osteoporosis treatment Archives

Posts

Prolia for Bone Fractures — I’m Still Not Impressed

April 1, 2024/in Bone Drugs /by Dr. Susan E. Brown

When the bone drug Prolia (denosumab) first came out in 2010, I took a hard look at it because it used a completely different mechanism than widely used bisphosphonate drugs, focusing on the RANK/RANK-L/OPG system to prevent osteoclasts from being “activated” instead of decreasing their number like bisphosphonates. I wasn’t satisfied in 2010 that this drug was any safer or more effective than bisphosphonates, and sad to say my skepticism has been borne out by recent research.

Dr. Brown’s 2024 Update:

Is Prolia a blockbuster bone drug — or a bust?

The FREEDOM Trial, which studied Prolia use in postmenopausal women for 3 years, found very little reduction in fracture risk. Vertebral and hip fractures were reduced 4.8% and 0.3% — meaning for 100 women they treated, only 5 saw fewer vertebral fractures than you’d expect with a placebo, and not even one woman was spared from a hip fracture by the drug. Given that hip fractures are considerably more harmful than vertebral fractures, these are minimal benefits indeed.

Although gains in bone density were observed, those gains were lost within 1 year of halting the drug (Cummings et al., 2017).

Furthermore, once they stopped using Prolia, patients’ risk of vertebral fracture quickly (<1–2 years) reverted to the same risk seen in those who’d never taken the drug in the first place (Cummings et al., 2017). They also lost a significant amount of the bone they’d gained by using Prolia — 35.5% of the total gain in the spine, 44.6% of the total gain in the femoral neck and 103.3% in the total hip (Zanchetta et al., 2017). In other words, the drug offered no lasting benefit.

Much more concerning: the finding that patients were more susceptible to having multiple vertebral fractures after discontinuing Prolia than patients who’d never taken the drug at all — and it was especially high in those who’d had such fractures prior to going on the drug in the first place (Cummings et al., 2017; Anastasilakis et al., 2017). This finding confirmed a number of earlier case reports of “rebound fractures” in patients who had discontinued Prolia within the preceding 12 months. Researchers speculated such fractures were a consequence of sudden renewal of bone resorption after the drug was stopped in combination with the absence of repair mechanisms during its use (Anastasilakis et al., 2017; Lamy et al., 2017; Polyzos & Terpos, 2016).

I’ve said repeatedly that working against nature invites unintended consequences, so I’m not surprised by these results. What is disappointing is the continued emphasis on the “magic bullet” approach to osteoporosis, when it has been clear for so many years that Prolia just doesn’t work.

Dear doctor, please treat me like a man

May 4, 2018/in Bone Drugs /by Dr. Susan E. Brown

Our skeletons were meant to last a lifetime, so when they show signs of not living up to this promise, we need to stop and ask ourselves, “What’s causing bones to weaken?”

Seems only logical, right?

While this is how thoughtful osteoporosis treatment begins, having spoken with thousands of individuals diagnosed with osteoporosis, I can’t help but notice a glaring difference between how women and men are treated when a bone health concern arises.

The double standard of conventional osteoporosis treatment

As a rule, women are told to take bone drugs when their T scores get to -2.5 or greater — without any investigation into the possible causes of their bone weakening. Often, they’re not even carefully questioned about their history, or even given a simple test for vitamin D adequacy. For a man with similar bone density or fracture history, however, a medical workup is usually ordered; he’s not simply handed a bone drug script.

Let me illustrate these statements with the cases of Sally and Robert.

Sally, a 61-year-old woman, experienced a spinal compression fracture and was found to have low bone density. Her hip and spine T-scores were -2.5 and -2.7, so she was diagnosed with osteoporosis. The doctor felt Sally’s osteoporosis was potentially dangerous, so he recommended bone drugs, despite all their limitations and unwanted side effects, as treatment. His recommendation was accompanied by remarks like, “You’ll fracture if you don’t.” When Sally expressed doubts, she heard, “You’ll end up disabled.”

