OSTEOPOROSIS

Clinical Risk Factors for Fracture:

1. Age over 70
2. Multiple fractures
3. Smoking
4. Weight less than 125 lbs
5. Prior fragility fracture
6. Maternal hip fracture
7. Frequent falls
8. Sedative use
9. Unable to stand from chair without use of hands
10. Significant visual or neurologic dysfunction

Some Treatment Choices to think about:

VITAMIN K
One of the most scrutinized groups ever is the 85,000 female nurses who took part in "The Nurses Health Study." Researchers have been tracking the eating habits and health histories of these women since 1980. One of the things they've looked at is which participants are more likely to break a bone. Fractures are the classic symptom of osteoporosis.

Since eating animal protein has been linked to osteoporosis, an analysis was undertaken to determine whether meat-eating had an adverse effect on the nurses' bone density. In 1996, researchers reported the results. Nurses who ate 3 ounces of meat or more per day had a significantly increased risk of forearm fracture compared to those who ate less than 2 ounces.

Diets with more vegetables and less meat are higher in vitamin K. A different set of researchers wanted to know if there is a relationship between vitamin K intake and hip fracture in the same nurses. Using 10 years' worth of data on 72,000 participants, they came to the conclusion that the nurses who got the most vitamin K were about a third less likely to get a hip fracture. Those who ate lettuce every day slashed their risk of hip fracture in half compared to those who ate it once a day or less (lettuce is a source of vitamin K). The significance of taking vitamin K was greater than taking synthetic estrogen, which didn't protect the nurses' bone density in this study. Nor did vitamin D. In fact, women who took a lot of vitamin D, but had low intakes of vitamin K, had a doubled risk of hip fracture! While vitamin D increases the amount of bone-friendly osteocalcin, only vitamin K can make it work properly.

Most osteoporosis studies are done on postmenopausal women because this group experiences a dramatic decline of bone density. Vitamin K shows remarkable results against bone loss in this population. In a study from the Netherlands, 1 mg of vitamin K per day for 2 weeks increased a bone building protein (carboxylated Gla) 70- 80% in postmenopausal women, restoring it to premenopausal range. Another study shows that vitamin K slows calcium loss by one-third in people who have a tendency to lose it (including men). In Japan, drugs containing vitamins K1 and K2 are being used to treat osteoporosis. The doses used in Japan are 45 mg a day. For prevention, the suggested dose is to take a vitamin K supplement that provides 8 mg of K1 and 2 mg of K2, i.e., 10 mg of vitamin K a day. To treat osteoporosis, doses up to 45 mg a day of vitamin K1-K2 should be used only if a physician monitors blood coagulation factors to make sure that the vitamin K is not causing blood to over coagulate.

VITAMIN D
Vitamin D enhances intestinal calcium absorption, thereby contributing to a favorable calcium balance. Increased calcium absorption also reduces parathyroid hormone mediated bone resorption. Those who lack adequate exposure to the suns' ultraviolet rays do not get the cholesterol within the skin converted into vitamin D. This population must obtain their vitamin D from food including vitamin D fortified dairy products, fish, eggs, and liver. Individuals with osteoporosis have been shown to have lower levels of vitamin D than people of similar age without osteoporosis. During the winter months, most population groups in the USA are vitamin D deficient. Common dose of 500-1000 iu daily.

THE IMPORTANCE OF EXCERCISE
Exercise is an effective therapy for preventing and treating osteoporosis. Its importance cannot be overstated. A study was performed to evaluate the effectiveness of certain exercises for the treatment of postmenopausal osteoporosis. Both back extension and posture exercises lasting for 1 hour were undertaken twice a week, as well as fast walking exercises for 1 hour 3 times a week. At the end of the study, women who added exercise to their medical therapy increased spinal bone density by 4.4%, while women receiving only bone-restoring medicines showed an increase in spinal bone density of just 1.6%.

CHELATIN THERAPY
Chelation therapy is a nonconventional treatment not yet approved by the FDA for treating atherosclerosis and a number of other diseases. Chelation therapy is available in the United States because the primary ingredient, EDTA, has been approved by the FDA for other uses. In an article by Rudolph, McDonagh, and Wussow, published in the Journal of Advancement in Medicine in 1988, chelation therapy was found to increase bone mineral density. The mechanism is believed to be the pulsing of the hormone, parathormone, which is made by the parathyroid glands and is essential in calcium metabolism. This pulsing probably results in deposition of calcium in the bones.

TOXINS
There is ample evidence that fluoride found in drinking water and toothpaste may contribute to bone destruction. The use of properly filtered water and toothpaste without fluoride is recommended.

ESTRADIOL
Dose of 0.4 mg of estradiol is adequate for the prevention and treatment of osteoporosis. See journal articles.

SUMMARY
The prevention and treatment of osteoporosis depends largely upon several factors:

1. Proper nutritional supplementation with vitamins and minerals, in particular calcium, vitamin D and K.
2. Exercise (weight bearing).
3. Progesterone/bi-estrogen replacement.
4. Consumption of soy extract, providing 110 mg of soy isoflavins.
5. Supplemental DHEA and melatonin.
6. Consider DHEA/testosterone replacement.
7. Consider chelation therapy.
8. Consider drug therapy for high fracture risk patients.
9. Consider taking 10 mg a day of vitamin K for prevention. Do not take vitamin K if you are taking coumadin or other anticoagulant medication. For treatment, take up to 45 mg a day under the care of a physician who monitors blood coagulation factors.