The bone thinning disease osteoporosis is becoming increasingly common. According to the National Osteoporosis Foundation, it is estimated that 10 million Americans have osteoporosis and around 34 million have low bone mass (known as osteopenia), placing them at increased risk of osteoporosis. As the population continues to age, this problem can only get worse, unless we take active steps to maintain bone strength.

Osteoporosis is a silent disease in that it is often not diagnosed until there has been a bone fracture and it is then harder to repair the bone damage. It is obviously better to prevent osteoporosis and it’s good to start at a young age. But even if you have osteoporosis it is possible to increase your bone density to safe levels with the right tools.

So why is osteoporosis so common, and are you likely to develop it?

Many factors affect our risk of developing this condition, such as:

• Advancing age.
• Lack of exercise.
• Low levels of vitamin D in your body.
• High levels of parathyroid hormone, which are most commonly caused by longstanding vitamin D deficiency. The parathyroid hormone levels usually normalize once the vitamin D is supplemented.
• A diet lacking in minerals such as calcium, magnesium, boron, strontium, manganese, zinc, copper and silicon.
• Low intake of vitamin C which weakens the collagen that gives bone its flexibility.
• Low intake of vitamin K. Vitamin K is found in dark green leafy vegetables, egg yolks, the fermented soy food called “natto”, moldy cheese, oily fish and liver.
• Low levels of the sex hormones estrogen and testosterone, especially in women with a premature menopause.
• Medications such as long term corticosteroids, antacid medications (which prevent adequate production of hydrochloric acid in the stomach), excess thyroid medication, some anticoagulants and some  anti-convulsant medications can lead to bone loss.
• Excess consumption of alcohol and/or cigarette smoking.
• Thin build with fine bone structure.
• Eating disorders such as anorexia.
• Undiagnosed gluten intolerance.

Osteoporosis is not a simple case of not getting enough calcium in the diet and is more related to our modern day lifestyles. It is also the epidemic of vitamin D deficiency, and if you are low in vitamin D you cannot absorb calcium from your food and you cannot deposit calcium in your bones. You can take a lot of calcium, but if you are vitamin D and/or vitamin K deficient then the calcium is useless!

Here are some factors under your control that can determine whether or not you will develop osteoporosis:

• A mineral deficient diet. Calcium is not the only mineral needed for a strong skeleton. Magnesium, manganese, zinc, silica, boron, strontium and copper are essential also. Dairy products such as milk, yogurt and cheese are a source of calcium but some people are allergic to dairy. Foods high in calcium and other minerals include tinned fish (including the bones), broccoli, Bok choy, raw nuts and seeds, tahini, hummus, seaweed and legumes. Refined foods are sadly lacking in all minerals – these include foods made of white flour and white rice. Gluten can reduce the absorption of minerals in many people, especially if they eat large amounts of gluten.
• Lack of physical activity. Sedentary jobs and hobbies promote bone loss as well as muscle loss. Weight bearing exercise helps to strengthen bones, and all exercise helps to maintain balance and flexibility; reducing the tendency of falls that cause fractures.
• A high sugar diet with sodas and diet drinks being especially bad. The high level of sugar and phosphorus in soda pop is particularly detrimental to bones.

What can you do to prevent osteoporosis?

Vitamin D

Vitamin D3 is made in large amounts from cholesterol in the skin when the skin is exposed to the sun. In reality, vitamin D is actually a steroid hormone and not a vitamin.

In addition to skin manufacture from sunlight, vitamin D can be found in some animal foods. It is also available in supplement form, with the current recommendation being that you take between 400 and 1000 I.U. of vitamin D 3 daily. Many people, especially those who avoid the sun or those living in cold countries, need much more than this and doses of around 5,000 I.U. daily may be needed before you can get your blood levels of vitamin D into the higher desirable range. Regardless of how you get it, make sure that you have an adequate amount of vitamin D in your body, which is an easy thing to check. It is vitally important to ask your doctor to check your blood level of vitamin D. The correct blood test to measure your vitamin D level is called 25(OH) D, also called 25-hydroxy-vitamin D3.