At the Center for Better Bones, we take the position that if the doctor thinks the problem is serious enough to warrant bone drug use, then it is surely serious enough to warrant a search for the causes of this problem. Yet Sally wasn’t given even one of the medical tests commonly used to identify causes of bone weakening. She was simply and forcefully told to take bone drugs.

Richard, a slender, 55 year-old man with T-scores of of -3 in the hip and -2.5 in the spine, had no fractures. Like Sally, Richard was diagnosed with osteoporosis and offered bone drugs — but beforehand, he was subjected to one of the most comprehensive osteoporosis workups I’ve ever seen. He was tested for vitamin D, parathyroid hormone, loss of calcium in the urine, blood calcium, bone formation markers, celiac disease, autoimmune factors, a hormone panel, comprehensive nutrition testing — even tests looking for unusual bone marrow disorders. The irony is, men in his family have a tendency to have low bone mass, yet none ever had a significant osteoporotic fracture — so he was given this battery of tests (and offered drugs) despite personal and familial history suggesting his fracture risk was low.

While these are just two cases, this is something I typically see in my clients: women are rarely given the same sort of medical workup for osteoporosis as men, even when (as in Sally’s case) they have already had an osteoporotic fracture.

Finding hidden causes of osteoporosis

Of course, we should all review and correct any shortcomings in diet, lifestyle, exercise, behavior, and even thought patterns that contribute to less-than-ideal bone health. But if you have excessive bone loss or low-trauma fracture, women especially should seek out a physician who will look for underlying medical causes of bone weakness. As a guide, you might print out my list of osteoporosis workup medical tests to give your doctor. Follow this up by politely asking to be treated… like a man.

should you take a drug for osteoporosis?

Osteoporosis risks vs. benefits of osteoporosis drugs — spinning the numbers

July 11, 2014/0 Comments/in Osteoporosis /by Dr. Susan E. Brown

When it comes to osteoporosis, most patients and their practitioners are primarily concerned with fractures. The thinking behind bisphosphonates was that if we could halt the bone breakdown process and make bones denser, we could prevent them from breaking. Most of the ads you see will tell you this is the case. But on taking a closer look, the numbers don’t seem so hot.

What’s disappointing to me is the way numbers from studies can be manipulated to exaggerate treatment benefits. Allow me to give you an example. When the manufacturers of Fosamax say that the drug can reduce fractures by up to 50% in high-risk women, what they are referring to are results of a 2004 study showing relative risk reduction among women who, as a group, are already highly likely to fracture before they are even selected for the study. Most people don’t have time to analyze study results in detail, but these reveal that out of thousands of high-risk postmenopausal women (those with osteoporotic bone density and a history of previous fracture), about twice as many (2.2%) of the placebo group will fracture as those taking the drug (1.1%). Because 1.1% indeed is half of 2.2%, the drug’s manufacturer can advertise that the drug reduces hip fractures by 50% — which is the relative risk reduction (that is, a comparison of the number of people who fractured in both groups). But let’s not forget that both groups contained many more people who did not fracture at all, and if you include them in your comparison, you get what’s called the absolute risk reduction — a paltry 1.1% (2.2 minus 1.1) — in those taking Fosamax compared to those not taking anything.

A 2008 review of more than 40 years’ worth of data on more than 12,000 women using alendronate — that’s a lot of data — shows that overall, there was a mere 1-2% absolute risk reduction with its use. Co-opting this science, direct-to-consumer marketing continues to play up the 45-50% relative risk reduction figures. Yes, relative risk reduction can be a useful tool for researchers, and of value to a healthcare provider when determining absolute risk reduction. But any good biostatistician will tell you that it does not seem to be as useful a measure for patients or families when choosing a method of treatment!

Another detail we don’t hear from the drug companies is that fracture-reduction benefit of these drugs is largely for secondary prevention — that is, when bone density is already osteoporotic and/or there has been an existing fracture. There is much less benefit in primary prevention, where bone density is not osteoporotic and there have been no previous fractures. In women with osteopenia, some research even suggests increased rates of certain types of fracture with prolonged use! In fact, these drugs are not recommended at all for primary prevention, yet women who are not at elevated risk for fracture are among the largest target audience of direct-to-consumer advertising for bone drugs.

