All You Need to Know about Bone Health
In this article, we will be covering some of the most often encountered bone diseases, including pressing bone health issues, such as osteoporosis, complete with treatment guidelines for this often encountered disease. Since women past menopause suffer from bone mass loss and they are thus the group most at risk for developing osteoporosis. We’ve also included a handy list of supplements which promote bone repair and bone growth.
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The Most Frequently Encountered Bone Diseases
Brittle bone disease, or Osteogenesis Imperfecta
Brittle bone disease affects children before they are born, or immediately thereafter. According to the National Human Genome Research Institute, 3 in 50,000 babies are born with it. It only occurs in babies who are born with the gene that causes it, which comes in 4 different variants. In turn, these 4 genes yield the first four types of OI (osteogenesis imperfecta, i.e. “imperfectly formed bone”). Types 5 through 8 are largely subtypes of type 4 and are extremely rare. The responsible gene does not allow for the proper production of collagen, which is required for bone formation. Type 2 OI can cause babies to be born with severely misshapen bones, loose joints, weak teeth, kyphosis, scoliosis, and other issues (including breathing and heart health problems). Symptoms include blue sclera and triangular shaped faces. Though there’s no treatment for the disease, quality of life can be improved through occupational therapies.
Degenerative joint disease, or Osteoarthritis
Since osteoporosis is also commonly referred to as ‘degenerative bone disease’, it can sometimes be confused with osteoarthritis (OA), or degenerative joint disease. The two are similar in terms of evolution and symptoms, but their causes and treatment are different. OA is a disease of aging: it affects 25 million Americans aged 25 and over, as well as one third of those over 65. It affects the joints of the neck, back, hands, hips, knees, neck, etc. It is caused by carrying around too much weight, or by performing repeated actions, which eventually wears through the cartilage at the ends of the two bones. This is followed by severe pain, joint inflammation, and the development of bone spurs. Smaller joints are treated with pain killers, topical creams, NSAIDs, and physical therapy. Larger joints such as those in the hips and knees may require joint replacement surgery.
Diagram of hip replacement surgery procedure
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Bone marrow disease
The spongy tissue present inside all your long bones is effectively the ‘blood cell’ factory inside your body, which usually releases healthy cells into the bloodstream. When bone marrow disease occurs, the body is no longer able to produce infection-fighting white cells, red blood cells which relay oxygen throughout the body, and platelets, which stop hemorrhages. All such diseases are severe and can only be treated through transplants, which first entail massive chemo and radiotherapy to kill the diseased blood cells. The receiver is then injected with donor marrow into a vein, which sends the substance to the bones. The most common such diseases include leukemia (a cancer of the blood with unknown causes), reticulum cell sarcoma of the bone (cancerous tumors), and aplastic anemia (the sufferer effectively stops producing blood).
Metabolic bone diseases
Metabolic bone disorders are caused by mineral level anomalies, usually involving calcium or phosphorus, but also vitamin D. These irregularities affect bone mass and structure, which, in turn, cause the frail bones to experience frequent fractures from mild impact, deformations of the bones, and ultimately severe disabilities. Such skeletal disorders include bone loss, osteoporosis (caused by steroid use, or other factors, most commonly menopause in women), osteomalacia (caused by Vitamin D deficiencies), osteodystrophy, parathyroid disorders, and Paget’s disease.
Post-menopausal osteoporosis in women is the most common type of metabolic bone disease. It affects older women, with a history of fractures, intestinal illness, organ transplant, and kidney health problems. Small body size can also be an indicator of future osteoporosis, in both men and women, and steroid use is an aggravating risk factor.
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Osteoporosis Treatment Guidelines
The current guidelines for the diagnosis, screening, treatment, and management of osteoporosis were issued by the Agency for Healthcare Research and Quality. They target a wide range of medical professionals, including family physicians, OBGyns, endocrinologists, rheumatologists, geriatricians, and doctors in preventive medicine. The guidelines include the following provisions:
- A focus on involving several types of medical practitioners in the decision making process, as well as the patient and her family.
- Counseling the patient on preventative measures, like physical exercise, quitting smoking, adopting a healthy diet, weight loss, and limiting alcohol intake. Environmental factors that target fall and injury risk reduction are also involved, including hip pads.
- The patient is advised to supplement her diet with calcium and Vitamin D.
- The patient is treated with several types of medicine, including hormones (estrogen for women and testosterone against hypogonadism for men), SERMs such as raloxifene, bisphosphonates (such as zoledronic acid, risedronate, alendronate, and others), Calcitonin-Salmon nasal sprays, Teriparatide (a parathyroid hormone), and Denosumab.
Is there any natural treatment for osteoporosis?
On the one hand, osteoporosis cannot be reversed and can severely affect one’s quality of life. On the other, treating it through pharmaceutical means can be expensive, as well as aggressive (it entails hormone replacement therapies). As such, it’s more than understandable that sufferers and their caregivers are always on the lookout for home remedies and alternative treatments for osteoporosis. The truth is that there’s no such thing as a miracle pill against this bone disease. But the better news is that everyone can take certain simple measures to slow down the progression of osteoporosis, as well as to improve their quality of life. Here are the main at-home remedies against this disease:
- A proper diet
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- Your main goal is to strengthen your bones by upping your calcium intake, so you’ll want to center your diet on calcium-rich foods. These include broccoli, tofu, salmon, leafy greens, and all types of dairy products.
- If you’re over 50, you should include at least 1200mg of calcium in your daily diet; a regular glass of milk contains 300mg.
