Winter Maladies: Natural Approaches
June Russell's Health Facts
Osteoporosis
All of us lose some bone as we age, but people with osteoporosis lose an excessive amount. In many cases, it can be prevented and treated, and all recent studies do not agree that high calcium intake has a positive effect on bone health. The more calcium one ingests at any given time, the smaller the percentage of calcium that is actually absorbed. And there is research that has shown that when we adapt to a low-calcium diet, we actually excrete less of it in our urine and increase our absorption.
In 1988 the National Women's Health Network announced that women who lived in countries where calcium intake was low had less osteoporosis than women in this country who are on a high calcium diet. Recently, a study published in the Journal of Applied Nutrition showed an increase in bone density in postmenopausal women who took more magnesium and less calcium than has been generally recommended. Calcium contains properties that make bones brittle, while magnesium binds to protein in our bones and keeps them supple. We suggest that you may need more magnesium to make your bones more like ivory and less like chalk, and that you find a product that will allow you to increase your magnesium intake to 600-800 mg/day while limiting calcium supplements to around 500 mg.
While magnesium helps the body absorb and utilize calcium, excessive calcium prevents the absorption of magnesium. Taking more calcium without adequate magnesium - and what is adequate for one woman may be inadequate for another - may either create calcium malabsorption or a magnesium deficiency. Magnesium is helpful for PMS and helps the body utilize B vitamins. Finally, high calcium diets may actually increase the risk of stroke says a UCLA study in the Journal of Clinical Investigation. Dairy products contain almost 9 times as much calcium as magnesium, and grains and beans are needed to help balance the amount of magnesium. Reduce your consumption of refined sugar and alcohol to prevent excessive magnesium from being excreted in the urine. Not only does sugar cause magnesium excretion, but also causes calcium to be leached out of your bones.
Guy E. Abraham, M.D., a research gynecologist and endocrinologist in Torrance, California, has given post menopausal women from 200 to 1,000 mg of magnesium a day to strengthen their bones (up to bowel tolerance or loose stools but not diarrhea). These women showed an average bone density increase of 11 percent in one year by increasing magnesium (600-1,000 mg/day) and lowering calcium (500 mg/day).
Beware of Bone-Density Testing! There are accuracy problems with all of the machines that measure bone density, and bone density is not always the same throughout your body. To complicate matters more, deposits of unabsorbed calcium - perhaps from arthritis - can result in overreads, in which machines report a higher density than what actually exists. The long-term safety of the osteoporosis drugs has yet to be established and there are labels that warn of possible digestive problems, so it might be wise to reserve the drugs for cases of advanced osteoporosis. These drugs work by inhibiting bone reabsorption. Most doctors ignore the information that has been in medical journals and attempt to frighten their patients into taking 1,500 mg of calcium a day. The majority of nutritional supplements contain twice as much calcium as magnesium, and numerous studies show that most of this calcium doesn't get into the bones. Boron and vitamins D and E are necessary for calcium absorption (the amount of vitamin E should be 200-400 IUs daily - no more than 800 IUs per day).
("Osteoporosis," report from author of Women's Health Letter, Nan Katherine Fuchs, Ph.D., 2001)
Four out of ten white women in the U.S. will fracture a hip, spine or forearm due to osteoporosis. As many as five out of ten will develop small fractures in their spine, causing great pain and a shrinking in height. This amounts to a total of 15 to 20 million people affected by a crippling and painful disease that is almost entirely preventable and reversible. Bone mass should reach its peak in our late 20s or 30s, but because of poor diet and lack of exercise, many women are already losing bone in their 20s (the drop in estrogen and progesterone accelerates bone loss). Bones are living tissue and need a good supply of nutrients and exercise because new bone is constantly being made while old bone is being reabsorbed and excreted by the body. For the vast majority of women, there is no need to take strogen to prevent osteoporosis.
The most important element of bones is minerals; calcium, magnesium, potassium, phosphorus and flouride. Equally important is the balance between the minerals. Too much or too little can affect bone structure. Testosterone and progesterone build bone, while estrogen appears to indirectly slow bone loss. Bone mass begins to decline in most women in their mid-thirties, accelerates for 3-5 years around the time of menopause, and then continues to decline at the rate of about 1-1.5% per year.
