Osteoporosis & Vitamin C Update

Journal PLoS One provides evidence that vitamin C, when ingested orally, can prevent bone loss (osteoporosis) and stimulate the formation of new bone (in mice).

The medical world has known for some time that low amounts of vitamin C can cause scurvy and brittle bones, and that higher vitamin C intake is associated with higher bone mass in humans.

Large doses of vitamin C, when ingested orally by mice, actively stimulate bone formation to protect the skeleton. It does this by inducing osteoblasts, or premature bone cells, to differentiate into mature, mineralizing specialty cells.

This data provides compelling evidence for a therapeutic potential for vitamin C. Mice with ovariectomies were divided into two groups, one of which was given large doses of vitamin C over eight weeks. The team then measured the bone mineral density in the lumbar spine, femur and tibia bones. The lead researcher Zaidi revealed that mice who received an ovariectomy without vitamin C had a much lower bone mineral density than those that received a “sham” operation. Mice with no ovaries but given large doses of vitamin C had roughly the same bone mineral density as the controls, suggesting vitamin C prevented bone density losses in this group.

Could simple inexpensive dietary supplements versus expensive drugs help prevent osteoporosis? I think so! I also like to use Ostera from Metagenics.

PLoS One.

Fosamax, Boniva, Actonel

Fosamax, Boniva, Actonel and other bisphosphonate osteoporosis drugs have been shown to increase bone fracture risk when used for several years. Irony aside, that’s bad enough. Research from the British Medical Journal reports that extended bisphosphonate use (about five years) nearly DOUBLED the risk of esophageal cancer. If bisphosphonate pills aren’t swallowed properly, the esophagus becomes inflamed, setting the stage for cancer.

I prefer using natural supplements and recommending movement therapy for osteoporosis.

Sources:
“Exposure to Oral Bisphosphonates and Risk of Esophageal Cancer” Journal of the American Medical Association, Vol. 304, No. 6, 8/11/10, jama.ama-assn.org

“Oral bisphosphonates and risk of cancer of oesophagus, stomach, and colorectum: case-control analysis within a UK primary care cohort” British Medical Journal, Vol. 341, No. 4444, 9/2/10, bmj.com

Vitamin K update

A study from Greece: For one year, a cohort of postmenopausal women drank milk. Some of the group drank milk fortified with calcium and vitamin D. Others drank milk further fortified with vitamins K1 and K2. Bone Mineral Density (BMD) increased in both groups. But only subjects in the K group had “significant” BMD increases in the lower spine. Vitamin K boosts levels of a protein your body requires to utilize calcium in bones.

Why drink the milk? Take supplements of calcium and vitamins D and K, you’re likely to get similar results. But using the K1 and K2 forms of the vitamin is essential. K3 is synthetic. It won’t produce the same benefits. Almost all of our K intake is K1. The primary sources are leafy green vegetables, broccoli, tomatoes, avocados, olive oil, whole wheat, and butter.

Osteoporosis & Ostera

Osteoporosis is characterized by loss of bone mass and is associated with an increased risk of fracture after falls, particularly in the hip and mid-back. Osteoporotic women are often physically frail as well, leading to disability. Weight-bearing and resistive exercises have been shown to reduce the loss of bone (as measured by bone mineral density). Come in to the office and I can teach you the most specific exercises to perform that will help you prevent further osteoporosis.

A comprehensive supplement for osteoporosis is Ostera by Metagenics. Order @ www.DrJeffreyTucker.meta-ehealth.com

Vitamin D Update From the Annual Congress of the European League Against Rheumatism

June 16-19, 2010 in Rome, Italy — vitamin D deficiency is a common feature in patients with a range of painful rheumatic and related autoimmune disorders. What is less clear, however, is the amount of vitamin D supplementation that would benefit these patients.

