Interior remodelling

Question

I have recently gone through a relatively easy menopause and am paying a lot of attention to my bones, doing what I can to avoid osteoporosis. I go to the gym three times a week to do weight-bearing exercises for an hour and a half, take calcium and vitamin D supplements regularly, and have a really healthy diet. All of this should be boosting my bone density. And yet I’ve had three fractures in the last 10 months. Why is this happening? And what am I doing wrong?

F.G., via email

Answer

You’ve been doing everything right, but you couldn’t have known that one important element in your regime to forestall osteoporosis was missing – largely because it’s only just been discovered. What’s exciting is that this newly discovered ‘solution’ to the problem of brittle bones is completely within the scope of natural medicine.

The missing element

Osteoporosis develops through a slowly progressing, dynamic process that can begin as early as in your mid-30s, although the process generally accelerates in women during or after
the menopause.

Bone is constantly being broken down by cells that get rid of old and damaged bone tissue. This process is called resorption, and the cells that do this job are called osteoclasts – the demolition men. Other cells, known as osteoblasts and osteocytes, are the builders, which form bone by laying down a mesh-like microarchitecture – known as the organic bone matrix – into which minerals are incorporated to give bone its density and strength.

Over time and as we age, the rate of bone resorption gradually begins to exceed the rate of bone formation, resulting in a gradual net loss of bone structure. The creeping decline in bone formation is the result of the construction of progressively ever-weaker bone matrices.

At this point, merely consuming more minerals from food and supplements, as many people do, will only lead to the mineralization and hardening of incompletely formed bone matrices, leaving them, paradoxically, more vulnerable to fractures.

In fact, in orthodox medicine, the drugs designed to prevent osteoporosis – called bisphosphonates, like ‘Fosamax’, can also cause fractures and debilitating bone degeneration.1

Quality vs density

This means that the strength of bone lies not in its density alone, but also in the integrity of its basic structural design, or bone ‘remodelling’. What’s needed is a natural ‘spur’ to reawaken the process of depositing the fully complete mesh-like microarchitecture that constitutes the bone matrix. Unfortunately, neither Fosamax nor calcium supplements will do that.

Bone remodelling is influenced by our genetics, eating habits, age and orthodox medications (such as corticosteroids). The process is adversely affected by certain lifestyle habits (not enough exercise, smoking and heavy alcohol consumption), as well as by the state of our other bodily systems function and overall health status. Inflammatory or infectious disorders, parathyroid dysfunction, insulin-related diseases and excess body fat all have a negative effect on the body’s ability to recreate a sound bone structure.

The good news is that recently published studies show that both herbs and certain vitamins can have a positive influence on bone remodelling.

Hops

Derivatives extracted from common hops (Humulus lupulus) known as reduced iso-alpha acids, or RIAA, have been shown to act as selective enzymes (called kinases), which trigger the transfer of certain phosphates from foods to other molecules and also boost the activity of molecules essential for bone health. Both these actions promote bone remodelling.2

Berberine

Studies have demonstrated that berberine (derived from Phellodendron amurense) inhibits bone breakdown, or bone resorption.3 In one animal study, which of course may not apply to humans, oral berberine prevented the loss of bone mineral density in the lumbar vertebrae, suggesting that it can inhibit osteoclastic bone resorption – at least in rats.4 It’s also been suggested that berberine might even encourage the formation of osteoblasts – the bone builders.5

Berberine has also been shown to be sensitive to 17 types of bacteria, seven types of fungi, and a variety of other organisms that may have adverse effects on you and your bones, including Amoeba, rickettsiae, Leischmania, mycobacteria, chlamydiae and Xanthomonas.6

While berberine has long been known to be non-toxic,7 to be on the safe side, any woman who wants to start bone-building early should not take it during pregnancy.

Vitamin D

Besides helping the body absorb calcium for mineralization, vitamin D plays a natural role in regulating bone turnover. A deficiency of this vital hormone, which is commonly seen in the elderly and in postmenopausal women, has been associated with an increased risk of osteoporosis and fractures.8

If you wish to take oral supplements, it’s best to stick to D3, the natural form of the vitamin.

Vitamin K

This vitamin is an important nutritional factor in the metabolism of bone proteins; it’s crucial for bone quality, bone integrity and the support of overall bone mass in both men and women. Regular intakes of vitamin K (especially K2) have been linked to increased bone mineral density. Studies have shown that supplementing daily with vitamin K can protect against age-related fractures, and may also affect other factors, such as changing bone structure (remodelling).9

An all-natural, gluten-free formula combining the above four components is now available online under the name Ostera, made by Metagenics Europe.

The daily serving size of one tablet contains 500 IU of vitamin D3 (as cholecalciferol), 500 mcg of vitamin K (as phytonadione), 90 mg of berberine HCl (extract of P. amurense bark) and 370 mg of
RIAA complex (extracted from common hops).

Taking a supplement like this will help your body to actually rebuild bone, rather than just increase the density of whatever depleted residual bone you might still happen to have.

One caveat: It’s important to note that vitamin K can interact with the common blood-thinner warfarin sodium (sold as Marevan or Coumadin). If you are taking this type of medication or have a tendency to form blood clots, make sure to contact your prescribing physician before starting Ostera, as vitamin K thickens the blood.

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