|
TREATMENT FOR OSTEOPOROSIS-OSTEOPENIA Written by Dr. Deborah Baker © 2006-2010 With Information from Michael Rae, Researcher Extraordinaire,
It is not just a case of calcium and Vit. D to be considered when thinking about osteoporosis. There are probably about 2 dozen nutrients and hormonal interplays needed to support the matrix of the bone tissue. This is a life-long project. A better bone mass before menses begin in the case of women makes for a much better chance of avoiding osteoporosis in later years. Get enough calcium. Current "official" recommendations suggest an intake of 1000 milligrams of calcium for younger adults, and 1200 milligrams for people over the age of 50. Some evidence suggests that a still higher intake (1300-1600 milligrams) of calcium is more effective for lowering fracture risk in the elderly. But these numbers are your total calcium need. The more calcium you get in your diet, the less you need from supplements. There is little evidence that ever-higher intake of calcium does your bones any additional good, and indeed taking too much calcium can inhibit the absorption and utilization of other important bone nutrients, such as zinc and copper
Even a total daily calcium intake of 3000 milligrams of calcium from conventional sources isn't enough to stop bone loss, let alone turn the decline around. You simply can't force the bones to take in more calcium, and build more bone, by taking more and more calcium: the mineral itself can only support your existing bone mass, or the building of bone induced by the other factors in your skeletal health program. But there is one seeming exception. The best calcium supplement is ossein microcrystalline hydroxyapatite complex (MCHC) which consistently halts, or even reverses, bone loss in controlled human trials. When put head-to-head against other calcium supplemental forms, MCHC consistently trumps the conventional calcium supplement. But actually, this is the exception that proves the rule, because MCHC's bone-building powers do not lie in the calcium itself. True MCHC is not just a form of calcium, but is a calcium-based crystalline nutrient complex, which is how the mineral is actually stored in your bones. Supplements do exist which contain "calcium hydroxyapatite" which lack this crucial nutrient matrix, either because the "calcium hydroxyapatite" is not derived from bone but from chemical synthesis (this is also known "calcium orthophosphate"), or because it uses bone meal, which is heat-treated ("ashed"), breaking down the MCHC crystalline structure and destroying the non-mineral components of the complex. But these supplements, even though they contain the same chemical form of calcium, fail to reproduce the unique effects of MCHC on parameters of bone health. Thus, the unique support for bone health provided by MCHC is probably due to a combination of its intact crystalline structure, and the vibrant blend of peptides,(small proteins) mucopolysaccharides, and growth factors which accompany the calcium in true MCHC supplements - factors which are not present in conventional calcium supplements, in bone meal, or in synthetic hydroxyapatite. The bottom line is that the effects of MCHC derive from the whole supplement, and not just from its calcium content. Unfortunately, of course, vegetarians cannot consume MCHC because it is an animal product (although premium MCHC supplements (like Cal Apatite Plus)use free-range, pasture-fed livestock from countries like New Zealand or Australia as sources for the raw materials). For vegetarians, the best calcium supplement is calcium citrate-malate. Calcium citrate-malate is not the same thing as calcium citrate, or as a simple admixture of calcium citrate and calcium malate. Calcium citrate-malate is prepared in such a way that a significant number of its calcium atoms are bound to both citrate and malate molecules at once. This unique form makes calcium citrate-malate six to nine times more easily dissolved in the stomach than plain calcium citrate. This superior solubility may be at least part of the reason for the fact that calcium citrate-malate is considerably better-absorbed than calcium citrate. In fact, despite what is often said, nearly all studies have reported that plain calcium citrate is actually no better absorbed than calcium carbonate when taken with food. Most studies find that about 22 to 26% of calcium from calcium carbonate or citrate is absorbed, whereas calcium citrate-malate absorption is consistently found to be around 36 to 37%% in capsules and tablets and can be as high as 42% when dissolved in orange juice. How Rumors Get Started The widespread myth of calcium citrate's superior absorption is in part the result of poorly-designed studies, which used calcium excretion as a measure of absorption. The reasoning for using this method is based on the fact that, once your body has used all of the calcium which it can at the time that a dose of calcium is taken in, any extra calcium initially absorbed will then be passed out in the urine. Thus, by giving a dose of calcium so high that the body can't use it all, and then measuring how much calcium passes out through the urine, the comparative bioavailability of two calcium forms can in theory be gauged by seeing how much calcium excretion they cause. That's a sensible-sounding and inexpensive testing method, and in many cases it probably gives a good picture of calcium absorption. But it falls down in comparing calcium citrate with the carbonate salt. First, the alkalinizing effect of the carbonate reduces the amount of calcium excreted through the urine, making its absorption look lower; and then, some studies suggest, the citric acid in calcium citrate increases the body's excretion of calcium, making its absorption look higher! Faith in calcium citrate's higher bioavailability was also shored up by a recent "meta-analysis" paper. Meta-analysis is done by combining the results of several separate studies into one mondo-report, which gives a clearer picture of the overall results of the available scientific evidence. But the authors of this meta-analysis made one critical mistake: in combining studies, they assumed that calcium citrate was basically the same as calcium citrate-malate, and lumped the results for the two forms together. In fact, of course, the two forms are considerably different. By combining studies on calcium citrate with studies on the much more bioavailable citrate-malate form, the citrate salt aquired an undeserved glitter, reflected from citrate-malate's radiance. On the other hand, the hype surrounding so-called "ionic coral calcium" is not the result of understandable errors in otherwise solid science, but of a lack of even the most elementary scientific credibility. Not one clinical trial has ever been performed using this calcium source to show that it is better absorbed or better utilized than other conventional calcium sources. Instead, astoundingly, the claims of high bioavailability for "coral calcium" are not based on controlled studies in humans, but on the stuff's ability to dissolve in water; and as has been shown, such a silly test bears little relationship to the ability of a living body do absorb calcium.34 Indeed, this kitchen-counter method of testing absorption leads to ridiculous exaggerations of calcium absorption, such as 50% absorption for calcium citrate, or 95% absorption for "coral calcium" itself. In the real world, no calcium source has such a high bioavailability. Calcium citrate-malate has been used successfully in many controlled trials to support bone mass and/or to lower fracture risk. Some of these trials have involved a direct face-off between calcium citrate-malate and other forms of calcium. Such trials demonstrate that, as might be expected from its greater bioavailability, calcium citrate-malate gives better protection to the bones than other vegetarian calcium sources - although its effects are still not as impressive as those of MCHC. Cal Matrix: This formulation adds extra nutrients and herbs for not only bone quality but also for those who suffer from joint degeneration. Cal Matrix Stomach Acid: Calcium must be ‘ionized’ for absorption by the stomach acid naturally present in the gastric environment. The problem is that about 40% of adults at midlife are low in gastric acid. Calcium carbonate is the most common form of calcium supplement and it is the hardest for the stomach to ionize even when normal levels of acid are present. Therefore studies show that at that time of life and later only about 2% of calcium carbonate is absorbed. Vitamin D: **UPDATED INFORMATION**
More recent studies have indicated that up to 70% of adolescents and adults have Vit D levels lower than 40 ng/ml...and anything below 35 ng distinctly reduces calcium absorption from the intestines. Cardiovascular problems occur more in the winter and at higher and lower altitudes indicating that Vit D has a protective function here. People with levels of 25ng or more over the 36ng level had half as much chance of having heart attacks. Other health benefits of higher Vit D levels in other studies were: -better maintained and lower blood glucose levels and hence insulin response..lowering one's chance of developing adult onset diabetes. -80% lower chance of developing colon cancer. -much lower rates of knee and hip arthritis. -the lowest rate of periodontal disease occurs in people with Vit D levels over 40 ng/ml. -nursing mothers need 4,000 IU of Vit D per day.....NOT the recommended 400 IU. Its no wonder science tells us that most mother's milk is low in Vit D....the mothers are! Indeed, the whole reason that our milk is now fortified with vitamin D is that rickets (degenerative bone disease caused by vitamin D deficiency) was epidemic in children in the Northern United States at the turn of the twentieth century - when kids spent a lot more time out-of-doors than do today's adults. There's a good reason for this: studies in human skin suggest that the amount of sun to which a person in Boston or Edmonton is exposed in the winter is not enough to make the body produce the vitamin. But even in sunny Spain, researchers have found that 80% of children have inadequate vitamin D levels in March and October, and the situation is much the same in France. From what we now know, the old RDA of 400 IU will not protect you from vitamin D deficiency except in the sunniest of climates. A controlled trial in teen and preteen girls in Finland showed that a 400 IU vitamin D supplement was not enough to keep serum levels of the active vitamin above the cutoff for insufficiency, and studies in the health of large populations confirm the finding in Canadian and Danish women lead to the same conclusion. More importantly, the use of standard 400 IU supplements have not been shown to reduce fracture rates, , and even 600 IU has little effect on BMD. Vitamin D Overdose:So how much vitamin D do you need? How much is vitamin D overdose? For optimal bone health - as opposed to simply avoiding a case of obvious rickets - scientists are now suggesting that the proper test is to see how much of the vitamin it takes to minimize the elevation of parathyroid hormone, which as we've noted leeches calcium from the bones when serum calcium levels are low. To reach this target, doses of as much as 4000 IU per day are recommended by some legitimate authorities,63 and such doses have been used successfully and with apparent short-term safety to achieve the goal. But it's premature to start using this high a dose: for one thing, taking this much vitamin D may be toxic when taken in the vegetarian form of ergocalciferol (vitamin D2) - although apparently not when you use cholecalciferol (vitamin D3 - the