Question: My mother had osteoporosis. Will I get osteoporosis too?
Here at the Center for Better Bones, we often say that it is difficult to solve a problem you do not fully understand.Osteoporosis does not happen “just because” — there are always underlying causes of osteoporosis. Some of these causes are lifestyle-related, but others can be undetected health problems of which the bone loss is just a symptom.
If you have a bone health problem — or if you or your doctor simply suspect you might have a serious bone concern — an osteoporosis medical work-up of tests is in order to look for the causes of your bone loss.
Step #1: Find out what is happening — are you really losing bone?
When there is any type of bone health concern, an attempt should be made first to understand exactly what is happening with the bones.
Questions we might ask here include:
- What is your bone density compared to young folks of your same sex?
- What is your bone density compared to folks of the same sex and same age?
- Are you underweight with small bones, and thus more likely to have a low bone density reading?
- Is your bone loss ongoing?
- If you’re female, is your bone loss related to the transitions of perimenopause and early postmenopause?
- Do you have multiple osteoporosis risk factors?
- Have you experienced any fractures?
- Overall, is there a real problem?
Step #2: Find out why it is happening — what’s the cause of your bone loss?
After these questions have been answered and it has been determined that there is a real concern, then the next step is to undertake medical testing to uncover the underlying causes of any real problems. A good osteoporosis medical work-up can include a variety of tests such as the ones listed below. Background information for these tests and their interpretation is provided in my two articles, The diagnostic tests to find what causes osteoporosis and Understanding your test results.
Tests included in the medical work-up for osteoporosis
- Vitamin D 25(OH)D blood test
- Ionized calcium test
- Intact parathyroid hormone blood test (iPTH)
- 24-hour urine calcium excretion test
- Thyroid hormone function test (TSH)
- Markers of bone resorption tests (NTx, Dpd, CTX)
- Vertebral deformity assessment
- Free cortisol test (blood or saliva)
- DHEA test (blood or saliva)
- C-reactive protein test (high sensitivity if possible).
- Homocysteine test (plasma or serum)
- Sex hormone testing
The final step in this process should be clear: once you know that you’re losing bone and have found out why you’re losing bone, you can stop the bone loss by addressing the underlying health problem that’s costing you bone! In some cases, it may be something as simple as improving your vitamin D status, either by spending more time in the sun or using vitamin D supplements, or both if needed. Other health concerns might need more complicated solutions, requiring further discussion with your healthcare provider to help you understand what your test results mean.
To thrive in life you need 3 bones: a wishbone, a backbone and a funny bone.
Oh, how I wish I had been the one to come up with the quote above. Instead, the credit for this wise — and clever — thinking needs to go to the famous country music singer Reba McEntire.
I wonder if Ms. McEntire realizes how paying attention to your wishbone, backbone and funny bone can also help build and strengthen the 206 other bones that are in your body?
How 3 special bones benefit your bones
Wishbone. I believe that we put our attention on grows stronger in our life. And putting attention to something often begins as a simple wish.
For all of the things that I wish for, I make a clear list, carry it wherever I go, and take time to give attention to those things. At the same time, I intentionally release worries and concerns that could be harmful to my goals.
Backbone. You have a wise inner guide when it comes to your health — have the confidence to listen to it! Remember, you always have the right to question the information you’re being given about your health and to make the ultimate decisions about what to do. If a recommendation “doesn’t feel quite right” but you can’t put your finger on why not, use your backbone to pay attention to your inner voice.
Funny bone. Every action we take to strengthen our bones should also increase our overall health and enjoyment of life. What’s more enjoyable than laughter, joy and celebration — all which benefit our bones? Many studies show that laughter helps to decrease stress, improve immune function and even reduce our response to pain.
If you want to get started with your funny bone, to the right is one of my favorite cartoon drawings.
Here’s to the health of all of your bones!
I’ve noticed that when I approach things from a little different angle I gain new insights. So, in celebration of May as “National Osteoporosis Awareness and Prevention Month,” let’s look at osteoporosis from a little different perspective than what many conventional practitioners tell us:
Did you know . . .?
