DR CABOT: Hi, everyone. This is Doctor Sandra Cabot and I’m joined by naturopath and author Margaret Jasinska.
MARGARET: Hi, Doctor Cabot. Thank you so much for inviting me on.
DR CABOT: And we’re talking about osteoporosis, which is a bone-thinning disease. Very, very common today in older people and something that is often treated, well, piecemeal. It really doesn’t receive holistic care. And the emphasis that we see from conventional medicine is drug therapy and a calcium supplement. And maybe a little bit of vitamin D. But for a lot of people, that’s not really a long-term solution. And it’s not a solution they feel comfortable with, when they investigate some of the potential side effects of the drugs, which in many cases can only be taken for up to five years.
So, we thought we’d look at some of the more holistic things you can do to build your bone density. In other words, to increase it. And also, to prevent getting osteoporosis.
Now, one thing that often proceeds osteoporosis is osteopenia. And osteopenia is where your bone density is reducing to a lower level, but not severe enough to be osteoporosis. Osteoporosis is where your bone density is so low that you’re at high risk of a fracture, even if you cough or you have minimal trauma.
MARGARET: Yes. It can be quite a scary disease, because you can be so vulnerable. It’s easy to slip and fall, and recovery can be very difficult.
DR CABOT: That’s right. Because your bones are not dense to start with. So, the healing takes much longer. So, it is advisable that all menopausal women have the screening bone mineral density test. It’s called the DEXA test, and it’s not invasive. It’s minimal, minimal radiation. And that will tell you if your bones are dense and strong. Or if they’re low density, which means osteopenia or more severe osteoporosis. So that’s a good test to have as a baseline.
MARGARET: Yes. And if you’ve got osteoporosis in your family or if you have a digestive condition, whether it’s celiac disease, inflammatory bowel disease, you should really get your bones checked earlier. Because a lot of patients that I’ve seen who have had digestive issues, they’ve been diagnosed with osteopenia in their late 30s already. And you wouldn’t expect that. And that can be a really scary shock. So, it’s good that they had a good, thorough doctor that ordered a bone density scan. Otherwise, you might never think of it until your bones get very, very bad.
DR CABOT: Yes. That’s right. So, we want to prevent losing our bones. They are perishable as we get older. They basically shrink away.
MARGARET: Yes. And if some of those prescription drugs aren’t particularly safe to use long term, what about those women that are diagnosed in the late 30s? They can’t be on those heavy drugs for long.
DR CABOT: Well, that’s right. The consensus is that the oral drugs – the bisphosphonates drugs – shouldn’t be taken for more than five to seven years. And in certain medical problems, they shouldn’t be taken at all. For example, in people with chronic kidney disease and even slightly impaired kidney function, they have to be extra careful taking these drugs, because they can accelerate kidney disease. So that’s not something you want to do long term.
And as far as the Prolia injections, which is denosumab – that’s the other name for the drug Prolia; they’re given every six months. That is the treatment that once you start, you really can never stop. So, if you start that, what? At the age of 50 or even younger, then you’ll be taking an injection every six months, for maybe 30 years. And so, that’s a bit of a… Well, let’s say that is a little bit of an overwhelming decision to have to make.
MARGARET: Yes. Yes.
DR CABOT: So, let’s look at some of the risk factors, Margaret.
MARGARET: Well, so like I mentioned earlier, having a digestive condition. Because if you have a problem with your digestive system, you’re not going to be absorbing nutrients well enough. So, you could be eating good, healthy food. You could be taking supplements. But if you’ve got a gut problem, if your digestion is bad, if you’re on a medication that can inhibit nutrient absorption, like a stomach acid-blocking drug for things like reflux, heartburn, you may not actually be absorbing what you’re consuming. So digestive issues, definitely.
And there’s family history. Osteoporosis runs strongly through some families. Some people are born with a more fine bone structure. Being underweight increases the risk of osteoporosis. Being a female.
