The Osteoporosis Reality You Should Know

“Grandma fell and broke her hip,” is the story we were told. She went into the hospital and had a surgery, but it was the beginning of the end. It was all downhill from there. She was unable to walk, lost her zest for life, and within weeks she had died.

People fear these fractures, and rightly so! But then they go to their doctor who orders a test and warns that fractures will happen if a certain medication is not taken. Then we see a famous actress in a commercial looking half her age, telling us how important it is to take osteoporosis medication. There is a whole culture of fear surrounding the aging process! Fear that it’s going to strike us – and we never know where it will strike next. Out of fear we take calcium and prescription drugs to ward it off.

But, the problem is, everything you have heard about osteoporosis is wrong!

Is Rickets Really Osteoporosis?

The reality of osteoporosis is very different. In many ways, osteoporosis is a disease of the Industrial Revolution. Prior to that time, people lived, worked, and traveled outdoors in the sunshine, and got plenty of exercise, but since that time several changes happened. Work moved indoors under artificial lighting. Cities also became polluted with soot and smog. Children, especially among the wealthy class, stayed indoors and didn’t play or do manual labor. After all, children were to be seen and not heard.

Many may remember the story of Heidi.  Her friend, Clara, lived in the city and was in a wheelchair, getting weaker, until she went to visit Heidi in the mountains where she gained strength and was miraculously able to walk again.  Her recovery was attributed in the story to the clean mountain air.  Really, however, Clara had a disease called “rickets.”  The “clear mountain air” was the sunshine she was getting for the first time in her life that made vitamin D.

The Secret Garden is another story about a child, Colin, with Rickets, who was healed by being outside in the sunshine. These stories were common because Rickets was common. During the industrial revolution in England, and most of Europe, there was an epidemic of Rickets.[i] People felt they had to get away from the “bad air” of the city and go out into the country to recover. The smog of the city actually prevents ultraviolet light from making vitamin D, so there was some truth to the idea.

Later, through a series of scientific investigations, the cause of Rickets was elucidated. Ultraviolet light from the sun produced a hormone that they called “vitamin D.” By the middle of the 20^th Century everyone knew what Rickets was and how to prevent it. Doctors knew the value of sunshine to make vitamin D, which allows the intestines to absorb calcium from food. Also, a source of supplementation for vitamin D was found in Cod Liver Oil. When I was little, my mom lined us kids up for a dose of Cod Liver Oil every week.  YUCK!

Rickets all but disappeared. The next generation doesn’t understand deficiency diseases, and few have even heard of Rickets. However, it has shown up as “osteoporosis,” a mild form of Rickets found in adults. As people aged, and did less exercise, remaining indoors and not getting much vitamin D, the body uses the calcium in their bones, and the bones get weaker, leading to fractures.

Causes of Osteoporosis

Vitamin D isn’t the only cause of osteoporosis, there are multiple factors:[ii]

• Stress increases cortisol, the stress hormone, that causes more bone breakdown.
• Lack of exercise, especially weight-bearing exercise, is common as we age.
• Deficiency of vitamin K is common in those who do not eat greens.
• Magnesium deficiency also contributes.

There are many other things that cause people to lose bone:[iii]

• Autoimmune Disorders
• Celiac disease
• Inflammatory bowel disease (IBD)
• Weight loss surgery
• Cancer
• Multiple sclerosis (MS)
• Spinal cord injuries
• Depression
• Eating disorders
• Diabetes
• Hyperparathyroidism
• Hyperthyroidism
• Cushing’s syndrome
• Low levels of testosterone and estrogen
• Chronic kidney disease
• Poor diet

Anything that affects absorption of nutrients, increases stress and inflammation, or decreases the ability to exercise will lead to osteoporosis.

Osteoporosis Causing DRUGS

When a drug was manufactured that would “build bone” the name was changed from “Rickets” to “osteoporosis.” The treatment for Rickets was vitamin D, but the treatment for the same problem by a different name, osteoporosis, is a drug.[iv]

Warning: Prescription drugs for osteoporosis should be avoided.  They kill bone cells, called “osteoclasts” doing permanent damage.  They may cause a disease called “osteopetrosis” which is thick, brittle bone, as well as necrosis of bone, especially of the jaw.  They also damage the lining of the esophagus and may lead to esophageal cancer.  This is the first kind of medication I remove from every patient who comes in my office.

There are four main kinds of drugs prescribed for osteoporosis:[v]

1. Bisphosphonates:
   – Alendronate (Fosamax)
   – Ibandronate (Boniva)
   – Risedronate (Actonel)
   – Zoledronate (Reclast)
2. Calcitonin (Miacalcin)
3. PTH analogs (Forteo)
4. Antibodies (Prolia)

Generally, they all do the same thing – inhibit the osteoclasts which break down the bones. This may sound like a good thing, but there are problems with this! You see, bone remodeling is going on all the time, and these medications prevent that from happening properly. For this reason, they cause unusual fractures, and/or death of bones.

Bone Resorption According to the Kidneys

The big question is: why are my bones getting thinner in the first place? The body is an amazing machine that runs on efficiency. Whatever is needed is added, and whatever is not needed is taken away. People don’t realize that as they are exercising they make tiny fractures in the structure of the bone. These microfractures are repaired at night, and made stronger so it doesn’t happen again. Bone that is not being used is resorbed and the calcium and phosphorus are used by the body. It’s a beautiful system controlled mostly by the kidneys.

The kidneys have the job of keeping all the minerals of the body in balance. If calcium drops low, kidneys will:

• Activate more vitamin D to absorb more calcium from the intestines
• Decrease the calcium lost in the urine
• Increase hormones to take calcium out of bones – by osteoclasts.