Vitamin D can be measured in two different units of measurement and in the USA the units used are ng/mL. In Australia and Canada the units of measurement are nmol/L.
The normal ranges of vitamin D for blood tests reported by different laboratories and countries vary significantly and you will be surprised by the large range between lower normal and upper normal – see table below;

Lower Limit Vitamin D         Upper Limit Vitamin D
75 nmol/L                                   200 nmol/L
30 ng/mL                                    100 ng/mL

You don’t want to be average here; you want to have levels of vitamin D that optimize strong bones. The optimal levels of vitamin D are higher than the average levels. You only want to supplement with natural vitamin D3, which is human vitamin D. The synthetic and inferior vitamin D2 does not work as well as D3.

The synthetic vitamin D used to fortify foods is vitamin D2 (known as ergocalciferol) – it is used to fortify soy milk, hemp milk, almond milk, other plant milks, margarine, and orange juice. In nature, vitamin D2 sources are found in mushrooms, various algae (such as spirulina, chlorella, and blue-green algae) and dark green leafy vegetables, but not in adequate amounts to satisfy human needs.

The other form of vitamin D is D3 (cholecalciferol), which is the kind your body produces as the result of sun exposure, and is also found in some non-vegan foods including egg yolks, butter, and oily fish like mackerel, salmon, sardines, and herring.

There is considerable controversy among vitamin D experts about the safety and effectiveness of oral supplementation with vitamin D2 (ergocalciferol) versus vitamin D3 (cholecalciferol). The basic difference between the two forms has to do with how they are manufactured. Vitamin D2 is derived from vegetarian sources, manufactured through the action of ultraviolet light on ergosterol from yeast. Vitamin D3, on the other hand, is manufactured from a cholesterol derivative of lanolin (an animal source). Vitamin D2 is cheaper and easier to make and has been used to fortify foods and make supplements.

I recommend you take enough supplements of vitamin D3 and/or get enough sunshine to keep your serum vitamin D levels around 150 to 200 nmol/L or 70 to 80ng/mL. Excess vitamin D intake can cause elevated blood calcium levels; so don’t overdose on it – it’s not a case of the more the better. Get your blood level checked every 6 months to find the dose of vitamin D3 that keeps you in the optimal levels.

Vitamin K is extremely important for those with low bone density as it works in concert with vitamin D to remineralize the bones. Vitamin D is required to absorb calcium from the intestines and to put calcium into the bones. However, the calcium needs to be integrated and spread throughout the bones in the correct places and this is what vitamin K can do. Vitamin K improves the architecture and strength of the whole bone.

Recommended supplements for osteoporosis and osteopenia

• MSM Plus Vitamin C
  Take one teaspoon daily in water or juice; this will build collagen in the skeleton. Also, eat plenty of citrus fruits, bell peppers (capsicums) and berries.
• Bone Build
  Contains a well absorbed form of calcium known as calcium hydroxyapatite, plus the other bone essential minerals magnesium, manganese, zinc, silica, boron, and copper. Because it is such a comprehensive formula you only need to take 2 capsules daily with food. Bone Build also contains vitamin D3 and vitamin K; however, if you have osteoporosis I recommend the higher amounts of vitamin K and D3 found in the Super Vitamin K capsules as well. Be aware that the cheap form of calcium called calcium carbonate is the most common form of calcium to be advertized and thus supplemented. Calcium carbonate is the same form of calcium that is found in chalk and is not the best absorbed form of calcium. I do not recommend it.
• Super Vitamin K 
  Liver Doctor brand of Super Vitamin K is the leading brand as it contains all the active forms of vitamin K plus an extra 2,000 I.U. of vitamin D3. These capsules contain 2200 mcg of vitamin K per capsule, and these higher doses are much more effective than low dose vitamin K. If you have osteoporosis, I recommend a dose of 2 capsules of Super Vitamin K daily with food. The only contraindication to taking vitamin K is if you are taking coumadin drugs such as warfarin.
• Strontium
  Take 1 capsule every second day with food.

What can I do if I have osteoporosis?

Talk to your doctor about the use of treatments to prevent bone loss. You may need to see an endocrinologist who specializes in treatment of osteoporosis.

You will need to take the minerals and vitamins mentioned above on a regular basis and must also ensure that your blood vitamin D levels are optimal.

You need a regular exercise program, even if it is only walking 30 minutes a day. With exercise, it’s the more the better, as exercise has been proven to increase bone density.
Talk to your doctor about the use of bio-identical hormones such as testosterone, estrogen and progesterone, especially if you have had an early menopause, or if your blood levels of testosterone are very low.

