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What is Osteoporosis :

Osteoporosis and Osteopenia its a systemic skeletal disorder that is characterized by a decrease in bone mass and a decrease in bone tissue that leads to bone being very fragile with a high susceptibility for fracture. Bones are a dynamic living tissue.  They serve four important functions: 1) Scaffold for the musculoskeletal system 2) Protection of vital organs 3) Reservoir of calcium and phosphorus 4) Compartment for blood cell production.

What is the architectural structure of bone : 

  1. Cortical bone : its the dense outer shell of bone.  Withing this structure lies the blood vessels and nerves that are found inside the bone
  2. Trabecular bone: This type of bone is also called spongy bone, and its surrounded by the cortical bone. Trabecular bone provides a framework for blood vessels and a foundation for blood product cell production.

This is important to know because some bones contain more cortical bone ( hardest , strongest bone likes those found in the upper femur) and others contain trabecular bone ( spongy bone) that is more prone to osteoporosis and osteopenia like the vertebral bodies in the spine ( this is why vertebral osteoporosis is more common than to say femoral osteoporosis)

What is the incidence of Osteoporosis : 

It is estimated that in North American and Europe 1 in every 3 women and 1 in every 10 men will have a fracture from osteoporosis.  1.7 million hip fractures occur every year globally and this number is expected to increase. The sad part about this is that 50% of women who fall and break a hip never walk again and 50% can die within a year due to the consequences of this condition.  It is estimated that 50% to almost 80% of the bone mass is determined by genetics alone. So if your parents have a history of osteopenia or osteoporosis, this increases your chances of getting the condition.  Another important factor to have in mind is that 50% of bone fractures occur in people who have normal bone density. This means that bone mineral density as determined by the bone scan density machine is not enough only to determine if you will have a fracture, but having a good bone strength is needed as well, and this is not measured on a bone density machine.

How is bone Strength determined :

  1. Mineral to matrix ratio
  2. Collagen amount and collagen type
  3. Micro damage and micro fracture
  4. Cortical bone thickness and porosity

What are risk factors for Osteoporosis and Osteopenia :

  1. Menopause | Andropause
  2. Thyroid hormone imbalances
  3. Parathyroid hormone over production
  4. Vitamin D and Calcium deficiency
  5. Excess protein intake
  6. Smoking and alcohol abuse
  7. Genetic predisposition
  8. Lack of exercise
  9. Fluoride in drinking water
  10. Too much vitamin A
  11. Soft Drink use and caffeine intake ( caffeine increases calcium loss and draws calcium out of bone)
  12. Medications like steroids, heparin, lasix, diuretics, excessive thyroid medication, antidepressants
  13. Gastric bypass surgery and removal of thryoid gland
  14. Proton Pump Inhibitors ( Gastric Reflux Medication)
  15. Poor Diet ( low intake of fruits a and vegetables was a marker for increase hip and bone fracture)

It takes more than Calcium to avoid bone loss: 

In order for the bone to be healthy and strong and avoid osteoporosis the body needs the following nutrients

  1. Calcium
  2. Magnesium
  3. Vitamin D
  4. Vitamin K
  5. Boron
  6. Manganese
  7. Zinc

If calcium supplements are to be taken, they need to be taken throughout the day for maximum absorption since the body cannot absorb more than 500 mgs at a time. It is also to be taken with meals. However you have to remember that its more than just calcium to prevent osteoporosis and osteopenia.

Is milk the best source of Calcium for Osteoporosis: 

Milk is not the best source since pasteurization can kill up to 30% of the available calcium that is available in milk. Tums, is also not a good source of calcium. Calcium supplements have been recently under scrutiny due to higher intake of this supplements being associated with carotid and coronary artery calcification. So be aware of taking calcium supplements without proper evaluation.  Always use pharmaceutical grade supplements. Lower grade products may be contaminated with lead, mercury, arsenic and aluminum. Some good companies that I personally recommed to my patients are Thorne Research, Biotics Research, Metagenics, Ortho Molecular, Pure Encapsulations among others.

