Osteoporosis

Osteopenia refers to bone mineral density (BMD) that is lower than normal, but not low enough to be classified as osteoporosis.

Osteoporosis is a condition where the bones become porous and fragile from mineral loss. Osteoporosis treatment is often introduced after the disease process has caused considerable damage. It progresses painlessly until a fracture occurs – typically in the wrist, hips or spine. While any bone can be affected by osteoporosis, the hip and spine are particularly vulnerable.

We begin to lose calcium from the bones early on in life around age 30 for white males and black females, and around 18 for white females. Recent studies suggest that girls may start losing calcium from their bones as early as age 13. Black males do not, as a rule, suffer from osteoporosis.

With this condition, bones become porous and fragile from mineral loss. Osteoporosis treatment is often introduced after the disease process has caused considerable damage. It progresses painlessly until a fracture occurs-typically in the wrist, hips or spine. While any bone can be affected by osteoporosis, the hip and spine are particularly vulnerable.

A hip fracture almost always necessitates hospitalization and major surgery and impacts the ability to walk unassisted, causing prolonged and often permanent disability and even death.

Interestingly, more women die from osteoporotic fractures each year than from breast and ovarian cancers combined. Spinal fractures also have serious consequences, including loss of height, severe back pain, and deformity. Even sneezing can cause the fracture of bones in the spine because of their thin and porous nature. Osteoporosis treatment is sometimes controversial, as many medical applications carry risks.

One in four women and one in eight men over the age of 50 have osteoporosis and require treatment. Many women are diagnosed with Osteopenia (bone thinning) that is not as severe as Osteoporosis or does not have all symptoms of Osteoporosis; however, Osteoporosis treatment is still recommended.

Warning Signs and Symptoms

Osteoporosis progresses silently over time therefore the warning signs for the condition also include the risk factors:

• Female of postmenopausal age (estrogen is partly responsible for keeping calcium in the bones)
• Surgical menopause (complete hysterectomy with removal of ovaries)
• History of bone fracture not attributable to an accident/injury
• Thin, small build
• Chronic use of anti-inflammatory steroids
• Excessive doses of thyroid medications or anticonvulsants
• Family history of osteoporosis or fractures
• Sedentary lifestyle
• Poor diet that does not include foods rich in calcium, magnesium, vitamin D and phosphorus
• Excessive intake of alcohol, caffeine or carbonated beverages
• Long-term smoker
• Hereditary factors (Tendency can be passed down)
• Having an overactive thyroid gland
• Diabetes
• Rheumatoid arthritis

Bone mineral exchange consists of two distinct stages:

• Bone resorption – osteoclasts on the bone’s surface dissolve bone tissue and create small cavities.
• Bone formation – osteoblasts fill the cavities with new bone tissue.

Usually, bone resorption and bone formation occur in close sequence and remain balanced. Osteoporosis treatment includes medications that have one goal: to restore this delicate balance through inhibiting the activity of the osteoclasts. The inability of the body to do so is one of the causes of osteoporosis.

In our opinion this is a misguided strategy. Balancing your lymphatic system and restoring it to an alkaline pH will eliminate your body’s need to pull calcium from your bones, and will allow it to redeposit the minerals back in your bones. Osteoblasts will work correctly only if sufficient magnesium is present.

Calcitonin is a hormone that occurs naturally within the body that increases bone density by affecting the levels of calcium in the blood

• Inhibits osteoclast activity
• Slows down the breakdown of bone
• Relieves pain that results from spinal fractures

