Osteoporosis is a condition that occurs due to a loss of skeletal bone density or bone mass. As a results the bones become more brittle and fractures are more common.
Frequently Asked Questions
Osteoporosis is a degenerative bone disease that affects both men & woman, but woman is more at risk due to declining oestrogen levels when their bodies go into menopause. Osteoporosis is a condition that occurs due to a loss of skeletal bone density or bone mass. As a result, the bones become more brittle and fractures are more common.
In previous years Osteoporosis was viewed as a disease that only affects ageing women, and was primarily treated with conjugated equine oestrogens (CEE) also known as Premarin. The plan of such treatment was to mitigate the decline in endogenous female hormone levels that occur during menopause. However, it is now clear that osteoporosis (like numerous other age-related conditions) is not a disease with a singular cause affecting a specific population only. Osteoporosis is a multi-faceted disease, and there are many interrelated factors which together cause its occurrence – it is thus imperative that one must use a comprehensive treatment plan to prevent this condition.
There are very few symptoms that a patient will experience, as this Osteoporosis is mostly a ‘silent’ condition. If a patient notices more than a 2-3cm decrease in height that might be cause for concern, and further more investigation. Since there is no pain associated with having Osteoporosis the bones become weaker and weaker with each passing year until an accidental fracture occurs in the wrist, hip or spine. Being aware of a family history of Osteoporosis and checking bone density levels are good preventative measures to keep in mind. Also remember that females going through menopause are at higher risk due to dropping oestrogen levels and need to be aware and take preventative measures before it is too late.
As a woman approaches pre- and menopausal phases of her life oestrogen levels start to decrease. This is a significant risk factor which can cause bone loss, and once a woman reaches full menopause, this declined level of oestrogen cause the bones to lose calcium and break down at an accelerated rate. Once a woman goes through perimenopausal & postmenopausal years the body will reabsorb bone from the skeleton and this can lead to Osteoporosis. (Unfortunately, whether you get enough calcium and build adequate bone mass early in life or not, this process will still occur.)
Scientific studies have revealed that the aetiology of osteoporosis stems not only from hormonal imbalances, but there are other influencing factors too which include the Sex Hormone Binding Globulin (SHBG). Generally stating, the higher the SHBG level, the less oestrogen is available in the body to contribute favourably to bone health.
Oxidation of fatty acids, and other molecules will produce reactive oxygen species that directly and indirectly impair new bone formation. This will promote excessive bone reabsorption and the onset of Osteoporosis.
- Chronic inflammation accelerates the absorption of existing bone while hindering normal production of new bone in the body.
- Fat cells produce a steady efflux of inflammatory cytokines while diminishing cells’ insulin sensitivity; both factors further impede normal bone production.
Elevated blood sugar
- Components of the metabolic syndrome as well
- AGE's; byproducts of high blood sugar.
These nutrients are often overlooked by mainstream medicine, even though they play a critical role in bone health. As an example: emergent research on vitamin K2 has attracted great scientific interest through the revelation of its involvement, along with vitamin D3, in both bone health and atherosclerosis, a condition to which osteoporosis is intimately related.
- A family history of the disease, be especially aware of your mother & grandmother,
- A thin or small-framed body
- A history of irregular or skipped periods
- Drinking excessive amounts of alcohol,
- Not getting enough calcium,
- Being inactive, or
- Having taken steroids or other bone-thinning medications.
- Insulin Resistance, Blood Sugar & Glycation can all contribute to the onset of Osteoporosis. Our bones function as an endocrine organ secreting compounds that act like hormones. Healthy production of bone matrix protein increases insulin sensitivity in other tissues.
- Conversely, people with the metabolic syndrome who are insulin resistant have poorer bone quality and an increased risk of osteoporotic fracture. Metabolic syndrome also raises SHBG levels, further reducing bioavailable levels of oestrogen and testosterone in the body.
- AGEs. Research suggests that advanced glycation end products, or AGEs, are implicated in bone loss. AGEs are formed when proteins interact with glucose molecules to form damaged structures in the body. One study examined the proteins in osteoporotic bones to determine if there was damage by AGEs. More AGEs present resulted in fewer bone-building osteoblasts. It is suggested that limiting AGE formation by maintaining a healthy blood sugar level may slow the osteoporotic process.
