❑ Eat plenty of foods that are high in calcium and vitamin D. The most potent sources are dairy products, but not all dairy has vitamin D. Check the label, as calcium and vitamin D should be consumed at the same time. Osteoporosis Recommendations. Other good sources of easily assimilated calcium include broccoli, chestnuts, clams, dandelion greens, most dark green leafy vegetables, flounder, hazelnuts, kale, kelp, molasses, oats, oysters, salmon, sardines (with the bones), sea vegetables, sesame seeds, shrimp, soybeans, tahini (sesame butter), tofu, turnip greens, and wheat germ.
❑ Consume whole grains and calcium foods at different times. Whole grains contain a substance that binds with calcium and prevents its uptake. Take calcium at bedtime, when it is best absorbed and also aids in sleeping.
❑ Include garlic and onions in the diet, as well as eggs (if your cholesterol level is not too high). These foods contain sulfur, which is needed for healthy bones.
❑ If you are a menopausal or postmenopausal woman with osteoporosis, include plenty of soy products in your diet. Soy is rich in phytoestrogens, which may, to some extent, substitute for your body’s own estrogen if it is manufacturing too little. Osteoporosis Recommendations. The latter effect is very important for osteoporosis. Estrogen depletion is strongly associated with osteoporosis.
❑ Avoid phosphate-containing drinks and foods such as soft drinks and alcohol. Avoid smoking, sugar, and salt.
Limit your consumption of citrus fruits and tomatoes; these foods may inhibit calcium intake.
❑ Avoid yeast products. Yeast is high in phosphorus, which competes with calcium for absorption by the body.
❑ If you are over fifty-five years old, include a calcium supplement in your daily regimen, and take hydrochloric acid (HC1) supplements. In order for calcium to be absorbed, there must be an adequate supply of vitamin D as well as sufficient HC1 in the stomach. Older people often lack sufficient stomach acid. Osteoporosis Recommendations.
❑ If you take thyroid hormone or an anticoagulant drug. Increase the amount of calcium you take by 25 to 50 percent.
❑ Vitamin K1, found in dark green vegetables like kale, cooked greens, spinach, Brussels sprouts, broccoli, asparagus, and some lettuces, retards bone loss. A three-year study in the Journal of Clinical Endocrinology and Metabolism found that taking the Upper Limit of vitamin K (500 micrograms per day) with 600 milligrams of calcium and 400 IU of vitamin D did not aid in additional bone health of the spine or hip. Osteoporosis Recommendations. Do not take more vitamin K than 500 micrograms without consulting your health care professional. Osteoporosis Recommendations. Continue to eat foods high in vitamin K.
❑ If you take a diuretic, consult your physician before beginning calcium and vitamin D supplementation. Thiazidetype diuretics increase blood calcium levels, and complications may result if these drugs are taken in conjunction with ‘calcium and vitamin D supplements. Other types of diuretics increase calcium requirements, however.
❑ Keep active, and exercise regularly. A lack of exercise can result in the loss of calcium, but this can be reversed with sensible exercise. Walking is probably the best exercise for maintaining bone mass. Other activities that strengthen bones include dancing, tennis, stair climbing, aerobics, skating, and weight lifting. Although swimming and cycling are good for your cardiovascular system, they are not weight-bearing and do not affect bone density. If you are overweight, inflammatory proteins called cytokines are released due to excess body fat. Osteoporosis Recommendations. These increase the loss of bone. Weight loss increases bone loss as well. However, engaging in aerobic exercise while losing weight reduces inflammation and increases bone mineral density.
❑ In a study published in the American Journal of Clinical Nutrition, women in the early stages of menopause did not reduce postmenopausal bone loss by including isoflavoneenriched foods in their diet. These women consumed 110 milligrams of isoflavone aglycones a day from the foods. It is possible that this amount was too low to show an effect. However, long-term trials using soy extracts have shown conflicting results. Women who have breast cancer or are at risk for it should consult their health care provider before using soy or isoflavone-enriched foods.
❑ In one study, taking 1,200 milligrams of calcium per day for four years was shown to reduce the risk of fractures by 72 percent. However, the participants in the study were followed for six more years; they did not get this much calcium, and the risk of fractures increased again.
❑ Some studies have reported an adverse effect on bones with high vitamin A intakes. It appears that vitamin A is safe if vitamin D intake is adequate. Be sure to take vitamin D with vitamin A supplements.
❑ Getting at least 400 micrograms per day of folic acid was shown to improve bone density, but riboflavin and vitamin B12 had no effect over a five-year study.
❑ Women are about four times more likely than men to develop osteoporosis, or weak, porous bones. But a study links vitamin B12 deficiency with low bone mineral density in men, and confirms similar, previously reported findings in women. Researchers funded by the Agricultural Research Service (ARS) reported the findings in the Journal of Bone and Mineral Research. While vitamin B12 deficiency has been linked with low levels of markers of bone formation, the mechanism behind the relationship is not known. The scientists examined the relationship between vitamin B12 blood levels and indicators of bone health measured in 2,576 men and women, aged thirty to eighty-seven, participating in the Framingham Osteoporosis Study.