Possible adverse side effects associated with osteoporosis medications (bisphosphonates)

Ulcers of the esophagus
Upper GI irritation
Irregular heartbeat
Fractures of the femur
Low calcium in the blood
Skin rash
Joint, bone, and muscle pain
Jaw bone decay (osteonecrosis) (rare)
Increased parathyroid hormone (PTH)

If patients knew the reality of these numbers and the dangerous side effects that come with taking bisphosphonates (see chart at left), I’m sure they would reconsider the merits of taking a prescription for low bone density for the rest of their days. This information is hard to find, and many practitioners don’t have the time to analyze the statistics of each and every study that comes across their desk.

I would advise patients to ask their providers what the absolute risk reduction is for a drug before taking it. Or you can also ask about the number needed to treat (NNT). This figure gives you a sense of how many people would have to take the medication for one person to receive a benefit, and the lower the NNT, the better the chance that the drug will benefit you. For example, the above information tells us that Fosamax reduces fracture risk by about 1% (absolute risk reduction), so 100 people would have to be treated for one to benefit from fracture risk — the NNT is 100, in this case. In essence, the NNT is telling us that for every single person who is benefitting from these drugs, 99 more are getting no benefit at all!

The business behind bone density drugs

Unfortunately, the ads we see on television for various osteoporosis drugs don’t mention how small the benefits really are, or how serious the side effects can be. As the Baby Boomers begin to grow older, pharmaceutical companies have a market larger than ever before for bisphosphonates, and they aren’t stopping at much to capitalize on it. In fact, this large aging population is part of the reason it looks like osteoporosis has become an epidemic in this country. In reality, US hip fracture rates have gone down since the late 1960’s in women and since the early 1990’s in men, despite an aging population. Because of the large number of aging Baby Boomers, the actual number of fractures can seem overwhelming, even though the rate is decreasing.

It’s true that such a large group of people getting older, possibly fracturing, and taking up hospital beds will represent a burden to society. This is partially why drug companies want to find a solution, but the other part — as I’m sure you can imagine — has to do with profits. In 2006, at least $2 billion was spent on Fosamax alone. Drug companies are pushing hard for direct consumer advertising to encourage women to get bone density tests, in the hopes they’ll then be treated for low bone density.

In an article on leveraging the potential osteoporosis market, a contributing editor to Medical Marketing and Media writes, “In the United States, 95–100% of women who are screened and diagnosed with osteoporosis receive treatment.” He goes on to advise drug companies to “drive diagnosis rates” by sponsoring traveling DEXA scans in shopping malls, clubs for the elderly, and community events.

The DEXA scan was developed in the early 1980’s as a way to quantify bone density, but unfortunately it doesn’t reveal much about the actual strength of bone. Patients are given a T-score that compares their bone to that of a healthy 20- to 30-year-old, then told they have osteopenia or osteoporosis! The Z-score, which compares your bone density to that of other men or women in your age group, is more helpful for tracking your bone density over time, but still not great at predicting risk. The reality is there are many factors that go into predicting fracture risk, and bone density is just part of the whole picture. It clearly works in the interest of pharmaceutical companies to compare your T-score to a young person’s, but you should know that while a machine may categorize you as osteopenic or even osteoporotic, you may never fracture a bone in your life. And the odds are with you — most people don’t fracture their bones, even if they are at high risk.

The Surgeon General’s advice — work with nature

In one sense, I agree with pharmaceutical companies: prevention is best. But I don’t agree with their approach to prevention. Pharmaceutical medications, in my opinion, don’t work with your body. They work by suppressing or fooling it into doing something it wouldn’t do naturally. I know that in certain circumstances, bisphosphonates can be helpful, but for the most part they should remain a last resort.

In 2004, the Surgeon General studied osteoporosis in the United States and wrote a report over 330 pages long on the best ways to promote bone health and prevent osteoporosis and fracture. His advice, in essence, is to work with nature.