- Oxidation - Oxidation of fatty acids and other molecules produces reactive oxygen species that directly and indirectly impair new bone formation and promote excessive bone reabsorption.
- Chronic inflammation. Chronic inflammation hastens the absorption of existing bone while impeding normal production of new bone.
- Fat cells produce a steady influx of inflammatory cytokines while diminishing cells’ insulin sensitivity; both factors further impede normal bone production.
- Vitamin K 2: For healthy, mineral-rich bone to form, healthy bone matrix protein must be produced. The realisation has occurred over the past decade that vitamin K is an essential co-factor in the production of the major bone protein, osteocalcin. Vitamin K-dependent enzymes produce changes in osteocalcin that allow it to tightly bind to the calcium compounds that give bone its incredible strength. Vitamin K2 directs calcium from the arteries (where they are not needed) to the bones (where they are essential for healthy bone). Thus, ensuring you consume enough Vitamin K2 is essential for healthy bones!
- Calcium & Vitamin D3 Satisfactory calcium intake is essential to allow healthy bone remodelling and prevent osteoporosis formation. Vitamin D3, on the other hand, promotes the intestinal absorption of calcium. In addition, it also regulates how much calcium enters and leaves bone tissue, in response to the body’s other calcium requirements.
- Trace Minerals Bone structures are primarily composed of matrix protein and calcium compounds, but there are small amounts of other trace minerals which are essential for normal bone function. These include: - magnesium, with the function of regulating calcium transportation;
- silicon, which reverses loss of calcium in the urine;
- boron, which interacts with other minerals and vitamins and also has anti-inflammatory effects.
The conventional model treating osteoporosis suggests that simple restoration of declining sex hormone levels (oestrogen) and provision of modest amounts of calcium and vitamin D should be sufficient to prevent osteoporosis. However when those steps fail (which they inevitably do), conventional medicine resorts to suggesting that osteoporosis must be an unavoidable consequence of ageing.
Vitamin K2: Osteoporosis has the main characteristic of a loss of calcium in the bones: shifting bones from their healthy hard state to a diseased state of softness. Atherosclerosis, on the other hand, is characterised by excessive flood of calcium into arterial walls: shifting them from their healthy flexible state to a diseased state of hardness. Insufficiency of vitamin K2 contributes to this unhealthy balance. It is there-fore vital to have the right amount of vitamin K2 in the body as this nutrient is necessary to direct Calcium, into the bones where it should be and vitamin K2 redirects Calcium from the arteries into the bones.
Sex Hormone Binding Globulin (SHBG): This is a protein which is produced primarily in the liver, and has the function of binding oestrogen and testosterone. It is common knowledge that as one ages oestrogen levels decline in both sexes and this results in significant, bone mineral loss. Experts now recognise that the steady rise in SHBG with ageing is directly correlated with bone loss and osteoporosis in both men and women.
Studies show that the SHBG molecule plays another key role in the body: it conveys essential signals to the heart, the brain, the bone and adipose (fat) tissue that ensure their optimal function! There’s even a special SHBG receptor molecule on cell surfaces that functions much like the ubiquitous vitamin D receptor protein, which helps cells to communicate with one another. In other words, SHBG itself functions much like a hormone.
New studies are finding a direct role for SHBG and its cell surface receptor in bone loss. The association is so strong that some experts are now suggesting routine measurement of SHBG as a useful new marker for predicting severity of osteoporosis.
AGE’s: Similarly, underappreciated contributors to bone loss in both men and women are advanced glycation end products (AGE’s); which are products of high blood sugar. AGE’s interact with proteins in bone causing impaired mineralisation and increases in the number of osteoclasts – bone resorbing cells. In addition, AGE’s encourage vascular calcification by activating a specialised receptor called RAGE. This RAGE molecule recruits calcium into vascular smooth muscle cells, leading to hardening of the arteries. There is a strong relationship between elevated blood sugar, osteoporosis, and atherosclerosis which creates a vicious cycle, linking the conditions in a manner unknown to the majority of mainstream physicians. There are suggestions that limiting AGE formation by maintaining a healthy blood sugar level may slow the osteoporotic process.
