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A newborn baby has 280 bones, throughout childhood many of these bones fuse together, resulting in a total of 208 bones in adults. Composed of water (10-20%), minerals (70%), and collagen (10%), bones are their strongest when a person is between the ages of 25 and 35. Keeping them healthy is vital.
Preventing bones from thinning is crucial for maintaining health. Osteopenia and Osteoporosis">Osteoporosis">Osteoporosis">Osteoporosis">Osteoporosis">Osteoporosis">Osteoporosis are conditions diagnosed by a doctor when one’s bone density is thinner than expected for a person’s age. For many, bones thin as one gets older. However, there are things that can be done to help ensure bones remain strong and reduce a person’s chance of breaking a bone.
Bones have more functions in the human body than you might realize. Here's just some of what they do:
Osteoporosis affects more than 75 million people in Japan, Europe and the United States and is estimated to affect more than 200 million people worldwide. Before a person develops osteoporosis, they have a condition called osteopenia, where the bones are thinner than normal but not as thin as those with osteoporosis.
If a person is deemed to be “at risk” for thin bones, a doctor may order a bone density test, a type of x-ray that determines the bone’s density. A bone density test is usually recommended for certain individuals:
Women age 65 years of age or older
Those with osteoporosis are at increased risk of bone fracture. The most commonly seen is a hip fracture, which frequently occurs after an accidental fall. Almost weekly in my private medical practice, I admit a patient to our local hospital after they sustain a hip fracture. In most cases, the patient has lost their balance and fallen.
When I admit a patient, I consult a bone specialist (an orthopedic surgeon) who will perform hip replacement surgery. The patient usually stays in the hospital for a few days before being transferred to a rehabilitation facility, where they will receive extra assistance and strength training using their new titanium hip.
Hip fractures can be dangerous and life altering. Studies have shown that anywhere between 14 and 48 percent of those with a hip fracture are at risk for dying within one year of their accident. The importance of strengthening one’s bones to help prevent a fracture cannot be overstated.
Those who are at risk for frequent falls should consider consulting with a physical therapist and may want to consider a “home safety evaluation” by a trained professional. It is not uncommon for a person to fall by stumbling on a throw-down rug or by accidentally tripping over a pet dog or cat. Poor vision or the presence of a cataract in the eye can also increase falling risks.
A person with evidence of osteoporosis or osteopenia should talk to their physician to determine if a blood test is required to rule out other conditions. A blood test that measures alkaline phosphatase can help rule out Paget’s disease, a condition where bones are malformed and weak. Also, a calcium blood test, if low, may indicate poor absorption or poor intake of the mineral in diet. An elevated calcium blood test may indicate a hormone abnormality (an overactive parathyroid gland) in which calcium is being leached from the bone.
A normal calcium blood level does not eliminate the need to take a calcium supplement. A kidney function blood test, complete blood count, magnesium, testosterone level (men) and estrogen level (women), and thyroid tests (TSH, Free T4, Free T3) should also be considered if searching for a cause of thin bones.
There are many diet and lifestyle changes a person can undertake to help maintain bone health. The more proactive one is ensuring proper nutrition and staying active, the healthier one’s bones will be.
Calcium – Ensuring one’s diet is high in calcium-rich fruits and vegetables is important for keeping bones strong.
Vitamin D – Assisting in bone strength is just one of the many health benefits of vitamin D. (Read more about Health Benefits of Vitamin D) Routine blood tests should be done to ensure adequate amounts are being consumed and/or produced. Spending quality time outdoors in nature is also a beneficial way to generate vitamin D.
Magnesium – An adequate intake of magnesium-rich foods, which include green vegetables, is crucial. Magnesium works together with calcium to make bones strong.
Weight-bearing exercise – Performing weight-bearing exercise for a minimum of 150 minutes per week is useful in keeping bones strong. Consider at least 30 minutes a day, five days per week.
Tai Chi – A type of martial art popular in Asia has been shown to help those 65 years and older reduce the risk of falling by 50 percent, according to a study in the Journal of the American Geriatrics Society.
Gut Health – Consuming cultured foods plays an important part in maintaining a healthy gut microbiome. These foods include miso soup, yogurt, kefir and sauerkraut. In addition, a diet rich in fruits and vegetables provides prebiotics, food for gut bacteria, which help good bacteria to thrive.
Pharmaceutical medicines approved by the FDA to prevent and treat osteoporosis include:
Bisphosphonates is the main class of pharmaceutical medicines that can help reverse osteoporosis or osteopenia and rebuild bones. However, some studies suggest that bone quality may be compromised.
The FDA has also approved an intravenous bisphosphonate osteoporosis drug called zoledronic acid (Reclast/Zometa), which can be given every two years for a cost of $1,200. It is usually covered by health insurance if a person has too many side effects when a bisphosphonate is taken in a pill form. However, these drugs are also not without side effects. Some patients may develop an upset stomach or possibly jaw pain or jaw bone death (osteonecrosis). The intravenous formulation has been reported to cause flu-like symptoms and rarely, even kidney damage in some people. Epocrates Online, a physician drug-prescribing database, lists 23 side effects possible when one takes a bisphosphonate medicine.
Due to these side effects, many choose a more natural approach, at least initially. While I do frequently prescribe prescription these medications for osteoporosis and osteopenia, many of my patients frequently consider at least trying alternative therapies first. In most cases, this is very appropriate.
There are many bone health supplements available which contain many of the above vitamins and minerals
Optimal bone health is an important aspect of one’s overall health. A well-rounded healthy diet, in addition to regular weight-bearing exercise, plays an important role in both the prevention and treatment of osteopenia and osteoporosis. Frequently, that is not enough, and nutritional supplements that help ensure adequate protein, vitamins, and minerals are needed for optimal bone strength. If that is not enough, prescription medications should be considered.
References:
By Dr. Eric Madrid, M.D.
