Osteoporosis is a loss of bone mass causing the bones to become porous and fragile and therefore dangerously weak, brittle and susceptible to fracture. The bone mass progressively deteriorates, usually in the hip, spine or wrist.

Our bones are constantly being remodeled, with bone tissue being broken down and rebuilt on a regular basis. Bone density (the degree of mineralization of the bone matrix) usually increases until age 30. Osteoporosis sets in when more bone is lost than can be rebuilt. Eventually, bones become brittle and easily fractured. There are two different types of bone - both of which lose bone mass later in life, but at different times. After age 30, a gradual loss in trabecular bone (the inner portion of bone) begins to occur. After age 40, Cortical bone (The dense outer layer of bone) begin to decline in mass.

10 million Americans estimated to have osteoporosis, eight million are women and two million are men. 34 million Americans are considered to be at risk for osteoporosis.  Osteoporosis causes more than 1.3 million fractures a year.

• 80 percent of those affected by osteoporosis are women
• 5 percent of non-Hispanic black women over age 50 are estimated to have osteoporosis; an estimated additional 35 percent have low bone mass that puts them at risk of developing osteoporosis
• 10 percent of Hispanic women age 50 and older are estimated to have osteoporosis. 49 percent are estimated to have low bone mass
• 20 percent of non-Hispanic white and Asian women age 50 and older are estimated to have osteoporosis, 52 percent are estimated to have low bone mass

Conventional medicine doctors prescribed for osteoporosis are Fosamax (alendronate sodium), Actonel (risedronate sodium) and Boniva(Ibandronate) which are all varieties of bisphosphonates.

Although these drugs seem to help slowing menopausal bone loss, unfortunately, these drugs can cause severe digestive reactions including irritation, inflammation, and ulceration of the esophagus, all of which may cause chest pain, heartburn, pain with swallowing, stomach upset, diarrhea, headache and joint pain.

I object to the increasing practice of treating women (and some men) long-term with drugs such as Fosamax and Actonel after tests show that their bones are thinning (a condition called osteopenia). It is not good medicine to use these not so safe drugs for patients who haven't even been diagnosed with osteoporosis.

Many physicians are unaware of the risks of taking bisphosphonates. There are increasing evidence showing that using bisphosphonates on a long-term basis can lead to very serious problems.

Patients on bisphosphonates can develope severe musculoskeletal pain, starting within days, months or even years after initiating treatment. Dentists and oral surgeons have found that some patients on these drugs are at risk of developing an untreatable condition called osteonecrosis of the jaw (ONJ). ONJ has also been found among patients taking oral bisphosphonates to treat or prevent osteoporosis. Osteonecrosis means death of bone tissue. ONJ can cause chronic pain and disfigurement of the jaw. Symptoms include toothache, jaw pain, loosening of teeth, recurrent infection of the soft tissue of the jaw, and bone exposure. The condition shows up most often after a tooth has been pulled and the surrounding tissue fails to heal. The early stages of the disorder don't show up on x-ray. ONJ appears to develop because the drugs interfere with the ability of bones to remodel themselves as they go through the continual process of bone breakdown and rebuilding. This is especially problematic in the mouth because the jaw bone becomes unable to repair microscopic fractures stemming from the constant stress of chewing. The accumulated damage from these tiny fractures sets the stage for osteonecrosis.

So far there is no treatment for ONJ, prevention is very important. An article in the December, 2005, issue of the Journal of the American Dental Association alerted dentists to this problem and suggested that all patients taking bisphosphonates have an oral evaluation before beginning intravenous therapy or within three months after beginning to take the drugs orally. Essentially, the goal is to make sure that patient's mouth is in perfect shape - no cavities, no gum disease and no other dental problems - prior to taking bisphosphonates. The fear is that if a patient develop ONJ, any dental procedure will make matters worse.

At this point,. Any patient considering long-term treatment with these drugs should be aware of their potential dangers. some dentists have begun to report a more serious concern in a sub-group of their patients: jaw necrosis, the death of the jawbone.

Early prevention is crucial - start at age 30, follow the bone building guidelines described below

1) Eat plenty of fresh, green vegetables and whole grains. Leafy dark green vegetables, beans, broccoli, sesame seeds, oats, and tofu -- are especially rich sources of calcium and magnesium should be a regular part of your diet. Eat foods high in flavonoids, which help stabilize collagen structures, such as blueberries, raspberries and hawthorne berries. Lower protein vegetarian diets are associated with significantly higher bone mineral density -- not to mention improved overall health. Trace minerals are also important in helping your body absorb calcium. Eating plenty of green leafy vegetables gives you calcium along with these helpful trace minerals. Boron and manganese are especially important. Foods that contain boron include apples, legumes, almonds, pears and green, leafy vegetables. Foods that include manganese include ginger, buckwheat and oats. The organic matter in our bones consists mainly of collagen, the "glue" that holds together skin, ligaments, tendons and bones. Zinc, copper, beta carotene and vitamin C are all important to the formation and maintenance of collagen in the body.