- Avoid foods rich in phosphorous, which can quicken the bone loss process. These include red meats, sodas, and foods with added phosphates.
- Alcohol and caffeine also have some calcium-inhibiting effects, and should thus be avoided.
- Though insufficiently researched thus far, it is believed that foods rich in plant estrogens, like tofu, soy milk, and other soybean products, can help during HRT for osteoporosis.
- For even more calcium, try adding milk to what you cook (soups, casseroles, stews, etc.). There are 20mg of calcium in each teaspoon of milk. And when making stock, add a bit of vinegar, to help dissolve some calcium off those bones.
- Dietary supplements for osteoporosis. Most women only take in half or one third of their recommended daily dose of calcium from the foods they eat. In such cases, calcium supplementation is recommended, but with the precaution that some new research has linked this practice with an increase in heart disease risk. Moreover, calcium supplements should always be taken in conjunction with vitamin D, for proper absorption. The daily recommended dose is 800 to 1000 IUs/day. Be aware that calcium supplements can interfere with the effectiveness of other drugs, so always consult with your doctor before starting supplementation.
Calcium and Bone Health
Why is calcium vital to bone health?
We’ve explained how to keep your bones healthy, both through diet, as well as through supplementation. But you might not fully understand why a calcium-rich diet is so important for the health of your bones. Here’s how the link between calcium and bone health works:
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- Essentially, your bones are made up of two substances: calcium and collagen, the soft protein to which the harder calcium attaches itself to make up those strong bones.
- Throughout your life, your bones act like a sort of calcium bank. During your childhood and teenage years, as you grow, your body is adding calcium to your bones at a faster rate than those calcium deposits are being depleted. It’s important to understand that your bones release calcium into the organism for all the other processes that require it.
- Most people continue to add bone mass until around age 20. After that, the process slows down, but never really stops. However, once you’re past the age of 30 that process is evolving at a very slow pace; meanwhile, it’s likely that your calcium requirements have increased, since you now have larger bones. It’s just as likely that you’re not getting enough calcium for healthy bones from your diet. This way, you’re depleting your bone density and making room for osteoporosis to settle in. Here are a few ways you can increase bone density.
- To keep your bones healthy, remember to get at least 800 to 1000mg of calcium each day. Vigorous exercise, which puts stress onto your bones and forces them to grow stronger, also helps, as does vitamin D, best received through exposure to sunlight. Osteoporosis has no visible symptoms and, often enough, people don’t even know they have it, until their first fracture occurs. According to the National Osteoporosis Foundation, some 14 million people aged 50 and upwards in America will be suffering from osteoporosis by 2020.
How does estrogen affect calcium levels in bones?
The link is rather simple, but it may not be immediately apparent, unless you think of the fact that many post-menopausal women develop osteoporosis. Once they enter menopause, women’s bodies start producing ever lower levels of estrogen. This hormone plays an essential role in the intestinal absorption of calcium. Lower estrogen levels essentially mean poorer calcium absorption, as well increased risks of low bone density. So, what can be done to fight this? Until recently, HRT was the go-to solution and 2004 research showed that low-dosage estrogen patches had helped elderly women increase their hip and spinal bone density. However, HRT should only be initiated under medical supervision, since it has also been linked to increased cancer and heart disease risks.
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Bone Health Supplements
It’s easy to get confused when dealing with the plethora of choices in terms of bone health supplements available on the market nowadays. “What is the best supplement for joint health?” many will ask. “And what about my knees? Are there any vitamins or minerals that can protect my knees against the inevitable signs of aging?” As a matter of fact, there is. Check out the list below and always make sure to compare it with the ingredient roster of your supplement of choice.
Supplements for bone healing
Protein enhances bone healing
Certain amino-acids like lysine, arginine, proline, glycine, cysteine, and glutamine, are great for encouraging bone healing.
Anti-oxidants repair oxidative damage done to the bone
In other words, anti-oxidants like vitamins E and C, as well as lycopene, act as anti-inflammatory agents, which help rebuild broken protein strands within the bone.
You’ll need extra minerals to heal
Zinc helps the bone produce much needed protein. Copper helps form bone collagen. Calcium and phosphorus enhance the rebuilding process of bone tissue. Silicon helps with collagen synthesis.
A multivitamin complex is recommended
Look for one that contains vitamin C, vitamin K, vitamin D, as well as vitamin B6. Vitamin C is a powerful anti-oxidant, vitamin D helps with the absorption of calcium, while vitamin K is required in the formation of bone protein osteocalcin.
Bone growth supplements
Bone growth supplementation is recommended for both post-menopausal women, who are at increased risk of osteoporosis, as well as for young kids and teens, whose bones are literally growing. A note on supplements containing vitamin D and calcium: it’s often the case that people consume enough calcium from their diets (1,000mg), but not enough vitamin D. Unnecessary calcium supplements may cause renal problems, through the formation of kidney stones. Focus on vitamin D intake and get plenty of time in the sun.
Much of what was said above about calcium also applies to vitamin K. According to the UMMC, you get enough vitamin C from your diet; typical sources include broccoli, spinach, cabbage, and low-fat dairy products. If you are deficient, supplement with a daily dose of 150 to 500mg. Bear in mind that vitamin K encourages blood clotting, so avoid it, if you’re also medicating with anti-coagulants.
Other necessary nutrients for bone growth include omega-3 fatty acids (DRI: 4,000mg), zinc, horsetail, oat straw, melatonin, and kelp (not recommended for hypothyroid sufferers).