Health Renewal incorporates the truth about the complex, interrelated factors that genuinely contribute to osteoporosis.
Health Renewal recommends a lifelong commitment to:
- An active lifestyle, and
- supplementation with targeted vitamins, minerals and nutrients that quench reactive oxygen species (ROS),
- reduce inflammation,
- control obesity and insulin resistance,
- promote healthy bone matrix protein synthesis, and
- supply sufficient trace minerals, to support healthy bone. Your Doctor at Health Renewal will determine your personal risk through a consultation and examination. You may be requested to undergo blood tests and a bone mass density scan.
Bone density test. The 10- to 30-minute procedure uses an x-ray machine, known as DXA, which exposes you to a very low level of radiation. Having low bone density does not mean you will get osteoporosis, but it does mean you have a greater chance of developing it if you lose bone density in the future. Sometimes osteoporosis medications are prescribed for people with low bone density. Your doctor will weigh factors such as medical history (including whether you have broken bones in the past), lifestyle, and your risk of falling to determine whether the drugs are right for you, or not. Research suggests the drugs may become less effective over time.
Ask your doctor about getting tested if you have a family history of the disease, have broken a bone as an adult, are Caucasian or Asian, have a small frame, take certain medications, or have a condition that increases risk, such as inflammatory bowel disease or multiple sclerosis.
Your Health Renewal Doctor will then address the deficiencies and risk factors to minimise your chance of developing complications such as fractures and deformities. Your daily chronic medications for arthritis and depression may require adjustments to lower your risk.
Female Comprehensive Hormone Panel:
- Male Comprehensive Hormone Panel
- Vitamin D, 25-Hydroxy
- Insulin (fasting)
To stop menopause-related bone loss, your doctor may prescribe drugs such as bisphosphonate, calcitonin, or raloxifene. Bioidentical hormone replacement therapy may also be considered to maintain bone density, and there are various administration options to suite your requirements.
With osteoporosis, the supplements are individually tailored. Please do not self-medicate. Self-Medicating is done when a person takes prescription medication or nutraceuticals on their own without a doctor's supervision and/or consent. There is no single supplement given to all clients with osteoporosis. The doctor will decide, based on your examination, history and blood tests, what would be the best for you and your specific needs and/or deficiencies.
Osteoporosis can become a debilitating disease resulting in fractured bones, chronic pain and loss of independence for a patient. The most critical step is prevention in the management of this condition and early detection is vital, hence be aware of your risk factors and seek advice.
The initial medical consultation at Health Renewal will be approximately 45 minutes. You will have to complete an in-depth questionnaire before the consultation so please arrive 20 minutes before the time. During the 45 minute consultation, your Health Renewal doctor will obtain a full medical history from you to determine your personal risk. A physical examination will be done after which he will decide which blood tests need to be requested from your local pathology laboratory. These results will then be analysed by your Doctor and this will be discussed with you at your follow-up appointments. This will determine whether a definite deficiency exists and you will be advised on your treatment options. These options may range from prescription medications, nutraceuticals, bio-identical hormonal creams or tablets or alternatively to having bio-identical implants or pellets inserted.
- blood cholesterol and
- glucose levels,
- blood pressure and
- body mass index (BMI) as part of Wellness Programs offered by healthcare practitioners.
This pathology supported genetic test is performed in conjunction with assessment of any food allergy or intolerances known to be associated with many chronic disorders. The results of the genetic test are combined with clinical indicators and lifestyle factors to identify a combination of risk factors that may lead to disease development or progression if left untreated.