Biggest Risk Factors

• Sedentary lifestyle. The strength of our bones depends very much on the amount of physical activity we build into our lives. Regular, weight-bearing exercise such as walking, running, hiking and weight training all help to drive calcium into the bones.
• Drinking carbonated beverages. The phosphates in most sparkling drinks cause calcium to be leached from the bones.
• Too much coffee or tea. The mainstream will say that caffeine is a diuretic drug that increases the flow of urine and that causes loss of calcium and other minerals. Actually, coffee is very acidifying to the lymph, which has to be then alkalized by calcium taken from the bones.
• Menopause. Following menopause, when female hormone levels wane, calcium is leached from the bones. (Estrogen helps the bones to retain calcium.) Surgical menopause (removal of the uterus and ovaries), also precipitates calcium loss.
• Use of certain drugs. Chronic use of anti-inflammatory steroids, excessive doses of thyroid medication or anticonvulsive drugs can contribute towards bone loss.
• Lack of vitamin D and sun exposure.
• Thin, Small Build
  Caucasian women with fine bone structure have an increased risk.
• Not Enough Calcium balanced with Magnesium in Your Diet
  The recommended daily intake of elemental calcium is 1,200 mg a day for adult women, between 1,500 and 1,800 mg a day if you are pregnant or lactating, and 1,500 mg a day if you have passed menopause. It is also important to include magnesium and vitamin D in your diet to help the absorption of calcium. (Many calcium supplements are now formulated with magnesium and vitamin D.)

Preventing Falls

Preventing falls is particularly important for people with osteoporosis since falls increase the likelihood of fracturing a bone in the hip, wrist, spine or other part of the body. In addition to the environmental factors listed below, falls can also result from impaired vision and/or balance, chronic diseases that impair mental or physical functioning and certain medications such as sedatives and antidepressants. It is also important to note that alcohol and certain medications do not mix well and can result in dizziness and loss of balance. If you have osteoporosis, it is important that you be aware of any physical changes (aches, loss of vision and hearing, etc.) you may be experiencing that may affect your balance or the way you move. These changes should be discussed with your doctor or other healthcare practitioner.

Some tips to help eliminate the environmental factors that lead to falls include:

When Outdoors

• Use a cane or walker to increase stability.
• Wear rubber-soled shoes to improve traction.
• Walk on grass when the sidewalks are slippery.
• In winter, consider carrying salt or kitty litter to sprinkle on icy sidewalks.
• Use carpet runners to increase traction in slippery outdoor areas such as patios.

When Indoors

• Keep rooms clutter-free, especially the floors.
• Mop up floor spills. Highly polished floors can become particularly slippery if wet.
• Wear supportive, low-healed shoes.
• Avoid walking in socks, stockings, or slippers. Use footwear with “skid-proof treads.”
• Make sure that carpets and area rugs have skid-proof backing or are tacked to the floor.
• Make sure that stairs have handrails on both sides and that stairwells are well lit.
• Install grab bars on bathroom walls near tub, shower, and toilet.
• Use a rubber bath mat or appliques in shower or tub. Clean often to remove slippery soap-scum.
• Keep a flashlight with fresh batteries beside your bed.
• If you use a step stool to access hard to reach areas, make sure it is sturdy with a handrail and wide steps.
• Consider using a cordless phone to avoid having to rush to answer the phone. Carry it with you so that you can call for help if you do fall.
• There is no need to rush to answer the phone, open a door or reach for things as rushing can decrease your ability to balance.

Magnesium Helps Osteoporosis

Magnesium deficiency may contribute to osteoporosis rise.

Increasing magnesium intake could increase bone density in the elderly and reduce the risk of osteoporosis, suggests a large American study. “Higher Mg intake through diet and supplements was positively associated with total-body [bone mineral density] BMD in older white men and women. For every 100 mg per day increase in Mg, there was an approximate 2 per cent increase in whole-body BMD,” said Kathryn Ryder and colleagues. Osteoporosis is characterized by low bone mass, which leads to an increase risk of fractures, especially the hips, spine and wrists.

An estimated 10 million people suffer from osteoporosis in the US alone, while another 34m are believed to have low bone mass, which puts them at risk of developing the disease. Women are four times more likely to develop osteoporosis than men. More than 2,000 volunteers aged 70 to 79 took part in the cross-sectional American study by completing a food-frequency questionnaire. All supplements and dietary intakes of magnesium were calculated from ingredients databases.

