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Mar 26, 2007 Vitamin D3, also known as cholecalciferol, is the natural form of vitamin D for humans. Vitamin D3 is produced in the skin with sunlight exposure. Vitamin D2, known as ergocalciferol, is a compound produced by irradiating yeast with ultraviolet light. A substantial body of new research documents that vitamin D3 is the preferable form and researchers clearly recommend its use. Vitamin D3 has been found to be at least three times as potent as vitamin D2, is more stable, safe, and useful in the body. The less desirable vitamin D2 has been generally used in prescription vitamin preparations and in food fortification, while the nutritional and health food industries generally use the superior, natural vitamin D form, D3. Dr. John Cannell, vitamin D advocate and founder of the nonprofit Vitamin D Council, speaks of vitamin D3 in the following manner: "If you take ergocalciferol, or "vegetarian" vitamin D, be warned. Ergocalciferol is not vitamin D, but a vitamin D-like patent drug whose patent has expired. It does not normally occur in the human body and is probably a weak agonist at the receptor site, meaning it may actually partially block vitamin D actions. Ergocalciferol is the villan in most of the reported cases of toxicity in the world's literature. All bets are off in terms of measuring blood levels if you take ergocalciferol. Some of the labs can pick it up, and some can't. Don't take ergocalciferol; it is not vitamin D." [Interview with Dr. Cannell in the Townsend Newsletter, November 2006, page 96.] For more details click here for Dr. Alan Gaby's recent summary of the new research comparing vitamin D2 and D3.
Apr. 2, 2007
April 16, 2007 Yes, you can use a simple urine or blood test known as a "marker of bone resorption" to see if you are breaking down bone too rapidly. In most cases a high rate of bone breakdown indicates that there is an on-going loss of bone mass. The bone resorption markers most commonly used are the urine NTx Osteomark marker and the urine deoxypyridinium cross-links. Your physician can order either of these tests. Generally an NTx score in the below-40 range or a deoxypyridinium cross-links score of 4 or below indicates stable bone mass. In both tests, the higher the number, the greater the likelihood of a more rapid rate of on-going bone loss.
April 23, 2007 In the U.S. and other industrialized countries, osteoporosis and bone fragility are more common among men than commonly thought. For example, in the U.S. and Canada one in eight men over 50 years of age have osteoporosis as defined by their low bone density. This compares to one in four women of the same age group. As for osteoporotic fragility fractures, men suffer about half as many spine and hip fragility fractures as women. Also, while men suffer fewer fractures, their risk of a subsequent fracture after the initial fracture is much higher than a woman's risk of repeat fracture. Further, men who fracture a hip are less likely to enjoy long-term survival than are women who fracture a hip.
May 7, 2007 The lowest calorie, wholesome beverage is spring water with high mineral content, such as the European “mineral waters.” Juices made of alkalizing vegetables like kale, collards, celery, bok choy, parsley, lettuces, cabbage and the like are also potent alkalizers containing relatively few calories. In addition, the “acid-tasting” juices of lemons and limes are transformed through metabolism to alkalizing agents. Thus, the juice of a whole lemon or a whole lime mixed in cold or hot water is an excellent beverage which aids in alkalizing. Equally, 1-2 tablespoons of apple cider vinegar mixed in water, with or without a bit of honey, helps to alkalize and improve digestion. Tea made from fresh ginger root is another favorite low calorie alkalizing and detoxifying beverage.
May 14,2007 Yes, studies show in several ways that stress weakens bone. For example, depressed people frequently have lower bone density and severely depressed folks have almost a doubled risk of hip fracture as compared to the non-depressed. Equally, worry tends to weaken bone and it has long been known that emotional stress leads to an increased loss of calcium in the urine. A bone-depleting rise in blood cortisol appears to be one of the mechanisms by which stress and negative emotions weaken bone.
May 21, 2007 Activated vitamin D is a hormone of great importance to muscle and a lack of vitamin D leads to muscle weakness and an increased tendency to fall. Numerous studies now document that supplementation with even 800 IU of natural vitamin D3 can reduce the risk of falling among the elderly. While research results vary according to populations studied, I have seen reports of anywhere from a 22% to a 70% reduction in falls with modest 800 IU daily vitamin D supplementation.