He provides an osteoporosis pyramid for prevention and treatment that starts with nutrition, physical activity, and fall prevention at the base. The second tier involves assessing and treating the underlying causes of compromised bone health. The very tip of the pyramid, and the last resort, is pharmacotherapy. The bottom line is that your bones are meant to last a lifetime. In most cases they don’t need drugs to keep them strong or prevent fracture. There are many, many natural ways to support your bones with proper bone nutrition and, many times, simple lifestyle changes to prevent osteopenia, osteoporosis, and needless fracture.

To learn more on the topic of osteoporosis and bone loss, read our additional articles here:

Rethinking “primary” osteoporosis: Isn’t all osteoporosis really just “secondary” osteoporosis?

July 11, 2014/0 Comments/in Osteoporosis /by Dr. Susan E. Brown

The medical literature defines osteoporosis as either primary or secondary. Primary osteoporosis is held to be a bone disorder of relatively unknown origin that occurs with aging and accelerates at menopause. Authorities state that there is no direct or singular cause for primary osteoporosis.

Secondary osteoporosis, on the other hand, is the type of osteoporosis that has a direct cause. This type of osteoporosis is “secondary to,” or caused by, something else. For example, osteoporosis caused by the use of prednisone is a very common form of secondary osteoporosis.

Is there really such a thing as “primary osteoporosis”?

In many years of researching bone health, however, we at the Center for Better Bones have come to challenge this distinction between primary and secondary osteoporosis. Our work leads us to suggest that all osteoporosis is indeed caused by something, and in this sense, all osteoporosis is secondary osteoporosis. For example, the American College of Rheumatology has estimated that 20% of all osteoporosis in the US is due to use of steroid medications. Other researchers have suggested that 20% of all hip fractures are related to smoking. The use of acid-blocking drugs has been shown to double fracture rates. Some studies suggest that almost 20% of those with osteoporosis have the disorder caused or worsened by an excessive loss of calcium in the urine. Vitamin D inadequacy could be causing half or more of all osteoporosis, and so forth.

In other words, the more we scratch the surface, the more we see that many of our current dietary and lifestyle behaviors directly limit bone health and encourage osteoporosis. Even the classic primary osteoporosis that is vaguely attributed to “aging” is now known to be caused by many concrete factors that affect older people, such as reduced kidney function, vitamin D deficiency, chronic low-grade metabolic acidosis, increased use of mood-altering drugs and other pharmacological agents, reduced nutrient intake, loss of muscle mass, and a reduction in physical activity.

It is also interesting to note that when osteoporosis is discovered in men, a great effort is generally made to uncover the causes of this osteoporosis. In fact, most male osteoporosis is considered to have a secondary cause. When women are found to have osteoporosis, however, there are fewer attempts to discover the causes of this bone weakening and more a tendency to explain that this is just “primary osteoporosis,” something that happens to women as they go through menopause into their senior years — as if it were normal to the female gender. But in other cultures, women don’t develop osteoporosis as a matter of course — and that says it’s not normal.

We at the Center for Better Bones, however, suggest that if you look carefully enough you will find secondary causes for almost all the osteoporosis among women just as in men. If we can’t find the cause, it is because our tools are not yet precise enough to catch the problem, not because there is no cause.

Below I list the disorders and conditions associated with the development of osteoporosis. These are recognized causes of “secondary osteoporosis.” Over time, I suspect you will see this list grow as we come to understand that all osteoporosis has a cause and is indeed secondary to something else.

Known secondary causes of osteoporosis

Table 1. Nutritional Factors

Nutrition	Anti-nutrients	Modern eating patterns
Chronic low-grade metabolic acidosis	High caffeine intake	High fat intake
Imbalance among the 20 key bone nutrients	High salt intake	High sugar intake
Inadequate intake of 20 key bone nutrients	Excess alcohol consumption	Processed and synthetic foods
Undereating or food restriction	Colas and other sugar-sweetened drinks	Eating on the run
Excessive protein intake		Skipping and incomplete meals
Excess vitamin A
Parenteral nutrition