Here are highlights from three recent studies:

1. Researchers in the UK assessed levels of vitamin D in patients with either inflammatory joint diseases (ie, rheumatoid arthritis, RA), osteoporosis, or unexplained muscle pain (ie, myalgia) — 30 subjects in each group — compared with a control group of 90 patients with chronic back pain [Kelly et al. 2010]. Within all 180 patients (two-thirds female) the median vitamin D level was 15 ng/mL and 58% were below the normal range (defined as 20-58 ng/mL by these authors). The median vitamin D level in control patients (with back pain) was 20 ng/mL compared with statistically significant lower medians of 14 ng/mL in the RA group, 12 ng/mL in the osteoporosis group, and 12 ng/mL in the myalgia group. The authors expressed surprise that vitamin D deficiencies also were evident in persons with diffuse muscle pain but suggested that patients in all groups would benefit from vitamin D supplementation. Note: Why patients with back pain were chosen as a control group is unclear, as other research has already found such patients to be vitamin D insufficient (ie, <30 ng/mL) overall.
2. A second study, conducted by Italian researchers, focused on 1,191 patients (85% female) with rheumatoid arthritis (RA) to determine a correlation between vitamin D deficiency and several clinical measures of disease activity [Idolazzi et al. 2010]. They found that levels of 25(OH)D were deficient (<20 ng/mL) in 52% of the patients not taking a vitamin D supplement and in one third of those taking supplements (?800 IU/day). In non-supplemented patients low levels of 25(OH)D significantly correlated with worse scores on 3 measures of disease activity: Health Assessment Questionnaire Disability Index, Mobility Activities of Daily Living Score, and Number of Swollen Joints Count. Significantly lower 25(OH)D levels were found in patients with active disease compared with those in disease remission and in those who were not responding to treatment compared with patients with a good response. Therefore, vitamin D sufficiency appears to be directly related to the course of rheumatoid arthritis and response to treatment; however, the authors conclude that further research is needed to assess the benefits of vitamin D supplementation in these patients.
3. Another reported study from Italian researchers evaluated the impact of vitamin D supplementation in patients with either inflammatory autoimmune disease (IAD; rheumatoid arthritis, spondyloarthritis, or connective tissue diseases; n=43) and noninflammatory autoimmune disease (NIAD; osteoarthritis or osteoporosis; n=57) [Sainaghi et al. 2010]. Mean 25(OH)D levels between the two groups at outset were equivalently deficient — 12.6±7.5 ng/mL IAD group, 13.1±8.8 ng/mL NIAD group. Following daily supplementation with 800 to 1000 IU of vitamin D3 for 6 months, only 29% of all patients reached 25(OH)D levels ?30 ng/mL considered to be sufficient and there were no significant differences observed between the IAD and NIAD groups. The authors conclude that, while the amount of supplementation was not adequate to normalize 25(OH)D levels in their patients the response to vitamin D (or lack thereof) did not appear to be influenced by the presence of an inflammatory autoimmune condition.

COMMENTARY: A separate presentation at EULAR 2010, based on a large multinational survey of women with RA, reported that among the 75% who were taking analgesic medications more than 7 in 10 (72%) still experienced daily pain [Strand et al. 2010]. Two-thirds of the respondents said that they constantly look for new ideas to address pain. Therefore, the studies above are of great importance because they demonstrate that painful inflammatory and noninflammatory rheumatologic or bone conditions are generally accompanied by vitamin D deficiencies. Based on prior research, it is not surprising that daily supplementation of 800 to 1000 IU of vitamin D3 was inadequate to significantly raise 25(OH)D to more normal levels. It is disappointing that none of the 3 research teams proceeded to the next step of testing more ample vitamin D supplementation and assessing outcomes on pain relief and/or disease moderation.