Bisphosphonate drugs

The class of drugs known as Bisphosphonates is the most commonly used type of drug and is most popular with medical doctors. Bisphosphonate drugs work by stopping bone turnover – in other words, they stop the breakdown and building of bone. I have never felt comfortable prescribing this class of drugs because Bisphosphonates can have irreversible side effects such as necrosis (death) of the jaw bone, as well as atypical fractures which do not heal well. It is generally accepted, but not always adhered to, that Bisphosphonate drugs should only be taken for a maximum of 5 years to avoid such awful side effects. Bisphosphonates are also given by injection.

Many people cannot tolerate the prescription drugs commonly used to prevent bone fractures, or they are too nervous about side effects like digestive upset and/or jaw bone disintegration caused by drugs known as the bisphosphonates (e.g. Fosamax, Actonel, etc.).

Strontium for stronger bones

Strontium is a naturally occurring mineral present in the soils, food and water. The availability of strontium from food, like many other minerals, depends upon the content of strontium in the soils of the regions where the produce is grown; thus, food is an unreliable source of strontium.

Do not confuse strontium with toxic radioactive Strontium-90, as they have entirely different effects in the body. The nutritional version of strontium can be taken safely in a low dose for years and actually removes radioactive strontium from the body if it is present in any significant amounts.

Trace amounts of strontium are found in the human skeleton and strontium is naturally absorbed at the bone matrix crystal surface. The effects of strontium on bone metabolism have been researched since the 1950’s and trials have shown that strontium improves bone metabolism by promoting new bone formation and decreasing bone breakdown; this promotes normalized bone density. Strontium attracts more calcium into the bones; this increases bone density.

Studies conducted at McGill University in the 1980s, and numerous worldwide studies since the 1960s, confirm the bone building and fracture preventive effects of the mineral strontium. Most of the recent research has used high dose strontium ranelate, (branded Protos) but similarly good results can also be achieved with much lower doses and other salts of strontium (such as gluconate, citrate and lactate). I never recommend large doses of strontium, and always check with a natural health care practitioner before taking large doses of any nutrient supplement.

In patients with low bone density, not responding sufficiently to exercise and vitamin D3, I prefer to use the mineral strontium citrate in a dose of 350 mg capsules, one every second day for 12 months.

Larger doses of strontium in lightweight people can cause digestive problems such as nausea and reduced appetite. I prefer strontium citrate with a lower dose of strontium. The dose I start with is 350 mg every second day and in many patients this is enough to get results. In very sensitive people, the dose of strontium can be adjusted so that there are no digestive side effects.

I have found that patients with low bone density only need to take a course of strontium citrate in a dose of 350 mg every second day for 12 months. This can be repeated every 12 months if bone density starts to diminish again. Strontium accumulates in the bones over 12 months and will be sufficient for an improvement in bone density over the long term.

In my practice, I generally see 5 to 10% improvements in bone density after 12 months, using strontium citrate in low doses.

Another recognized benefit of strontium supplementation is pain relief and the re-mineralizing of bones affected by cancer metastasis. Strontium supplements also reduce the incidence of dental cavities and improve cartilage metabolism in osteoarthritis. Research indicates that the optimal therapeutic daily dose of strontium supplements is 680 – 1000 mg, however I prefer to use lower doses for preventative effects and those with sensitive digestive tracts.

Strontium is a useful aid to build bone density especially in people who are intolerant to Bisphosphonate drugs and this includes a lot of people. Furthermore, Bisphosphonate drugs can only be taken for 5 years due to a risk of jaw bone necrosis.

Strontium should be taken at night on retiring away from food and away from calcium supplements, because calcium impairs strontium absorption.

People with a past history of blood clots or heart disease should not take strontium in high doses and should check with their health care practitioner. It should also be avoided in pregnancy and lactation.

References:
Wright, J.V., Fight – Even Prevent – Osteoporosis with the hidden secrets of this bone-building miracle mineral. (Reprint from Nutrition and Healing. Tahoma Clinic, 2008)
DeHart, S.S. (July 7, 2008). Strontium and Osteoporosis: A treatment not offered to American Women
Dean, W. (May 2004) Strontium breakthrough against Osteoporosis

The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.