Table 2. Lifestyle Factors

Physical Activity/Exercise	Other
Inadequate physical activity	Smoking
Poor muscle development	Significant weight loss
Sub-optimal strength	Use of recreational drugs
Immobilization (prolonged bedrest)	Use of medications (see Table 3 below)
Weightlessness (as occurs in space flight)	Birth control methods such as tubal ligation
	Other surgeries such as hysterectomy, bariatric, gastrointestinal, etc.
	Emotions such as worry, unhappiness, fear
	Response to stress (increased levels of cortisol, epinephrine norepinephrine)

Table 3. Medical Conditions

Endocrine or Metabolic Causes	Connective Tissue/Genetic Disorders	Digestive Disorders / Dysfunction	Rheumatological & Autoimmune Diseases	Neurological Diseases
Acromegaly	Cystic fibrosis	Celiac disease	Ankylosing spondylitis	Epilepsy
Adrenal disorders, including: Adrenal insufficiency Cushing’s syndrome Hyperadrenocorticism	Ehlers-Danlos syndrome	Chronic hepatic disease	Lupus	Parkinson’s disease
Diabetes mellitus (Types I and II)	Glycogen storage diseases	Gastrectomy	Multiple sclerosis	Polio, history of
Gaucher’s disease	Hemophilia	Gastric bypass (Bariatric surgery) or other GI surgery	Rheumatoid arthritis	Spinal cord injury
Hemochromatosis	Homocystinuria	Inflammatory bowel disease	Bone, Bone Marrow, and Blood Diseases	Psychiatric Disorders
Hyperparathyroidism	Hypophosphatasia	Malabsorption syndrome (celiac disease and IBD, such as Crohn’s disease or ulcerative colitis)	Leukemia and lymphomas	Depression
Hyperthyroidism (Graves Disease)	Idiopathic hypercalciuria	Malnutrition	Mastocytosis	Anorexia nervosa and bulimia
Hypogonadism (sex hormone deficiency), including: Androgen insensitivityAthletic amenorrheaEstrogen deficiencyHyperprolactinemia Klinefelter’s syndromePremature menopauseTurner’s syndrome	Marfan syndrome	Pancreatic disease	Multiple myeloma	Other health factors
Hypopituitarism	Menkes steely hair syndrome	Primary biliary cirrhosis	Plasma cell dyscrasias	Alcoholism
Hyperpituitarism	Muscular dystrophy	Renal Diseases	Post-transplant bone disease	Amyloidosis
Thyrotoxicosis	Osteogenesis imperfecta	Chronic kidney disease	Sickle cell disease	Congestive heart failure
Pulmonary Diseases	Panhypopituitarism	End stage renal disease		Idiopathic scoliosis
Chronic obstructive pulmonary disease (COPD)	Pseudoglioma	Renal tubular acidosis		Parental history of hip fracture
Emphysema	Porphyria			Premature ovarian failure
	Riley-Day syndrome			Prior fracture as an adult
	Thalassemia			Sarcoidosis

Medications*

*(Not all drugs in each category affect bone health, so be sure to ask your physician to consider one that is less harmful to bone.)