For all health conditions, the nutraceuticals are individually tailored by the Health Renewal Doctor. The doctor will decide- based on your history, physical examination and blood tests what would be the best for you and your specific needs and/or deficiencies. It cannot be overemphasised that one must not self-medicate. Self-Medicating is done when a person takes prescription medication or nutraceuticals on their own without a doctor's supervision and/or consent. By not having a physical examination and blood testing done by a qualified and practising integrative medical practitioner, you could be not treating vital deficiencies or conditions such as elevated blood pressure, high sugar level, high stress levels (that can lead to adrenal burnout) and high blood clotting factors that could lead to heart attacks and stroke. In addition, aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. There is no single supplement prescribed to clients as there is no magic bullet that can support all the essential nutrients that one's body needs. Today's food is not functional and we need to supplement in order to maintain optimal bodily functions and nutrition.
Make an appointment to consult with your Health Renewal Doctor who is an integrative doctor and he or she will assist you in determining your risk factors and how best to prevent any problems or conditions that you may be susceptible to. The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments, nutritional supplements and a healthy diet and lifestyle.
The initial medical consultation at Health Renewal will be approximately 45 minutes. As this is a prolonged medical consultation, the initial consultation fee will be R 975 on arrival (for the non-loyalty programme members) you will have to complete an in-depth questionnaire before the consultation so please arrive 20 minutes before the time. During the 45 minute consultation, your Health Renewal doctor will obtain a FULL medical history from you to determine your personal risk. A physical examination will be done after which the Doctor will decide which blood tests need to be requested from your local pathology laboratory. If you have a medical aid, these should be able to be claimed as well.
Once your blood results are received, they will then be analysed by your Health Renewal doctor who will begin working on a unique prescription plan for you with the compounding pharmacy. At your pre-scheduled second appointment 2 weeks later, the results and examination findings will be discussed with you. This will determine what abnormalities or deficiencies exist and you will be advised on your treatment options. These options may range from prescription medications, nutraceuticals, bio-identical hormonal creams or tablets or alternatively to having bio-identical implants or pellets inserted.
In office treatments such as carboxytherapy may also be recommended for certain conditions such as hair loss, erectile dysfunction ED, menopause or PMS. If you need to lose weight our Body Renewal Medical Weight loss program may be recommended. All these recommendations will be summarised on a sheet or print out which you can take home with you. The nutraceuticals offered at Health Renewal are of superior quality (Solgar) and are not rancid nor contain Hg (mercury ) or PCB'S (which is very important for Omega 3 Essential fatty acids EFA's). They are also free of gluten, preservatives, wheat, dairy, soy, yeast, sugar, artificial flavour, sweetener and colour. We have a great professional team made up of doctors, trained and registered nurses and therapists to support you at any time.
1. You are kindly requested to bring any supplements that you are currently taking, along to your consultation. The doctor can check the ingredients in take this into account when prescribing a treatment plan for you.
2. Also, if you have had any blood work done in the past 6 months, please bring the results along to the consultation. Should you not be in possession of the hard copies, please request these results from the lab you visited. Usually your ID number is sufficient.
Depending on the exact prescription given, you may be required to return to the doctor within 1-4 months’ time, in order to ensure optimum hormone levels are achieved. This will be determined by a repeat blood test and may be requested by your Health Renewal doctor.
You should ensure that you are current with your gynaecological visits/breast exams/mammograms (for female patients) and prostate exams (for male patients) as recommended by your GP/gynaecologist.
Depending on which form of supplementation you and your Health Renewal Doctor have decided on, one could expect to follow up with your physician from anything between every 3 months to once every 6 months.
The good news is that there's plenty you can do, no matter how old you are, to bolster your bones and prevent osteoporosis.
Get enough Vit D3 from sunlight: It has been calculated that if you expose your skin to the sun in a bathing suit long enough to produce slight redness of the skin, you'll produce the equivalent of 10,000-25,000 IU of oral vitamin D. In South African climate, just five to ten minutes in the sun two to three times a week, exposing your hands, legs, and arms, is more than adequate to satisfy your vitamin D requirements. Sticking to these guidelines means you're also not likely to significantly increase your risk of skin cancer in the process.
