Your Bones – Updated and Expanded Edition

From PART 1: YOU ARE AT RISK FOR OSTEOPOROSIS

Chapter 1: If You Are a Woman, You’re at High Risk for Osteoporosis

What Is Osteoporosis?

Osteoporosis—literally, “porous bone” (osteo = bone, porosis = porous)—is a progressive loss of bone that results in bone thinning and increased vulnerability to fracture. Osteoporotic fractures—also called fragility fractures because they happen in thinned out, fragile bone—occur primarily in the wrist, rib, spine, and hip, often during daily activities, such as stepping off a curb, which should normally pose no risk for a fracture.

Why Are Women at Higher Risk Than Men of Losing Too Much Bone?

For Two Key Reasons:

First, women start out with less bone than men. Women’s peak bone mass is naturally less than men’s because women are smaller and have less muscle. When we use our muscles, the muscle contractions put stress on bone, to which it responds by becoming stronger. Men’s larger muscles produce stronger contractions, resulting in more stress and approximately 35–40% larger bones.

Secondly, the female hormones, estrogen and progesterone, play vital roles in bone remodeling, and levels of both hormones drop with menopause (medically defined as the last menstrual period); for most women in the Western world, the median age for menopause is 51, but the range for its onset is large—generally If You Are a Woman between ages 42 and 58. Estrogen prevents excessive action by osteoclasts, specialized bone cells that remove worn out or dead bone to make room for new bone. Progesterone is required by osteoblasts, the bone-forming cells

that pull calcium, magnesium, and phosphorous from the blood to build new bone. Production of both hormones greatly declines during a woman’s transition through menopause, resulting in increased bone resorption and decreased formation of new bone.

Am I Really at Risk? How Common Is Osteoporosis?

If you are a woman, the answer is emphatically “Yes!” One in four women will develop osteoporosis after menopause. Lifetime risk for fragility fractures, an indicator of osteoporosis, is 50% in women versus 25% in men. Twenty-five million Americans have osteoporosis or are at significant risk for it. Osteoporosis is responsible for at least 1.5 million fractures each year, including 250,000 hip fractures.

Men Are Not Immune to Osteoporosis

Although women are most at risk, 25–33% of men will experience an osteoporotic fracture in their lifetime. In men, however, the rapid increase in fracture risk begins later, at approximately age 70.

From PART 2: WHY CONVENTIONAL MEDICINE IS NOT THE ANSWER FOR STRONG BONES

Chapter 2: The Bisphosphonate Patent Medicines Prescribed to Prevent Osteoporosis Should Be Your Last Choice for Healthy Bones

It’s true, as Sally Field emphasizes in her TV ads for Boniva, that you have only one body. It’s not true that Boniva or the other bisphosphonate patent medicines commonly prescribed to prevent osteoporosis offer the best way to take care of it!

The Bisphosphonate Patent Medicines Prescribed for Osteoporosis (e.g., Fosamax, Actonel, Boniva, Reclast), Have Very Nasty Side Effects

Although prescribed to 30 million Americans each year, the bisphosphonate patent medicines (the oral forms, including Fosamax Boniva, Actonel, and the latest additions to the bisphosphonate arsenal, the once yearly IV-administered patent medicines Reclast and Aclasta), are well known to be dangerous.

An FDA alert, issued January 2008, warned physicians that all bisphosphonate patent medicines may cause “severe and sometimes incapacitating bone, joint, and/or muscle (musculoskeletal) pain . . . [which] may occur within days, months, or years” after starting the medication, and in some patients, may not resolve even after discontinuing the patent medicine.

Even more alarming, these patent medicines have now been conclusively linked to a number of other serious adverse side effects including osteonecrosis of the jaw (jaw bone death, osteo = bone, necrosis = death), atrial fibrillation (irregular heartbeat), and increased risk of bone fragility leading to bone fracture—yes, that’s right, an increased risk of bone fracture from the very patent medicines prescribed to prevent it!

Bisphosphonates Don’t Build Healthy, New Bone—They Cause Retention of Old, Brittle Bone

The bisphosphonate patent medicines suppress the activity of osteoclasts, the body’s specialized cells whose job it is to remove worn out, injured, or otherwise damaged bone. This is a task that must be taken care of before such weakened bone can be replaced with new strong bone.