Up to 80% of all those who experience an “osteoporotic” fracture do not have “osteoporosis” as defined by bone density (that is, a T-score of -2.5 or greater.)
Instead, they may have “osteopenia” or even normal bone density. These fractures are not related to mineral density issues, but to sub-optimal health and inadequate repair of the bone protein collagen matrix.
What this means for you: Get enough of all the 20 key bone nutrients daily as well as adequate protein to enhance healthy bone protein matrix.
You can reduce your real risk of fracture even without gains in bone density.
For example, supplementation with vitamin K2 strengthens bone and reduces fracture risk without substantially increasing bone density. Strength training also significantly reduces fracture risk yet only causes minor changes in bone mineral density.
What this means for you: Go beyond seeing bone density as the most important factor in bone health. Consider your total body muscle strength, balance, wellness, and zest for life. Keeping bone density loss to a minimum is important, but big gains are not essential for useful fracture reduction.
Bone size matters
Small and thin women have special bone health concerns. For example, small bones break more easily than larger ones; thin women lose more during the menopause transition; and often as a group they experience tendencies toward weak digestion, poor sleep, low energy, excess worry and anxiety, and low bone formation.
What this means for you: If you’re thin, much less thin and worried, keep building and maintaining bone strength as top priorities. Take care not to lose weight, since when you lose weight you also lose bone.
During the transition into menopause the average woman loses 10% of her bone mass
And many thin women and selected others lose up to 20%. Interestingly enough, much of this loss occurs in the first year before the last period.
What this means for you: Begin a bone building program well before you see signs of the menopausal transition. Bone loss actually begins in the early 30s. Even in youth we need to build stronger bones with appropriate diet, exercise, and nutritional supplementation.
Remember, it is never too late (nor too early) to build, and rebuild, bone. And what better time to start than National Osteoporosis Awareness and Prevention Month!
While I focus this blog on women and their greater risk for bone loss, it’s important to remember that men suffer from poor bone health and osteoporosis too.
In fact, some risk factors may affect men even more than women. For example, a new study highlights than men who smoke were more likely than women who smoke to have osteoporosis and fractures of their vertebrae.
How does bone loss affect men?
- Bone density decline: Just as women do, men lose bone density as they get older. The rate increases after the age of 50, due to lower vitamin D, calcium absorption and sex hormone levels. A low level of testosterone is associated with the development of osteoporosis.
- Hip fractures: About 30% of hip fractures occur in men. However, mortality in men after a hip fracture is considerably higher than in women.
- Cost of osteoporosis: Approximately 20% of the total cost of osteoporosis in the United States is attributed to fractures in men.
- Secondary causes: Two-thirds of men with osteoporotic fractures have one or more secondary causes of metabolic bone disease, including steroid use and low testosterone.
What men can do for bone health
As more attention is paid to osteoporosis and fracture risks of men, we inevitably will see a push to drug therapy. But the natural approach for bone health is highly effective for men too:
• Determining if there’s a secondary cause for bone health, including low testosterone
• Getting enough of the 20 key bone-building nutrients, with my Better Bones supplements
• Eating an alkalizing diet and
• Strengthening bones and muscles through exercise
• Reducing stress and practicing meditation
• Eliminating any tobacco use and excessive alcohol intake
• Avoiding pesticides and plastic food contamination as they can be estrogenic and reduce testosterone
Now that you know the risks men face to their bone health, you can help family members, friends and partners take steps to better bones and a better body. One good place to start is the Bone Health profile that is designed for both men and women. Take it or share it now!
Joshua D. Jaramillo, Carla Wilson, Douglas J. Stinson, David A Lynch, Russell P Bowler, Sharon Lutz, Jessica M Bon, Ben Arnold, Merry-Lynn N McDonald, George R. Washko, Emily S Wan, Dawn L DeMeo, Marilyn G Foreman, Xavier Soler, Sarah E Lindsay, Nancy E. Lane, Harry K. Genant, Edwin K Silverman, John E. Hokanson, Barry J Make, James D Crapo, Elizabeth A Regan. Reduced Bone Density and Vertebral Fractures in Smokers: Men and COPD Patients at Increased Risk. Annals of the American Thoracic Society, 2015; 150226144213008 DOI: 10.1513/AnnalsATS.201412-591OC
“Can stress cause osteoporosis?” I’ve been asked this question by thoughtful women at least a thousand times. Until now, my response of “yes” was based on ancient Eastern medical sciences which directly link emotions and bone health.