REFERENCES: 
Idolazzi L, Bagnato G, Bianchi G, et al. Vitamin D deficiency in rheumatoid arthritis: prevalence, determinants, and associations with disease activity. A cross-sectional study. Ann Rheum Dis. 2010;69(Suppl 3):516. Abstract SAT0093.
Kelly C, Scott K, Bell G, et al. Vitamin D levels in a spectrum of rheumatic disease. Ann Rheum Dis. 2010;69(Suppl 3:481. Abstract FRI0509.
Sainaghi PP, Bellan M, Carda S, et al. Response to vitamin D supplementation in inflammatory autoimmune diseases: a retrospective study. Ann Rheum Dis. 2010;69(Suppl 3):652. Abstract SAT0506.
Strand V, Emery P, Fleming S, Coke E. The impact of rheumatoid arthritis on women: focus on pain, productivity, and relationships. Ann Rheum Dis 2010;69(Suppl 3):748. Abstract OP0002-PARE.

Fosamax, Boniva, Actonel, and other osteoporosis drugs

The more we find out about this drug, the worse it gets.  If you are on these meds I hope you’ll do your research and consider natural alternatives like Ostera from Metagenics. Using a bisphosphonate drug–especially when taken for several years increases your risk of esophageal cancer. 

Have you ever wondered about those specific instructions that tell bisphosphonate users to drink a full glass of water and not lie down for 30 minutes after taking the drug?  If the drug isn’t swallowed properly, it can irritate the esophagus. If that happens too often, it can cause esophagitis–inflammation of the esophagus. 

A few years ago, Danish researchers reviewed more than 11,000 medical records and found that patients with esophagitis were significantly more likely to develop esophageal cancer.

Recognizing the importance of this potential link, a team of UK researchers examined medical records for more than 78,000 patients. As reported this past September in the British Medical Journal, the UK team found that extended bisphosphonate use (about five years) nearly DOUBLED the risk of esophageal cancer.

This is pretty horrifying when you consider that more than 20 million people have used Fosamax since it was introduced in the 90s. And that’s just one brand of this very popular class of drugs.

I recommend Ostera and Cal-Apatite. These can be ordered @ www.DrJeffreyTucker.meta-ehealth.com

I’m still upset over this Osteoporosis issue

In the early 80s, few people had even heard of osteoporosis. And it wasn’t until the next decade – 1993 – when the World Health Organization (WHO) created clear definitions of it. This gave firm criteria for doctors to diagnose brittle bones as a disease.

WHO created this guideline: a woman has osteoporosis when her bone mineral density (BMD) is 2.5 deviations below the standard BMD of average healthy young women. The measurement is made by an x-ray exam. Seems pretty straightforward. Women with a T score of -1.0 and -2.5 have osteoporosis.

Except the WHO study was financed by three drug companies. These three companies were the Rorer Foundation, Sandoz, and SmithKline Beecham. The study they funded led to not only defining criteria for diagnosing osteoporosis… But also to establishing it firmly as a marketable disease.

The drug companies stood to benefit greatly if definitions of osteoporosis included large numbers of postmenopausal women. Especially if BMI testing was adopted into routine medical care.

There’s one important point to make here. Women’s bones do become more brittle with age. And hip and thigh fractures are a major cause for concern for women after they hit menopause.

The following year – in 1994 – the WHO study group recommended screenings and interventions. They determined that the “appropriate time” for these tests was menopause. To make sure no one missed it, their recommendation was published in Osteoporosis International. Suddenly, BMD became part of routine care for millions of postmenopausal women. The drug companies were assured that millions would be seeking billions of dollars’ worth of their drugs.

By 1995 Fosamax appeared on the market. The first of the brand new osteoporosis drugs. It was swiftly approved by the FDA. Osteoporosis screenings, treatment, and drugs became part of the American lifestyle. Almost overnight.

But there has never been any proof to show that any of these steps actually help women whatsoever.

What is safe and effective for bone nutrition and osteoporosis prevention? Weight bearing exercise and the supplement Cal Apatite with Magnesium by Metagenics. If you already have osteopenia (bone loss) or osteoporosis then you need  Ostera by Metagenics. Order from www.DrJeffreyTucker.meta-ehealth.com

Osteoporosis drugs are getting to be a joke!