The authors did not identify the exact role of magnesium, but suggested it may be via calciotropic hormones, by acting as a buffer against acidic Western diets, or by substituting for calcium in the bones. Magnesium intake was positively associated with BMD in white, but not black, men and women. These observations could be due to racial difference in calcium regulation or nutrient responses. Dietary sources of magnesium include green, leafy vegetables, meats, starches, grains and nuts, and milk. Earlier dietary surveys show that a large portion of adults do not meet the RDA for magnesium (320 mg per day for women and 420 mg per day for men).

Responding to this study, a spokesperson for the UK-based charity, the National Osteoporosis Society, said: “Although there have been previous studies into the effect of magnesium on bone density, it is always encouraging to learn of studies which help build upon our knowledge of bone health.” “Some research has suggested that a low magnesium level may be a risk factor for osteoporosis although magnesium deficiency is, in fact, very rare in humans. As yet there is no evidence that magnesium supplementation reduces fracture risk,” she said. For healthy bones the Society recommends a mixed, well-balanced calcium-rich diet and regular weight-bearing exercise.

The study was published in the Journal of the American Geriatric Society (November, Vol 53, No 11, pp 1875-1880).

Related Article: Getting Enough?

Last year, the National Academy of Sciences announced new recommended intakes for magnesium.

• Women need 310 mg a day (ages 19 through 30) or 320 mg (over 30)
• Men need 400 mg (19 through 30) or 420 mg (over 30)

How much magnesium are you getting? And is it enough to keep you from running short? “Unfortunately, there isn’t a reliable test of magnesium deficiency that’s widely available,” says the University of Southern California’s Robert Rude. “About all a primary care physician can do is measure the level of magnesium in the blood. But that doesn’t tell you if the level of magnesium is adequate within the cells, which is where it’s critically important.”

“I think that magnesium should be obtained from the diet, if possible,” says Jerry Nadler of the City of Hope Medical Center in Duarte, California. “That’s because many magnesium-rich foods are the healthier foods to eat.” But if someone can’t get enough from food (see “Magnesium Counts,” p. II), “then taking a magnesium supplement clearly is better than nothing.” Multivitamin and mineral supplements seldom contain a day’s recommended dose of magnesium, simply because the 300 or 400 mg necessary won’t fit into a pill small enough for most people to swallow.

So if you want more than 25 percent or so of a day’s supply from a supplement, you’ll probably need to buy it separately. Don’t worry about how the magnesium is bundled-whether it comes in an oxide, chloride, or any other form. “There’s no convincing evidence that one is better-absorbed than another,” says Connie Weaver of Purdue University. And don’t be afraid to get your calcium and your magnesium in a single supplement. “Calcium doesn’t interfere with magnesium absorption, as some people believe,” says Weaver.

But not all magnesium supplements are equal. Dolomite (a naturally occurring calcium-magnesium combination) is more likely to contain lead than other kinds of magnesium. Can you get too much magnesium? “Taking too much from magnesium-confining antacids or drugs causes diarrhea,” says magnesium expert Mildred Seelig. “So most people find out quickly when they’ve exceeded a safe dose.” No cases of magnesium toxicity from food have ever been reported, says the National Academy of Sciences. As for supplements, the NAS recommends a ceiling of 350 mg a day as a Tolerable Upper Intake Level (UL).

Related Article: The Bottom Line

• The average American gets too little magnesium from food. The richest sources are legumes, nuts, whole grains and wholegrain bread and cereals, and some vegetables.
• Too little magnesium in the diet could increase the risk of diabetes, high blood pressure, heart disease, and stroke, but the evidence isn’t conclusive.
• With the possible exception of treating migraines, there’s no good evidence that getting more than the recommended levels of magnesium (see “Getting Enough?”) – from food or supplements – provides any additional benefits.

COPYRIGHT 1998 Center for Science in the Public Interest

COPYRIGHT 2000 Gale Group