Osteoporosis
OSTEOPOROSIS
What is osteoporosis:
Osteoporosis is a disease of excessive bone loss and decreased bone density, which leads in increased risk of bone fractures. There are two types of bone cells important in the process of osteoporosis: osteoclasts (bone resorption) and osteoblasts (bone formation). Osteoporosis in women typically starts in their mid-thirties, often 15 years before menopause, with a bone loss of 1 to 1.5 percent per year.
Osteoporosis and Estrogen:
Bone mass in women declines rapidly during menopause. Production of estrogen declines by 40%-60%. Lack of estrogen stimulates production of a substance called interleukin-6, which stimulates growth of osteoclasts, thus increasing bone loss, especially during the first five years of menopause. After this period, the body adjusts to lower levels of estrogen. Estrogen therapy temporarily retards osteoporosis progression, but does not truly prevent or reverse it. However, estrogen therapy does not come without risks. Estrogen therapy alone was found to cause an increased risk of endometrial cancer, and a slightly increased risk of breast and cervical cancers.
Osteoporosis and Progesterone:
Production of progesterone drops to zero at menopause. Lack of progesterone causes a decrease in new bone formation. Progesterone therapy will actively increase bone mass and density and can possibly reverse osteoporosis. Postmenopausal osteoporosis is primarily a disease of bone loss caused by a progesterone deficiency and secondarily a poor diet and lack of exercise. Natural progesterone hormone is an essential factor in the prevention and proper treatment of osteoporosis.
Osteoporosis and Testosterone:
Testosterone helps to retain the calcium hydroxyapatitein the formation of the bone, resulting in good density. Estrogen may slow the bone loss, and progesterone may stimulate new bone formation, but without sufficient testosterone and mineral support, the resulting bone is weak. The use of testosterone for the treatment of osteoporosis is not FDA approved.
Low-density does not equal fragile bones:
Bone mineral density (BMD) refers to the quantity, not the quality of bone. It reveals nothing about the strength, micro-architecture, turnover, size, or shape of bone, all of which are contribute to fragility.
Strontium and osteoporosis:
Strontium is a non-essential trace mineral that is found in minute amounts in the body. It is in the same mineral family as calcium and magnesium, and it has been shown to promote growth of new bone in both animals and people. The largest amounts of strontium are found in spices, seafood, whole grains, root and leafy vegetables, and legumes. Strontium is available in 227mg capsules. However, supplementation with strontium does not mean you need less calcium. Always use more calcium than strontium.
A key to hormone balance is the knowledge that when estrogen becomes the dominant hormone and progesterone is deficient, the estrogen becomes toxic to the body (listen to your body). A saliva hormone test should be done to confirm these symptoms.Osteoporosis Treatment Program:
Bone Mineral Density measurements: Get a BMD measurement at baseline before treatment and every 2-3 years thereafter if low density.
Diet: Eat a healthy, low protein, balanced diet which includes the minerals and nutrients listed below. Protein should not exceed 20% of daily caloric intake. Avoid smoking and excessive alcohol consumption.
Calcium: 1200mg daily, mostly by diet. Supplements should be taken at bedtime when they are best absorbed. Calcium may also aid in sleep. Increase the amount of calcium you take by 25-50% if you take a thyroid hormone or an anticoagulant drug.
Vitamin D: Blood levels of 25-hydroxyvitamin D should be at 65ng/mL. An adequate amount of vitamin D should be taken to reach this blood level. Although the quantity of vitamin D necessary to reach this level varies from person to person, most people need 6,000-10,000 IU to reach this level (new 2010). Vitamin D improves calcium absorption, a well as providing many other health benefits. (more information available at www.grassrootshealth.net)
Vitamin C: 2000mg daily. Enhances immunity and aids in proper bone growth helping to build up collagen.
Beta-carotene: 15mg daily. Improves immune function and promotes proper bone growth.
Vitamin B Compex: 50mg three times daily. Involved in energy production.
Folic Acid, Vitamin B6 and Vitamin B12: folic acid- 400mcg daily, B12- 300mcg daily, B6- 25 to 100mg daily. Important in the conversion of the amino acid methionine to cysteine. If a person is deficient in these vitamins, there will be an increase in homocysteine level. High homocysteine levels in menopausal women have been associated with an increase in bone loss.
Vitamin K2 –Use Tri-K once to three times per day with a fatty meal. Used to solidify calcium into the bone matrix.
