Healthy Bones or Osteoporosis?
It’s more than just bone density! (part 1)
by Carole Tashel, Clinical Herbalist
If you’re a woman over 50, you are surely aware of the current crisis of osteoporosis in the US, as well as various strategies to detect or prevent the disorder. Much of the popular literature aboutosteoporosis focuses on building bone density as the key to bone health.A closer look reveals that, like most diseases, osteoporosis is more complex than that.
It’s important to remember that healthy humans build and maintain strong bones throughout their lives, and this includes into old age. As Susan Brown, Ph.D., states simply in Better Bones, Better Body: Beyond estrogen and calcium, “[Osteoporosis] is not an isolated disease process that happens to fully healthy people.”
Focusing primarily on bone density distracts us from attending to the many factors that contribute to vibrant health, such as exuberant movement, sunshine, overall endocrine balance, an optimal diet geared to the individual, effective stress management and great digestion.
Osteoporosis (literally, holes in the bones), is characterized by excessively thin, fragile bones that fracture easily. There are around 30 known risk factors: Some are medical, such as hyperparathyroidism, hyperthyroidism, irregular menstrual periods, diabetes, or long-term use of pharmaceuticals like steroids, aluminum-containing antacids, tranquilizers and diuretics. Other risk factors are related to lifestyle, like smoking, coffee and alcohol use, very low body weight, etc. Though the entire health picture must be examined to get a true picture of what’s contributing to fragile bones, low bone density gets the lion's share of the attention.
Here are a few little-known but nonetheless important facts about osteoporosis that may surprise you and contradict what you've been led to believe:
* The majority of people who fracture their bones have normal bone density. This mystery forces us to look more deeply to gain a more complete understanding of how to maintain healthy bones.
* Thin bones are not necessarily weak or unhealthy. And though just about all 80-year-olds have thin bones, they don't all break their hips if they fall.
* Not all women lose bone rapidly following menopause; conversely, it's not necessarily a problem when women do lose bone then.
* At menopause, some Mayan Indian woman in Mexico lose bone at the same rate as women in the US, and their postmenopausal estrogen levels are even lower than ours. Yet they don't break bones or lose height. Other such cross-cultural studies show clearly that neither menopause nor low calcium intake is the “cause” of bone fracturability.
* Osteoporosis can actually be halted and reversed through diet, supplements and weight-bearing exercise. Even if you’ve already had an osteoporotic fracture, you can prevent further fractures.
THE REDEFINITION OF A DISEASE
Women are usually encouraged to be screened for osteoporosis by having a bone mineral density test—DEXA—around the time of menopause. This can serve as a baseline for later comparison. (DEXA is much more accurate than the heel or wrist tests offered at shopping malls.)
Interestingly, in the past, the diagnosis of osteoporosis used to be applied only if a fracture occurred, or if there was a serious deformity of the spine. But in 1992, the World Health Organization, together with pharmaceutical and medical equipment companies, redefined osteoporosis based upon low bone density as revealed by DEXA. Bone density is "scored" by comparing it to the "normal" bone density of a 30-year-old woman.
To make things worse, eventually a new condition was defined—"osteopenia," or somewhat reduced bone mass—instantly placing millions of women in a "pre-osteoporotic" category. Dr Susan Love, gynecologist and author (Dr. Susan Love’s Hormone Book), thinks osteopenia "isn't a disease or even a risk factor, and should not be treated." In this case, screening technology may be getting way ahead of the understanding of a condition.
Many feel it's arbitrary and pointless to compare 55- or 65-year-old bones to 30-year-old bones. The tests measure only density, but cannot evaluate the infinitely more important qualities of bone strength and flexibility. Remember, low density does not necessarily translate into increased fragility. Instead, osteoporosis is a degenerative disease where bones fracture not only because they are thin, but because they are substandard and unable to repair themselves.
Calcium is in the limelight, so to speak, because you can see it in x-rays, measure it, and take it in pills. However, bones that break lack not just calcium, but many other nutrients and minerals, and suffer as well from a decrease in the non-mineral, structural framework of the bone.
One pharmaceutical answer to low bone mass is a drug called Fosamax (similar to Actonel, Boniva and other biphosphonates). It deposits in the skeleton, coating bone cells with a crystalline covering, while halting bone breakdown as well as bone formation. There are lingering questions whether the "old" bone retained could then become more brittle rather than stronger. The long-term adverse effects of Fosamax are essentially unknown. A worrisome problem was recently discovered in some women taking the drug longer than six years: areas of dead bone in the jaw. While it was thought this occurred only in those undergoing concurrent chemotherapy, dental hygienists are seeing this condition in many women not on chemotherapeutic drugs. Since invasive procedures like extractions or root canals may lead to a non-healing jawbone, the American Association of Endodontists now recommends that dental surgeons check for this condition in those on Fosamax.
The advantage of taking Fosamax compared to not taking it at all is extremely modest. In a three-year study of older women with osteoporosis and at least one previous fracture, 2% of the women taking a placebo had a subsequent hip fracture, compared to 1% of those on Fosamax. That said, Fosamax may be useful—even a life-saver—for someone with a multitude of risk factors, previous fractures and in imminent danger of breaking another bone.
continued next month.....
Carole Tashel, Clinical Herbalist, is author of Gardening the Southwest.
Even after 25 years, she is still moved by the beauty, effectiveness
and revolutionary aspects of natural healing.
Contact Carole at 505.466.6153 or firstname.lastname@example.org
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Susun Weed. Green Nations Gathering 1998.
Using herbs and other ideas for keeping bones strong and reversing osteoporosis. Why dense bones may not be healthy. Building strong bones means building flexible bones.
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