Take your vitamins: Unless you get adequate vitamin D especially from the sun, about half the calcium you take ends up down the toilet. Vitamin D helps your body better absorb calcium from food. Most people don't get enough vitamin D from sources such as food and sunlight, and supplements are necessary (the vitamin is also linked to numerous other health benefits, including preventing cancer and heart problems). How much you need is debatable: many experts advise that the currently recommended levels of 600 IU daily are too low and that we need up to 2,000 IU or more for optimal health. In addition, vitamin C, magnesium, vitamin K, potassium, and phosphorus are each linked to better bone health. You can get your recommended intake of these from a combination of a regular multivitamin and a diet rich in fruits and vegetables.
Take Vitamin K2: Osteoporosis is characterised by loss of calcium from bones, shifting them from their healthy hard state to a diseased state of softness. Atherosclerosis, on the other hand, is characterised by excessive, flow of calcium into arterial walls, shifting them from their healthy flexible state to a diseased state of hardness. Insufficiency of vitamin K2 contributes to this unhealthy balance as vitamin K is necessary to direct Calcium into the bones where it should be and vitamin K2 redirects Calcium from the arteries into the bones. Vitamin K2 is critical because the biological role of vitamin K2 is to help move calcium into the proper areas in your body, such as your bones and teeth. It also helps remove Calcium from areas where it shouldn’t be, such as in your arteries and soft tissues.
Get enough calcium: This mineral is the main component of bone, and women need at least 1,000 mg a day--1,200 after menopause. Yet 64% of us don't get enough, especially after age 50, when adult intake averages just 784 mg a day. Eat calcium-rich dairy foods and consider taking two 500 mg supplements a day. Take the supplements at separate times, i.e. one at breakfast and the other at dinner, this is advised because the body can absorb only about 500 mg at a time. Additional food sources include fat-free milk, which provides a third of the daily value for calcium, ready-to-eat cereals, and fresh broccoli.
In the book “The Calcium Lie”, Doctor Robert Thompson M.D. addressed this important issue in his book. It is discussed that bone is composed of at least a dozen minerals, and if you focus exclusively on calcium supplementation you are likely going to worsen your bone density. This will actually lead to an increased risk of osteoporosis. Interestingly, Dr Robert proposes that one of the best practical alternatives to uses in daily lives, is the use of natural, unprocessed salts, such as Himalayan salt, as they are one of the best sources of a wide variety of trace minerals.
To naturally increase your bone density and decrease the risk of developing osteoporosis eat high-quality, organic, biodynamic, locally-grown food. Omega-3 fat content also plays a major role in building healthy bone, so ensure you get enough of this important substance.
It is vital to eat the right kinds of food for a comprehensive strategy towards healthy bones. If your diet only comprises of processed foods, this can trigger biochemical and metabolic conditions in your body, which in turn will decrease bone density. Avoiding such unhealthy foods is a positive step in the right direction!
Mind your Sodium-Potassium levels:
Two additional nutrients that play an important role in bone health are sodium and potassium. It is important to maintain the optimal ratio between these two in order to maintain the correct bone mass. If your diet includes many processed foods, there's a very good chance your potassium to sodium ratio is far from optimal, because such processed foods are notoriously low in potassium while high in sodium. If your body is in a state of imbalance in regards to sodium & potassium, this wrong ratio can contribute to a number of diseases, including osteoporosis. An easy way to ensure you get these two important nutrients in more appropriate ratios, simply ditches processed foods! They are very high in processed salt and low in potassium and other essential nutrients, which in a nutshell make them bad for your body. Instead, eat a diet of whole, unprocessed foods, ideally organically grown to ensure optimal nutrient content. This type of diet will naturally provide much larger amounts of potassium in relation to sodium, which is optimal for your bone health, and your overall health. If you find it difficult to eat the recommended amount of vegetables, give vegetable juicing a try.
Other components in food: Phytic acid and oxalic acid, is found naturally in some plants, they bind to calcium and can inhibit its absorption. Foods with high levels of oxalic acid include spinach, collard greens, sweet potatoes, rhubarb, and beans. Among the foods high in phytic acid are fiber-containing whole-grain products and wheat bran, beans, seeds, nuts, and soy isolates. The extent to which these compounds affect calcium absorption varies. It is interesting to note that research shows, for example, that eating spinach and milk at the same time reduces absorption of the calcium in milk.