Zinc: 15-30mg daily. Promotes a healthy immune system. Zinc helps make collagen which forms the foundations of the bone. Zinc helps vitamin D absorb calcium. Zinc is needed for the proper formation of osteoclasts and osteoblasts, the two cells which are essential for bone turnover
Magnesium: 500-1000mg daily, mostly by diet. Helps in metabolizing calcium and vitamin C and helps to convert vitamin D to the active form necessary to ensure that calcium is efficiently absorbed by your body.
Strontium: 227mg three times daily or 227mg daily for preventive measures (new 2003).
Boron: Improved the metabolism of both calcium and magnesium. Research conducted by the US Department of Agriculture demonstrated that giving post-menopausal women a short course of 3mg boron supplements daily resulted in a 44 percent reduction in the amount of calcium excreted in their urine. Boron is found in alfalfa, kelp, cabbage and leafy greens.
Progesterone: natural, topical applications twice daily. Applied 21-25 days per month is postmenopausal or the two weeks before menses if not menopausal. Increases BMD. Check progesterone level periodically.
Estrogen: Indicated for vaginal dryness or hot flashes in postmenopausal women. May use low-dose natural bi-estrogens as prescribed by a physician.
DHEA: supplementation helps increase bone strength.
Exercise: Performing weight-bearing exercises 20 minutes daily or 30 minutes three times per week helps to maintain bone mass.
References:
1. Dr. John R. Lee. What Your Doctor May Not Tell You About Menopause. Chapter 12. Hormone Balance and Osteoporosis.
2. Dr. Jonathan Wright. Nutrition and Healing. Vol 10, Issue 2, February 2003.
3. James F. Balch, MD and Phyllis A.Balch, CNC. Prescription for Nutritional Healing, 2nd Edition.
4. Integrative Medicine Access. Osteoporosis.
5. Dr. Marily Glenville. The Natural Health Website for Women. Osteoporosis.
6. Robert Listecki, Pharmacist. Glen Ellyn Pharmacy, 486 Roosevelt Road, Glen Ellyn, IL 60137. Tel (630) 469-5200.
7. Jim Paoletti, Pharmacist. ZRT Laboratories.
8. Loredana Badulescu, RPh, PharmD candidate, Midwestern University, 2002.
9. Rachel Baker, PharmD candidate, University of Illinois at Chicago College of Pharmacy, 2010.
What is osteoporosis:
Osteoporosis is a disease of excessive bone loss and decreased bone density, which leads in increased risk of bone fractures. There are two types of bone cells important in the process of osteoporosis: osteoclasts (bone resorption) and osteoblasts (bone formation). Osteoporosis in women typically starts in their mid-thirties, often 15 years before menopause, with a bone loss of 1 to 1.5 percent per year.
Osteoporosis and Estrogen:
Bone mass in women declines rapidly during menopause. Production of estrogen declines by 40%-60%. Lack of estrogen stimulates production of a substance called interleukin-6, which stimulates growth of osteoclasts, thus increasing bone loss, especially during the first five years of menopause. After this period, the body adjusts to lower levels of estrogen. Estrogen therapy temporarily retards osteoporosis progression, but does not truly prevent or reverse it. However, estrogen therapy does not come without risks. Estrogen therapy alone was found to cause an increased risk of endometrial cancer, and a slightly increased risk of breast and cervical cancers.
Osteoporosis and Progesterone:
Production of progesterone drops to zero at menopause. Lack of progesterone causes a decrease in new bone formation. Progesterone therapy will actively increase bone mass and density and can possibly reverse osteoporosis. Postmenopausal osteoporosis is primarily a disease of bone loss caused by a progesterone deficiency and secondarily a poor diet and lack of exercise. Natural progesterone hormone is an essential factor in the prevention and proper treatment of osteoporosis.
Osteoporosis and Testosterone:
Testosterone helps to retain the calcium hydroxyapatitein the formation of the bone, resulting in good density. Estrogen may slow the bone loss, and progesterone may stimulate new bone formation, but without sufficient testosterone and mineral support, the resulting bone is weak. The use of testosterone for the treatment of osteoporosis is not FDA approved.
Low-density does not equal fragile bones:
Bone mineral density (BMD) refers to the quantity, not the quality of bone. It reveals nothing about the strength, micro-architecture, turnover, size, or shape of bone, all of which are contribute to fragility.