June 18,2007 While we think of calcium from dairy products and vitamin D as the major bone builders, abundant research now shows that vegetables, particularly green vegetables, are also essential for optimum bone health. Most vegetables, and certainly green leafy vegetables, help keep the body in a good acid-alkaline balance and that's important to bone. Also important is the fact that green leafy vegetables are an excellent source of vitamin K1. Vitamin K status is independently associated with fracture risk, whether one's bone density is high or low. Higher blood levels of vitamin K are clearly associated with lower fracture risk. Vitamin K is a nutrient that helps calcium adhere to the bone protein matrix. Interestingly enough, as we will discuss in the near future, one specific form of vitamin K known as MK-7 is particularly beneficial to bone and has been shown also to reverse arterial calcification. Thus, we see that vitamin K, and specifically MK-7, is the key nutrient that keeps calcium in the bones and out of the arteries. For more information on vitamin K and bone, click here for a special report on MK-7.
June 25, 2007 According to recent studies, this indeed appears to be the case.
For many years it has been noted in large US surveys that depressed people had a substantial 70% increased risk of hip fracture. It was often thought that the high cortisol levels associated with depression might be part of the reason for the increased fracture risk. Now the large CAMOS 5-year Canadian osteoporosis study has found that use of anti-depressants known as serotonin reuptake inhibitors (SSRIs) was strangely associated with increased fracture risk. Individuals using these medications, such as Prozac, Zoloft, and Paxel, for five years or more had twice the risk of osteoporotic fracture than those not using these drugs. Further hip bone density was 4% lower and spinal bone density 2.4% lower in those who used anti-depressants as compared to non-users.
(Reference: David Goltzman, Archives of Internal Medicine, Jan. 23, 2007.)
July 2, 2007 Interestingly enough, the answer is yes. To uncover this, calcium guru, Dr. Robert Heaney, and colleague, Dr. Barger-Lux, at Creighton University, looked at the bioavailability of eight different formulations of calcium carbonate. The absorbability of each product was compared to plain calcium carbonate that had been prepared without added pharmaceutical ingredients. Through careful studies of actual calcium absorption they discovered that six of the eight forms of calcium carbonate were substantially less well absorbed than the pure calcium carbonate. One provided less than half the calcium it was labeled to deliver! The study shows that the formulations and additives like fillers, binders, colors, and other ingredients can substantially reduce the absorption and value of a supplement.
July 10, 2007 A recent meta-analysis of studies from all over the world found that smoking is associated with an increased risk of hip and other osteoporotic fractures in both men and women. After adjusting for age and weight, the risk of hip fracture, for example, was 55% higher in smokers than in non-smokers. (Ref.: Kanis et al., Smoking and fracture risk: A meta-analysis, Osteoporosis International, vol. 1, issue 2, pp. 155-162, Feb. 2005.)
July 17, 2007 The data clearly suggest that it is not! According to the data collected by the USDA (U.S. Dept. of Agriculture), today we would need to eat five apples to get all the same nutrients that one apple contained in 1965. The same USDA data reported significant loss of minerals in both vegetables and fruits between 1940 and 1991. Some of the mineral reductions in vegetables and fruits were reported as below.
(Mineral Reductions from 1940 to1991) Vegetables Fruits Potassium -16% -19% Magnesium -24% -16% Calcium -46% -16% Zinc -59% -27% Copper -76% -20% Iron -27% -20% Sodium -49% -29%
And how do we account for these food mineral losses? Modern farming methods have led to an amazing mineral depletion from agricultural soils all over the world. As reported from the 1992 Rio Earth Summit, over the last 100 years there has been a disappearance of 72% of the minerals in the agricultural soils of Europe, a 76% loss in Asia, and an 85% loss of soil minerals in North America.
July 24, 2007 A recent British study asked just this question and found a significantly increased risk of fracture among those using acid blockers (proton pump inhibitor medications). Specifically, those using higher doses of acid blockers for more than a year had a 250% increased risk of hip fracture than non-users. Even modest doses of acid blockers used regularly for 1–4 years increased the risk of fracture by 20–60%. (Ref., Metz, Journal of American Medical Association, Dec. 27, 2006.)