Vitamin D and K to Prevent Osteoporosis 

Now, dermatologists are now telling us to avoid the sun.  We use sunscreen; we wear hats and clothing, we stay indoors or stay shaded from the “cancer-causing sunshine.”  (This is the topic of another discussion.) And, we work under artificial lighting all day. I have tested thousands of people for vitamin D levels in the blood and can count on two hands the number who have normal levels who aren’t supplementing.

Vitamin D helps us to absorb and use calcium which is required by the body at a constant level.  Without a consistent supply of calcium from food, the body takes it out of our bones to make our muscles and nerves work.  Osteoporosis is just a mild form of Rickets. Osteopenia is mild osteoporosis. All of them are related to the amount of calcium in the bones.

Vitamin K works with vitamin D to build bone.[vi] While vitamin D causes more calcium absorption from the intestines, vitamin K is needed to put that calcium into the bones. The recommended daily dose of vitamin K based on coagulation studies is much lower than what is needed for bone health.[vii]

Achieving Bone Balance

If you take calcium supplements you may cause imbalances in other areas such as magnesium.  If you don’t have good balance of nutrients the calcium deposits in your body causing bone spurs, kidney stones, and hardening of the arteries.[viii]  It is a mistake to take more calcium to build the bones because the food we eat has plenty.  What we need is balance and proper usage.

The nutrients that work together to build bone are complex and should be derived from food.  Vitamin D supplementation is essential, however, for all the reasons we discussed.

Vitamin D works with vitamin K and vitamin A as well.

Moreover, there must be adequate magnesium to build bone, which is found in green vegetables, whole grains, nuts and seeds.  Since Americans don’t live on these, but rather eat them occasionally, it’s common for people to be deficient in magnesium. One study on people with celiac disease indicated that the cause of osteoporosis was not a lack of calcium, but magnesium. When the people took extra magnesium their osteoporosis resolved.[ix]

Exercise for Stronger Bones

You cannot build bone without exercise.  I repeat: If you don’t stress the bone, you can take all the supplements you want, but you won’t increase the strength of your bones.  I cannot emphasize enough the value of regular (3-5 times per week) weight-bearing exercise.  Walking is good if you walk a lot, or fast.  Running is better for short exercise duration.  Studies show that those who are doing significant exercise gained as much as 5% of bone in a year, whereas those who didn’t exercise, or just walked comfortably, lost as much as 5% of their bone mass.[x] Even older people build bone with regular exercise – there is no age limit.

Most will have to start slowly and gradually increase to a one-mile jog.   Jack LaLanne-style calisthenics at home are also a great idea.  (Besides, it’s the BEST way to stay out of a nursing home!!!)  Watch videos here. I want to encourage this because of our tendency to think we can take a pill instead – don’t even think about it. Don’t skip to the supplements – exercise! There is no substitute for activity to build bones.

Healthy Bone Recommendations 

1. Exercise regularly.
2. Exercise some more.
3. Guess what? YES, EXERCISE!
4. Vitamin D3 50,000 IU once or twice per week. A good daily dose is 10,000 IU.
5. Vitamin K2 about 2 mg per week (best if eaten in dark green vegetables)
6. Vitamin A (natural form of mixed retinoids and carotenoids) 50,000 IU per week.
7. Magnesium 400mg in the evening before bed. (Better yet: eat more green vegetables, whole grains, legumes, nuts and seeds!)
8. Continue exercising 3-5 times per week – FOR LIFE!

Another important way to build bone is to kick-start your circadian rhythm with your anabolic metabolism. This can be accomplished with three rules:

1. Eat breakfast before 8am.
2. No food after 6pm.
3. Go to bed before 10pm.

This lowers stress hormones, and allows the release of Growth Hormone (HGH) every night to re-build your bones stronger than they were before.[xi]

Stamp Out Osteoporosis

This would be adequate to build bone, as well as improve your strength, stamina, energy, and immune system.  Moreover, your chances of getting cancer would drop by about 50%![xii] Studies in nursing homes where residents never see the light of day show that there is much more to vitamin D than just building bones.[xiii]  It also prevented acute upper respiratory infections. Good nutrition that includes dark green vegetable to give vitamin K and magnesium, and regular exercise does make a difference, both in testing and in the lives of each individual. Using the above recommendations to reverse or prevent osteoporosis will have many other health benefits!

 

 

 

 

Sources:
[i] http://www.actareumatologica.pt/oldsite/conteudo/pdfs/ARP_2007_3_205_AR_-_Raquitismo.pdf
[ii] https://www.healthline.com/health/osteoporosis-causes#hormones
[iii] https://www.nof.org/patients/what-is-osteoporosis/
[iv] https://www.pdr.net/drug-summary/Fosamax-alendronate-sodium-352.460
[v] https://www.health.harvard.edu/womens-health/osteoporosis-drugs-which-one-is-right-for-you
[vi] https://pubmed.ncbi.nlm.nih.gov/33255760
[vii] https://pubmed.ncbi.nlm.nih.gov/15018483/
[viii] https://www.ahajournals.org/doi/full/10.1161/JAHA.116.003815
[ix] https://pubmed.ncbi.nlm.nih.gov/9116391/
[x] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4889622/
[xi] https://pubmed.ncbi.nlm.nih.gov/8627466/
[xii] https://www.cancer.gov/about-cancer/causes-prevention/risk/diet/vitamin-d-fact-sheet
[xiii] https://pubmed.ncbi.nlm.nih.gov/27861708/