In the last twenty years, osteoporosis has morphed from a relatively rare (albeit serious) condition affecting elderly women into an epidemic threatening close to half of all post-menopausal women and almost one-third of men in the United States. What’s changed? Frankly, not much except the hype. Unfortunately, I believe this is yet another case of the medical establishment and drug companies creating disease diagnoses by manipulating diagnostic criteria. The more medications prescribed for osteoporosis and osteopenia, the more profits for the corporations. And not a lot of doctors are offering healthy, natural solutions prior to doling out prescriptions, either.
In my clinical practice, I’ve found that an integrative program of botanical and nutritional compounds, together with diet and exercise, supports bone health without having to resort to drugs. I’m not dismissing the seriousness of osteoporosis. Bone loss and related fractures have always been a concern for women over 65. After the age of 30, bone loss gradually begins to outpace bone growth. Catabolic activity increases in relation to anabolic activity, and bone resorption begins to outpace formation by about 0.5-1.0% per year. Following menopause, the rate may accelerate to 1.0-5.0% with the dip in reproductive hormones, although diet and botanical supplementation can effectively mitigate this. Within five years after menopause, hormone fluctuations generally settle down and bone loss evens out to a gradual, normal decline of 1.0-1.5% per year.
Bone density tests are commonly used to evaluate bone health. However, bone density screening via the bone mass density (BMD) test cannot decipher between calcified bone and healthy bone, nor can it determine the strength of your bones. The BMD test compares your bones to those of much younger women, and doesn’t consider your individual baseline. Based on the diagnostics currently used, many people do not have as serious a condition as they have been told. I recommend getting an initial test and monitoring from that point forward, realizing that a certain amount of bone loss is natural with age. (I also like to assess teeth and fingernail health because their status correlates with bone health.)
It’s important to understand that bone loss is a natural process. Only bone loss (resorption) can initiate healthy new bone formation (deposition). Good bone health relies on a balance between the processes of building up and breaking down, or what I call the “anabolic-catabolic” effect. Within the integrative medical model I’ve created (the Eclectic Triphasic Medical System, or ETMS), anabolic restoration using herbal compounds and nutritional agents is a fundamental objective that is seldom addressed in botanical medicine treatment protocols for bone health, and yet it is essential to consider as people age.
Effective anticatabolic therapies decrease fracture risk by reducing the rate of bone turnover, thereby maintaining bone microarchitecture and increasing bone mineral density. At present, oral bisphosphonates such as alendronate (Fosamax) are the preferred treatment for osteoporosis. Fosamax works by inhibiting bone resorption, thereby preventing further bone loss. But remember, bone function is a two-way street; if resorption is delayed, then so is formation—if no bone is lost, no new bone is made. New bone is different from older bone—it’s strong and flexible, with the ability to bear both compression and tensile pressure. Disturbingly, recent reports suggest that some patients using bisphosphonates may be unable to repair or replace older or damaged bone.
Diet and weight-bearing exercise are commonly recommended for preventing osteoporosis, but the oft-heard recommendations just aren’t enough. For example, although calcium is heavily promoted as the most important nutrient for bone health, it’s certainly not the only essential nutrient. In fact, I’ve found that other nutrients are equally, if not more, important: The best diet for bone health is rich in plant phenols, vitamin C, and folic acid (abundant in fruits and vegetables); magnesium (whole grains, nuts and seeds); omega-3 fatty acids (cold water fish and flax seeds); boron (plums or prunes are the richest source); and isoflavones (fermented soy products).
Although it may seem heretical, I recommend calcium supplements only for those with known osteoporosis or the elderly who cannot get enough through diet alone; in such cases, I suggest a high-quality, fully chelated calcium supplement of 400-600 mg. To obtain the benefits of calcium, you need adequate stomach acid and a well-functioning GI tract. If you have GI issues, including IBS, celiac disease, or even heartburn, you can’t absorb calcium. Many people, particularly older people, lack the digestive acids necessary to break down and absorb calcium. So although antacids like Tums are promoted as good calcium supplements, they actually oppose the stomach acid needed for calcium absorption.
To improve digestion and promote the absorption of dietary calcium, I recommend sipping a glassful of water with 1-3 teaspoons of apple cider vinegar during meals. In addition, consume foods rich in pre- and probiotics daily, both of which enhance the absorption of vitamins and minerals. Prebiotics contain inulin, found in sunchokes, asparagus, and chicory; probiotics are found in fermented foods such as high-quality kefir, yogurt, sauerkraut, and natto. Natto is particularly good because it is the richest source of vitamin K-2, which works together with vitamin D to drive calcium into the bones.