animal-sourced form).63 But clinical trials show that we don't need to self-experiment with these massive doses to get results. Controlled studies show that vitamin D, together with calcium, helps to reduce the risk of fracture at a dose of 800 IU per day. However, in the case of osteopenia or osteoporosis, I do start people on Vitamin D3 5000 IU for the first 3 months at least and then drop down to the Vitamin D3 1000 IU. There is a very intricate process in place in your body for the conversion and production of Vitamin D to occur in your skin, liver and kidney Skin + Sunlight Þ 7-Dehydrocholesterol Þ D3 (cholecalciferol). D3 to Liver then Converted to 25-Hydroxycholecalciferol (which is 5x more potent than D3) 25-HDCC to Kidney then Converted to 1,25-Dihydroxycholecalciferol (which is 10x more effective as D3). Buy Vitamin D3 - 5000 IU.....US Only..Here Vitamin D3 - 1000 IU - Canada..Here Now we look at a dynamic which rarely looked at when assessing the osteoporotic patient. Do they have any kidney or liver dysfunction. This could include things such as nephritis, being on dialysis, mercury toxic load in the kidney and/or liver, hepatitis, cirrhosis, fatty degenerative liver, toxic overload of any type, chronic medication ingestion, etc. If either or both of these organs are compromised, then so is the enhancement of Vitamin D and its metabolites and its ability to assist in calcium metabolism. Calcium is controlled by a hormone called parathyroid hormone from four small glands on the corners of the thyroid gland. If calcium levels in the blood become low, then parathyroid hormone is secreted causing releasing of calcium from the bones. Conversely, if calcium levels in the blood are high, parathyroid hormone is inhibited and calcium will be used for bone, building nerve transmission etc. as needed. The role estrogen plays in bone mass is that as it lowers in life, it makes the osteoclasts, the cells which are responsible for bone breaking down, more sensitive to parathyroid hormone which causes increase breakdown of bones. This results in an increase in circulating calcium for other needs than bone maintenance. Osteoblasts, on the other hand are the cells responsible for building of bone...these are the ones we want to stimulate, particularly in later life to keep bone mineralized and strong. Some of the things we can do follow: Lifestyle Factors: Avoid coffee, alcohol and smoking.
Take a quality Magnesium Supplement You Can Absorb. Magnesium is central to various aspects of bone metabolism, and borderline magnesium deficiency is surprisingly common. Unfortunately, far too many bone health formulas rely on magnesium oxide as the source of this mineral, for the simple reason that it takes up less room in a capsule, and therefore requires fewer capsules to be taken to reach the daily dose. But compared to other sources of the mineral, magnesium oxide has "extremely low" bioavailability (22.8%). Additionally, magnesium oxide is an antacid, which can impair digestion and nutrient absorption. This is an especial concern in many older people, whose low stomach acid may even trigger pernicious anemia (flat-out B12 deficiency). Magnesium citrate is certainly somewhat better, at 29.64% absorption,67 but it's still far from the best magnesium you can choose; and, indeed, much of the supposed "magnesium citrate" on health-food store shelves is not true, fully-reacted magnesium citrate, but a mixture of magnesium oxide and magnesium citrate. Much better absorption is available from other forms of magnesium. Among the available forms of magnesium, fully-reacted magnesium monoaspartate stands out as the best, with a remarkable 41.7% bioavailability. Remember the neglected nutrients. Calcium, magnesium, and vitamin D are very well-known as nutrients with an important place in bone health. By contrast, you may never have heard of the powerful support that Menatetrenone and Strontium can lend your bones before reading this special issue of Advances. But there are a host of nutrients important to bone health which are too often neglected in putting together a total lifestyle program. These would most prominently include manganese, zinc, and copper, and would extend to other, even more commonly-neglected nutrients such as silicon, boron, and vitamin C.68 Methylating nutrients such as vitamin B12 and folic acid may also be important to bone health, perhaps because of the toxic effects of homocysteine on the protein fibers in bone. Boron - 3mg per day decreases urinary excretion by 47% and increases levels of 17-B-estradiol - the most biologically active estrogen, naturally. Boron also activates Vit D in the kidney. We would get enough if we ate 3 vegetable servings and 2 fruits per day (best source of boron) and yet recent surveys show that only 51% of people eat one serving. Do not take all of your calcium at once. Someone who is taking 800mg. per day - if they take it all at once, the absorption rate is about 15%. If it is divided over the day, the absorption can be raised to 40%. The standard of suggesting one consumes 1,000 me per day is based on the fact that 40% is about the max one actually absorbs. Do not use oyster shell, dolomite or bone meal. In 1981 the FDA warned against these forms because of lead content. One brand had as much as 25 mcg/800 mg and 6mcg/800mg or over is toxic for children. Vit B6, Folic Acid and Vit B12 - a depletion of these elements results in an increase in homocysteine which leads to a defective bone matrix or structure. If you would like to ask Dr. Deb. any questions or receive any further information about the professional products found on this site and in our stores, please e-mail to Dr. Deb
|
|
|||||||||
KEEP UP TO DATE ON HEALTH ISSUES..JOIN OUR FREE NEWSLETTER LIST! |
|
Dr. Deb's Alternative Health Sites:
Dr. Deb's Homeopathic Book for Flu and Colds, etc.
|
||||||||