Strontium and osteoporosis:
Strontium is a non-essential trace mineral that is found in minute amounts in the body. It is in the same mineral family as calcium and magnesium, and it has been shown to promote growth of new bone in both animals and people. The largest amounts of strontium are found in spices, seafood, whole grains, root and leafy vegetables, and legumes. Strontium is available in 227mg capsules. However, supplementation with strontium does not mean you need less calcium. Always use more calcium than strontium.
A key to hormone balance is the knowledge that when estrogen becomes the dominant hormone and progesterone is deficient, the estrogen becomes toxic to the body (listen to your body). A saliva hormone test should be done to confirm these symptoms.Osteoporosis Treatment Program:
Bone Mineral Density measurements: Get a BMD measurement at baseline before treatment and every 2-3 years thereafter if low density.
Diet: Eat a healthy, low protein, balanced diet which includes the minerals and nutrients listed below. Protein should not exceed 20% of daily caloric intake. Avoid smoking and excessive alcohol consumption.
Calcium: 1200mg daily, mostly by diet. Supplements should be taken at bedtime when they are best absorbed. Calcium may also aid in sleep. Increase the amount of calcium you take by 25-50% if you take a thyroid hormone or an anticoagulant drug.
Vitamin D: Blood levels of 25-hydroxyvitamin D should be at 65ng/mL. An adequate amount of vitamin D should be taken to reach this blood level. Although the quantity of vitamin D necessary to reach this level varies from person to person, most people need 6,000-10,000 IU to reach this level (new 2010). Vitamin D improves calcium absorption, a well as providing many other health benefits. (more information available at www.grassrootshealth.net)
Vitamin C: 2000mg daily. Enhances immunity and aids in proper bone growth helping to build up collagen.
Beta-carotene: 15mg daily. Improves immune function and promotes proper bone growth.
Vitamin B Compex: 50mg three times daily. Involved in energy production.
Folic Acid, Vitamin B6 and Vitamin B12: folic acid- 400mcg daily, B12- 300mcg daily, B6- 25 to 100mg daily. Important in the conversion of the amino acid methionine to cysteine. If a person is deficient in these vitamins, there will be an increase in homocysteine level. High homocysteine levels in menopausal women have been associated with an increase in bone loss.
Vitamin K2 –Use Tri-K once to three times per day with a fatty meal. Used to solidify calcium into the bone matrix.
Zinc: 15-30mg daily. Promotes a healthy immune system. Zinc helps make collagen which forms the foundations of the bone. Zinc helps vitamin D absorb calcium. Zinc is needed for the proper formation of osteoclasts and osteoblasts, the two cells which are essential for bone turnover
Magnesium: 500-1000mg daily, mostly by diet. Helps in metabolizing calcium and vitamin C and helps to convert vitamin D to the active form necessary to ensure that calcium is efficiently absorbed by your body.
Strontium: 227mg three times daily or 227mg daily for preventive measures (new 2003).
Boron: Improved the metabolism of both calcium and magnesium. Research conducted by the US Department of Agriculture demonstrated that giving post-menopausal women a short course of 3mg boron supplements daily resulted in a 44 percent reduction in the amount of calcium excreted in their urine. Boron is found in alfalfa, kelp, cabbage and leafy greens.
Progesterone: natural, topical applications twice daily. Applied 21-25 days per month is postmenopausal or the two weeks before menses if not menopausal. Increases BMD. Check progesterone level periodically.
Estrogen: Indicated for vaginal dryness or hot flashes in postmenopausal women. May use low-dose natural bi-estrogens as prescribed by a physician.
DHEA: supplementation helps increase bone strength.
Exercise: Performing weight-bearing exercises 20 minutes daily or 30 minutes three times per week helps to maintain bone mass.
References:
1. Dr. John R. Lee. What Your Doctor May Not Tell You About Menopause. Chapter 12. Hormone Balance and Osteoporosis.
2. Dr. Jonathan Wright. Nutrition and Healing. Vol 10, Issue 2, February 2003.
3. James F. Balch, MD and Phyllis A.Balch, CNC. Prescription for Nutritional Healing, 2nd Edition.
4. Integrative Medicine Access. Osteoporosis.
5. Dr. Marily Glenville. The Natural Health Website for Women. Osteoporosis.
6. Robert Listecki, Pharmacist. Glen Ellyn Pharmacy, 486 Roosevelt Road, Glen Ellyn, IL 60137. Tel (630) 469-5200.
7. Jim Paoletti, Pharmacist. ZRT Laboratories.
8. Loredana Badulescu, RPh, PharmD candidate, Midwestern University, 2002.
9. Rachel Baker, PharmD candidate, University of Illinois at Chicago College of Pharmacy, 2010.
Progesterone and Bone
Lee JR. Osteoporosis reversal; the role of progesterone. International Clinical Nutrition Review 1990;10(3):384-91. Transdermal progesterone supplementation with and without conjugated estrogens was evaluated in a clinical setting using 100 women aged 38 to 83 years. The average time from onset of menopause was 16 years. 63 women were followed for three years with dual photon absorptiometry. Treatment also included dietary changes, nutritional supplements, and exercise. All individuals followed showed an increase in bone mineral density over the three years, with the greatest increase occurring in the first year. There was no difference noted between estrogen/progesterone and progesterone only groups. Subjective changes included increased libido, diminished hot flushes, reduced joint pain, and increased mobility and energy. No side effects were noted during treatment protocol.
Liang M, Liao EY, Xu X, Luo XH, Xiao XH. Effects of progesterone and 18-methyl levonorgestrel on osteoblastic cells. Endocr Res . 2003 Nov;29(4):483-501.
The authors evaluated in this study the effects of progesterone (P4) and levonorgestrel (LNG) on markers of bone growth, utilizing normal human osteoblasts as well as the osteosarcoma cell line, MG-63. Their study found that, compared with placebo, both P4 and LNG increased the proliferation and differentiation of human osteoblasts through osteocalcin gene transcription.
Prior JC, Vigna Y, Alojado N. Progesterone and the prevention of osteoporosis. Canadian Journal of Obstetrics/Gynecology and Women's Health Care 1991; 3(4):178-84. In this review article, the authors propose that cyclic progesterone both prevents bone loss and acts as a bone-builder. The studies discussed focus on abnormal menstrual cycles as an important risk factor for osteoporotic fractures. Their conclusion is that the first step in preventing osteoporosis is treating ovulation disorders.
Prior JC, Vigna YM, Schecter MI, Burgess AE. Spinal bone loss and ovulatory disturbances. New England Journal of Medicine 1990; 323:1221-7. A review of the available data indicates that progesterone acts to promote bone metabolism. It appears to be independent of estrogen by either acting directly at progesterone receptors, or indirectly through competition at glucocorticoid receptors in the osteoblasts.
Lee JR. Osteoporosis reversal; the role of progesterone. International Clinical Nutrition Review 1990;10(3):384-91. Transdermal progesterone supplementation with and without conjugated estrogens was evaluated in a clinical setting using 100 women aged 38 to 83 years. The average time from onset of menopause was 16 years. 63 women were followed for three years with dual photon absorptiometry. Treatment also included dietary changes, nutritional supplements, and exercise. All individuals followed showed an increase in bone mineral density over the three years, with the greatest increase occurring in the first year. There was no difference noted between estrogen/progesterone and progesterone only groups. Subjective changes included increased libido, diminished hot flushes, reduced joint pain, and increased mobility and energy. No side effects were noted during treatment protocol.
Liang M, Liao EY, Xu X, Luo XH, Xiao XH. Effects of progesterone and 18-methyl levonorgestrel on osteoblastic cells. Endocr Res . 2003 Nov;29(4):483-501.
The authors evaluated in this study the effects of progesterone (P4) and levonorgestrel (LNG) on markers of bone growth, utilizing normal human osteoblasts as well as the osteosarcoma cell line, MG-63. Their study found that, compared with placebo, both P4 and LNG increased the proliferation and differentiation of human osteoblasts through osteocalcin gene transcription.
Prior JC, Vigna Y, Alojado N. Progesterone and the prevention of osteoporosis. Canadian Journal of Obstetrics/Gynecology and Women's Health Care 1991; 3(4):178-84. In this review article, the authors propose that cyclic progesterone both prevents bone loss and acts as a bone-builder. The studies discussed focus on abnormal menstrual cycles as an important risk factor for osteoporotic fractures. Their conclusion is that the first step in preventing osteoporosis is treating ovulation disorders.
Prior JC, Vigna YM, Schecter MI, Burgess AE. Spinal bone loss and ovulatory disturbances. New England Journal of Medicine 1990; 323:1221-7. A review of the available data indicates that progesterone acts to promote bone metabolism. It appears to be independent of estrogen by either acting directly at progesterone receptors, or indirectly through competition at glucocorticoid receptors in the osteoblasts.
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