Research more than two decades ago showed that vitamin D is critical for bone health and for preventing osteoporosis. I advise everyone to have vitamin D blood levels checked; the optimal range is between 50 and 80. It may take very high amounts of vitamin D3 supplementation (from 2000-8000 IU) to achieve healthy blood levels.
To prevent overdosing on vitamin D and the problem of hypercalcemia, you must monitor your blood levels of vitamin D and take Vitamin K (150-300 mcg.). Vitamin D-3 dosage must be based on assessment of both the 25 OH (25-hydroxy-vitamin D) and 125 diH (1,25 dihydroxy-vitamin D) blood levels. Individual needs vary greatly: People with autoimmune conditions or lymphoma are particularly prone to hypercalcemia from taking high amounts of vitamin D, while those who live in the north (especially people with darker skin) require higher levels of vitamin D in the winter. Vitamin K (300 mcg. -5 mg.) not only increases bone mineral density in osteoporosis, but also reduces fracture rates. Furthermore, there is evidence that vitamins K and D work synergistically to improve bone density. Optimizing your vitamin D levels can also help to prevent many different types of cancer, including pancreatic, lung, breast, ovarian, prostate, and colon cancers, as well as heart disease, neurological, and autoimmune diseases. Maintaining healthy normal levels of vitamin D reduces your risk of dying from any cause.[i]
An additional mineral that I recommend for osteoporosis is boron, a trace mineral essential for bone metabolism and joint health. Boron has been shown to improve calcium absorption and enhances collagen synthesis. Studies have shown that participants taking boron supplements (500 mcg. -6 mg.) reap the benefits of harder and stronger bones.
In my experience, the most overlooked factor in osteoporosis is the effect of emotional stress on bone health. Most people can easily understand how stress negatively affects emotional wellbeing, cardiovascular health, and digestive health. But you might be surprised to know that chronic stress—which many people accept as a fact of life—is a primary cause of osteoporosis, as well. Repeated stress causes hypothalamus-pituitary-adrenal axis (HPAA) exhaustion, creating a catabolic state that erodes bone health.
Bone turnover is basically a function of anabolic (bone-building) and catabolic (bone breakdown) process, and with age, stress, and a lack of healthy nutrition, the catabolic state slowly dominates over the anabolic state. The basis for an effective, permanent solution to bone health (and general health) is through the use of botanical adaptogenic remedies with enhanced anabolic actions, including Rhaponticum carthamoides, mumie, Eurycoma longifolia, epimedium, royal jelly, pantocrine, and Cissus quadrangularis, along with anabolic nutrients such as the amino acids found in high-quality whey protein concentrate containing lactoferrin, colostrum (Beyond Whey), and along with vitamin D and K, EPA/DHA rich fish oil, the anabolic amino acid arginine, and boron. Eating a diet rich in fruits and vegetables creates a more alkaline environment that also improves bone health.
Osteoporosis is considered a weakness of the Kidney Essence (neuroendocrine and endocrine system) with physical manifestations of not feeling supported in life. Intervention using botanicals that also build inward anabolic “Essence” and mediate the neuroendocrine and endocrine systems is vital for bone health (strength and density). Inward anabolic Kidney Essence herbs that can significantly aid in building bone strength and density include vitex, humulus, discorea, andasparagus racemosus.
An herbal tea made from nutrient dense herbs provides additional bone-strengthening minerals in an easily absorbable and tasty beverage. Drink 2-3 cups of this tea daily.
DY’s Simple Nutrient-Rich Mineralizing Bone Tea:
- Combine equal parts of horsetail, nettles, comfrey leaf, and hibiscus flowers.
- Pour freshly boiled water over herbs (use 1-2 heaping tablespoons of herbal mixture to one cup of water).
- Steep, covered, for 20 minutes.
- Enjoy hot or chilled.
Osteoporosis is really only as frightening as we let it be. With attention to diet, implementation of healthy lifestyle changes, and the addition of adaptogenic formulas to support anabolic metabolism, most women can prevent, treat, and even reverse bone loss without drugs and their side effects. Our youth-obsessed culture tends to undermine our self-esteem as we age rather than celebrate what we have learned and accomplished. As we continue along the amazing journey of life, perhaps we can begin to view our life’s journey as making us stronger. And with the right support, our bones will help to carry the load.
[i] Saliba W, Barnett O, Rennert HS, Rennert G. The Risk of All-Cause Mortality Is Inversely Related to Serum 25(OH)D Levels. J Clin Endocrinol Metab. 2012 May 30.