Osteoporosis Reversal and Prevention

The Restoration of Health by Addressing Causal Factors

Paul A. Goldberg MPH, DC, DACBN, DCBCN

Founder and Consultant to The Goldberg Tener Clinic A widespread concern of women and men as they approach middle age is accelerated loss of bone density known as Osteoporosis, leading to fractures, loss of height, disability and significant, ongoing pain. The fear of Osteoporosis is well justified due to its high prevalence and the suffering that often results.

Losing bone density is a normal part of aging. Osteoporosis, literally meaning “porous bone,” is where the bone loss is accelerated. When a patient’s bone loss is excessive but modest it is referred to as Osteopenia which often evolves into Osteoporosis with time.

Over one and a half million fractures of the hip, spine, and wrist occur yearly due to bone loss. One in six women in the U.S. will experience a hip fracture, equal to that of the combined risks of breast, endometrial and ovarian cancer with a prevalence rate for women over fifty of seventeen- and one-half percent.[1] After sixty five years of age one in two women and one in five men will develop bone loss-related fractures.

Hip fractures result in death in twenty percent of all cases. Of the survivors, twenty five percent are left disabled and relegated to a nursing home. The number of vertebral fractures is larger still, with seven hundred thousand occurring each year[2] with resulting disfigurement and ongoing pain.

Old Too Soon…Smart Too Late.

Osteoporosis is not just due to age. It occurs because the person’s body is out of balance for diverse reasons. Osteoporosis is not a single entity even though often approached medically in that manner. We do not consider that it needs to be a “chronic disease”, as approached medically but rather a complex situation to be sorted out and addressed productively once causal factors are identified and addressed, not “treated,” and corrective actions taken. In doing so health can be regained, bone density improved and further loss of bone mass averted.

Osteoporosis proceeds silently with patients having significant bone loss by the time a fracture occurs and discomfort is felt.

People are often totally ignorant about Osteoporosis perhaps due to a youth-oriented culture where younger people often have little contact with older persons. They rarely see the lady with the dowager’s hump, nor the nursing home resident crippled by a hip fracture. They don’t have it and they rarely see it on their cell phones or social media, so why be concerned? We get old too soon and smart too late!

Preventive measures can prevent osteoporosis and the fractures that result from it.  Insufficient accumulation of bone during the formative years of skeletal growth predisposes to fractures later in life. Taking steps to maximize bone density in youth and early adulthood leaves less chance of developing osteoporosis with age. It is not only possible but natural to have sufficient bone mass to get us into our eighties and nineties without enough bone thinning to cause a fracture.

Differences in bone mass accumulated during the formative years explains in part racial and sexual differences in osteoporosis incidence. White and Asian women have the lightest skeletons and black men have the heaviest with white men and black women having skeletons of intermediate density. This corresponds directly to the order of occurrence of fractures. Lesson? Build up bone mass while young and in middle age to avoid osteoporosis in later years.

Education or Misinformation?

Misinformation labeled as education regarding osteoporosis emanate from the Dairy Council and the Pharmaceutical Industry. Typical advice? Drink cow’s milk and eat Tums containing calcium carbonate. The Dairy Council has heavily advertised to the public and brainwashed dietitians and medical professionals advocating cow’s milk onto a trusting audience. Epidemiological studies conducted independently of the dairy industry do not support the use of dairy products to prevent or correct osteoporosis.

Lactose intolerance to some degree affects most adults. Lactose intolerance in turn, contributes to a variety of disorders including GI issues/ malabsorption which can contribute to the development of Osteoporosis.

Epidemiological studies looking at the relationship of osteoporosis to cow’s milk were conducted by Biochemist Collin Campell, Ph.D. of Cornell University. Campbell discovered that in those nations with high intakes of dairy products e.g. the United States, the rates of osteoporosis were highest, while in countries where the dairy consumption was low, rates of osteoporosis were the lowest. Not only was milk consumption not seen as preventive of osteoporosis, but the opposite association was seen. Cow’s milk is a source of significant health problems in the United States.[1]

The dairy industry boasts that milk products provide 75% of the calcium in most Americans diet but this is a fact to be lamented, not celebrated. Better sources that supply us not only with calcium, but also with a wide array of other minerals and nutrients for good health include many green leafy plants and other vegetables…….the source where the cow got her calcium originally.

Antacid Preparations

The U.S. population takes an enormous number of antacids and H2 blockers, both over the counter and via prescriptions. These compounds neutralize or block the production of stomach acid required for good mineral absorption. As one gets older stomach acid decreases naturally. Inhibiting it further frequently leads to digestive and absorptive issues. Watch the video below for a more comprehensive discussion of the hazards of antacids / H2 blockers / PPI’s.

Prevention 

Prevention of osteoporosis involves many factors. Behaviors contributing to or preventing bone loss include:

• Excessive Protein intake- The pervasive high protein crazes in our nation can be a contributing factor in osteoporosis development. Excessive protein results in an excess of phosphorus being ingested, resulting in the leaching of calcium and other alkaline minerals from the bones to neutralize excess acidity.

• Addressing malabsorption syndromes e.g. Crohn’s, Ulcerative Colitis, celiac disease, intestinal allergies, etc. is important to alleviate and address. These can significantly affect bone loss.

• Soft Drinks, particularly those with phosphoric acid as well as caffeine, alcohol and tobacco should be avoided.

• Exposure to natural sunlight in moderation is critical for “Vitamin D” production which is involved with normal bone physiology. It is wise to have Vitamin D levels clinically evaluated periodically. Sunlight is needed to produce Cholecalciferol (“Vitamin D”) which in turn governs mineral balance, absorption, immunity and other functions related to bone health.

