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Managing Osteoporosis - Considering the Overlooked Nutrients and Best Assessment Tools

Dr. Krysten DeSouza
18 December 2017
Collaborative Healthcare Network
5–3405 South Millway
Mississauga, ON L5L 3R1

Managing Osteoporosis - Considering the Overlooked Nutrients and Best Assessment Tools

Managing Osteoporosis - Considering the Overlooked Nutrients and Best Assessment Tools

We’ve all seen the commercials on TV telling us to drink milk to keep our bones strong. We know that we hit peak bone mass before the age of 30, and as we age, our bone mass starts to decline. Depending on our genetics and lifestyle, some of us may decline faster than others. Osteoporosis is the age-related decline in bone density that men and women may experience after 50 years old. Progression into osteoporosis is marked by a weakening of bone tissue that increases the risk of easy fractures, specifically in the hip, spine, and wrist.[1] It is important to note that osteoporosis is an entirely preventable condition, and is associated with poor nutritional and lifestyle habits throughout life. There are many dietary and nutritional approaches that can significantly reduce progression and are of utmost importance for those at high risk.

How Do We Lose Bone Mass? Managing Osteoporosis - Considering the Overlooked Nutrients and Best Assessment Tools

Most people think that bones are very static structures and we have the same ones for life. In reality, our skeletons are incredibly active and dynamic structures, constantly breaking down in some areas and rebuilding in others depending on the forces that we place on them. Bones act as reserves for many micronutrients, especially calcium, zinc, magnesium, and phosphorus. Diets that are highly processed are devoid of nutrients and require that the body compensate for the lack of nutrients. These diets are also highly acidic and require buffering from the bone to balance out the pH of the body. Compound this over many years, and the bone tissue can become very weak, especially if we are lacking physical activity.

Why Do Women Develop Osteoporosis Earlier Than Men?

Women have higher levels of estrogen than men, and estrogen is protective for bone structure. Once a woman becomes perimenopausal, her estrogen levels start to decline, which means she doesn’t have the same hormonal protection for her bones. The earlier a woman goes into menopause, the earlier her bone mass will start to decrease, and the higher her risk of osteoporosis and fractures. For men, things are a little different, and the decline in bone mass is simply a result of age. However, because our average life expectancy has increased over the last few decades, more men will live to experience the progression into osteoporosis.

So, if your genetics are not on your side and early menopause is in store for you, what can you do to keep your bones as strong as possible?

Education Is a Key Piece of the Osteoporotic Puzzle

The more knowledge there is around bone loss, the more conscious one can be about their sources of nutrients and in what ways they might be losing bone mass. Remember those old milk commercials claiming to keep your bones strong? Well, evidence exists to prove and refute this point. Studies carried out over many years showed that people who consumed milk in their childhood had higher peak bone mass, and tended to have fewer fractures later in life. The earlier the exposure to milk, the better for preventing fracture. So what do you do if you’re lactose intolerant or have a dairy allergy? Well, this same study showed that dietary calcium intake had similar benefits to milk. Whether you chose to supplement calcium or fortify your diet with high-calcium vegetables, vitamin D, and other micronutrients, your bone structure can be maintained.[2]

Know If You Are at Risk

According to the American Association of Family Physicians, those at risk for osteoporosis include those with a family history of osteoporosis, white race, dementia, poor nutrition, cigarette smoking, alcoholism, low body weight, estrogen deficiency, inadequate physical activity, and early menopause.[3] Additionally, individuals with certain health conditions are at high risk for bone loss before the age of 50. These people are often on high doses of corticosteroids or hormone therapies; or they have been diagnosed with rheumatoid arthritis, Cushing’s disease, hyperthyroidism, hyperparathyroidism, malabsorption syndrome, or other chronic inflammatory disease.