Should you take hormone replacement therapy to prevent osteoporosis? Although estrogen can slow bone loss around the time of menopause, the missing piece to the puzzle is diet and lifestyle plus the bone-building hormone progesterone - the natural hormone not the synthetic progestins. The scientific evidence is clear that after 5-6 years, bone loss continues at the same rate with or without estrogen. There are a number of pharmaceutical drugs being used to treat osteoporosis, none of which work very well. Unfortunately, the old bone which is saved by using fosamax is eventually structually unsound, and after 3-4 years it has no benefit. For awhile flouride was being tauted as an osteoporosis drug, but like fosamax, it only slows bone loss temporarily - and the long-term consequence is an increased rate of hip failure due to structurally unsound bone.
Even though getting adequate calcium is an important factor in preventing osteoporosis, a lack of progesterone causes a decrease in new bone formation and using a natural progesterone cream will actively increase bone mass and density and can reverse osteoporosis. Weight-bearing exercise is the only thing besides progesterone found to actually increase bone density in older women. Osteoporosis is not a calcium deficiency disease, it is a disease of excessive calcium loss. Getting adequate calcium is an important factor in preventing osteoporosis - and antacids tend to cause you to lose calcium - the added calcium in antacids may only offset the damage.
A magnesium deficiency may be more common in women with osteoporosis than a calcium deficiency, and trace minerals are also needed in helping the body absorb calcium. Your body needs a certain amount of magnesium in order to get the calcium to your bones - without magnesium, calcium cannot build strong bones. Milk has a poor calcium to magnesium ratio, so don't depend on milk to get your calcium. Everyone should have at least 600 mg of easy-to-absorb calcium daily. Although you can easily get that in a healthy diet, taking a calcium/magnesium supplement is an excellent form of health insurance.
To be incorporated into bone, calcium requires the help of enzymes which require magnesium and vitamin B6 to work properly, and we tend to be more deficient in magnesium and B6 than we do in calcium. The best absorbed form of calcium is called calcium citrate - avoid oyster shell calcium, as it can be contaminated with heavy metals. If you are female and over the age of 12, you should be taking 300 mg of calcium, combined with 200 mg of magnesium every day. If you can find one that includes B6, so much the better. Menopausal women can take 600 mg of calcium with 400 mg of magnesium. A deficiency of vitamin D can cause calcium loss - vitamin D stimulates the absorption of calcium. The best way to get vitamin D is direct sunlight on the skin, and even a few minutes of this exposure can cause the liver and kidneys to produce vitamin D. This should be a priority for older people who do not get outside.
As we age, we tend to produce less stomach acid, and for calcium to be absorbed both vitamin D and stomach acid are required. For this reason it is important to avoid antacids and the H2 blockers such as Tagamet and Zantac, which block or suppress the secretion of stomach acid. The last thing people need is less stomach acid. Heartburn and indigestion are caused by poor eating habits and a lack of stomach acid. Alcohol, coffee and smoking creates a negative calcium balance in the body.
Don't take antacids with aluminum and don't use aluminum cooking pots. It has been shown that small amounts of aluminum-containing antacids increase urinary and fecal excretion of calcium, and it also inhibits the absorption of flouride and phosphorus, creating a negative calcium balance. The calcium is being excreted instead of being utilized. Diuretics, commonly used for treating high blood pressure, are medicines that cause water loss in the body, and along with the water, you lose minerals, most notably calcium, magnesium and potassium. If you need a diuretic, try a gentle herbal one, such as dandelion root in a tincture, capsule or tea.
What is so bad about flouride? There is good solid evidence that flouridated water increases your risk of hip fractures by 20-40%. While even eating a normal diet the average person exceeds the recommended dose because so much flouride has been put into our food and drink. Avoid flouride and be thankful if you live in an unflouridated community. Cortisones give bones the message to stop growing, so if you must take cortisone use a low dose natural cortisone rather than the synthetic ones. I don't recommend CAT scans because of the high level of X-rays, but the safest and most accurate ways to measure bone are with Photon Absorptiometry, and Dual Energy X-ray Absorbtiometry (DEXA), which is 96-98% accurate and uses very low-dose X-rays. A newer technique for measuring bone loss measures a substance in the urine that can indicate rapid bone turnover rate. One of the best ways to find out if you are losing bone is to measure your height every 6 months, and if you are losing height that is a sure sign that you are losing bone in your spine.
("The Truth About Osteoporosis," John Lee, M.D., well-known lecturer and author of health books, March 2002)
All women can gain bone by lifting weights at any age. Just exercising will not strengthen bones - to help build bone, exercise must be done against resistance.
("Lifting Weights for Bone Strength," Dr. Mirkin's E-Zine, March 2002)