• Prescription drugs- Many drugs including steroids, H2 blockers and antacids can result mineral loss.

• Autoimmune Conditions, Kidney Disease and Cushing’s Syndrome increase osteoporosis risk. By eliminating the causes of autoimmune illness or other issue as we focus on in our practice, the bone loss activity dissipates.

• Lack of Activity -Maintaining an active lifestyle with weight bearing activities stimulates osteoblastic/bone forming activity and should be utilized throughout our lives.

• Toxins from the environment can have a highly detrimental effect on bone density. It is common in our practice to evaluate patients with bone loss for toxic exposures to lead, other heavy metals, pesticides and herbicides as this often yields important information to help the patient with.
  

Identification / Monitoring of Osteoporosis

Identification of those with bone loss begins with a personal and family history. Nothing can substitute for a thorough case history including occupation and lifestyle factors. Even apparently low risk patients can have early osteoporosis. The case history should be followed up by a physical examination and appropriate laboratory testing.

Choosing the Right Evaluation Procedures

Standard x-rays will not reveal osteoporotic bone until bone loss approaches 30 to 50%, a dangerous level leading to fractures of the spine, wrist and hips.

The DEXA Scan is used to identify bone loss at earlier stages. This technology calculates bone mass based on tissue absorption of photons revealing the patient’s bone mean density and allowing determination of the risk of fracture occurring.

The limitation is that while a DEXA scan can help determine the bone density it does not determine how rapidly bone content is being resorbed from the bone nor how rapidly it is being lost.

Bone metabolism is based on the balance between the building up of bone by osteoblasts and the degradation of bone by osteoclasts. Osteoporosis is characterized by an imbalance between resorption and formation.

The development of new urine and blood markers for bone resorption are useful in identifying and monitoring mineral balance.

The CTX peptide is a substance released into the bloodstream during bone resorption. It’s used to assess bone turnover and is useful in monitoring osteoporosis and the effectiveness of programs aimed at slowing bone loss.

CTX is a fragment of type I collagen, a major protein in bone. When bone is broken down, enzymes called matrix metalloproteinases (MMPs) release fragments of collagen, including CTX and can be measured in blood and urine. Elevated CTX levels indicate increased bone breakdown. This is seen in conditions where bone loss outpaces bone formation.

Medical Treatments for Osteoporosis

• Bisphosphonate drugs (e.g. Fosamax or Reclast) to slow down bone breakdown. These drugs can cause a wide range of side effects, from mild gastrointestinal issues to serious complications like jaw problems and fractures. Common side effects include heartburn, stomach pain, and muscle or joint pain. More serious side effects include osteonecrosis of the jaw, femur fractures, and kidney damage.
  

• Hormone replacement therapy (HRT) for postmenopausal women. Side effects include headaches, nausea, breast tenderness, and mood changes. Some women experience bloating, fluid retention, and changes in their periods. Additionally, HRT can increase the risk of blood clots, stroke and breast cancer.
  

The Goldberg Tener Comprehensive Approach to Osteoporosis

Our approach to preventing and reversing Osteoporosis does not involve” treatments”. At the Goldberg Tener Clinic, we do not view Osteoporosis just as a “bone disease,” but as a symptom of physical imbalances including nutritional, hormonal, digestive, inflammatory, lifestyle and environmental factors.

 Our approach is oriented to total health renewal involving identification and addressing causes and creating the right conditions so the full spectrum of the patient’s health issues are addressed and their health is restored body wide.

Osteoporosis occurs for a multitude of reasons. Each patient is given a personalized program including assessment for nutritional imbalances, dysglycemia, digestive efficiency, toxicology, lifestyle behaviors and endocrine factors.

Part of a comprehensive history for females is a review of the menstrual and reproductive history. Activity/exercise habits including strength training are evaluated. The quality of the diet including specific nutrient balances such as the calcium/phosphorus ratio and the patient’s ability to absorb nutrients are quantified and qualified. Evaluation of toxic minerals and compounds in the body that interfere with nutrient mineral absorption are often performed. Sleep patterns and stress levels influencing cortisol levels are part of the evaluation. Patients who have been on long term hormone replacement therapy/birth control pills are investigated for hormonal influences in their bone loss evolution.

Other areas for investigation:

• Exercise, especially weight bearing activities

• Diet quality—Is the patient getting sufficient or excessive magnesium, protein, vitamin K2 and Vitamin D? Are they overdosing on certain supplements, proteins or carbohydrates?

• Digestion – Does the patient have good digestion and absorption of nutrients?

• Carbohydrate Metabolism- Evaluation of the glucose/insulin balance is important as dysglycemia can cause or accentuate bone loss.

• Medications e.g. steroids or acid blockers (which reduce calcium absorption). Many other drugs interfere with the process of bone remodeling and if present need to be given consideration.

• Muscle weaknesses and imbalances

• Sleep patterns and stress levels
  

Summary

Bone loss/osteoporosis is a major source of chronic illness in our nation affecting a high proportion of both men and women. The resulting pain, disfigurement, disability, death, and expense can be prevented. Rather than taking a pharmaceutical approach we focus on identifying the causes of the bone loss, addressing those causes and establishing an individualized program for the patient to inhibit further bone loss and restore good health.

Osteoporosis has long received inadequate attention. We view the medical and alternative medical approaches inadequate and often hazardous. Information the public receives is often the product of pharmaceutical and other commercial interests that run contrary to good health.