❑ They found that those with vitamin B12 levels lower than 148 picomoles per liter (pM/L) were at greater risk of osteoporosis than those with higher levels. Plasma B12 levels below 185 pM/L are considered “very low,” according to some experts. The study found that those with vitamin B12 concentrations below 148 pM/L had significantly lower average bone mineral density—at the hip in men, and at the spine in women—than those with concentrations above this level. This study suggests adequate vitamin B12 intake is important for maintaining bone mineral density. Animal protein foods, such as fish, liver, beef, pork, milk, and cheese are good sources of vitamin B12.
❑ A study conducted by the Journal of Clinical Nutrition reported that women who are vegetarians experience significantly less bone loss than women who consume meat. Soy, beans, peas, and lentils supply proteins, and green vegetables are all very rich in calcium. As well as containing abundant amounts of other vitamins and minerals.
❑ Klinefelter’s syndrome, which results in low testosterone levels in men, also leads to osteoporosis.
❑ A study reported in the Journal of the American Medical Association revealed that senior citizens who took tranquilizers suffered 70 percent more hip fractures than did other people their age. Very often, medications can affect balance. You should discuss this particular side effect with your physician before taking any medication.
❑ One study purports to have identified a link between osteoporosis and high blood levels of the amino acid homocysteine. Homocysteine is involved in methionine metabolism, and is normally recycled into methionine or converted into cysteine in the body. High levels result in possible increased risk of heart disease and stroke.
❑ Caffeine has been linked to calcium loss. In one study, adults given 300 milligrams of caffeine excreted more than the normal amount of calcium in their urine. Another study revealed that caffeine is associated with decreased bone minerals in women.
❑ Carbonated soft drinks contain high amounts of phosphates. These cause the body to eliminate calcium as the phosphates themselves are excreted, even if calcium must be taken from the bones to do this.
❑ Bone disintegration with pain in the hips, lower back, or legs and vertebral fractures (usually affecting people over fifty years old) is common.
❑ A balloon kyphoplasty, in which a balloon is inserted into a spinal fracture, inflated, and injected with a bone cement, can provide support and pain relief for people with some spinal fractures.
❑ The use of sodium fluoride, which was once thought to be helpful in building bone, has been shown to be ineffective for the treatment of osteoporosis. While sodium fluoride does increase bone mass in the vertebral column, the bone itself is of inferior quality. Women participating in a study at the Mayo Clinic in Rochester, Minnesota, were three times as likely to suffer from a fracture of the arm, leg, or hip if they took sodium fluoride than if they took a placebo. Some of the participants also suffered from unusual lower leg pain, perhaps due to stress fractures.
❑ A number of different prescription drugs are sometimes prescribed for people with osteoporosis, including:
• Alendronate (Fosamax) is a type of drug known as a bisphosphonate. It inhibits the resorption of bone. Other drugs in this class are risedronate (Actonel) and ibandronate (Boniva). Which are taken orally one or more times a month. A newer option is an intravenous drug (Reclast), which can be taken just once a year.
• Calcitonin (sold under the brand names Cibacalcin and Miacalcin) is said to prevent further loss of bone mass in 70 percent of the people who take it. It should not be taken by anyone with a history of kidney stones.
• Raloxifene (Evista) is a selective estrogen receptor modulator (SERM)—a drug that acts like an estrogen in some respects but is not estrogen.
• Teriparatide (Forteo) is a new drug that is a synthetic version of parathyroid hormone and works by increasing the action of osteoblasts, the body’s bone-building cells. This causes bones to become denser and more resistant to fractures. It is the first drug to stimulate new bone growth. But it requires giving yourself daily injections, and the drug can only be used for up to two years.
All of these drugs have potential side effects. They are not suitable for everyone. If bone mass is still decreasing after two years on the same medication, doctors usually prescribe another drug.
❑ Hormone replacement therapy is often prescribed for people who have osteoporosis. There are risks attached to this treatment. Before agreeing to it, you need to consider whether the risks outweigh the benefits.
❑ The FDA has approved three drugs for men with osteoporosis—alendronate (Fosamax), risedronate (Actonel), and zoledronic acid (Reclast). Osteoporosis Recommendations. These are all bisphosphonates. Teriparatide (Forteo) has also been approved for men.
❑ Dehydroepiandrosterone (DHEA) and human growth hormone (HGH) are two hormones whose production progressively declines with age. Research suggests that supplementation with either of these hormones may help increase bone strength and treat osteoporosis. However, these hormones should be used only by those with true growth hormone deficiencies.
❑ Research conducted by the World Health Organization concluded that people who were given a protein supplement recovered more quickly from hip fractures than those who were not. In addition, they found that people who took protein supplements were less likely to suffer a hip fracture in the first place. Osteoporosis Recommendations.
❑ A study reported in the March 2000 issue of The Journal of Family Practice found that taking vitamin C can help to prevent nerve pain after a fracture.
❑ Tests for bone loss are very easy and noninvasive. Dual energy x-ray absorptiometry (DEXA) is probably the most reliable method of determining osteoporosis. It is easier to fix bone problems before too much loss has occurred. So, women should be tested in their mid-thirties and then every five to ten years until menopause and more frequently after menopause. Exposure to radiation from this test is less than in other methods used to detect this condition. Another type of test, the collagen cross-linked N-telopeptide (NTx) test. Is particularly useful for women in that it shows how fast you are losing bone mass. It is performed on a urine sample.