For some 5,000 years ancient Eastern medicine has said that skeleton health, as all health, flows from a state of internal mind-body-spirit-emotional balance. Strong emotions and one’s response to them hold sway over specific organs and internal energy circuits. For example, while anger upsets the liver, the emotion of fear, anxiety and worry drain and dry the bones.
Modern Science catches up with Ancient Science
Now with the concept of “stress-induced osteoporosis,” modern Western science is catching up with ancient Eastern science. Here’s how.
One important way Western medicine is showing a healthy respect for the power of emotions is by recognizing that depression and anxiety are linked to weaker bones. The emphasis is the detailed study of the biochemical mechanisms involved, and I recently saw the first medical article identifying “stress-induced osteoporosis.” The research focused on the production and activity of stress hormones such as cortisol, epinephrine and norepinephrine.
As most things in modern medicine tend to do, the article attempts to unravel the nuts and bolts mechanisms by which stress alters physiology. I suspect they are most likely looking for knowledge which would allow for the development for a drug to interfere with the mechanics stress-induced damage. While contemporary medicine is not exactly aimed at getting to the roots of anyone’s stress response, it at least now recognizes the emotion-bone link.
However, from my clinical practice it is clear to me that Traditional Chinese Medicine, Ayurveda of India and ancient biblical texts had it right. Health lies in balance, and chronic negative emotions are powerful forces that can disrupt internal balance. As for bone…fear, anxiety and worry take their toll. Previously I detailed a simple procedure to begin modulating the fear response. Read more here.
I’ll be writing more on this soon.
Baldock, P. A., et al. 2014. Neuropeptide y attenuates stress-induced bone loss through suppression of noradrenaline circuits. Journal of Bone and Mineral Research 29(10):2238–2249. DOI: 10.1002/jbmr.2205.
Furlan, P. M., et al. 2005. The role of stress-induced cortisol in the relationship between depression and decreased bone mineral density. Biological Psychiatry 57(8):911–917. DOI: 10.1016/j.biopsych.2004.12.033.
When I look back, 2014 was an exciting year for bone blogs! I think my personal favorite was my blog about new information about strong women and strong bones.
In case you missed it — or any other top 2014 blogs — here are the blogs women found most helpful this year on their path to Better Bones.
Nourish the root to receive the fruit
Strong women, strong bones
25 positive intentions
Probiotics and bone health
How to overcome your fear
My own vitamin D miracle
Why I value meditation
Protein: good or bad for bone?
What blog was your favorite or what did you enjoy learning more about bone health this year? I look forward to reading your responses below to continue our conversations in 2015!
Happy New Year!
I know how scary a diagnosis of osteoporosis or osteopenia can be — especially when you’re told your only option is to take a bone drug – possibly for the rest of your life. I work with women every day who are facing this fear and frustration.
Most women aren’t aware they have other choices — because their doctors don’t know what those options are, and the big drug companies certainly aren’t going to tell them!
The first thing you should consider before filling that prescription is that you have a right to know all of your options — as well as the whole story about that drug you’re being asked to take. As someone who has studied the effectiveness of a natural approach to bone health for more than 20 years, here are five crucial reasons why bone drugs should be your last resort for osteoporosis, osteopenia or fear of bone loss.
1. You’ll put your bones at long-term risk.
Bone drugs have troubling side effects that can significantly affect your bone health, especially when used over time. One troubling side effect is seen with bisphosphonate drugs. While they may halt bone breakdown in the short term, after about a year, these bone drugs also halt bone building — leading to brittle bones that may bemore susceptible to fracture, not less. How’s that for irony?