Aug. 8, 2007 Apple cider vinegar tastes acidic because of its malic acid content. However, when apple cider vinegar is metabolized by the body its malic acid is converted into a weak base capable of removing acids from the body. Thus, when we consume apple cider vinegar and it is metabolized by the body, it actually turns out to be an alkalizing agent. Remember here we are talking about apple cider vinegar and not white vinegar, rice vinegar, or even balsamic vinegar. The latter three have different chemical compositions and are indeed acid forming even after being processed by the body.
Aug. 23, 2007 Oxalic acid is found mainly in certain plants, with foods like spinach, rhubarb, Swiss chard, and beet greens having relatively high levels of this acid. Oxalic acid is a strong organic acid which combines with calcium to form a relatively insoluble calcium oxalate. Thus it is thought that oxalic acid would limit calcium absorption. Generally the calcium which comes from foods that are high in oxalic acid is poorly absorbed. If the food has a small amount of oxalic acid, it is not likely to affect the calcium absorption from that food. For example, calcium absorption from low-oxalate Chinese vegetables (Chinese mustard greens and Chinese cabbage flower leaves) was comparable to that of milk. The calcium absorption from sweet potatoes, which have a moderate amount of oxalic acid, was less than half that from milk. What this means in a practical sense is that if you eat spinach or rhubarb, which are high in oxalic acid, you cannot depend on having the body absorb the calcium from these foods. If a food has a moderate oxalic acid content, like sweet potatoes, you will be able to absorb some but not all the calcium from that food. There are some alkalis in foods like sweet potatoes that have a significant amount of oxalic acid, but they are nonetheless still alkalizing overall and good for you. Perhaps the most important point to remember is not to depend on the calcium from high oxalate foods. Oxalic acid can be a problem if taken in large amounts as it can react with minerals such as calcium in the bladder to form kidney stones. This is not normally a problem unless an individual is eating large amounts of food high in oxalic acid or has a predisposition to form kidney stones. Sept. 4, 2007 I have some questions about molds on my lower back. I started the Alkaline Food Program and my urine tested at 7. Would it hurt me to try for a pH level of 8? I'm not sure if the mole is cancer, but I read somewhere that cancer is dormant at 7 and will die at 8.5 pH. First of all, if you have a mole that is of concern you should certainly see your physician or a dermatologist, for a mole that might be cancerous is extremely serious and should not be self treated. As for the pH issue, we do not strive for a pH of 8.5 in any situation. What we have found to be the ideal urine pH measurement is a level between 6.5 and 7.5 when measured in the first-morning urine after at least six hours of rest without urinating. According to our research and that of Dr. Russell Jaffe, this is the best and most valid simple measurement of pH. The first-morning urine pH after at least six hours sleep (without urinating) is what we call the “equilibrated” urine pH. This “equilibrated” urine pH measurement gives us a rough approximation of mineral status within the body and a measurement between 6.5 and 7.5 in such an equilibrated urine is ideal. Such first-morning urine of 8 or above is considered to be problematic and not desirable. For more information on this you might look at Dr. Brown’s recent book, The Acid Alkaline Food Guide.
Sept. 11, 2007 Ipriflavone is a synthetic flavonoid that has some estrogen-like characteristics. It is used in Italy, Hungary, and Japan as a drug for the treatment of osteoporosis. A recent large clinical trial suggested that it was ineffective at building bone density and preventing fractures, although other smaller studies have suggested that it has some value in the treatment of osteoporosis. For our in-depth analysis of Ipriflavone, and for the European guidelines on its use as an osteoporosis drug, click here. One of the things you will note in our analysis is that Ipriflavone has been found to decrease significantly the white blood cells known as lymphocytes in about 13% of the people who use it. When this happens a person should stop using Ipriflavone. Thus if you are using Ipriflavone you should have your doctor do a complete blood count and check your white blood cell lymphocyte level from time to time. For complete details on how the Europeans use and monitor this drug see our report mentioned above. Our website and our work are dedicated to natural ways of rebuilding bone health. Our programs are not only good for bone but good for the entire body. If you are interested in a more natural bone building program, you might read our book, Better Bones, Better Body and consider a telephone consultation with Dr. Susan Brown.
