get little exercise

·        Those who are small-framed or thin

·        Long-term use of certain prescription medications such as corticosteroids

·        A personal history of thyroid or parathyroid problems

·        A personal history of excessive dieting or an eating disorder

·        A personal history of intensive athletic activity resulting in an irregular menstrual cycle

Screening for osteoporosis can be individualized so it’s important to consult with your Primary Care Practitioner[ii]. Because osteoporosis is more common in women, screening is typically recommended for all women over the age of 65, but it may also be recommended for younger women or men of any age who are at higher risk, especially those who have had a recent bone fracture[iii].

Osteoporosis screening relies on a bone density test. There are two main types: a central DXA test of the hip and spine that uses low-levels of Xray, and a range of other screening or “peripheral” tests that might be offered at health fairs or free clinics. Peripheral test results often need to be confirmed by a DXA test.

Bone density test results are reported using T-scores. A score higher than -1 (such as -.5 or +.5) is considered normal bone density. A result between -1 and -2.5 means you have low bone density or “osteopenia”, the precursor of osteoporosis. A score below -2.5 (such as -3 or -4.5) means you have osteoporosis.

Conventional treatment of osteoporosis[iv]

Primary Care Practitioners may prescribe for those identified to have osteopenia in order to prevent further bone loss, as well as those with osteoporosis. 

Medications include biophosphonates, usually taken orally; or monoclonal antibody medications that are given by means of a shot every 6 months. Finally, hormone therapy might be prescribed for both women and men. Most if not all these medications must typically be taken for life.

What can you do on your own?

Many health care providers suggest preventive self-care for their patients, particularly those at lower risk. These include avoiding smoking and alcohol consumption, maintaining a healthy body weight and getting plenty of exercise.

But an important but lesser known fact about osteoporosis is that it’s associated with an endocrine or hormone imbalance. This is why risk factors include post-menopause, early hysterectomy, excessive dieting, intense athletic activity, hyperthyroidism and parathyroidism, all of which are a result of, or can result in, hormone imbalance. It is also why hormone therapy can be prescribed for both women and men who have osteoporosis.

There are therefore other measures you can take to support the endocrine system in order to help prevent, delay or reduce the severity of osteoporosis, such as:

·        Consume plenty of healthy fats such as fishoil (the best source is from eating fish), olive and coconut oil: the endocrine system needs healthy fats to make hormones

·        Unless you have been advised against this by your health care provider, get 30 minutes of direct sunlight every day without sunglasses or sunscreen: many hormones are synthesized from Vitamin D

·        Avoid or reduce endocrine disruptors that are found in coffee, Nutrasweet, many household products, cosmetics, pesticides and food additives, and keep the cell phone away from your body: resources and more information on endocrine disruptors and how to avoid them can be found at the excellent website of the Environmental Working Group (https://www.ewg.org/research/dirty-dozen-list-endocrine-disruptors)

·        Traditional Chinese medicine and Ayurvedic medicine both recommend breast massage for women, and testicular massage for men to support the endocrine system: check out this article for more information on breast massage (https://www.womenshealthmag.com/health/a31676972/breast-massage/). If you are a man, you could look into testicular massage.

In addition to supporting the endocrine system, regular weight-bearing exercise such as walking, hiking, dancing or gardening can be an important component of addressing osteoporosis. Also helpful is resistance exercise such as lifting weights (but keep them light!).

An excellent resource that covers many of these self-care recommendations is the Save Our Bones program. Much of the information and assistance provided through this program is free or low-cost: https://saveourbones.com/ . Participants in the program claim these measures alone can halt or reverse bone loss.

An integrative approach to addressing osteoporosis

Alongside conventional medicine options, and for those who do not tolerate long-term prescription medications well, a natural approach like homeopathic remedies, which are federally recognized in the US, can be very helpful.

Because osteoporosis has no symptoms, the best way to gauge effectiveness for all interventions, including prescription medications, self-care and homeopathic care, is repeat bone density tests. For those with osteoporosis, Primary Care Providers typically recommend that this test be done yearly or every other year; for those with osteopenia (the precursor of osteoporosis), tests are usually less frequently.

The main aim of homeopathic care for osteoporosis is to help the body restore the balance between resorption and regrowth of bone tissue.

There are a small number of low-potency “organ support” homeopathic remedies that can be taken daily, cycling through the series and changing remedies every 3 weeks or so[v]. Some of these remedies support the kidney and parathyroid, both of which are an important part of the solution since they help regulate calcium in the body. This kind of protocol can be followed until bone density tests indicate normal T-scores (higher than -.1).

Call me for a free 15-minute consultation or schedule one on the online scheduler to learn more about how I can help you address your osteoporosis.

[i] “Osteoporosis risk factors”, Michigan Medicine, https://www.uofmhealth.org/health-library/te7603

[ii]  National Osteoporosis Foundation, “Bone Density/Exam Testing”, https://www.nof.org/patients/diagnosis-information/bone-density-examtesting/

[iii] Kling, JM, B Clarke, N Sandhu (2014) Osteoporosis: prevention, screening and treatment”, Journal of Women’s Health 23(7):563-72.

https://pubmed.ncbi.nlm.nih.gov/24766381/

[iv] Mayo Clinic, “Osteoporosis Diagnosis and Treatment”, https://www.mayoclinic.org/diseases-conditions/osteoporosis/diagnosis-treatment/drc-20351974

[v] I am indebted to Karen Allen CCH, whose years of experience with endocrine issues including osteoporosis has provided me with invaluable advice.