What are Calcium Rich foods : 

  1. Kelp
  2. Brick cheese
  3. Barley
  4. Sesame seeds
  5. Almonds
  6. Shrimp
  7. Brazil nuts
  8. Tofu
  9. Walnuts
  10. Kale
  11. Pecans and dates
  12. Prunes
  13. White beans

Excess Calcium Supplements can cause the following conditions : 

  1. Clog Arteries
  2. Block uptake of other vitamins
  3. Decrease iron absorption
  4. Kidney stones
  5. Decrease thyroid function
  6. Interfere with vitamin K production

What is the role of Magnesium in Osteoporosis : 

Magnesium is an important supplement in the body. Its probably the most deficient mineral we have. Reasons for this are multiple but it all starts with how food is produced in United States. Soil now a days is deficient in minerals, including magnesium. Soil is treated with potash , a potassium salt, that depletes the soil from  magnesium. In addition genetically modify foods, non organic produce, radiation to food, herbicides, fungicides, glyphosate (Roundup sprayed on crops) can make food less nutrient dense. As if this was not important enough, we are eating more processed foods, less fruits and vegetables, more packaged foods that robbed our body of this important mineral. Magnesium is involved in more than 300 functions in our bodies and its needed to decrease osteopenia and osteoporosis.  The dosage should be at least 300 to 500 mgs of elemental magnesium.

Role of Magnesium in Osteoporosis: 

  1. Increases the absorption of calcium
  2. Activates vitamin D
  3. Helps in parathyroid hormone production
  4. Helps other hormones in the absorption of calcium  ( calcitonin)
  5. Activates bone building cells
  6. Increases mineralization density

What are Magnesium rich foods:

  1. Kelp
  2. Wheat germ
  3. Almonds
  4. Cashews
  5. Brown Rice
  6. Corn
  7. Brazil nuts
  8. Sunflower seeds
  9. Sesame seeds
  10. Pumpkin seeds
  11. Peanuts
  12. Prunes
  13. Dandelion greens
  14. Dark leafy vegetables

What is the role of Vitamin D in Osteoporosis:

Vitamin D is not widely available in foods however egg yolks, cold water fish, fortified milk and fortified orange juice contain vitamin D. The primary source of vitamin D is from solar UV B irradiation of the skin that triggers the concersion of provitamin D3 to provitamin D3 and then vitamin D3. Vitamin D affects calcium and phosphate metaboism in the bone, intestines and kidney. Studies in osteoporosis and osteopenia have suggested that intakes of at least 700-800 IU of vitamin D per day are necessary for fracture reduction and osteoporosis and osteopenia prevention.

Vitamin D sources for Osteoporosis prevention:

  1. Cod Liver oil
  2. Salmon
  3. Sardines
  4. Tuna, canned
  5. Shiitake Mushrooms
  6. Egg yolk
  7. Sunlight
  8. Fortified foods

What other factors besides nutrients involved in Osteoporosis :

Nutrients are extremely important in preventing and treating osteoporosis and osteopenia. However, its more than that. Hormones play a big role in its prevention as well. It is estimated that approximately 90% of women who do not take hormone replacement therapy or estrogen will have a fracture by age 85. Is its clearly stated that estrogen maintains bone, progesterone builds bone and testosterone makes the bone strong. Low testosterone levels have been shown to decrease bone mineral density in the spine and hip. Also high Cortisol levels, the stress hormone, can affect bone metabolism and lead to osteoporosis.

What can I do to prevent, treat or manage Osteoporosis and Osteopenia : 

Testing. The gold standard and what traditional medicine does to diagnosis this condition is doing the bone density scan or DXA scan. This is a valuable tool and extremely important in the management and diagnosis of this condition. However, as you can see in this article there is much more than that. Test that you can do to diagnose and proper manage this condition are the following

  1. Dexa scan or bone scan
  2. Micro nutrient testing ( mineral and vitamin deficiencies )
  3. Computed Tomography ( most sensitive but more expensive than DXA scan)
  4. Urine testing for bone turnover markers ( NTX testing). Measures how fast the bone is breaking down or how fast is responding to therapy
  5. Genome testing to determine if you have a genetic predisposition for the development of osteoporosis

Texas Menopause has a lot to offer to patients in the prevention of bone loss and reversal of Osteopenia and Osteoporosis. Visit us today and book your appointment online now.

Osteoporosis by Dr. Joel Rivera

osteoporosis osteopenia

Spinal Fracture and traumatic vertebral injury medical concept as a human anatomy spinal column with a broken burst vertebra due to compression or other osteoporosis and osteopenia back disease.




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