Osteoporosis is a multi-factorial skeletal disorder of progressive bone mass loss, demineralisation and frequent fractures, which accelerates with menopause.
Mature bone matrix is a complex highly mineralised structural framework, composed primarily of collagen and containing a small number of non collagenous proteins and glycoproteins.
The bone loss during the first decade following menopause is predominantly at the expense of the trabecular bone (the inner layer with a spongy honey-comb
texture – 50% loss) whereas only 5% of the cortical bone (the dense compact part) is lost.
Osteoporosis is considered to be present when bone density is a T-score of -2.5 or lower.
Osteopenia is a reduction in bone density with a T-score between -1.0 and -2.5.
Osteoporosis is a ‘silent’ disease, often not noticed until a fracture occurs, and this often the result of a very simple movement. Prior to a fracture occuring the only signs of
a problem may only be a loss of height and/or kyphosis.
Factors that can affect bone density are:
– smoking and drinking alcohol. Smokers are more likely to suffer osteoporosis than non smokers and excessive alcohol (over the ‘moderation’ level of 14 units weekly) can also speed up bone loss.
– Caffeine, also has a detrimental affect. One study concluded that just 4 cups of coffee daily was sufficient to cause significant loss of bone density.
– Diet. Bone, like any living tissue, is constantly regenerating and will do so adequately if the blood supplies adequate nutrients. Often the modern diet does not allow this.
To help maintain bone density there are a number of factors to be aware of:
It is important to make an effort to keep all mineral levels optimum (not just calcium). The essentiality of minerals such as zinc, manganese, magnesium and copper has been known for a long time.
Zinc is needed for normal bone formation and is a co-factor for Vitamin D which is essential for the proper absorption of calcium.
Adequate Vitamin D can be obtained simply by being out side for part of a day but may need to be supplemented if a person is completely house bound.
See page on Vitamin D.
Manganese is needed for bone mineralization and making bone and cartilage connective tissue.
Magnesium is particularly important, since magnesium regulates calcium transport. Supplementation with magnesium has been shown to significantly increase the mean bone density and to help prevent bone fractures.
Boron is critical as it is necessary for the utilization of calcium and vitamin D and to deconjugate estrone into 17-beta-estrodiol which helps prevent osteoporosis as well as many menopausal symptoms.
Copper deficiency can result in reduced bone mineral content and bone strength.
Calcium is not as common as we are led to believe. Calcium can be obtained from many food sources, not just dairy products. Foods such as the following contain good levels: Sea foods, seaweeds, kelp, sesame seeds, tahini, almonds, brazil and hazel nut,watercress, fresh greens, parsley, figs, black treacle,tofu, goats and sheep milk, chick peas, soy and kidney beans.
Calcium supplements increase the risk of kidney stones and can interfer with iron and zinc absorption.
However, conventional medicine persists in supplementing with calcium only or at best
with added Vitamin D added, even though there is little evidence that it is effective in preventing osteoporosis the elderly except in those that have a very low calcium intake.
A study designed to measure the difference between this and the addition of trace elements on the bone density of post menopausal women showed a clear improvement in the group that were given calcium plus trace elements but not in the group given calcium only.
Other studies have shown that calcium supplementations of 660-3000mg daily had no significant effect on trabecular bone loss in post menopausal women and actually caused hypercalcemia and hypercalciuria in many of them.
Conventional treatment of oestrogen, with or without supplemental calcium and vitamin D, tends to delay bone mass loss but not reverse it.
Treatment with oestrogen has favourable and unfavourable effects.
On the plus side, apart from delaying bone loss, oestrogen may also decrease the
risk of cardiovascular disease, reduce/eliminate menopausal hot flushes, sweating, vaginal dryness etc.
On the negative side it may affect liver metabolism, increase the risk of blood clots, increases the risk of uterine cancer (if not used in conjunction with progesterone) and may increase the risk of breast cancer. Research is continuing.
Treatment with transdermal progesterone has resulted in progressive increases
in bone mineral density and definite clinical improvement in pain relief, height
stability, increased physical activity and fracture prevention.
See page on ‘ Menopause – Symptoms and treatment’
I have seen very satisying results when women have taken ‘hormonal herbs’ (often Black Cohosh) in conjuction with Colloidal minerals over a period of 12-18 months. Bone density tests definitely slowly improve.
Calcitonin and para-thyroid hormone are also possible factors in calcium loss. Both are hormones produced by the thyroid, so it makes a lot of sense to make sure that the thyroid is functioning adequately. In many post menopausal women this is not the case and in many the addition of a little extra Iodine to the diet can make a huge difference.
Vitamin C is also essential for healthy bones and skin. All fresh fruits will supply Vitamin C, just make sure your daily intake is sufficient.
Overall diet can also make a considerable difference. There have been studies that show that women that have eaten a vegetarian diet for a good part of their life tend to lose a smaller proportion of bone mass than do women that have eaten a carnivorous diet.
Exercise is important.
Studies show that weight bearing exercise helps prevent osteoporosis in load-bearing bones and that any type of exercise that maintains fitness will help prevent fractures through development of musculature.
Weight bearing exercise however must be maintained in order for it to be effective, which can often be difficult for some elderly people.
Yoga is often a good choice for older people as it is a strong but gentle form of exercise.
Vibrational plates can also be used to good effect but I feel need to be of a specific vibration.