There is a new option to osteoporosis
By Dr. Martin Gleixner, MSc, ND
Osteoporosis is recognized as a major public health issue. This chronic condition causes bones to progressively become thin and porous, leading to a decrease in bone strength and an increased risk of breaking a bone.
According to the Osteoporosis Canada website, at least 1 in 3 women and 1 in 5 men will suffer from an osteoporotic fracture during their lifetime. The cost to the Canadian health care system of treating osteoporosis and the fractures it causes is estimated to be $1.9 billion annually.
Recently, conventional treatment options for this disease have been put into question.
A number of recent studies have proposed that women who are taking drugs for osteoporosis would be better off not using them or only using them for a short period.
Recent headlines in newspapers worldwide stated, “MDs should rethink osteoporosis drugs” (Globe and Mail, June 14, 2012).
Mounting evidence is indicating that such drugs called bisphosphonates (including Actonel, Fosamax, Didronel and Aclasta) may have risky side-effects.
Although these risky side-effects are rare, they are potentially devastating. Research studies indicate that bisphosphonate drugs may cause osteonecrosis of the jaw, a painful deterioration of the jawbone. More recently, it was found that women taking these medications were at risk of unusual spontaneous femoral factures (the femur is the bone linking the hip to the knee). Apparently, such fractures can occur without any associated trauma such as a slip and fall.
Assessing the need for drug therapy in the treatment of osteoporosis should be conducted on a patient-by-patient basis.
The first step is to assess the stage of bone loss. Osteopenia (early stages) or osteoporosis can be diagnosed by a bone mineral density test (BMD), such as a dual-energy x-ray absorptiometry (DEXA) scan. Discuss these results with your medical doctor or naturopathic doctor so that you have a good understanding of the degree of overall bone loss and the progression of your bone density changes. It should be noted that DEXA scan measurements are not a very good measure of actual fracture risk, and therefore each individual should be evaluated based on the totality of their symptoms and risk factors.
According to a new study published in the New England Journal of Medicine, inconsistencies were found in who would benefit from bisphosphonate drugs. It was indicated that the short-term use of bisphosphonate drugs may only provide benefits to women over age 65 who have previously suffered a fracture or who have very low bone density (advanced osteoporosis). Other research indicates that there are no benefits in post-menopausal women if they have no history of fractures.
As researchers and doctors sort out who can benefit and how long someone can be on bisphosphonate drugs without increasing their risk of serious side-effects, a large majority of patients are left wondering how they can protect themselves against bone loss.
To help fill this void in health care, I have devised a Bone Health Program that addresses both the prevention and treatment of osteoporosis. Part of this program incorporates the FOOT Plan (Fully Optimized Osteoporosis Therapy Plan). The FOOT Plan is based on the work of Dr. Mark Swanson, ND, who through his practice in Washington (USA), dedicated time to devise clinically successful treatments that aim to not only stop, but also to reverse bone loss.
An individualized approach is required to fully understand why someone has bone loss. Appropriate recommendations should be made based on a full assessment that includes the analysis of bone density and blood tests results, a physical examination, a review of different organ systems (e.g. digestive system) and a complete review of lifestyle factors.
Therefore, the first step behind the Bone Health Program includes evaluating the following risk factors and addressing previous or on-going causes:
- Family history. Approximately 30 different genes are associated with osteoporosis. Although we can’t change the genes with have, we can affect how/when these genes are expressed. The newest scientific findings, especially in the field of research called epigenetics, has shown that modifiable environmental factors can turn on (or off) certain genes involved in the development of osteoporosis.
- Poor lifestyle choices early in life. As it turns out, we reach our peak bone mass around the age of 30. Therefore low physical activity, diets lacking in minerals, vitamins and protein, as well as excess pop consumption during childhood and early adulthood, can set the stage for lower baseline levels of bone mass. This inevitably leads to increased risk of developing osteoporosis later in life.
- Gender. Women are more at risk than men, but osteoporosis is still common in men.
- Sex hormonal deficiencies. Low levels of progesterone, estrogen, and/or testosterone can lead to bone loss. Such hormonal imbalances are especially common in menopause (and andropause), but can occur during any stage of life.
- Low levels or excess thyroid hormones (hypothyroidism/hyperthyroidism).
- Nutritional deficiencies can occur with dietary restrictions, insufficient whole foods, excess junk foods and soft drinks, and gastrointestinal disorders leading to malabsorption issues (eg celiac disease, Crohn’s disease or ulcerative colitis, etc…).
- Lack of sunshine exposure leading to deficiencies in vitamin D. Many, especially those who can’t tolerate the sun, or those living in the northern hemispheres are at risk of developing low levels of vitamin D. A blood test verifying for 25-OH-D3 should be conducted for anyone with low bone density.
- Advanced age (although it can occur at any age).
- Tobacco smoking.
- Excess alcohol consumption (greater than three units/day).
- Sedentary lifestyle and lack of weight-bearing exercises.
- Excess endurance training.
- Heavy metals (especially cadmium and lead).
- Many over-the-counter and prescription drugs (e.g. corticosteroids/steroids and SSRI antidepressant medications).
In the next column, we will further elaborate on the Bone Health Program that aims to treat osteoporosis by optimizing bone density, quality, and micro-architecture.
The key to successful outcomes is to demonstrate efficacy in the patients who receive treatment. The Bone Health Program is designed to be a safe, yet effective alternative to bisphosphonate drugs. Start now, so that you can be added to the others who report improved bone density using the FOOT Plan.
Please read Part 2 of this article.
Published by Dr. Gleixner on Thursday, July 12th, 2012 in Times & Transcript.
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