Sept. 18, 2007 Some studies now suggest that there is indeed a link between diabetes and the risk of osteoporotic fracture, particularly in older women. There are likely many reasons for this association, but one is probably that most diabetics tend towards an acidic condition and this causes bone loss. Interestingly enough, the diabetic medications may also be contributing to bone problems. For example, a recent study looked at the new diabetes drug known as Avandia. When this drug was used for only 14 weeks it resulted in a 1.9% decline in total hip bone density. At the same time the placebo group had no change in bone density. There was also a loss in spinal bone density amongst those who used Avandia. This bone loss is especially interesting because it occurred with only 14 weeks of drug use. (Grey, A. et al., Journal of Clinical Endocronology & Metabolism, Jan 30, 2007.)
Oct. 26, 2007 It is true that as we age there develops a reduced ability of the skin to synthesize vitamin D3 from sunlight exposure. In fact, it is reported that a 70-year-old produces approximately 4 times less vitamin D via skin synthesis as compared with a 20-year-old. Thus it is extremely important that we have our vitamin D levels checked as we age. Even though we may be getting good sunlight exposure, we may not be producing enough vitamin D and may need to depend more highly on vitamin D supplements. Nov. 20, 2007Can you give me some specific details on how low levels of vitamin D might impact my calcium absorption? In a vitamin D deficient state, the small intestine absorbs no more than 10% to 15% of the dietary calcium consumed. On the other hand, if you have adequate vitamin D you're able to absorb 30% to 40% of the calcium you consume. Specifically, calcium expert Dr. Robert Heaney from Creighton University has found that individuals with a vitamin D level averaging 34ng had a 65% greater calcium absorption than those with a vitamin D level averaging 20ng (Heaney et al., 2003, “Calcium Absorption Varies within the Reference Range for Serum 25 Hydroxyvitamin D,” Journal of the American College of Nutrition, vol. 22, no. 2, 142-146).
Dec 12, 2007 No, it is not a problem. Keep drinking your apple cider vinegar with the spring water. Both are good for your bone. Apple cider vinegar helps to alkalize, reduces inflammation, and enhances digestion—all of which favor bone. For more information on why alkalizing your body pH helps bone, and how an acid tasting food like apple cider vinegar helps to alkalize, see my book, The Acid Alkaline Food Guide. Oh yes, and taking the apple cider vinegar in a cup of hot water with a bit of honey before meals will also help to increase your natural hydrochloric acid production, thus enhancing digestion.
Jan. 3, 2008 You ask a very interesting question, which is essentially, how do we really know how many people experience an osteoporotic fracture? It is not an easy question to answer because many people suffer “silent” spinal fractures that are never reported to physicians. In fact, it is estimated that two-thirds of all spinal fractures are undiagnosed; thus, they never enter into the official statistics (Cooper and Melton 1992). For example, my father at age 85 was in a car accident and it was incidentally discovered on x-ray that he had had two previous spinal fractures in his upper back. He had never noticed any pain, nor had any reason to think there might be a spinal deformity. Even now at age 98 he has no back pain, but has lost several inches of height. Equally, many rib fractures are never reported. What we do know about, however, are most, but not all, of the hip fractures that occur. The total number in the US is held to be over 300,000 a year. Some hip fractures, however, do slip by the statistics, such as the one experienced by my grandmother. At the age of 101, she fell in the bathtub and fractured her hip. She refused to go to the doctor and said that she “had taken care” of her two sons for a hundred years and they should now take care of her. She went to bed and remained there for one year to the day, at which point she died in her sleep. So groups like the National Osteoporosis Foundation have made it their business to estimate how many osteoporotic fractures do occur. Their statistic is that one half of women age 50 and older will experience one or another osteoporotic fracture during their lifetime. Here’s a link to that statistic on their website: www.nof.org/diseasefacts.htm . They also report that one in four men over the age of 50 will also have an osteoporotic fracture in their remaining lifetime. Granted it is in the best interest of the National Osteoporosis Foundation to seek out the highest possible fracture statistic estimates, and they likely include a great many inconsequential spinal vertebral fractures that were never noticed by the people experiencing them. In my estimation of fracture incidence, I tend to include only fractures of significance and do not pay much attention to the undiagnosed spinal vertebral fractures. In this sense it is probably fair to say that 30% of US Caucasian women will experience one or another meaningful osteoporotic fractures in their lifetime. For example, looking at spinal fractures alone, I would mention a recent 15-year study looking at 2,700 US Caucasian women. At the onset of the study the average age was 69. Over the next 15 years, 18% of these women suffered a spinal fracture. (Cauley et al. 2007). Finally, the longer you live, the more likely you are to fracture. By the age of 90 about 32% of all females and 17% of all males in the US have experienced a hip fracture (See Susan Ott website: http://courses.washington.edu/bonephys/). (Cooper, C and LJ Melton, Vertebral fracture: How large the silent epidemic? BMJ, 1992; 304:793-94.) (Cauley, Jane et al. Long-term risk of incident vertebral fractures. JAMA, 2007; 298(23):2761-67.)
