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Restorative Medicine in the Treatment of Osteoporosis

Non-pharmacological measures for preventing osteoporosis are calcium 1000mg/day for pre-menopause and calcium 1500 mg/day post menopause, vitamin D 400 IU/day, exercise, smoking cessation, limiting alcohol and caffeine, and the use of natural medicines in restoring all the organs involved in calcium metabolism, which includes the digestive tract, kidneys, liver, skin, thyroid, and parathyroid.

Nutritional Supplements

• Calcium: Calcium is known for its ability to impact bone formation positively, and it also slows down bone resorption.
• Magnesium: The typical American diet often contains less than 2/3 of the RDA for magnesium. Deficiency is common in women with osteoporosis and is associated with abnormal bone mineral crystal formation. Magnesium is necessary for the absorption of calcium and plays a part in the conversion of vitamin D to its active form.
• Vitamin K: Vitamin K is a cofactor in the synthesis of osteocalcin, a unique bone protein that attracts calcium to bone tissue. Inadequate vitamin K levels impair normal bone mineralization.
• Boron: Evidence suggests that boron may promote synthesis of compounds related to bone health, including estrogen, testosterone, DHEA, and vitamin D, and may play an important role in maintaining bone mass.
• Manganese: In a study of 14 women with osteoporosis, blood levels of manganese were 75% lower than those of age-matched controls. Studies suggest that manganese is a necessary mineral for bone mineralization.
• Vitamin D: IN many patients with osteoporosis, there is an impairment in renal conversion of vitamin D to its most active form. This may result from deficiencies in estrogen, magnesium, or boron.
• Folic Acid: Folate is important in the metabolism of homocysteine, a metabolic intermediate that may affect osteoporosis by interfering with collagen crosslinking, resulting in a defective bone matrix. Increased levels of homocysteine have been found in post-menopausal women.
• Other nutrients: Additional studies suggest that vitamin B-6, vitamin C, zinc, copper, silicon, and strontium play roles in maintaining bone mass.

Exercise

• Exercise plays an important role in prevention and treatment of osteoporosis. Weight-bearing exercise strengthens bones, increases bone mass, and increases a person’s reaction time and stability, thus decreasing the likelihood of a bone-breaking fall.
• Walking, running, tennis, aerobics, and weightlifting are effective at building and maintaining bone mass. Swimming may increase bone density while strengthening the cardiovascular system.

Hormonal Therapy

• Estrogen: Estrogen replacement therapy inhibits bone resorption and reduces the incidence of osteoporotic fractures. However, ERT also increases the risk of certain forms of cancer. While the increased risk of endometrial cancer is prevented by the concomitant use of progestogen, there is evidence that ERT may also cause breast cancer. However, it has been shown that one of three naturally occurring forms of estrogen, known as estriol, may actually prevent breast cancer. (A combination estrogen medication called Triestrogen (containing 80% estriol, 10% estrone, and 10% estradiol) may present a safer alternative to standard ERT in the management of postmenopausal osteoporosis.

• Progesterone: Progesterone appears to enhance new bone formation in contrast to estrogen, which merely inhibits resorption of old bone. Unlike estrogen, progesterone is not carcinogenic, and there is evidence that progesterone actually prevents certain female cancers.
• Testosterone and DHEA: Although testosterone and DHEA are considered male hormones, they are produced in substantial amounts by the ovaries. Each of these hormones has been shown to enhance new bone formation.

Other Considerations
The physician should rule out gastrointestinal problems, such as hypochlorhydria, dysbiosis, and malabsorption, which can compromise nutritional status, especially of minerals and fat-soluble nutrients such as vitamin K.

Individuals should avoid exposure to toxic metals, especially aluminum, which can bind to phosphorous in the intestine, leading to phosphorus depletion and fecal calcium excretion. Magnesium deficiency enhances the absorption of aluminum.

Certain medications such as glucocorticoids, anticonvulsants, anticoagulants, and some diuretics may result in a loss of bone tissue.