2) Avoid soda pop and carbonated beverages and high protein Diet. One of the leading contributors to osteoporosis in the U.S. is carbonated soft drinks containing phosphorous. Research has shown a direct link between too much phosphorous and calcium loss. Our other source of excessive phosphorous in the U.S. is eating too much meat. Keep meat consumption to no more than once a day.

3) Avoid caffeine, Alcohol, and Cigarette Smoking. Each of these substances creates a negative calcium balance in the body. Substances called phytates and oxylates bind with calcium in the large intestine and form insoluble salts, rendering the calcium useless. The bone mineral content of smokers is 15-30% lower in women and 10-20% lower in men. Cigarette smoking is a significant risk factor for osteoporosis. Twice as many women with osteoporosis smoke as compared with women who do not have osteoporosis. So no more than one cup of coffee and one alcohol drink per day. If you are at a high risk, I advise elimination. You should also restrict your consumption of refined sugar, sugary drinks and salt. All of these promote calcium loss. For a healthy beverage, drink green tea. Famous for its cancer-fighting properties, green tea is also a good source of vitamin K, which improves bone mineralization.

4) Avoid dairy products. Milk and other dairy products are not the best source of dietary calcium. That's because milk, cheese, and all animal products are high in protein. The more protein you eat, the more calcium you need to neutralize the acidic byproducts of protein. Don't depend on milk to get your calcium. Milk has a poor calcium to magnesium ratio. Your body needs a certain amount of magnesium in order to get the calcium into your bones -- without magnesium, calcium can't build strong bones. In fact, magnesium deficiency may be more common in women with osteoporosis than calcium deficiency.

5) Decrease your sodium intake. Avoid salty processed foods and fast food. Don't salt your food before tasting it.

Stress or strain on bones stimulates the formation of new bone. Weight-bearing exercise is the only thing besides progesterone found to actually increase bone density in older women. 30 minutes of weight bearing exercise 4-5 times a week. Brisk walking with hand-held weights counts as weight-bearing exercise. Those women who don't exercise continue to lose bone, regardless of what else they are doing. Exercise can help increase flexibility, strength, and coordination as well. A weight lifting program of just half an hour three to four times a week can significantly improve bone density.

1) Antacids with Aluminum and don't use aluminum cooking pots

It has been shown that small amounts of aluminum-containing antacids increase the urinary and fecal excretion of calcium, inhibit absorption of fluoride, and inhibit absorption of phosphorus, creating a negative calcium balance. The calcium is excreted instead of being utilized.

2) H2 blockers such as Tagamet, Zantac and Pepcid.

As we age, we tend to produce less stomach acid. To be absorbed, calcium requires vitamin D and stomach acid. For this reason, it's important to avoid antacids and the H2 blockers which block or suppress the secretion of stomach acid.

3) Diuretics

Diuretics cause water loss in the body. Along with the water you lose minerals, most notably calcium, magnesium and potassium. They are commonly used to treat high blood pressure, swelling of the lower leg, and congestive heart failure. People who use diuretics have a higher risk of fracture. If you need to use a diuretic, try a gentle herbal one such as dandelion root.

4) Fluoride

There is good, solid scientific evidence that fluoridated drinking water increases your risk of hip fractures by 20-40%. So much fluoride has been put into our water and toothpaste over the past 30 years that levels in our water, food and drink are very high. While eating a normal diet the average person exceeds the recommended dose. There is also evidence that ingesting high levels of fluoride can cause abnormal bone growth. Please avoid fluoride, in all forms including toothpastes and mouthwashes. If you are at a high risk for osteoporosis, I recommend a water filter that removes fluoride.

5) High Dose Cortisone

A well known risk for osteoporosis is long term treatment with the synthetic cortisones such as Prednisone. While progesterone gives bones the message to grow, the cortisones give bones the message to stop growing. If you must be on a cortisone, talk to your doctor about using a low dose natural cortisone called hydrocortisone rather than the synthetic cortisone.

Estrogen can slow bone loss around the time of menopause, but the scientific evidence is very clear that after 5-6 years, bone loss continues at the same rate, with or without estrogen. A very large study published in the New England Journal of Medicine in 1995, studying risk factors for hip fractures in white women, which followed over 9500 women for eight years, found no benefit in estrogen supplementation in women over the age of 65. Dr. John R. Lee said, "It is clear that progesterone, combined with proper diet and exercise, steadily increases bone density regardless of age."

Reference

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