Lack of vitamin D is a big one, because if you don’t get enough vitamin D, then any calcium that you are eating can’t actually get into your bones, where you need it. So, vitamin D helps calcium travel to the parts of your body where it’s needed. And also, vitamin K, in particular K2, is another nutrient that deficiency is common. And it’s also something that helps get the calcium to where it’s needed. So, a lot of women, a lot of people take a calcium supplement, but you may not be getting the most out of it, if you’re vitamin D and K2 are too low.
DR CABOT: That’s right. And the normal range in the blood for vitamin D really is too wide. So, depending on whether it’s measured in nanomoles/l or nanograms/ml, the range goes from 75 to 200 or from 30 to 80. So, you don’t want to be 80. And then in a range of 75 to 200. You may be told that you’re in the normal range. But that’s not ideal.
MARGARET: Exactly. You want it to be optimal, not just getting by.
DR CABOT: You want it to be over 100, really, if you’ve got osteoporosis. Or if you’re getting it measured in nanograms/ml, you’d want it to be at least 70. And that’s going to have a bone-building effect.
Now, with vitamin K, in some countries you can’t get the proper dose of vitamin K. It’s overregulated. So, on Liver Doctor, you can get a Super Vitamin K, which has got 3 types of vitamin K, including the K2 in the proper dose. And vitamin K is like an architect, because it’ll put the calcium where it’s needed. So that’s really important because your bones are stronger in certain parts of the cortex. And the vitamin K, really, is a very clever vitamin.
MARGARET: Yes. What about magnesium, as well? A lot of people don’t think about magnesium and bone health. They think, well yes, magnesium will help you sleep, and it’ll help you relax. And it helps get rid of muscle cramps. But, really, the majority of the magnesium in your body is in your muscles and your bones. And not getting enough magnesium will weaken your bones.
DR CABOT: Drastically! And so many people are magnesium deficient. And the blood tests for magnesium is not very accurate. It doesn’t show you how much magnesium is in your bones, right? It’s only the tip of the iceberg. Whereas, vitamin D blood test is very accurate. So, you can’t go buy a blood test to guarantee that you’ve got enough magnesium in your body. And anyone with low bone density should be taking it. And it definitely is involved in bone metabolism and bone health and bone strength. So, magnesium is a vital mineral.
So many people have a mineral-deficient diet, don’t they, Margaret?
MARGARET: Yeah! Absolutely! Because modern food processing and refining and modern farming practices and nutrient depletion in the soil. Modern foods just aren’t as good a source of nutrients, as they used to be.
DR CABOT: That’s right.
MARGARET: Even if you are eating all homemade, healthy meals. They’re just not going to be as nutrient dense.
DR CABOT: That’s right. And you can always grow some of your own herbs and vegetables. Put some good fertilizer in the soil, some kelp powder. And then your produce will be much higher in minerals, which you will absorb into your bones. But some of the minerals you need for bones, as we said, calcium, magnesium, you also need manganese, zinc, silica, boron and copper. And when food was grown properly with proper fertilizers, the food was much richer in these minerals. So, often I tell people to use kelp powder in their food as a condiment, as in soups or in stir fries. Or you can put it in your smoothie. And that way you’re getting a very wide range of essential minerals, particularly calcium, in a well-absorbed form.
MARGARET: Yeah. And so easy to do, isn’t it? Just add a small amount to your food.
DR CABOT: Yeah. Just on a regular basis, just like you would, salt and pepper. And bone broth is a good way to get your kelp and other minerals. So, there’s lots of good ideas for making bone broth on our website. So, look into that. And also, you can take a good formula like Bone Build, which has got all these trace minerals in it. Just take it every day. And that way, you know you won’t become mineral deficient.
But when you look at so many processed foods with refined flour and vegetable oils; they taste good but they really don’t have any texture. They don’t have the minerals in them that our bones so desperately need.