Take a test: If you are a high-risk patient to Osteoporosis it is crucial to get screened for osteoporosis because one of the scariest things about this bone-thinning condition is that it doesn't cause symptoms and takes decades to develop. Ask your doctor when you need a bone mineral density test (some recommend them at age 65, some at menopause, and some even earlier if you're at an increased risk). Common risk factors to keep in mind include a family history, broken bones as an adult, being Caucasian or Asian, a small frame, certain medications, or conditions that increase risks such as inflammatory bowel disease or multiple sclerosis.
Do weight-bearing exercise: Walking, dancing, stair-climbing, or skiing, any activity that forces your skeleton to support your weight speeds the work of bone-building osteoblast cells. According to one study doing just a half hour of brisk walking boosted two measures of bone growth, so intense exercise is not required. Avoid high-impact moves such as running or jumping if you already have osteoporosis, as this places you at risk of fractures.
Use The Power Plate: This machine is a valuable exercise tool for prevention and treatment of brittle bones. The Power Plate works with Whole Body Vibrational Training (WBVT) which has also been shown to be a safe, natural way to ward off osteoporosis, and it’s gentle enough even for the disabled and elderly.
Strengthen and tone your muscles: The stronger you are, the less likely you'll be injured in a fall and break a bone. What's more, lifting weights as little as twice a week reverses loss of mitochondria, giving you and your muscles extra energy. A 16-week strength-training program has also been shown to cut arthritis pain by 43%. Bonus benefit: Muscle workouts boost your metabolic rate as much as 15%, so you burn more calories even when you're inactive.
Try yoga for better bone density: Practice Yoga poses that strengthen the areas most likely to suffer from osteoporosis- such as the hips, spine, and wrists. This can help maintain bone density. Certain poses that focus on the spine can also help improve posture, preventing the hunched back that is typical in older osteoporosis sufferers. Good poses to try including in your routine are “the chair” pose and “cobra”. Women who have small frames or family histories of osteoporosis are more prone to the disease – so if your mother or grandmother has been diagnosed, be doubly sure to add these poses to your repertoire.
Practice Tai-Chi: Postmenopausal women who've practice the slow, graceful movements of this exercise for years have denser bones, even beginners slow the process of bone loss as soon as they start.
Go for a jog: When various activities were tested for their ability to stimulate bone growth, running scored three times higher than walking and other nonimpact exercises such as stair climbing and stationary cycling, which had almost no effect. Do you hate running? As an alternative which will get just as good results, try jumping jacks, tennis, swing dance, step aerobics, or anything that's higher impact than you're used to and that varies your routine. However, women who have already been diagnosed with osteoporosis or who have a family history of the disease should consult their doctors before starting a high-impact exercise routine because the activity may increase their risk of fractures.
To recap: One of the best ways to achieve healthy bones is a diet rich in fresh, raw whole foods that maximises natural minerals so that your body has the raw materials it needs to do what it was designed to do. In addition, you need healthy sun exposure along with regular, weight-bearing exercise.
- I have seen doctors, in good faith, leave patients on steroids for years, thinking they are doing right. A friend of mine was on steroids for so long, she has severe osteoporosis." - Mary Ann Mobley
- "Today osteoporosis affects more than 75 million people in the United States, Europe and Japan and causes more than 2.3 million fractures in the USA and Europe alone." - Gro Harlem Brundtland
- "Such lifestyle factors such as cigarette smoking, excessive alcohol consumption, little physical activity and low dietary calcium intake are risk factors for osteoporosis as well as for many other non-communicable diseases." - Gro Harlem Brundtland
- "Last year I was diagnosed with osteoporosis." - Sally Field
- "As we may know, osteoporosis affects around 10 million Americans, most of whom are over 55, and it is the cause of an estimated 1.5 million fractures annually." - Lois Capps
- "Although approximately 80% of osteoporosis sufferers are women, as the longevity of the male population increases, the disease will assume increasing importance in men." - Gro Harlem Brundtland