Updated: Mar 3, 2019
It’s not something that everyone thinks about, until they incur a fracture, yet osteoporosis is a condition which affects 44 million Americans, striking 1 in 3 women and 1 in 5 men. It follows something called osteopenia and is characterized by skeletal bones becoming more porous, thinner and eventually fragile. Those with osteoporosis are at increased risk of fractures and also experience chronic unexplained pain. Often they pass this pain off as age or an old injury but until they actually get a diagnosis, most are unaware they have it.
What is interesting is that osteoporosis has been increasing at a fairly exponential rate for over the past 30 years. Some cultures have had as much as a 300% increase in its rate of diagnosis in the past 20 years. Because it is silent, most people are unaware they have it until they experience their first fracture. But, 20 to 40% of people who fracture their hips die within 6 months of the injury, and many survivors need long-term care. Many researchers pass the problem off as an age related incident, but the trends have continued to increase each year and osteopenia continues to be diagnosed in ever younger populations. In other words, we can see an upward trend in the chances of osteoporosis as the population ages, but this trend is also driven by the food industry and the nutritional value of the foods we purchase.
So, if you've been led to believe that the key to preventing osteoporosis is increasing your calcium intake and starting on a regimen of pharmaceutical drugs, then stop right there. None of that is true. The American Dairy Association would have you believe that drinking more milk will protect you. But, Studies over the last few decades have demonstrated the highest Incidence of hip fracture in some of the highest dairy consuming countries in the world. Countries such as Sweden and North America. In countries with lower dairy intake it is almost seven-fold lower. Hip fracture rates are also lower in Asian and Latin American populations where lower quantities of dairy are consumed. It is interesting to note that rates of osteoporosis over the past decade in countries such as Asia have increased exponentially, right along with their increase in processed foods.
Drugs are not the answer, and they never were. The incidence of bone fractures may actually increase with osteoporosis drugs because it causes bone to become more brittle with use. As for calcium, yes it is required for bone remodeling, but it is not the lone ranger. There are over a hundred minerals required to build bone. In fact, calcium is no more important than any of the other minerals, but to isolate it as a cure for osteoporosis is a mistake. That would be similar to saying that sand is the only component required to make cement! Sand alone cannot make cement any more than calcium alone can make bone.
The question is why do we have a risk of this devastating condition? Medical experts would have us believing it is merely a consequence of aging. Yet when we look at older people without it, we find some interesting things. Perhaps the most interesting thing we find, is that osteoporosis is not universal based on aging. So let’s simply stop saying it’s an aging issue, and see what else accelerates it.
It is important to understand that the strength of your muscle triggers your bone to become more dense or stronger. In other words, the stronger you are the less of a chance you have of osteoporosis. So it would therefore make sense that things that decreased your strength (inactivity included) would have a profound influence on your risk factors for osteoporosis. While it is perhaps obvious that strength training builds strong bones, it is not always obvious why some people lose strength faster than others. Until now.
According to a study at Washington University School of Medicine in St Louis, a strong link between osteoporosis and the use of steroids exists. In the United States and other developed countries we are all too quick to treat pain and inflammation with high doses of cortisone. But while cortisone has a use, it also has many side effects. Other than increased risk of heart attack it also comes with peptic ulcers, bleeding and cataracts, the musculoskeletal side effects include muscle weakness, loss of muscle mass, osteoporosis, vertebral compression fractures, aseptic necrosis of femoral and humoral heads, pathologic fracture of long bones, and tendon ruptures. (Source) These side effects, and the effects on the muscle mass and strength become important as we consider the link between muscle strength and strong bones.
Other drugs can cause muscle damage too. Some of the most notorious are the statin drugs. It is well known that the most common side effect is muscular pain, joint pain and weakness. The problem is that Statins such as Lipitor, Zocor, Pavacol and Mevacor lower cholesterol by inhibiting HMG-CoA reductase, a key enzyme in cholesterol synthesis. But they also activate the atrogin-1 gene, which plays a key role in muscle atrophy. If you take the drug for more than two years, you also begin to experience nerve damage too further decreasing the muscles ability to remain strong. That’s only one risk, other risks include a 50% increase in your chances of diabetes, further causing damage and more weakness to your muscles. Remember, weak muscles lead to weak bones.
Proton pump inhibitors (PPIs), are used to treat gastroesophageal reflux disease (GERD) and other similar disorders, but they also increase your risk of osteoporosis. More than 20 million Americans take prescription PPIs, both by prescription and over the counter.
Tranquilizers, are used to treat a variety of anxiety disorders, agitation and muscle spasms, and to prevent seizures, but they also lead to muscle weakness. How? Benzodiazepines have a sedative/hypnotic effect, they are sometimes used to treat insomnia and the anxiety component of depression. Benzodiazepines can cause sedation and fatigue by dampening activity in key parts of the central nervous system (CNS), this ultimately leads to less activity, which leads to muscle loss, which affects your bone development.
Antihistamines are used to relieve or prevent the symptoms of allergic disorders (such as hay fever) or the common cold. Some antihistamines are also used to prevent motion sickness, nausea, vomiting and dizziness, and to treat anxiety or insomnia. But they are also central nervous system depressants. Most list tiredness and drowsiness among the potential side effects; some list dizziness and weakness.
Antidepressants are typically used to treat depression, they're also frequently prescribed for anxiety disorders, eating disorders, obsessive compulsive disorder, chronic pain, smoking cessation and some hormone-mediated disorders, such as severe menstrual cramps.
