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  Commentary December 3rd, 2009

The Editor 

Guest Commentary


Osteoporosis: A Disease or Natural Process?

Osteoporosis by definition is a disease characterized by low bone mass with deterioration of the bone increasing the risk of fracturing, which affects mostly middle aged and elderly men and women. It is a major health threat affecting almost 44 million men and women in the United States and by 2010 it is projected to affect an estimated 53 million. This condition was unheard of until about 1944. So what has brought about this increasing condition?

Basically, it is a change in definition of the condition by Big Pharma in order to sell their Osteoporosis drugs. Bone—a body tissue is an ever changing process as are all body tissues. As one ages, so does one’s hair color, vision, skin texture, muscle strength, etc. Big Pharma calls the natural aging of bone a “disease” for which they have conveniently created life- long expensive drugs. These drugs have many serious damaging side effects. Labeling a natural occurring process as a “disease” gives them the opening to sell millions of the many so called “osteoporosis” drugs. The most popular currently are Fosomax, Actonel and Boniva.

The skeletal frame consists of over 200 bones and made up of many critical tissues. Foremost is collagen which makes up 22% of bone. Cortical and trabecular bone provide for what we see as actual bone. Cortical bone is the dense compact outermost bone making up 80% of the bone. It forms the outer protective layer and is 80-90% calcified. Trabecular bone makes up the other 20% of bone. Only 15-25% is calcified; the rest is soft marrow. Trabecular bone has a greater turnover than cortical bone and fractures occur more commonly in trabecular bones as in the spine and wrists, whereas the arms and legs are mostly of cortical bone.

There is a constant growth and repair of bone with a new skeletal frame occurring every eight years. This process is brought about by specialized bone cells known as osteoclasts and osteoblasts. Osteoclasts break down or reabsorb bits of bone and osteoblasts reverse the process to build bone. Peak bone mass or maximum bone density occurs in women between 25-30 years of age. This is when the bones are strongest and densest.

This remodeling is a constant process throughout one’s life and is dependent on several factors and nutrients. Paramount are the hormones of estrogen and testosterone. There are also 20 key nutrients necessary for bone growth on which I will elaborate about later.

Since some basic physiology and terms have been established, let’s look at the natural process and not the “disease” as Big Pharma would like you to believe it is. It is important to accept that nutrition alone cannot bring about maximum peak mass as we age. Bone strength generally correlates with the strength of the muscles attached to it. Thus, exercise is vital to ensure this bone strength with activity at all ages. Does TV watching 4-6 hours a day, as many children do now, build this strength versus physical play? As we age and retire, many become sedentary couch potatoes. Are they benefitting their health?

There are two methods of detecting osteoporosis – the bone mineral density (BMD) test and the ultrasound screening test. Neither can predict fracture occurrence; only density (not strength). The most common test doctors rely on today is the dual energy x-ray absorptiomerty (DXA). The National Osteoporosis Foundation recommends bone density testing for: women 65 years and older, all postmenopausal women under 65 years who have one or more risk factors for osteoporosis, post-menopausal women who incur broken bones, women who are considering osteoporosis therapy, men or women who have been on glucocortiocoids longer than two months, and men who have low testosterone values. These are broad recommendations. Consult with your physician if in doubt.

The World Health Organization has established the following classification. If the “T” score is greater than -1, the bone density is considered normal. If the “T” score is -1 to 2.5, the bone density is low but not osteoporosis. If the “T” score is -2.5 osteoporosis is present. Not all DEXAscan machines read accurately. Be sure to ask for a current calibration of the unit.

If a diagnosis of osteoporosis is given, request a complete blood chemistry panel including a hormone panel and mineral profile. Discuss diet with the doctor in detail. Have him/her explain the good and the bad of osteoporosis medications (bisphosphonates) as Fosomax, Actonel and Boniva. These drugs are not the miracle workers they are touted to be.

They have multiple side effects. Mandibular necrosis (jaw rot) interference with the production of CoQ10 (a vital source of cell energy), heart disease (arterial fibrillation), specific type of hip fractures and the usual digestive upsets as vomiting, nausea, diarrhea, etc.

Natural supplements are rapidly gaining in popularity. With as good or better results and less danger than the bisphosphonates which pharmaceutical companies are reluctant to reveal. Calcium alone, as in milk, is of little benefit. A combination of calcium, strontium, vitamin D3, boron, manganese, copper, zinc, phosphate, vitamin B6 and B12, folate are just a few of the essential ones. They may be hard to find in a one pill dose so shop around from reputable companies, not necessarily the cheapest.

Dietary considerations are essential to look at also. Our modern American diet and the industrialization of farming is making it difficult to absorb key nutrients our bones need from the foods we eat. This abnormal diet produces a low-grade metabolic acidosis in our blood.

Studies document a 1/10th drop in blood Ph stimulates osteoblasts (bone builders) to be inhibited and osteoclasts (bone reabsorbers) are stimulated and minerals are lost from the bones. Long term occurrence perpetuates osteoporosis. Do you see the similarities of osteoporosis to statin (cholesterol reducing) drugs? Pharmaceutical companies want to treat the symptoms and not the cause, extracting billions of your dollars and to some danger to your health. These facts I have presented are all documented in medical newsletters but reluctant to be fully shared by established medicine.

I hope all physicians have up-dated themselves with interest for their patient’s better health. Now that I have sufficiently discombobulated you about your aging skeleton, let’s have a drink – got milk?

by Donald Brust, DVM, (retired)
Valley Center, CA.
Editor’s Note: Dr. Brust is a retired veterinarian, formerly in Bonsall, now living in Valley Center. Though retired, he is active in the community and has kept up with his studies of medicine, both human and animal, and is a frequent contributor to The Paper.





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