Misconceptions abound when it comes to osteoporosis, a dreaded disease marked by porous, brittle bones and hunched backs. Most people think of osteoporosis as a women's disease, but it's more than that. While 8 million American women have been diagnosed with osteoporosis, more than 2 million men also are affected by it.

Osteoporosis: A Silent Problem

Osteoporosis can develop because, starting at about age 35, our bone cells do not make new bone as fast as it is broken down. Our bones become more frail and fracture more easily. Fractures, especially of the hip, spine and wrist, are more likely to occur, even without trauma. Osteoporosis has no symptoms until a bone is fractured. Many people go for decades without a diagnosis of osteoporosis—until they fall and an X-ray reveals porous bones.

Bone density can be measured with a dual-energy X-ray absorptiometry (DEXA) scan, but many people don't get this test. I recommend a baseline DEXA scan by age 50, and if results are normal, follow-ups every three to five years.

The most worrisome risk for a person with osteoporosis is a hip fracture. According to the National Osteoporosis Foundation (www.noforg), an average of 24% of hip-fracture patients age 50 or older die in the year following their fractures, often as a result of long-term immobilization that leads to blood clots or infection. Six months after a hip fracture, only 15% of patients can walk unaided across a room.

Virtually every person with osteoporosis who has come to my clinic is confused about the best way to promote bone health. Conventional doctors typically prescribe osteoporosis medication, such as alendronate (Fosamax) and ibandronate (Boniva). However, these drugs can cause side effects, such as digestive upset and blood clots, and they don't address the underlying nutritional deficiencies that promote bone loss.

The natural protocol I recommend includes a healthful diet (rich in vegetables, fruit and fish and low in refined-sugar products and red mcat) ...weight-bearing exercise (such as walking and stair-climbing)...and good hormone balance (deficiencies of some hormones, such as testosterone, accelerate bone loss). I also suggest certain bone-protecting supplements.

Caution: People with kidney disease should not take supplements without consulting a doctor. With kidney disease, the kidneys cannot process high doses of nutrients.

My recommendations for women and men: To help prevent osteoporosis, take the first three supplements listed below. If you have osteoporosis or osteopenia (mild bone loss that can be diagnosed with a DEXA scan), take the first three supplements listed and as many of the others as you're willing to try, in the doses recommended...

Super Trio Prevents And Treats Osteoporosis

  • Calcium is the most prevalent mineral in bone tissue. Taking supplements helps prevent a deficiency. Most studies have found that calcium slows bone loss but does not increase bone density when used alone. Women with osteoporosis should take 500 mg of calcium twice daily with meals. It should be a well-absorbed form, such as citrate, citrate-malate, amino acid chelate or hydroxyapatite. To boost absorption, take no more than 500 mg per dose, Calcium carbonate, which is widely used, is not wellabsorbed. For osteoporosis prevention, men and women, as well as boys and girls starting at age 13, should take 500 mg daily.

Calcium supplementation for men with osteoporosis is more complicated. Some recent research has identified a link between high calcium intake (from dairy products) and increased prostate cancer risk. A meta-analysis in the four nal of the National Cancer Institute that reviewed 12 studies on this association concluded, "High intake of dairy products and calcium may be associated with an increased risk for prostate cancer, although the increase appears to be small." A recent study found that calcium intake exceeding 1,500 mg a day (from food and supplements) may be associated with a higher risk of advanced, and potentially fatal, prostate cancer. The saturated fat in dairy products may raise prostate cancer risk.

Until there is more definitive information, I recommend that men who have osteoporosis, regardless of whether they have eliminated calcium-rich foods from their diets, take no more than a 500-mg calcium supplement daily. Men with prostate cancer should consult their doctors before using calcium supplements.

  • Vitamin D promotes absorption of calcium. Deficiencies of this vitamin are more common in Americans over age 50 than in younger adults. Sun exposure prompts the body to produce vitamin D, and the kidneys help convert it to its active form. As we age, our skin cannot synthesize vitamin D as effectively from sunlight, and our kidneys become less efficient. People with darker skin, those with digestive problems (due to malabsorption conditions, such as Crohn's disease) and those with limited exposure to sunlight are also at greater risk for vitamin D deficiency. Preliminary studies indicate that an inadequate intake of vitamin D is associated with an increased risk of fractures.

For the prevention of osteoporosis, I recommend 600 IU to 800 IU of vitamin D daily. People with osteoporosis should take 800 IU TO 1,200 IU daily. Vitamin D is fat soluble, meaning it is better absorbed when taken with meals (containing small amounts of fat).

For many patients with low vitamin D levels, I recommend 2,000 IU of vitamin D daily. To ensure that vitamin D levels are optimal. I monitor blood levels once or twice a year. Overdosing can lead to heart arrhythmia, anorexia, nausea and other ill effects.

  • Magnesium, an important constituent of bone crystals, is crucial for the proper metabolism of calcium. A deficiency of magnesium impairs bone-building cells known as osteoblasts. Like calcium, magnesium requires vitamin D for absorption.

Researchers at Tel Aviv University in Israel looked at the effect of magnesium supplementation on bone density in 31 postmenopausal women with osteoporosis. This two-year, open, controlled trial (both the researchers and patients knew who was receiving the placebo or the supplement) involved giving the participants 250 mg to 750 mg of magnesium daily for six months and 250 mg for another 18 months. Twenty-two patients (719) experienced a 1% to 8% increase in bone density. The mean bone density of all treated patients increased significantly after one year and remained at that level after two years. Among an additional 23 postmenopausal women not receiving magnesium, mean bone density decreased significantly.

For osteoporosis prevention, take 400 mg to 500 mg of magnesium daily...for osteoporosis, take 500 mg to 750 mg daily. In both cases, take in divided doses.

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