2. You’ll also face risks to your whole body.
Serious consequences like stomach irritation, heighten risk of esophageal cancer, blood clots, leg cramps, vision changes, nausea, vomiting, constipation… for a complete look at thedangerous side effects of using bone drugs long-term, I’ve developed this chart. These side effects are critically important to consider, especially if you’re being asked by your doctor to take bone drugs for may be likely normal bone loss or even as prevention.
3. Bone drugs produce few lasting results.
Popular bisphosphonate bone drugs “work” by temporarily creating bone mass from drug molecules, but they don’t offer lasting results. Based on my experience, I’ve learned that just because bones may look denser on a bone scan it doesn’t necessarily mean they are measurably stronger. What’s more, the recommended limit for taking bone drugs safely is just five years, at which time any “benefits” of bisphosphonates disappear.
4. The U.S. Surgeon General recommends natural approaches first.
When it comes to treating patients with osteoporosis and osteopenia, guidelines from the Surgeon General of the United States state that improvements to dietary and exercise habits are the first steps your physician should recommend, followed by investigation of potential underlying causes of bone loss. The report goes to say the final step — the last resort — is to use bone drugs – and only in cases of osteoporosis. I couldn’t agree more!
5. Your doctor may not truly understand what’s best for you.
Unfortunately, I don’t see many conventional physicians following the Surgeon General’s guidelines. They try to “fix” the problem immediately, and as a result, too many women are automatically prescribed bone drugs rather than being offered natural and effective options. You have a right, and even the obligation, to decide what is best for you and your body!
Common causes of bone loss – how to address them naturally
I’ve found that for many women, the underlying cause of their bone loss can be effectively addressed by working with Nature and the body’s own healing capabilities. Here are a few of the most common causes for you to consider:
Cause of osteoporosis and bone loss
How the natural approach works
|Inadequate nutrients can cause your body to steal the minerals you need from your bones’ reserves.||Even a perfect diet may not provide your bones with enough nutrients, so considersupplementation for optimal bone health.For example, getting adequate vitamin D can reduce fractures as much as – or even more than – drug therapies.|
|An acid-forming diet causes your body to release buffering mineral compounds from your bones that should instead be safeguarded for your future bone health.||An alkaline-forming diet with fresh vegetables, nuts, fruits and adequate protein helps keep buffering minerals in your bones where they belong.|
|Chronic stress increases your production of the stress hormone cortisol, which is extremely damaging to your bones.||Minimize your stressors — both physical and emotional — through self-care activities such as exercise, meditation or relaxation, to support your health and to feel calmer.|
|Lack of weight-bearing exercise leads to muscle and bone loss.||Exercise halts bone loss because bones strengthen in response to the strain put upon them. Doing something as simple as walking 20 minutes per day can reduce your fracture risk.|
What’s causing your bone loss?
There’s a lot of fear and anxiety around an osteoporosis or osteopenia diagnosis. To help you understand more about your true risk for bone loss and how a natural approach can help without the risks and side effects of drugs, take our exclusiveFracture Risk Assessment. Remember, you have a right to explore all your options, and to do what is right for you.
I’ve just returned from listening to thousands of scientists and physicians discuss their research at The American Society of Bone and Mineral Research Annual Conference. You can imagine how exciting it is to hear the newest findings, especially when it comes to the natural approach to building bone.
I’ve got plenty of interesting blog ideas, and here’s just the start of the news I’ll be blogging on in the coming weeks:
The latest important topics in bone health
• Vitamin D absorption can vary greatly from person to person — one dose does not fit all.
• 3 simple functional tests to assess your hip fracture risk
• New understandings about body weight and fracture — is being heavy protective?
• Silica: New research on its bone-building actions
• Skeletal nutritional needs: Have we missed the mark?
• What your breathing pattern reveals about you bone health
• Just how important is gym class for preventing osteoporosis decades later?
• Inflammation destroys bone, and not just in rheumatoid arthritis
• An engineer’s view on the 3 ways bone break — my views on why
• Does bone size make a difference?
What topics peak your interest most? Let me know and I’ll do my best to get you the details as soon as I can. Stay tuned and be well!
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