Natural Medicine Q&A
Ask Dr. P
by Kasra Pournadeali, ND
Natural Medicine Specialist

Recently, more awareness is being aimed toward a new epidemic. It's a disease, which typically begins in childhood and early adulthood, but manifests in the elderly. It affects about 40% of all women and 15% of all men, and although it typically occurs after age 60, it can develop at age 8. The bad news about this disease is that most of us will be affected, the good news is that there are ways to prevent and treat it if we become afflicted. It's called Osteoporosis and it's when our bones lose their minerals and strength, and we develop risk for spontaneous fracture.

Q: Why do we get Osteoporosis?

Although there are at least three types of Osteoporosis, the most common type (postmenopausal) occurs with falling hormone levels in females. Hormone levels in men fall as well (andropause), but since the male gender typically has a higher bone density to begin with, men are not as severely affected. Falling hormone levels are not the only part of the picture like many doctors believe, as there are several important nutrients required for bone health, which become less available as we age. This happens because the efficiency of our digestive system decreases and we are less able to extract these important nutrients from our food. The process is further aggravated by the overuse of medicines like acid blockers, or antacids, which inhibit normal digestive function. Risk factors like being Caucasian, small-framed, sedentary, or a smoker, consuming alcohol, caffeine, or a high protein diet, having ovaries removed, never having had children, taking drugs that block testosterone, or using certain prescription drugs also can contribute to your risk of Osteoporosis. Any combination of these risk factors, lower nutrient availability and falling hormone levels leads to undesirable changes in bone metabolism and the rate of your bone breakdown exceeds the rate of your bone building or regeneration.

Q: How is Osteoporosis diagnosed?

At my office, we use a DEXA scanner. It's the gold standard of assessing a person's risk for Osteoporosis. Although DEXAs were previously costly, current technological advances have made them inexpensive and fast. There are also some urinary tests, which monitor breakdown products of bone, but they should not be used to diagnose Osteoporosis. They do not take into account bone building activity or a person's current bone status, which also needs to be considered. I usually start out with a baseline DEXA and urine test on patients to determine initial therapy, monitor with a urine test after six months, and a repeat DEXA after a year. It's critical to keep in mind that Osteoporosis is a disease of childhood and early adulthood, which only manifests in old age, so all adults should be screened. One example, myself, a relatively young, healthy adult male, not expected to be at risk, was shown with DEXA screening was to be at moderate risk for Osteoporosis in my age bracket!

Q: Dr. P, I take Estrogen, isn't that enough?

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 optimal to assure your bones (and entire body) gets the nutrients it needs to be healthy. 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 estrogen in halting bone loss. If hormone therapy is necessary, based on your individual situation, 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 hormones (more like those naturally found in the body) vs. synthetics prescribed by most medical 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 drug?

You are probably referring to the drugs alendronate and raloxifene. Alendronate works by inhibiting osteoclast activity (bone breakdown) to yield a net decrease in bone loss, while raloxifene is a SERM (selective estrogen receptor modulator) which mimics estrogen activity 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 what their long-term safety or effects are. The studies on these drugs have all been of less than 3-5year duration, so we just aren't aware of their safety and effectiveness beyond that. I do know that Osteoporosis is not from an alendronate or raloxifene deficiency, so it makes more sense to me to address underlying nutritional deficiencies and falling hormone levels (with natural hormones, if necessary) instead of recommending drugs with only a 5 year track record.

For more information or to schedule an appointment, please contact the Northwest Center for Optimal Health at (360) 651-9355.