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Osteoporosis – Six simple steps to keep your bones strong

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Osteoporosis is a systemic disorder causing low bone mass; usually in older people, it causes bones to become brittle and weak, and falls can cause breaks.

Here we explode some of the Bone Health myths that maybe causing problems rather than solving them.

Firstly, you need to understand the cycle of bone strengthening. We all develop brittle bones throughout our lives and at any age, but our osteoclasts break down the brittle bones and hand the raw materials to our osteoblasts, which use them to remake strong bones.

One of the problems in bone health as we age is that there are a number of ‘myths’ about what you need to do to make strong bones. Here we look at research to understand whether the claims are true.

The Myths of bone health – Six simple steps to maintaining strong bones

  1. Supplement with vitamin K?

Japanese doctors have been using supplements of vitamin K2 for a number of years now to treat osteoporosis. But it is not yet approved in this context within the EU. Researchers from Madrid produced a review in 2019 of the effects of deficiency in vitamin K and bone health (1). In it they state, “most studies find that low serum K1 concentrations, high levels of undercarboxylated osteocalcin (ucOC), and low dietary intake of both K1 and K2 are associated with a higher risk of fracture and lower BMD“. You may help prevent osteoporosis by taking vitamin K, but can you correct osteoporosis by increasing levels?

Vitamin K is a fat soluble vitamin. The prefix K came from the German word Koagulant. Typically, vitamin K1 has been used with new-born babies to aid blood clotting.

But its alter-ego, vitamin K2 (as MK4 or MK7), seemed to have a ‘more direct’ effect on bones according to Dr. Geeta Hampson, who lead an 18 month clinical trial at the Osteoporosis Screening and Research unit at King’s College London.

In this she used K1, or K2 (as MK4), or a placebo, with 105 women (Av age 68.7). Vitamin D and Bisphosphonate were also included and all the women has post menopausal osteoporosis.

There was consensus that sometimes the osteoclasts seem to break the cells down faster than bone-building osteoblasts can repair them. Vitamin K2 seems to be critically involved, and previous research has shown Vitamin K2 is known to activate several proteins known to be important in bone formation. However, results in this clinical trial were not exactly stunning. Slight improvements were however noted (2).

     2. Sort out your gut?

It used to be argued simply that K2 was found in egg yolks and some milk products such as cheese and butter; while K1 was found predominantly in green leafy vegetables. Now it is clear that commensal bacteria in your gut actually make these vitamins for you, assuming you have a healthy gut, with the right bacteria present.

Our osteoclasts and osteoblasts are made from stem cells in our bone marrow and the health of our bone marrow has now been shown to be dependent upon the health of our gut Microbiome (3).

This one is true – it is becoming increasingly clear that you need a healthy microbiome for strong bones.

Go to: Heal Your Gut

     3. Sort out your diet – drink more milk?

Historically, osteoporosis treatment was in the hands of GPs, who recommend you consumed more cows’ dairy. This advice is questionable.

Dairy consumption, whether from milk, butter, yoghurt or cheese,  is actually rather a problem – it actually lines the gut wall and reduces the absorption of magnesium. This and a low magnesium diet can restrict plasma magnesium levels. Stress, alcohol and drugs can also lower magnesium levels. Is it any surprise that 40% of women in the UK are low in magnesium.

Magnesium is essential for bone health – foods include nuts, seeds, vegetables and whole grains. Or you can supplement with 350 mg a day, and/or you will get good levels of magnesium in a colourful Rainbow Diet.

Calcium is essential – The American bone health Website recommends 150 mg of calcium a day. If you don’t want to consume about two thirds of a cup of milk, try two large helpings of greens. Eat far more leafy greens anyway!

Beware calcium pills though – there are links to heart problems. People who build calcium levels in their arteries (from dairy or supplements) have a six times greater risk of coronary artery disease according to research from LA Biomed.

Phosphorus is important – two helpings of pulses each week will do. Other useful minerals include Boron.

3. Vitamin D3

Go in the sunshine every day for 2-3 hours or  supplement with 2,500 IUs of vitamin D a day when you cannot.

American Bone Health (4) recommend that 2500 IUs is the daily level for good bone health as you age. That would be about 3-4 hours on the beach with the sun on your body..

4. Oestrogen vs Progesterone

Hot flushes and bone pains after menopause? Doctors may well recommended HRT, but it is now known to triple the risk of some cancers (5).

While many people think that post menopausal osteoporosis stems from lowered oestrogen, the science doesn’t particularly support this theory either. Indeed, there are 14 receptor sites for progesterone for every single oestrogen receptor site on your bones.

Judy Evans runs progesterone link in the UK and is adamant that you can prevent brittle bones and osteoporosis as you age by using Natural Progesterone creams (6)

5. A poor thyroid causes osteoporosis?

Iodine deficiency is a huge problem in the Western world. 50 or more years ago our salt was iodized, our bread was made with iodine (now it’s bromide that blocks iodine) and we used to eat more seafood and even kelp.

The thyroid does impact our bones, because it is one of the main controllers of metabolism. If we become fatigues, lethargic, start to increase weight, then our doctor may prescribe Levothyroxine. In the majority of cases this would be a mistake. Hashimoto’s can lead to low thyroid levels, as can lymphatic thyroiditis. The former may be associated with thyroid nodules, the latter may be associated with Goitre.  In other causes, the reason for low thyroid hormone is actually due to low iodine. And selenium collects in the thyroid and low levels of selenium are associated with low thyroid hormone. Low iodine and low selenium can be linked to osteoporosis and brittle bones. urinary iodine levels are significantly lower in women with osteoporosis (7).

6. Take exercise?

Yes and no. Aerobic exercise will help a little, but load bearing exercise is the way to prevent osteoporosis. Try some light weight bearing exercise, if you can. Harvard Health are right behind me here (8). It is important – but this could be a problem, especially if you already have brittle bones!

The Truth about strong bones?

The six simple steps are:

  • Heal your gut,
  • Focus on vitamin D (and possibly K2 for prevention),
  • Magnesium, Phosphorus (from lentils),
  • Iodine (sea kelp),
  • Weight bearing exercise, and
  • Calcium from plants 

Stick to a simple, natural solution.

Go to: A simple guide to bone health and beating osteoporosis

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References

  1. Vitamin K and Bone Health: A Review on the Effects of Vitamin K Deficiency and Supplementation and the Effect of Non-Vitamin K Antagonist Oral Anticoagulants on Different Bone Parameters; Celia Rodríguez-Olleros Rodríguez, Manuel Díaz Curiel; J Osteoporos. 2019; 2019: 2069176.
  2. The additive effect of vitamin K supplementation and bisphosphonate on fracture risk in post-menopausal osteoporosis: a randomised placebo controlled trial; Amelia E. Moore et al; Arch Osteoporos. 2023; 18(1): 83.
  3. The gut-bone axis: how bacterial metabolites bridge the distance; Mario M Zeiss et al; J Clin Invest. 2019;129(8):3018–3028
  4. American Bone Health – https://americanbonehealth.org
  5. HRT increases breast cancer risk by a third – https://www.canceractive.com/article/hrt-raises%20breast%20cancer%20risk%20by%20a%20third
  6. Natural Progesterone and Judy Evans – https://www.canceractive.com/article/progesterone–the-natural-protector
  7. Body iodine status in women with postmenopausal osteoporosis; Tufan Arslanca et al; Menopause, 2018 Mar;25(3):320-323.
  8. Weight bearing exercise and slowing osteoporosis – https://www.health.harvard.edu/staying-healthy/slowing-bone-loss-with-weight-bearing-exercise