Beyond calcium: nutrients for osteoporosis and poor bone health

Beyond Calcium: Nutrients for Osteoporosis and Poor Bone Health

By Andrew Gaeddert

Ten million Americans over fifty have osteoporosis and 1.5 million people have fractures due to poor bone health. Of the 80,000 men who sustain a hip fracture annually, one third will die within a year. Nutrients not only prevent bone problems, they have numerous other health benefits as well. Adequate calcium and vitamin D are necessary whether or not people take osteoporosis medication. In this article, we will explore the benefits of the most important bone-building nutrients.

Supplemental calcium alone does not usually restore lost bone in individuals with osteoporosis. Calcium in combination with other nutrients or drugs is required. It is recommended that calcium be obtained from foods. This is very difficult if one is sensitive to dairy products. Supplements come in several forms including carbonate, hydroxyapatite (from veal bones), citrate, citrate malate (which has been found as the best absorbed), lactate, and gluconate. To maximize absorption, divide doses, and take with food.

Although not all studies have shown a benefit, one study of 3,200 elderly French nursing home residents, receiving 1,200 mg of calcium and 800 IU of vitamin D or a double placebo,1 showed reduced incidence of hip fractures within eighteen months. In a study of 389 ambulatory men and women aged sixty-five or older receiving 500 mg per day of calcium citrate malate, and 700 IU of vitamin D or a double placebo, subjects were able to reduce bone loss from the spine, hip, total body, and the incidence of fractures was lowered by fifty percent after 3 years. Patients also consumed 700 mg of calcium and 200 IU of vitamin D in their diets during the study. According to the National Academy of Sciences, the recommended calcium intake for women and men over fifty years of age is 1,200 mg, however some experts recommend 1,500 mg per day for postmenopausal women. The safe upper limit for calcium is 2,500 mg per day.

In a recent Women’s Health Initiative study using calcium and vitamin D, both subjects and the placebo group were allowed to take additional calcium supplements, which may have skewed the results. Calcium intake for the placebo group averaged about 1100 mg per day from a combination of supplements and diet. Although the NIH said that the trial had no effect on hip fractures and bone density, critics say that the study essentially compared those taking about 2,000 mg of calcium per day (test subjects) with the placebo group taking about 1,000 mg per day. Additionally subjects were only taking 400 IU of vitamin D per day.

Nevertheless, women over sixty had a 21 percent reduction in risk for hip fracture. Women who consistently took their full dose of calcium had a twenty-nine percent decrease in risk. As a result, the NIH has said that current calcium guidelines should remain in place and women over sixty especially should consider the supplements for bone health.2

MAGNESIUM

Magnesium may be just as important to bone health as calcium. “Magnesium is a lesser studied component of bone that may play a role in calcium metabolism and bone strength. Magnesium deficiency may contribute to a loss of bone mineral density via lower retention of calcium and decreased intestinal absorption of calcium,” according to Kathryn Ryder, MD, who has studied the importance of magnesium intake in 2,038 men and women seventy to seventy-nine years of age.3 Magnesium is a cofactor for alkaline phosphatase, an enzyme that plays a role in normal bone mineralization. In a study of thirty-one postmenopausal women receiving 250 mg of magnesium one to three times per day, seventy-one percent had an increase in bone density of 1-8 percent after one or two years. These improvements occurred even though the women did not take calcium supplements, and despite the fact that BMD rarely increases spontaneously in this age group.4 Magnesium supplementation has also been shown to reverse bone loss in patients with celiac disease whose osteoporosis had persisted despite consumption of a gluten free diet.5 Food sources of magnesium include whole grains, nuts, beans, dark green leafy vegetables, fish, and meat. The main side effect of excessive magnesium intake is diarrhea.

STRONTIUM

Strontium is similar in composition to two other bone-friendly minerals, calcium and magnesium. Virtually all of the 300-350 mg of strontium contained in the human body is found in the bones and teeth.6 In fact, strontium can actually replace some of the calcium in bones and teeth, making them thicker and stronger.7

Strontium also appears to draw extra calcium into the bones. We generally get about two milligrams of strontium daily from food, including spices, seafood, whole grains, root and leafy vegetables, and legumes.8

Strontium has proven as effective as the pharmaceutical drugs commonly used to treat osteoporosis. Compared to the drugs, strontium offers the bonus of being free of side effects. Studies published up to 2002 have turned up no cases of toxicity and no significant side effects for dosages up to 1,700 mg of strontium daily. However, bone deformities occurred in animals given a low-calcium diet along with high doses of strontium, so be sure to recommend adequate calcium while taking strontium supplements.9

Studies conducted over the past hundred years consistently show that strontium benefits bone health. Studies have determined the minimum effective dose to be 680 mg of active strontium for postmenopausal women with osteoporosis and 340 mg in post-menopausal women without osteoporosis.