Get Tested Managing Osteoporosis - Considering the Overlooked Nutrients and Best Assessment Tools

Knowing where you stand can be a motivating factor to either get your act together, or know that you’re on the right track. If you have strong risk factors for osteoporosis, it might be a good idea to raise your concerns with your physician and talk about how early they recommend you having a bone mineral density test done. It is often not recommended unless you are in early menopause, have one of the chronic inflammatory conditions that cause bone loss, or are over the age of 65; however, many private clinics offer testing. The test itself is called a “DEXA scan,” and does involve a small amount of radiation in order to see through the layers of your spine.[3]

According to the US guidelines for osteoporosis treatment and management, a thorough workup of a patient should include the following blood tests:[3]

  • 1,25‑hydroxyvitamin D;
  • serum calcium;
  • serum creatinine (a measure of kidney function);
  • thyroid stimulating hormone (low TSH has been associated with low bone mineral density);
  • parathyroid hormone; and
  • alkaline phosphatase (a marker of bone and liver health).
  • Many professionals consider osteoporosis to be an end-stage disease, meaning the process began 20–30 years ago and has been steadily progressing over the years. By the time a diagnosis is given, bone loss and nutrient levels have gone so low that symptoms such as fractures become more of a risk. While osteoporosis can be difficult to manage, strengthening the bones and fortifying the diet can do a lot to increase numbers and slow progression.

    Alkalinize Your Diet

    As mentioned previously, highly processed foods as well as diets high in protein and low in fruits and vegetables are very acidic and will leach nutrients out of the bone tissue. Other highly acidic foods include grains, buckwheat, refined sugar, cheese, and coffee. The solution? Reduce consumption of these foods and increase alkaline foods in the diet, such as leafy green vegetables, almonds, coconut, bananas, avocados, and spices.[4]

    Get Moving

    The primary strategy for prevention of fractures stresses the importance of maintaining a healthy body weight through regular exercise. There is absolutely no medication on the face of the planet that can replicate what exercise does for us, and the most important thing that anyone can do to strengthen their bones is weight-bearing exercise. Whether you enjoy yoga, dancing, weight training, or playing a sport, getting your body moving will activate different muscle groups, strengthen the bones in those areas, and improve your circulation. All good things!

    Fortify with Supplements

    Vitamin D: I believe in individualized medicine, but this is one thing I put every patient on across the board. No matter how much time you spend outside, our Canadian sun is limited and definitely not strong enough to penetrate the skin and provide the right dose of vitamin D all year round. The ability to use and convert vitamin D from the skin is also a very individual thing, and some people are more efficient converters than others. Either way, there is no point in supplementing with calcium if you don’t have the adequate vitamin D to absorb it, so make sure you add this to your plan.

    Magnesium: Another very important nutrient that is often low in Canadians is magnesium. Our soil levels are low, which means our vegetables that grow from the soil are not as strong of a source of magnesium as they used to be. Magnesium and calcium work together in the maintenance of strong bones and healthy muscles. Get more of this, especially if you have higher levels of inflammation in the body and suffer from a lot of aches and pains.

    Combination Formulas: Research has allowed supplement and nutraceutical companies to put together some really great formulas for bone health. The unfortunate thing is most of these formulas require taking anywhere from 6 to 10 capsules per day in order to reach the recommended doses. Needless to say, this can be overwhelming for a lot of people, but the alternative of consuming all the nutrients in individual capsules can be even more overwhelming. In order to chose the best combination formula for your bones, consider products that contain the following:

  • Zinc
  • Boron
  • Phosphorus
  • Calcium
  • Vitamin K2
  • Copper
  • Manganese
  • Managing Osteoporosis - Considering the Overlooked Nutrients and Best Assessment Tools

    Optional: Microcrystalline hydroxyapatite (MCHC) is essentially bone meal from another animal that comprises the full spectrum of nutrients for bone health. It has conflicting evidence but is commonly found in combination formulas as a more bioavailable source of nutrients. Strontium ranelate is a bit harder to find in Canada, and has insufficient evidence to prove its safety and efficacy. However, the few studies that have been done show an increase in bone mineral density for the more extreme cases of osteoporosis.[5]

    As you can see from this article, the management of osteoporosis encompasses a whole bunch of things that everyone should be doing regardless of their risk factors. Don’t wait until your bone mineral density is low before you start making changes to your diet and exercise plan. Awareness is half the battle, and most people are not motivated to make a change unless someone close to them is affected by a disease. Be the exception! Get your diet on track with alkaline foods, drink plenty of water, and just keep moving!