Time for some different ideas:

Osteoporosis has become a massive disease entity with two distinct medical opinions. There are those that feel that this disorder needs treatment to address the symptoms. They employ the calcium and medication rational. On the other end of the spectrum is the approach that considers that osteoporosis is a sign of other underlying disorders. The concept is to address the underlying causes that lead to this end point. Treatments consist of first ascertaining the issues and then in a systematic fashion resolving the problems.

At the Center of Health™ we choose to address your medical concerns with an integrated approach. This allows you to choose your options from a number of potentials after thoroughly being able to understand the disorder.

Who ?

When we discuss Osteoporosis the magnitude is quite startling. Did you know that according the the NIH ( National Institute of Health) Osteoporosis is responsible for more than 1.5 million fractures annually, including: 300,000 hip fractures, 700,000 vertebral fractures, 250,000 wrist fractures, and 300,000 fractures at other sites. 80% of those affected by osteoporosis are women. 8 million American women and 2 million men have osteoporosis, and millions more have low bone density. One out of two women and one in eight men over age 50 will have an osteoporosis-related fracture in their lifetime. 10% of African-American women over age 50 have osteoporosis; an additional 30% have low bone density that puts them at risk of developing osteoporosis.

Bone 101:

Bone is a living tissue, in a dynamic equilibrium between building and breakdown. During our first 20+ years of life we have the opportunity to increase the ultimate density.

There are many factors that contribute to either the strong or weak bone mass. The sole concept of calcium, as the key agent responsible for the end result, is absolutely incorrect.

Bone is made up of mineral components which comprises between 60 to 70 percent of the mature bone matrix, with the remainder basically collagen and water. The mineral components provides strength and the organic component provides flexibility.

The bone matrix is composed of both calcium and phosphate salts, and an organic component, that is largely collagen fibers. The calcium and phosphate salts combine to form hydroxyapatite crystals and give bone its amazing tensile strength.

Risk factors, not under your control

There is an extensive array of factors contributing to your bones integrity. The following lists are intended to give you an outline. Remember that you can modify most of the risks and reverse this disorder.

Being female
Thin and/or small frame
Advanced age
A family history of osteoporosis
Post menopause, including early or surgically induced menopause
Abnormal absence of menstrual periods (amenorrhea)
Being Caucasian or Asian, although African Americans and Hispanic Americans are at significant risk as well

Factors Under Your Control

Diet, including:

1. Fats
2. Sugar
3. Caffeine
4. Excessive Salt
5. Alcohol

Live Style Considerations:

1. Sun exposure
2. Exercise
3. Smoking
4. Medications, see the list below
5. Emotional Stress

Osteoporosis Symptoms ??

There are a number of warning symptoms, available to many. Have you experience any of these potential danger indicators ? Please keep perspective, these symptoms and signs many also indicate other health concerns.

Cramps in the leg or feet
Dowager's hump
Periodontial disease
Rickets
Bone pain
Brittle or soft finger nails
Heart Palpatations
Premature gray hair
Non-traumatic fractures

Associated Diseases to consider that cause bone loss:

A number of diseases can mimic osteoporosis. They have a negative effect on the bone mass, due to their processes of decreasing bone deposition or increasing loss. Some affect both aspects at once, hence a very high bone loss rate.

Primary Biliary Cirrhosis
Anorexia Nervosa
Hypercalciuria
Cushing's disease
Bone marrow disorders
connective tissue Disorders
Rheumatoid Arthritis
Chronic Obstructive Pulmonary Disease (COPD)

Testing:

The gold standard in testing your bone density is a DEXA machine, that will evaluate both the femur and lumbar spine. T and Z scores will determine your current density, with respect to your age and those in their 20s.The interpretation of the scores is simple. A T score is based on your density, in standard deviations, compared to a young adult. Between 0 to(-)1 your bone density is within normal limits. (-)1 to (-)2.5 indicates a loss and is termed osteopenia. From (-)2.5 and greater your density is considered in the osteoporosis category. A Z score is age matched, to your peers.

The next step, in testing, is to determine if your choice of therapy is successful. DEXA devices, although very accurate, need a lengthy time frame of between 18-24 months for sufficient changes, in your bone density, to give you this information.

There are two FDA approved tests which measure the rate of bone remodeling, via cross-linked protein excretion. These include the N-Telopeptides (Ntx) and Pyridinium (pyd) tests, both utilize the second morning urine, hence they are easy to collect and reasonably priced.
We use the Pyridinium testing due to it's apparent increased sensitivity. For further discussion of this test see the Great Smokies Lab web site.

Nutritional Considerations:

When we start our assessment we want to address two distinct aspects of nutritional status. The first is your intake. The questions are not only if and how much is present, but also the quality. The second has to do with timing and digestability. As you will see a broad array of nutrients are essential for good bone health.

Vitamins:

D
K
C
B6
Folic Acid
Silicon

Minerals:

Calcium
Magnesium
Boron
Zinc
Copper

Protein:

Source
Amount

Hormonal considerations:

The area of hormonal considerations is so intertwined and broad that a full discussion would likely become a book, at the minimum. To simplify the issues, always look in the direction of how the hormone in question will influence the loss or retention of bone components. Consider the case of a hyperthyroid (excessive) condition. With an increased metabolism the bone turn over and loss of minerals, via the urine, would be accelerated. The correct balance of all the hormones is essential.

Adrenal
Thyroid
Parathyroid
Ovarian/testicular
Pancreatic

Gastorintestinal:

This subject area is probably one of the most overlooked but necessary for anyone experiencing osteoporosis. In 19 years I have yet to find an osteoporitic patient without some level of GI upset that is contributing to their disease.

The evaluation can be easily accomplished with a simple stool sample or blood information and is strongly recommended for a complete overview of the bodies function.

Hypochlorhydria/achlorydria
Lactose Intolerance
Colitis

Adverse Drug List:
Steroids
Anticonvulsants
Antacids
Excessive Thyroid Medications
Heparin
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Caffeine containing Medications

Additional Resources:

As a note there are very limited integrated sites. Most contain the usual and expected limited vision information. If you find some that you find appropriate, please let me know.

Osteoporosis and Womens Health
National Osteoporosis Foundation
Osteoporosis Society of Canada
NIH site for Bone Disorders
Doctors Guide
National Osteoporosis Society

Discussion:

The key consideration in the discussion of your potential, for or expression of osteoporosis, should be focused on the assessment of all causative factors. The first step in your regaining your health is a comprehensive history, followed by a physical examination. Don't allow this seemingly long listing of potential causes to diminish your resolve to eliminate your risk or disease. One of the nice aspects to this disease treatment is the enhancement of your health overall.

Ready for evaluation and treatment ? Please contact the Center at 541.773.3191. We look forward to enhancing your health.

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