In a 2-year French study published in 2002, 338 postmenopausal women were divided into groups taking varying levels of strontium with 500 mg calcium and 800 IU vitamin D daily. All three groups showed dose-dependent increases in lumbar bone density in 12 and 24 months. For example, the 85 women taking 680 mg of active strontium daily showed bone density increases of 3 percent in the first year, and 2.4 percent in the second year, with a 44 percent reduction in new vertebral fractures compared to the placebo group.10 In a study of 160 postmenopausal women who didn’t have osteoporosis, also published in 2002, all participants showed a significant increase in bone density in two years of taking 340 mg of active strontium daily, along with 500 mg of calcium. In this study, the placebo group actually reported more adverse effects than the participants taking strontium did! Moreover, in yet another study published in 2002, 353 women with a previous vertebral fracture, taking 680 mg of strontium daily, experienced a 3 percent annual increase in lumbar bone density.11

A three-year study published in 2003 showed that women with osteoporosis taking 680 mg of active strontium daily experienced a forty- one percent reduction in vertebral fractures, and an 11.4 percent increase in vertebral bone density, compared to a 1.3 percent decrease in overall vertebral bone density in the placebo group.12

In a large study published in early 2004, consisting of 1,649 postmenopausal women who had experienced at least one vertebral fracture, the participants taking strontium had half as many vertebral fractures at the end of one year as the control group who received placebos. After three years, the women taking strontium had forty-one percent fewer fractures than the placebo group, and showed bone density increases of 14.4 percent in the spine, and 8.3 percent at the femoral neck. Authors of the study noted that these reductions in fractures are similar to those found with other drugs currently used to treat osteoporosis, including alendronate (forty-seven percent), resedronate (forty-nine percent), raloxifene (thirty percent) and parathyroid hormone (sixty-five percent after 21 months).13

In another recently published study consisting of 1,442 menopausal women with osteoporosis, half took 2 g of strontium daily along with vitamin D and calcium supplements. The women taking strontium experienced a 10 percent decrease in vertebral fractures and a 6.8 percent increase in vertebral bone density com- pared to only 1.3 percent decrease in vertebral bone density for the control group that took only vitamin D and calcium.14 And in the largest strontium study yet, 5,091 women who took 2 g of strontium every day for three years also showed a forty-one percent reduction in hip fractures.15

When evaluating strontium supplements, make sure to use a product that contains 680 mg of active strontium for osteoporosis, and 340 mg per day for osteopenia. For example, two capsules per day of BioStrong, developed by the author, contain 680 mg of active strontium, and peperine, an herb extract that improves absorption.

ADDITIONAL NUTRIENTS AND RECOMMENDATIONS

In addition to calcium, vitamin D, magnesium and strontium, vitamin K, manganese, and boron support bone health. Soy protein and fish oil may act synergistically to decrease bone loss after menopause, although neither has been proven to actually increase bone density. Lignans found in black and green tea, sunflower seeds, flaxseed, broccoli, pumpkin seeds, garlic and peanuts may have a protective effect on the bones. Herbal kidney tonics such as OsteoHerbal16 are used to increase bone strength and may help promote balance and calcium absorption. It is the author’s current recommendation to have clients take adequate calcium and vitamin D with meals, and to take

1-2 capsules per day of BioStrong strontium between meals on an empty stomach for one to three years. For clients wishing to avoid bisphosphonate drugs, herbal formulas may be considered.

NOTES

  1. Chapuy MC, Arlot ME, Duboeuf F, et al. Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med. 1992; 327(23):1637-1642.
  2. WHI.org
  3. Ryder KM, Shorr RI, Bush AJ, et al. Magnesium intake from food and supplements is associated with bone mineral density in healthy older white subjects. Journal of the American Geriatrics Society, 2005;1875-1880.
  4. Stendig-Lindberg G, Tepper R, Leichter I. Trabecular bone density in a two year con- trolled trial of peroral magnesium in osteoporosis. Magnes Res. 1993; 6:155-163.
  5. Rude RK, Olerich M. Magnesium deficiency: possible role in osteoporosis associated with gluten-sensitive enteropathy. Osteoporos Int. 1996; 6:453-461.
  6. Haas, Elson. Excerpt from Staying Healthy with Nutrition:The Complete Guide to Diet and Nutritional Medicine at http://www.healthy.net/scr/article.asp?ID=2084.
  7. Dean, 2.
  8. Wright, Jonathan V. “Fight-even prevent-osteoporosis with the hidden secrets of this bone-building miracle material,” p9, reprinted from Nutrition and Healing at www.tahomaclinic.com/strontium.shtml.
  9. Wright, Jonathan V. “Fight-even prevent-osteoporosis with the hidden secrets of this bone-building miracle material,” p9, reprinted from Nutrition and Healing at www.tahomaclinic.com/strontium.shtml.
  10. “Strontium ranelate improves bone density in postmenopausal osteoporosis” at http://emeryneuro.com/ strontium_improves_bone.htm.
  11. Wright, 6.
  12. Wright, 7.
  13. Gardner, Amanda. “Long-shelved drug cuts fracture risk” Health Day News at www.healthcentral.com/news/NewsFullText.cfm?id=517172.
  14. Seppa, N. Strontium compound prevents some fractures. Science News. Jan. 31, 2004, v. 165 i5 p68.
  15. J.Y. Reginster et al. Osteoporosis Int. 2002 13 (Suppl. 3) Abst 014
  16. Gaeddert, AG. Health Concerns Clinical Handbook, 4th Ed. Oakland, CA, 2006. p. 187.

Andrew Gaeddert has designed Focus on Osteoporosis and Preventing Fractures, a self-paced course offering 4 CEU’s. The course is available on CD – Call 800-233-9355 for more information.

Mr. Gaeddert is an herbalist and author of the books Chinese Herbs in the Western Clinic, Healing Digestive Disorders, Digestive Health Now, Healing Skin Disorders and Healing Immune Disorders.

© September 2006

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