Natural Medicine Q&A
Ask Dr. P
by Kasra Pournadeali, ND
Natural Medicine Specialist
In the Northwest, we are blessed with a milder climate than in other parts of the country. Unfortunately, having less sunlight puts us at risk for decreased bone health. Yes, Vitamin D, which our bodies convert from sunlight, is important for strong, healthy bones. Without enough of it and other nutrients, our bones suffer. The result is low bone density / brittle bones A.K.A. Osteoporosis (os tee o po ro sis.) It's a very important topic to me, because not only am I affected but 20% of all men and 60% of all women are as well. Left untreated, it can lead to spontaneous fractures of the hip and low back, resulting in what's often permanent disability. This month's column focuses on bone health; how to prevent getting brittle bones, and how it can be treated.
Q: Dr. P., I've always eaten very well, how could I possibly be at risk for brittle bones? Ellen
Ellen, the most common type of Osteoporosis (postmenopausal) occurs with decreased hormone levels in women. Hormone levels in men fall too (andropause), and for that reason, men should also think about bone health. Falling hormone levels or calcium supplements are a small part of the picture, unlike what most doctors believe, as there are several other important nutrients necessary for bone health, which are less available as we age. This is because the efficiency of our digestive system decreases with age, and we become less able to extract important nutrients from our food. The process is further aggravated by medicines like acid blockers, or antacids, which inhibit normal digestion. You may also be plagued with risk factors like being Caucasian, small-framed, not exercising, smoking, drinking alcohol or caffeine, having a high protein diet, having your ovaries removed, or taking certain medicines, any of which can increase your risk for Osteoporosis.
Q: Dr. P., I think I'm at risk for Osteoporosis, what do I need to do to get checked? Cindy
Cindy, aside from knowing your risk history, you need to be assessed with a specialized X-ray device called a DEXA scanner. It's the gold standard in assessing for Osteoporosis. Although getting a DEXA scan was previously costly, technological advances have made them fairly cheap (about $50,) and fast (2-3 minutes). There are also some urine tests, which measure breakdown products of bone, and therefore tell us just how much (if any) bone you’re losing. A urine test needs to be done because first, it tells us if you're actively losing bone, and second, it tells us if your treatment to prevent bone loss / or build bone is working. The DEXA cannot show either unless you wait a full year to retest-- really too long to assess how your treatment is working. At our office we recommend a baseline DEXA and urine test on patients to determine initial therapy, monitor with a urine test after three months, and repeat the DEXA after a year. This way we're able to determine if the treatment is working or if we need to make changes without waiting a year. Please remember that Osteoporosis can occur in anyone, present company included! Screening is cheap, and doing it can assure you prevent permanent disability, which occurs all too often with Osteoporosis.
Q: Dr. P, I've taken Estrogen for years, isn't that enough? Deena
No. Many nutrients (and not just Calcium) are also necessary for bone health. Vitamin B6, D, and K, Magnesium, Silicon, Manganese, Phosphorous, Zinc, Boron, and Copper are a few examples. Your diet needs to be rich in these nutrients and digestive function needs to be maximized to assure your bones (and whole body) gets the nutrients it needs to stay as healthy as possible. If nutrient therapy alone is not enough, there are also natural medicines like Ipriflavone (an isoflavone from soy,) which has been shown in double blind studies to be as effective as low dose estrogen in halting bone loss. If hormone therapy is necessary, I recommend plant-derived natural hormones instead of animal-derived synthetics. In next month's column, I'll explain more about the benefits of using plant derived natural hormones vs. synthetics prescribed by most doctors, which have a number of side effects and increase risk for certain cancers.
Q: Dr. P, what do you think of the new Osteoporosis drugs? Aren't they safer than hormones? Tina
Tina, you're probably referring to the drugs alendronate (Fosomax) and raloxifene (Evista). Alendronate works by inhibiting bone breakdown while raloxifene is a SERM (selective estrogen receptor modulator,) which mimics estrogen in the body. These drugs have been shown in studies to stop bone loss. However, they do have side effects, and it is not known whether they are safe or beneficial to use long-term. No one has compared the safety of these drugs to the natural hormones, which are thought to exhibit protective effects against some cancers. I think these new drugs are an important option for people who don't respond to the natural therapies, or natural hormones. Keep in mind though that Osteoporosis is not from an alendronate or raloxifene deficiency. To me, it makes more sense to address underlying nutritional deficiencies, normalize falling hormone levels with natural hormones (if needed,) before using a drug with only a 2-5 year track record.
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