Osteoclasts are the first phase of the bone renewal process. They take out the bone “trash” to make room for new bone. If osteoclasts are prevented from doing this necessary job—which they very effectively are by bisphosphonates, which work by literally poisoning osteoclasts—damaged bone is left in place rather than cleared out, so no room is made for new bone to be laid down. Eventually, the amount of unhealthy, compromised bone tissue accumulates to the point that bones become very fragile, and any trauma or insult heals poorly, if at all.

The bisphosphonates don’t just inhibit, they virtually crush all new bone formation. Researchers at the University of Texas performed bone biopsies on nine women who had been taking Fosamax for 3 to 8 years, but had nevertheless suffered non-spinal fractures (in the lower back, ribs, hip, or femur) while performing normal daily activities (walking, standing, turning around). New bone formation in these women was nearly a hundred times lower than that normally seen in postmenopausal women.

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More Evidence Confirms Bisphosphonates (e.g., Fosamax, Reclast, Aclasta, Actonel, Boniva) Are NOT Your Bones’ Best Friends

Since the publication of the first edition of Your Bones in April 2011, a great deal more evidence has surfaced confirming that your risk of an osteoporotic fracture is not going to be lessened—but, in fact, may be increased, by taking any of the bisphosphonates.

As of April 2012, 630 papers had been published in the peer-reviewed medical literature on PubMed discussing adverse events caused by the bisphospho­nates, including 201 review articles. (These are papers that summarize a number of studies in one article.) Here’s a quick overview of just a small selection from the important recently published papers that provide many reasons why relying on a bisphosphonate, like Fosamax, Boniva, or Reclast, is more likely to harm you rather than help your bones.

From PART 4: HOW TO HAVE STRONG BONES FOR LIFE

Chapter 7: Strong Bones for Life, Naturally

What Your Bones Really Need to Stay Strong

As you now know, bone is dynamic, living tissue that is constantly being broken down and rebuilt, regardless of one’s age or sex. Until recently, not getting enough calcium and women’s postmenopausal drop in estrogen were singled out as the only issues. Today, vitamin D’s importance for bone health is once again being recognized.

It’s true that calcium, vitamin D, and estrogen play key roles in preventing osteoporosis, but maintaining healthy bones throughout life requires a good deal more than simply calcium, estrogen, and vitamin D. Normal bone metabolism is a complex dance among over two dozen nutrients including the vitamins K (especially K2), B6, B12, and folate as well as vitamin D, and the minerals boron, magnesium, phosphorous, zinc, manganese, copper, silicon, molybdenum, selenium—and possibly strontium—as well as calcium.

Also, while estrogen regulates the action of osteoclasts, specialized bone cells that remove dead portions of demineralized bone, progesterone is required by the osteoblasts, the bone-forming cells that pull calcium, magnesium, and phosphorous from the blood to build new bone mass.

What you need to know about each of these factors essential for building and maintaining healthy bones is discussed below and in Appendix B.

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Bone-Building Exercises

Use It or Lose It

Lack of weight-bearing and resistance exercise is a well-documented risk factor for osteoporosis. Numerous studies show that not moving against gravity—whether as a result of being an astronaut on a space mission, in bed recovering from a surgery or illness, or life as a couch potato—leads to massive loss of bone minerals, as much as 1% of bone mineral mass per week!

On the other hand, consistent bone-building exercise is one of the most effective ways to decrease your fracture risk. In response to resistance exercise train­ing (any type of exercise that puts real demands on muscle and thus its attachments to bone), a number of studies of postmenopausal women have shown that bone responds with increases in bone mineral density sufficient to move these women back toward the norm seen in healthy younger women.

After a year of regular exercise, the typical gain in BMD is 1–3%. Doesn’t sound like all that much—until you real­ize that, without exercise, after age 40, women start los­ing BMD at a rate of 0.3–0.5% per year. The rate of BMD loss increases after age 50 to about 1–1.5% per year, and frequently ramps up to more than 2% per year during the first 6–10 years after menopause, after which it slows back down to somewhere between 1–2% per year.

If regular exercise can give you a gain in BMD of 1–3% per year instead of a loss of 1–2% a year, it’s actu­ally preventing a 1–2% loss plus adding another 1–3% in BMD—this translates into an actual gain in BMD from exercise of 2–5% per year.

However, exercise is definitely a “keep using it or keep losing it” situation. In studies in which post­menopausal women stopped exercising, the gains they made in spinal bone mineral density were lost after a period of inactivity.