MARGARET: Absolutely! And also, a lot of people don’t eat enough protein to support their bone health, either. The bone is largely made of hard collagen, which is protein. And so, protein like meat, seafood, poultry, eggs. You need that kind of protein in order to… You know, our body is continually breaking itself down and rebuilding itself. So, you need a regular intake of protein. And the protein from plant foods is a lot harder to actually absorb and utilize. So, we have had patients who significantly increased their red meat intake and then went and got a bone density scan and showed was their bones were way stronger.
DR CABOT: Yeah. And also, your bones need collagen because it makes them flexible. So, if you do have a fall, instead of just brittle bones shattering, they bend. They’ve got that flexibility. So, eating good quality protein will help your bones to make more collagen. And so will a bone broth. And you can also take the Collagen Food powder, which gives your body the raw materials to make collagen.
The other thing is, what about hormones? Well, we talked about vitamin D, which is actually a hormone and not a vitamin. But when it comes to other hormones, particularly our sex hormones, they can help to build bone density, particularly testosterone. And some women and even some men, we find very low in testosterone.
MARGARET: I have male patients in their 30s who have below testosterone. Some are obese and type 2 diabetic, others are thin and eat well. So, it’s worth getting measured because you never know what your hormone levels are.
DR CABOT: That’s right. Well, blood tests for testosterone is very accurate. So, we measure the total testosterone and the free testosterone. And if it’s very low, often the patient will be tired and they’ll have muscle weakness, low libido. But in the context of this podcast, they could have low bone density. And testosterone has been shown to improve bone density, as well as muscle strength and muscle size. Now, we’re not talking about taking huge doses like Arnold Schwarzenegger and getting those huge big muscles. We’re just talking about getting your testosterone up into the normal range.
So, testosterone is bone building. And, of course, some people who have plenty of money use growth hormone when they get old. They get into the 60s and 70s and they find they’re getting atrophy of their muscles. We call it sarcopenia. Well, if that is shrinking of your muscles, that could be happening to bones. But it’s very expensive. It’s very expensive growth hormone injections, but it does work in small doses. So, that’s another hormone that can help.
So once again, we look at everything we can do to preserve that bone strength. Because as we get older, we’re more likely to have falls. And if you have a fall and break your hip, well, your health’s gonna deteriorate after that. So, keeping your bones strong is a constant thing to do.
MARGARET: Yes, because we’re fighting against time. So, we are going to lose muscle and bone mass, as we get older. But you’re either going to lose it quickly or you’re going to lose it slowly. Or you’re going to lose it early in life or very late in life. So, it’s about maintaining your quality of life, maintaining your independence, ability to move freely.
DR CABOT: That’s right. Yeah. And of course, exercise is vital for your bone strength. So, weight-bearing exercise like walking, jogging on grass, not on something hard, like concrete or asphalt. Push ups are good.
MARGARET: Yeah. Strengthening your muscles, holding heavy things, doing squats, lunges.
DR CABOT: Yeah. Exercise is really important for building your bones.
Another mineral that we didn’t mention was strontium. Now, years ago, it was used in the form of a drug called Protos (P-R-O-T-O-S) in very high dose, which I always thought was excessive. And some people did get some side effects from that, like nausea. But actually, in small dose, strontium is a mineral that can help to prevent bone loss. You only need a small dose. So, you can take a strontium capsule, about 300 milligrams every second day. And some people find that quite good as well.
So, once again, it’s minerals, minerals, minerals, isn’t it?
MARGARET: And proteins, and exercise and sunshine.
DR CABOT: Yes, that’s right. So don’t be weak as you get older. Stay strong. Keep your bones strong. And the good news is we’ve had a lot of patients whose bone density has increased.
MARGARET: Exactly! So, it’s measurable. So why not implement all these strategies? And then in a year or so, get your bone density checked again and you can monitor your progress. And it’s very exciting and motivating to see that what you’re doing is working.
DR CABOT: It is. The DEXA bone density test is a very good test. And you can monitor the outcome of doing all these things, taking minerals and changing your diet, exercising. And if needed, taking some hormones. And as always, if you have any questions, please email us. We love to hear from you and we hope you’ve enjoyed this podcast. Thank you.
MARGARET: Thanks for listening. Bye bye!