Aluminum-containing antacids: interfere with the intestinal absorption of calcium.
Anticoagulants (heparin): used to prevent blood clotting. Vitamin K is one of several vitamins that play a role in bone metabolism. Since some oral anticoagulants interfere with vitamin K, their long-term use may increase the risk of osteoporosis, particularly of the spine and ribs.
Anticonvulsants: interfere with vitamin D metabolism, thereby lowering the availability of calcium for bone mineralization. The two widely used anti-epileptic drugs phenytoin (Dilantin®) and carbamazepine (Tegretol®) are recognized to have direct effects on bone cells.
Anti-depressants: daily use of SSRIs (selective serotonin reuptake inhibitors), a popular anti-depressant, may lead to increased risk for fragility fracture in older adults. Daily use of SSRIs is associated with a reduction in bone density in the hip and spine and with an increased risk of falling. Examples of drugs in this class include Prozac®, Paxil® and Zoloft®.
Anti-neoplastics (cancer treatments): used to treat a variety of cancers, immune disorders and resistant arthritic conditions. Cancer treatment-induced bone loss (CTIBL) is most common in breast (including aromatase inhibitors) or prostate cancer patients undergoing therapies resulting in low levels of sex hormones.
Antipsychotic drugs
Antiretroviral drugs
Aromatase inhibitors
Barbiturates
Cimetidine
Corticosteroids
Conception control agents: reports suggest that women who use Depo-Provera® (Depo-medroxyprogesterone) may lose significant bone mineral density, possibly because of the low estrogen that it induces.
Cyclosporine A and tacrolimus
Cytotoxic drugs
Furosemide
Glucocorticoids (≥ 5 mg/d of prednisone or equivalent for ≥ 3 mo)
Gonadotropin-releasing hormone (GnRH) analogues: used in the long-term treatment of endometriosis and uterine fibroids. GnRH therapy decreases production of the hormone estrogen to the levels women have after menopause. GnRH analogues are used in the treatment of breast cancer in women to suppress estrogen levels, and in prostate cancer in men to suppress testosterone levels.
Heartburn and ulcer medication: proton pump inhibitors that reduce stomach acid production have been associated with an increased fracture risk, perhaps because calcium absorption from food is less efficient in the absence of stomach acid.
Immunosuppressives: used in organ transplants and for the treatment of some diseases of the immune system.
Lithium
Loop diuretics
Methotrexate (Rheumatrex)
Phenolbarbitol
Phenothiazines
Thiazolidinediones (diabetes medication): a study found a higher risk of fractures among women who take the drug rosiglitazone (Avandia®), possibly because the drug increases the activity of the cells that absorb bone in the bone remodeling process. Also, clinical trials have shown that female patients treated with pioglitazone (ACTOS®) for type 2 diabetes mellitus were at an increased risk of fracture, particularly of the forearm, hand and wrist, and foot, ankle, fibula and tibia. No increased risk of fracture was identified in men.
Thyroid hormone therapy: sufficient levels of thyroid hormones are necessary for normal bone development; excessive amounts, however, can cause bone loss over time.

How to work with your doctor to heal osteoporosis

June 27, 2011/0 Comments/in Osteoporosis /by Dr. Susan E. Brown

When people come to me for a consult, one of the first steps I take is to get their medical history. As I’ve stated before, osteoporosis doesn’t happen in isolation — there’s always a reason for bone loss. If I see someone who’s losing bone at a rapid rate but doesn’t know why, I’ll encourage him or her to work with a physician to determine what’s causing the bone loss. In many instances, solving the hidden health issue puts an end to bone loss and helps to restore bone health more rapidly.

But working with a physician is challenging for some of my clients. Many of us grew up in an era where doctors were considered the unquestioned (and maybe unquestionable) authorities when it came to our health. And why not? It takes years of hard work and study to earn an MD or DO, and even once they have their degree, physicians keep studying and learning. Surely a doctor knows better how to handle a health issue than someone who doesn’t have that level of education… right?

While it’s true that medical professionals dedicate a great deal of time and energy to understanding how to treat diseases of the body, it defies common sense that any health professional, no matter how caring or dedicated, should be “in charge” of the decisions affecting a patient’s day-to-day health. Doctors aren’t mind readers; without a patient’s input, they can’t possibly know what their patients consider acceptable (or unacceptable) when it comes to health. I find that when clients work with their practitioners, the partnership between doctor and patient is often productive. But it’s important to realize that what the doctor does — treating the illness — is not the same as healing the patient. A doctor may suggest treatments, but is up to the patient to decide if the treatment is something they want to try as part of their healing process — and it’s also the patient’s responsibility to speak up if they don’t like what’s being offered.

I know this isn’t always easy. Not only are some people reluctant to speak up — physicians can be intimidating for those used to following “doctor’s orders” — but they may feel as though they lack sufficient information to make a decision. But what I tell my clients is, if you don’t feel you know enough to make an informed decision, then don’t make the decision until you do know enough.

Now, sometimes even well-informed patients encounter closed-minded resistance to their suggestions and input. I had one client who, after experiencing a nasty leg fracture, asked her doctor to perform some of the medical tests for osteoporosis that I commonly suggest, only to have her request dismissed. She was told, “You don’t need all these tests,” and when she tried to explain that she believed that they might uncover the reason for her weak bones, the doctor responded, “Who’s driving this bus, anyway?”

