Osteoporosis and Osteopenia - Loss of Bone Density

Osteoporosis, or loss of bone density, can be addressed safely, effectively, and naturally using strontium and other nutrients.

Loss of bone density, called osteopenia when mild and osteoporosis when severe, is becoming more and more common as our population ages and becomes more sedentary. It is also often seen in young people with Chronic Fatigue, Fibromyalgia or pain. Although drug companies mostly promote expensive (and sometimes toxic) medications to both patients and physicians, the good news is that simple, safe and cheap natural remedies are even MORE effective than medications! It is easy to address osteoporosis safely, effectively, and naturally!

Osteoporosis can worsen with age, inactivity, and hormonal deficiencies (estrogen, testosterone, and DHEA). Currently, the rate of osteoporosis among older women is estimated to be about 29 percent. Yet only 13 percent of older women have been diagnosed with the disease. Osteoporosis can be easily diagnosed by performing a simple test called a DEXA scan. Fortunately, many therapies can be effective at restoring bone strength and even at eliminating osteoporosis pain.

Although using calcium to increase bone density has received most of the media attention, it is actually a rather small player when it comes to improving bone strength. In addition to weight-bearing exercise and natural estrogen, many other nutrients and therapies can dramatically improve bone density and decrease bone pain. Sadly, except for calcium, most doctors only hear about expensive biphosphonate prescription medications such as Fosamax®. Although these can be helpful, I would certainly start first by adding the nutrients that your body needs to make strong bones. Nutritional support can be taken with the medication (or instead of the medication, if OK’d by your doctor).

If you already have osteoporosis, I would take a biphosphonate medication such as Fosamax® or a related medication in addition to the therapies below. The usual dose of Fosamax is 70 mg once a week on an empty stomach taken with a full glass of water. It is best to take it immediately on waking and then stay upright for 30 minutes so gravity helps it get past the stomach quickly (it can irritate the stomach). For those of you on the 35 mg a week prevention dose, you should be aware that the 35 and 70 mg tablets cost exactly the same amount; you can save half the cost with a 70 mg tablet by breaking it in two. The same price for both low and high dose tablets is commonly seen with many medications. Although Fosamax has been associated with jaw and other problems, my impression is that the risk of this is MUCH lower than the risk of a fracture, so until your bone density improves from osteoporosis to the milder osteopenia, I would combine the biphosphonate medication with the natural remedies below. Then I would continue the natural remedies alone when better.

There are many other nutrients that are critical for bone production. These include magnesium, boron, folic acid, copper, manganese, zinc, and vitamins B6, B12, D and C. All of these are present in a good multivitamin powder. In addition I recommend adding:

1. Calcium, 400 to 1,000 mg daily. Be sure you get a form that dissolves in your stomach. Unfortunately, most calcium tablets are chalk (calcium carbonate) and do not dissolve. Because of this, they go in your mouth and out the other end, doing no good along the way. If you get one that is a chewable, powder, or liquid, this is not a problem. If you get a tablet, put it in some vinegar for an hour and see if it dissolves. If it does not, it will not dissolve in your stomach either, and I recommend that brand not be used. If you are taking thyroid hormone supplements, do not take the calcium within 2-4 hours of the thyroid hormone or you will not absorb the thyroid hormone. In addition, make sure that your Free T4 thyroid blood test (not the TSH test) is not above the upper limit of normal because too high a thyroid dose can also cause osteoporosis. You may choose to take your calcium at meals and/or because it is better absorbed with food, and calcium taken at night can help you to sleep.
2. Strontium. This mineral is highly effective at improving bone density. I am not speaking about strontium-90, the very dangerous radioactive compound released during nuclear testing. The strontium available in health food stores is non-radioactive and very safe — even in high doses. Studies using strontium for 353 osteoporosis patients showed a dramatic 15% increase in lumbar spine bone mineral density (BMD) over two years in patients using 680 mg of strontium (2,000 mg of strontium ranelate) a day.¹ They then repeated the placebo-controlled study with 1649 osteoporotic women. New fractures decreased by 49 percent in the first year of therapy, and bone mineral density in the lumbar spine increased by an average of 14.4 percent after 3 years. There was an 8.3 percent increase in hip BMD as well². Other forms of strontium have shown similar benefits, and 340 mg of elemental strontium daily appears to be a good dose. Strontium gluconate is better absorbed than strontium carbonate. If possible, take the strontium on an empty stomach and at a different time of day than the calcium, as calcium can block strontium's absorption. Early data also suggests that the strontium may also be helpful in addressing osteoarthritis. Although it took 3 to 36 months of therapy, taking strontium was associated with a marked reduction in bone pain in osteoporosis patients.³
3. Hormonal support (see "Bio-identical Hormones Are Safe"). Make sure that your DHEA and testosterone levels are optimized, since these hormones also can improve bone density considerably. In men, testosterone deficiency is a major cause of osteoporosis. Bio-identical hormones are discussed in the section on hormonal therapies. It seems that even very low dose transdermal (by patch) estrogen replacement therapy improves bone density in menopausal women. The findings come from a study of 400 postmenopausal women aged 60 to 80 with thinning bones who received either the patch containing natural estradiol or a placebo. The results showed that women in the therapy group had improved bone density in the spine and hip and experienced reduced bone turnover. The lead investigator stated that the ultra-low dose estrogen patch offers a more natural approach to menopausal hormone therapy, because it is replacing circulating estrogen rather than increasing it. This study's results were presented at the 52nd Annual Clinical Meeting of the American College of Obstetricians and Gynecologists (ACOG) 2004 held in Philadelphia.
4. Fish oil also may decrease osteoporosis. I would add it mostly if you also have dry eyes, dry mouth, or depression (all of these suggest fish oil deficiency). You can either increase your intake of salmon and tuna or use fish oil.⁴

To optimize bone density, these are the key nutrients I would recommend:

1. Vitamin D 2,000-4,000 IU/day
2. Vitamin K 300-600 mcg/day
3. Calcium 400-1,000 mg/day
4. Magnesium 200-400 mg/day
5. Boron at least 2 mg/day
6. Silica 50-200 mcg/day
7. Strontium 340-680 mg/day

So here is how I would improve bone density:

1. Take a good multivitamin powder daily.
2. Take a supplement that supports healthy bones. This should contain strontium, calcium, magnesium, high-dose vitamin D, and more.
3. Optimize your hormone levels using safe bio-identical hormones.
4. Walk more (1/2-1+ hours a day). This can be done in a warm water pool if needed.
5. If your problem is severe enough that you have osteoporosis, I would use a biphosphonate medication (like Fosamax) with the above natural therapies at least until you have improved from osteoporosis to osteopenia.
6. If you have depression, dry eyes, or dry mouth, take a fish oil supplement daily.
7. If drinking excess alcohol, stop or cut back, as this is a major cause of loss of bone density.

References

Meunier, P.J., et al. "Strontium ranelate: dose-dependent effects on established postmenopausal vertebral osteoporosis-a two-year randomized placebo-controlled trial." Journal of Clinical Endocrinology and Metabolism, May 2002; 87 (5): 2060-6.

Meunier, P.J., et al. "The effects of strontium on the risk of vertebral fracture in women with postmenopausal osteoporosis." New England Journal of Medicine, 2004, January 29; 350 (5): 459-68.

McCaslin, F.E., et al. "The effect of strontium lactate in the treatment of osteoporosis." Proceedings of the Staff Meetings of the Mayo Clinic 34: 329-34, 1959.

Inflammation and Aging. Ronald E. Hunninghake, M.D. (Tape) The Center For the Improvement of Human Functioning International (run by the late and wonderful Hugh Riorden, M.D.).