There are many different kinds of antidepressants, including tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), selective serotonin re-uptake inhibitors (SSRIs), dopamine antagonists and lithium, among others. But they lower your potassium levels (hypokalemia) which in turn leads to muscle weakness which decreases bone strength.
Antipsychotics are used to treat schizophrenia, bipolar disorder and other serious psychiatric conditions. Antipsychotics are also often prescribed "off label" to treat agitation and depression, among other conditions. Antipsychotics are powerful CNS depressants. In studies, the side effects include fatigue, lethargy and weakness. Many of these drugs also lower dopamine levels, which can lead to drowsiness and sleepiness as well.
Antibiotics used to treat many health conditions caused by bacteria, including ear and skin infections, urinary tract infections, food poisoning, pneumonia, meningitis and other serious illnesses are also used in the livestock to prevent sickness. In fact, half of the antibiotics used in the US is used in the livestock.
Researchers have long known that some people who take antibiotics experience feelings of tiredness and extreme fatigue, but it's still not clear exactly why. If you read the safety and prescribing information for sulfamethoxazole/trimethroprim (Bactrim DS), for example, you'll see "unusual tiredness or weakness" listed as a potential side effect. Similarly, the package insert for cephalexin (Keflex, Keftabs, Panixine, Biocef, Zartan) lists fatigue as a potential side effect too.
Diuretics (sometimes called water pills) are used to treat high blood pressure, glaucoma, edema and other conditions. Diuretics can interfere with the balance of electrolytes — the major ones being sodium, potassium and chloride — in your body. Electrolyte imbalances can cause serious health problems, including extreme fatigue, muscle weakness and achy joints, bones and muscles (along with many other symptoms not related to fatigue).
What we find is that many prescription drugs and over the counter medications either cause muscle pain and weakness, fatigue, dizziness or, such as in the case of cortisone, inhibit the ability of osteoclasts to dismantle old bone and then renew that bone, leading to weaker bone structures. Either way the road points to weaker bone materials after a lifetime of use of certain medications. Couple that with inactivity and you have the perfect osteoporosis storm.
Lately, we have heard an increase in the term gluten intolerance. And for good reason. Gluten not only causes chronic gas, nausea, bloating, diarrhea, constipation and brain fog, but it also interrupts your gut flora too.
Gluten is a protein found in grains such as wheat, rye and barley. According to statistics from the University of Chicago Celiac Disease Center, an average of one out of every 133 otherwise healthy people in the United States suffer from celiac disease (CD) but previous studies have found this number could be as high as 1 in 33. Gluten sensitivity occurs at a higher rate, but is given little credence by the medical community at this time. It is however a very real phenomenon.
Those with undiagnosed gluten intolerance (including sensitivities) often have malabsorption of nutrients due to chronic intestinal damage. This means that your body is unable to optimally take nutrients from food and distribute them throughout your body, so you become essentially malnourished. This malabsorption of nutrients can lead to osteoporosis. But it goes much deeper than this. When patients with celiac disease and osteoporosis were put on a gluten-free diet for one year, they were able to improve not only gastrointestinal symptoms but bone density as well, researchers said. In the study, 4.5 percent of people with osteoporosis also had celiac disease, compared with only 0.2 percent of people with healthy bones. Researchers say this occurrence was high enough to justify regularly screening patients with osteoporosis for celiac disease, and if the results come back positive to put them on a gluten-free diet to treat both conditions.
Soda is another culprit for accelerating bone demineralization. Most sources point to the conclusion that soda decreases calcium absorption. Researchers have also discovered that parathyroid hormone (PTH) concentrations rise strongly following diet soda consumption. PTH functions to increase blood calcium concentrations by stimulating bone breakdown, and as a result release calcium from bone which is then removed from the body via urination. Caffeine is also known to increase calcium excretion and promote bone loss, therefore, since many sodas also contain caffeine as well as phosphoric acid, then this combination is likely an explanation for some of its bone-harming ingredients. A 2006 study in the American Journal of Clinical Nutrition found consistent associations between low bone mineral density and caffeinated and non-caffeinated cola (both regular and diet), but not other carbonated beverages.
Phosphorus also occurs naturally in many foods, but is added to processed grains. In the Western diet, phosphorus is commonly consumed in excess – at about 3 times the recommended levels, whereas dietary calcium is often low, primarily because we do not absorb it well and calcium molecules in dairy are too large in general for effective absorption. Although phosphorus is an important component of bone mineral, a high dietary ratio of phosphorus to calcium can increase parathyroid hormone (PTH) secretion, which is known to increase bone breakdown. Studies in which women were given increasing quantities of dietary phosphorus found increases in markers of bone breakdown and decreases in markers of bone formation.
Obviously, we need to be careful of the type of food we eat and our exposure to pharmaceutical drugs. But it reaches far deeper than simply changing our lifestyle. It would appear that fluoride in drinking water may also interfere with osteoblast cells contributing to a higher fracture risk in populations that consume water from city sources.
If you are inactive, it is important to immediately consider strength training. Inactivity leads to bone loss, but weight bearing activity cannot stimulate strength within skeletal muscles if it is submaximal. Remember that bone is living tissue that requires regular physical activity in order to renew and rebuild itself, but only if the muscle is appropriately stimulated.
Resistance training can combat this effect because as you put more tension on your muscles it puts more pressure on your bones, which then respond by continuously creating fresh, new bone. Whole body vibration is the best, since it tends to increase bone at a faster rate. At ReVibe, one of our clients experienced a 9.2% increase in only a year.