The FDA has warned osteoporosis patients that the very drugs they take to strengthen their bones… may be making them even weaker. For the past several years I’ve talked to my patients about reports that suggest these drugs may increase risk of thigh-bone fracture. Especially in women taking these drugs for five years or more.

Finally the FDA is telling major drug makers to put a warning on their labels. So here’s the “joke” - The FDA is issuing its warning… and stresses that patients shouldn’t quit their drugs! Not unless they start to feel new thigh pain. And not even then. Not until their doctor tells them to quit the drug. But the real issue isn’t that these drugs may be dangerous… It’s that they may not actually do any good at all.

The research that promoted these drugs in the first place was funded by the drug companies that stood to gain the most. The results that prompted the FDA to initially approve the drugs don’t stand up to much scrutiny.

OK, let me get this straight – take one of the drugs listed below thinking you are doing something for osteoporosis, yet these drugs may actually increase the risk of bone fractures. 

• Actonel
• Actonel with Calcium
• Atelvia
• Boniva
• Fosamax
• Fosamax Plus D
• Reclast and Boniva

Here’s  the FDA statement:

“While it is not clear whether [these drugs] are the cause, a rare but serious type of thigh bone fracture, has been predominantly reported in patients taking [them].”

The FDA has told the manufacturers to put a warning label on their drugs. But it’s told the public to keep taking them… unless their doctor orders them not to.

What is safe for bone nutrition?  I recommend the supplement Cal Apatite with Magnesium by Metagenics. If you already have osteopenia (bone loss) or osteoporosis then you need  Ostera by Metagenics. Order from www.DrJeffreyTucker.meta-ehealth.com

Bone nutrition (osteoporosis)

I get asked alot about osteoporosis prevention. Clients love to show me there bone density test results. Most people seem to think taking calium by itself is enough to prevent osteoporosis.   Heres what you need to know for bone support - strong bones require more than calcium. Calcium without magnesium doesn’t occur in a natural human diet, so calcium shouldn’t be introduced to the body by itself. For most people to have complete bone nutrition, I recommend calcium, magesium, phosphorus, and vitamin D3.  Some people may need manganese, boron, silica, strontium, digestive enzymes, and often additional betaine hydrochloride, and ALWAYS vitamin D (and high doses of that last one if a lot of calcium is swallowed). 

Calcium alone has been found in several experiments to be improperly laid down in the body, even affecting arterial walls causing the arteries to get smaller (yikes!). 

DON’T take  antacids and think you are getting your calcium. The form of calcium in antacids is an inferior form and actually lowers the acid level (pH) in the stomach, which is necessary for digestion of many nutrients and proteins. 

In my opinion the best supplement for bone nutrition is Cal Apatite with Magnesium by Metagenics. If you already have osteopenia (bone loss) or osteoporosis then you need  Ostera by Metagenics.

www.DrJeffreyTucker.meta-ehealth.com to order

Whole Body Vibration Update

 A 12-week course of low-frequency vibration appears to be safe and feasible for improving dynamic balance in women with fibromyalgia, new research findings suggest.

Narcis Gusi, PhD, with the University of Extremadura in Caceres, Spain,
and colleagues reported their findings in the August 2010 issue of
Arthritis Care & Research.

As most of you know I use the Deep Muscle Stimulator (DMS) for neural and musculoskeletal rehab, but this article discusses whole-body vibration (WBV).  In WBV, a patient stands on a platform that oscillates at a particular frequency and amplitude, causing muscle contractions through stimulation of sensory receptors.

The study included 41 women aged 41 to 65 years who were randomized
either to a control group or to the vibration intervention, which
included a 30-minute session of instruction plus 3 sessions of
self-administered WBV per week for 12 weeks. Each session consisted of 6
repetitions of a 45- to 60-second, 12.5-Hz vibration.

WBV  has been shown to improve body balance and bone mass density (osteoporosis) in women. It may help muscle conditioning, endurance, and pain.

Arthritis Care Res. 2010;62:1072–1078.