Your Bones Are Alive!

When I talk to people about osteoporosis or other bone issues, I am amazed to discover that many people don’t realize that bones are alive and constantly rebuilding themselves. In fact, just like the skin, the bones you have today are not the same bones from several years ago. Your body constantly replaces old bone with new bone. You don’t have to break a bone just to get the body to build new bone. Great, another fact for Jeopardy. Well, that is what we are going to talk about because it is a breakdown in this process that is the cause of osteoporosis.

OK, first some science. Bone is made by cells in our body called osteoblasts. Bone is broken down and the debris removed by cells called osteoclasts. If you mess with the balance of either one of these cells, bone growth and/or strength is affected. There is also a gland called the parathyroid gland. It sits next to the thyroid gland (hence the name) and it makes two hormones. The first is calcitonin and it regulates the osteoblasts. The second is parathyroid hormone and it regulates the osteoclasts. Both hormones are in a delicate balance in the body. So, if the body needs calcium, it “steals” it from bone. The bone becomes more brittle over time and bingo “osteoporosis”. There is also a condition called osteopenia. Consider that a mild form of osteoporsis, so when I say osteoporosis, I am referring to both. Lots of facts. Let’s try to tie them together.

As I mentioned bones are living tissues that have to be broken down and rebuilt constantly, just like all the cells in our body. When both the break down and the build up are in “synch” then all is well. When it starts to favor the side of “break down” we have the beginnings of osteoporosis. So what causes it? Well in no particular order it is usually a deficiency of something.

Magnesium is needed for calcitonin to work properly. That is the stuff that makes the osteoblasts work and build new bone. Not enough magnesium, then new bone is not formed efficiently even with all the calcium we may need. It’s interesting that countries with the highest intake of calcium compared to magnesium also have the highest rates of osteoporosis. In the US and Switzerland, we take in a ratio of calcium to magnesium at 4 to 1 and 5 to 1 respectively. South Africa takes in a ratio of calcium to magnesium at 2 to 3. The rate of osteoporosis in The US and Switzerland is 20 and 27 times that of South Africa.  How to fix it? Read labels and make sure your diet gives you about equal amounts of calcium and magnesium. A gram each should about do it.

Excess acidity in our diet accounts for osteoporosis too. When the body becomes too acidic, it pulls calcium from the bones to counteract the acidity. What do you think TUMS is made from? Acidity will increase with a diet of too much processed foods, soft drinks, cigarettes, alcohol and such and too little fruits and vegetables. How to fix it? Change the diet.

Vitamin D is in short supply in many of the northern areas (including us). Vitamin D works to increase the absorption of calcium in through the gut. Too little Vitamin D and you can take boat loads of calcium and all you will get is a very expensive remedy for heartburn. How to fix it? Vitamin D.

Estrogen also affects osteoporosis as it inhibits osteoclasts from working. As a result old bone is never broken so that new bone can replace it. Even though the bone may remain dense, it is weaker. Unfortunately that is also how those osteoporosis medications work. Your DEXA scan reads great but the final product is far from satisfactory. A DEXA scan essentially measures the amount of calcium in your bone, compares it to a 20 year old woman of equal height and weight and implies the more calcium the stronger the bone. As you see this is not always the case. Back to the hormones. Progesterone also plays a role by aiding the osteoblasts to replace bone. Bottom line, you need both estrogen and progesterone and not just one. How to fix it? Unfortunately in this estrogen dominant society, it may be easier said than done. So many things are inundated with estrogens amongst other bad stuff. Look for organic or at least minimally processed foods. Have your hormones checked. Likewise on a personal note, I only recommend bio-identical hormones from accredited compounding pharmacies although I am sure many of my medical brethren may disagree.

Last but not least there is my favorite good old fashioned remedy; get off your duff and exercise. This includes not only endurance exercises but also resistance or weight bearing exercises. No you don’t have to become a Scharzenegger but you need to use weights or belts or whatever. Every gym, fitness center and recreation center I know have trainers available that can assist you. On my treatment list for osteoporosis, exercise takes the top three positions.

Now this does not even scratch the surface of all the different causes and influences for the development of osteoporosis but it does show you that osteoporosis is reversible. It is not just a lack of calcium and the suggestions I mentioned are easy and a good place to start. As always contact your medical physician before you start anything or stop into the Balance of Life Clinic and we can talk about what concerns you. Don’t just go get a bag of supplements or a jar of over the counter phytoestrogens. (These are hormones from plants and don’t need a prescription. Talk about buyer beware). Remember I’ve always said that anything in excess can be harmful. A smart health care consumer is informed and aware.

Clifford Sonnie, M.D., M.P.H. is the Medical Director at the Balance of Life Clinic.