Jan. 22, 2008 In 2006 and then again in 2007 there were published reports of scientific studies showing a correlation between the use of bisphosphonate osteoporosis medications like Reclast™ and Fosamax™ and the risk of serious atrial fibrillation. Atrial fibrillation refers to heart rhythm problems that can increase the risk of heart attack and stroke. The Reclast™ study included 7,738 postmenopausal women with osteoporosis. Those treated with the drug Reclast™ had more than double the risk for developing serious atrial fibrillation (Black et al. 2006). A second study looked at the Fosamax™ data from the Fracture Intervention Trial. The study published in The New England Journal of Medicine noted that the risk of serious heart rhythm problems could be 50% greater for those taking Fosamax™ as compared to those using the placebo (Compston 2007).
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Feb 13, 2007 Osteoporosis by itself, that is, low bone density, does not hurt per se. Osteoporosis does not have to imply damage to the bone or inflammation of any sort. Fractures of the bone, however, hurt, as the bone is actually damaged. With a fracture the bone is less able to withstand the stresses put on it and is working to repair itself (that is, it is in a state of inflammation where blood cells and repair nutrients are rushed to the area to break down and recycle the damaged part of bone and, over time, to lay down new bone in that area). The first prescription for fracture pain reduction is to reduce stress on the area—to rest. Second, it is important to provide the bone with all the nutrients it needs to heal itself. These begin with adequate vitamin D (be sure to have your level tested, striving for an ideal 50 ng level). Vitamin C is also essential for proper collagen formation and a key “repair” nutrient. Other important minerals include zinc, manganese, magnesium, copper, and bioavailable silicon (orthosilicic acid, in particular). For a full list of key bone nutrients and suggested doses click here.
Feb. 27, 2008 This question touches on many important points. Let me address a few of them. For many years estrogen replacement therapy (ERT) was used in osteoporosis. This drug therapy, however, was never said to reverse osteoporosis or to build bone; it was just able to halt bone loss (it is one of the “anti-resorptive” medications). Most importantly, after decades of widespread use there was finally a clinical trial conducted to test the anti-fracture efficacy and safety of estrogen replacement with and without a progestin. This study, known as the Women’s Health Initiative, was halted prematurely due to adverse drug effects. Both the estrogen-only and the estrogen-plus-progestin segments of this study were halted prematurely due to early results showing an increased incidence of stroke, thrombosis, breast cancers, and heart disease. Further, the fracture reduction capacity of estrogen was relatively low, and earlier studies had shown that to get any fracture benefit at all ERT had to be taken from menopause and continued for life. Here the problem is that the longer estrogen is used, the greater the risk of adverse impacts. So all in all, the data is quite clear that ERT is too dangerous and of too low a benefit to use for fracture prevention (for more details see my book Better Bones, Better Body). As for the scope of your actions to correct osteoporosis, I suggest you cast a broader net and work in the full 19 key nutrients (for example, calcium alone without magnesium, vitamin D, and vitamin K is of little value and can even be harmful), strength training, stress reduction, an alkaline diet, and all the points of my 10-step Better Bones, Better Body Program.™ Finally, if for any reason you decide to use an estrogen patch and you have a uterus, the drug should always be accompanied by progesterone to reduce the risk of estrogen-induced endometrial cancer.
Mar 12, 2008 According to an analysis done by the American Academy of Rheumatology Task Force on Osteoporosis, 4 million cases of osteoporosis in the U.S., or 20% of the total number, are attributable to corticosteroid use (American College of Rheumatology Task Force on Osteoporosis, Guidelines Arthritis Rheum, 1996;39:1791-1801). |
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