Osteoporosis is a condition characterized by a severe decline in bone mineral density.
Osteoporosis affects nearly 1 in 4 adult women over age 65, and 1 in 20 men over age 65 (source). If left untreated, people with osteoporosis can suffer life-threatening spine or hip fractures. For example, the average life expectancy after a senior citizen suffers a hip fracture is 12 months, whether they have surgery to repair/replace the hip or not. Spine and hip fractures can be very painful and debilitating.
Unfortunately, the best medicine for osteoporosis is the proverbial ounce of prevention.
Bone density loss is typically checked on a DEXA bone density scan. These scans are usually recommended during, or shortly after, menopause. According to the American College of Obstetricians and Gynecologists, bone density scans are recommended:
- In all women age 65 and up
- Postmenopausal women under age 65 with past medical or family histories of osteoporosis or spine/hip fractures
While this can help detect osteoporosis at earlier stages, these guidelines suggest screening at ages far older than the times when bone density loss initially begins. For a better understanding of bone density loss, it is important to understand what bone density is.
The image above shows an illustration of healthy bone density (left) and osteoporosis (right). The major difference, as you can see, is that the healthy bone has a thicker, fuller mesh, or matrix. The thickness of this matrix is determined by available vitamins and minerals, such as calcium, magnesium, boron, phosphorus, as well as vitamins C, D, and K. The matrix, or mesh collagen network, is determined by amino acid intake and hormone levels, such as estrogen, testosterone, and progesterone.
A More Proactive Approach is Needed
Logically, preventing osteoporosis is a much better goal than trying to reverse it once it has already happened. Fortunately, there are tests that can help you determine if you are losing bone density long before you ever reach the osteoporosis stage.
For example, one such test is called an N-telopeptide urine test, or Ntx for short. This test measures the amount of a specific protein byproduct of bone breakdown. When the amount of this byproduct becomes too elevated in the urine, it suggests that the individual is losing bone density faster than they are rebuilding it. If allowed to continue down this path, the individual would eventually develop osteoporosis. Research on the N-telopeptide test has shown that it can allow physicians to identify individuals at high risk of developing osteoporosis post-menopause.
Perhaps the biggest advantage of the N-telopeptide test is the ability to use it frequently as a barometer of treatment effectiveness. Unlike the conventional DEXA bone density scan, which is typically performed every two years (or more), the N-telopeptide test can be repeated as often as every 3-4 months. This gives your physician much greater control of the prevention/management process. If a physician determines a patient has low bone mineral density, a given intervention can be trialed over 3-4 months to see if it is helping instead of having to be on treatment for two years before repeating the DEXA bone density scan. At that point, if the treatment is not helping, the physician and patient have lost two years of time and money.
The most comprehensive approach to preventing osteoporosis is using the N-telopeptide test in conjunction with the conventional DEXA bone density scan. This way, real-time changes in bone breakdown in response to therapy can be verified or updated as necessary. Additionally, bone density status can continually be monitored on an ongoing basis.
Strategies for Treating/Preventing Osteoporosis
From a natural perspective, considering micro-nutrient deficiencies are often the underlying reason osteoporosis develops, it only makes sense to try to use micro-nutrient interventions to help prevent osteoporosis. The difficulty in this approach, however, lies in the fact that different patients may have different micro-nutrient deficiencies. We can either run expensive laboratory testing to determine these deficiencies for each individual, or we can simply recommend nutrients that contain all of the micro-nutrients inherent in healthy bone matrix.
For example, microcrystalline hydroxyapatite is a mineral compound comprising the entire matrix of bone. Studies show that supplementation with MCHC can improve bone breakdown on comparative and N-telopeptide tests, thereby eliminating the cost associated with extensive micro-nutrient laboratory testing for nearly all patients. The relatively low cost of MCHC also makes this intervention attractive for osteoporosis prevention.
Aside from micro-nutrient testing from patient to patient, there are instances where abnormal hormone metabolism can also contribute to declining bone mineral density. It is no coincidence that many cases of osteoporosis are initially diagnosed shortly after the onset of menopause. As intrinsic production of estrogen and progesterone decline, the quality of bone matrix also suffers; however, it may not be a simple estrogen or progesterone deficiency directly causing the bone density loss. Rather, estrogen, testosterone, and progesterone must all be maintained in ratio to one another to also maintain normal integrity of bone matrix.
Thankfully, testing for hormone levels is relatively straightforward and easy, even from the comfort of your own home. While many physicians typically check hormone levels via blood testing, saliva and/or urine hormone levels are often more indicative of the status of your body’s hormone utilization. Therefore, salivary or urine hormone testing can provide your physician with real-time information on your body’s ability to use these phytohormones.
Depending upon the results of hormone testing, natural hormone precursors can often be recommended in order to stimulate the body’s natural production of these hormones.
In other instances, prescription bio identical hormones may need to be prescribed when the body’s natural production fails.