I see this sort of thing too often to be surprised by it, but the reality is that the patient, not the doctor, “drives the bus.” To her credit, my client was not happy with her doctor’s attitude, so she went and got a second opinion. When she told the new practitioner what the first had said, she got a much better answer. “Well, of course you’re the driver,” said the physician. “I’m really more like a tour guide.”

I always urge clients who encounter such obstacles to keep one thing firmly in mind: YOU are in the driver’s seat. If you have a “tour guide” who insists on taking the wheel from you, or who tries to guide you in a direction you believe to be wrong for your health, listen to your inner voice and put on the brakes! As the driver, you are responsible for what direction you take, and how fast you travel. It’s your journey — so don’t let anyone send you somewhere you don’t want to go.

Nothing comes from nothing—rethinking “primary osteoporosis”

March 29, 2010/0 Comments/in Osteoporosis /by Dr. Susan E. Brown

When osteoporosis is diagnosed in men, a great effort is made to uncover the causes of the excessive bone loss. In fact, most male osteoporosis is considered to have a secondary cause, that is, to be caused by something, whether it’s a disorder like celiac disease, the use of various medications, or habits such as smoking, etc. Most osteoporosis in women, however, is simply considered a normal development due to menopause or advancing age. However, outside of the Western world, women don’t necessarily develop osteoporosis as a matter of course — and that says it’s not normal.

We at the Center for Better Bones have come to challenge this distinction between what scientists call “primary” and “secondary” osteoporosis. Our work leads us to suggest that all osteoporosis is indeed caused by something, and in this sense, all osteoporosis is secondary to something else. For example, the American College of Rheumatology has estimated that 20% of all osteoporosis in the US is due to use of steroid medications. Other researchers have suggested that 20% of all hip fractures are related to smoking. The use of acid-blocking drugs has been shown to double fracture rates. Some studies suggest that almost 20% of those with osteoporosis have the disorder caused or worsened by an excessive loss of calcium in the urine. Vitamin D inadequacy could be causing half or more of all osteoporosis, and so forth.

The reasons why someone may develop osteoporosis are many and varied, including undiagnosed medical problems or unhealthy lifestyle issues, such as smoking, acidic diet, etc. But if you can pinpoint out why you’re losing bone, there may be some way to halt your bone loss and perhaps even restore your bones to health. Lifestyle issues are easy to spot; undiagnosed medical issues take a bit more work.

I always tell my clients, “Take heart, and take action.” If you are losing bone but don’t know why (or if you’ve been told that your bone loss is “normal” or “expected” for someone of your age and gender), then it’s time to find some answers. I encourage you to review my article on secondary osteoporosis so that you understand — and maybe recognize — some of the hidden sources of bone loss that might be affecting you.

Natural treatment for osteoporosis

November 14, 2008/0 Comments/in Osteoporosis /by Dr. Susan E. Brown

It’s just not true that osteoporosis can only be treated with drug therapy. A natural program of nutritional and lifestyle changes can be as or more effective as drug therapy in rebuilding bone. And it comes without side effects. What’s more, it lasts longer—the drugs only affect your bones while you’re taking them, but changes to your diet and lifestyle can last a lifetime!

Natural treatment for osteoporosis begins with adequate nutrition. If you are currently losing bone, it’s important that you understand the value of the proper acid-alkaline balance for bone health and how to maximize your nutrient intake. I also recommend minimizing bone-depleting factors, as described in our Total Load Model.

Natural osteoporosis treatment also involves a practical, individualized bone-strengthening exercise program, since exercise is an important method for building strong bones at any age.

As part of an overall life-supporting program, you should also build digestive strength, and learn how to enhance the strength of your endocrine glands. It’s also good to develop a program to enhance your immunity and reduce overall inflammation, since osteoporosis is now believed to be an inflammatory disorder.

You can try Dr. Brown’s comprehensive supplements in her at-home bone health program, developed with Women’s Health Network. Get her exclusive formulations along with her detailed lifestyle and diet guidance, plus telephone support whenever you need it. Learn more about the Better Bones Program.