Calcium
for Osteoporosis
Calcium for Osteoporosis
By: Dr. George Obikoya
Osteoporosis affects 10 million Americans, mostly
women, and 34 million more have low bone mass. It is defined as
"a skeletal disorder characterized by compromised bone strength
predisposing to an increased risk of fracture." 1 While no
accurate overall measurement of bone strength exists, bone mineral
density (BMD) is frequently used as a proxy.
We need calcium for strong bones, but vitamin
D is equally important -- it helps the body with calcium absorption.
In fact, calcium supplements plus vitamin D can increase calcium
absorption by up to 65%. To further increase the absorption of calcium
in your diet, make sure to take your vitamin supplement in a liquid
form. Americans up to age 50 are advised to take 200 IU (international
units) of vitamin D daily. From age 51 to 70, the advised dose is
400 IU. For people over age 70, it's 600 IU.
Vitamin D is also made in the skin when it is exposed to sunlight.
However, concern about skin cancer has caused many people to limit
their time in the sun and an increasingly indoor workforce certainly
doesnt help either. In addition, during the winter across the northern
half of the U.S., there is an insufficient amount of the sun's rays
reaching the skin to stimulate production of vitamin D. Studies
have shown the positive effects of extra vitamin D and along with
calcium supplements, you should take take vitamin D with calcium
in a liquid form to promote calcium absorption.
Osteoporosis is a condition normally associated with postmenopausal
women but osteoporosis, or brittle bones, is also seen in men. Indeed,
osteoporosis in men has received much less attention; however, it
is increasingly recognized as a problem. Studies have shown that
30 percent of all hip fractures occur in men and vertebral fractures
are much more common in men than previously thought. The female-to-male
ratio is only 2-to-1, so osteoporosis is clearly not a problem that
is isolated to women.
These facts underscore the importance of osteoporotic
fractures:
* Only one third of patients regain their prior level of functioning
after a hip fracture, and one third are discharged to nursing homes.
2
* About 1 in 5 patients dies within a year after a hip fracture.
* Vertebral fracture may result in chronic back pain and disability.
3
* Existence of a fracture greatly increases risk of subsequent fractures.
4
* Direct medical costs for osteoporotic fractures are estimated
at $13.8 billion in 1995 dollars. 5
Strong bones require the action of two cells in the body. Osteoblasts
use dietary calcium and minerals to manufacture new bone, while
osteoclasts clear away old or damaged bone. Osteoporosis and increased
likelihood of fractures results when the clearing-away process is
faster than the formation of new bone.
The main cause of osteoporosis is aging. The sex hormones, estrogen
and testosterone, both produced (but in different amounts) in men
and women, are key to the balance between bone renewal and deterioration.
Women who are entering menopause can fight osteoporosis with exercise,
a calcium-rich diet, calcium supplements, and estrogen-replacement
therapy and other medications. Note that estrogen replacement therapy
has recieved considerably bad press lately, and its use is strongly
discouraged.
Men in their 60s rarely receive any such medical alert that their
bones are becoming brittle, even though their testosterone levels
decline and some men suffer from male menopause, or andropause.
These men need to be supplemeting with calcium beforehand to prevent
the onset of these conditions. For those men and others, osteoporosis
is a real risk. Because the optimum levels of testosterone on the
tests actually decline, this can appear to be part of "normal
aging" and is not given a second thought, until osteoporosis
sets in. Declining testosterone levels contributes to a plethora
of other problems, but this will be discussed elsewhere as it is
not relevant to the topic at hand. Suffice it to say that low free
(and total) testosterone levels can contribute to an enhanced risk
of osteoporosis in men.
In addition to the decline in sex hormones, certain other medical
conditions and lifestyles predispose both men and women to the dangers
of osteoporosis at an earlier age than normal. Osteoporosis is classified
as primary or secondary. Primary osteoporosis develops without any
known risk factors, whereas secondary osteoporosis is the result
of another medical condition.
Men frequently have an underlying secondary cause of osteoporosis;
men with such problems should be aware of the possibility of osteoporosis
and take necessary preventative measures, such as a daily vitamin
supplement. Hypogonadism (low testosterone activity) is the most
frequent condition associated with secondary osteoporosis; it causes
a decline in testosterone. Corticosteroid prescription medications
like prednisone are also important causes of secondary osteoporosis.
Other risk factors are chronic bowel disease, which may result in
malabsorption of nutrients; hyperthyroidism (an over active thyroid);
and smoking. People who smoke tend to lose more calcium than nonsmokers.
So, if you smoke, take more Calcium. Lack of exercise is another
problem that predisposes us to osteoporosis. Exercise at any age
helps to build bones; the best exercise is walking up and down stairs.
When you do this you are lifting your whole body weight, plus you
are strengthening the muscles of the thighs and the underlying bones
as well.
Like women, men should ensure that they are getting enough calcium
and vitamin D in their diets. Vitamin D in liquid form increases
the body's ability to absorb calcium. Men should also have a bone-density
test done if they are on corticosteroids. This is a very simple,
noninvasive test that measures the thickness of some of the major
bones in the body. It only takes a few minutes to perform and should
be done as a simple, preventative measure.
A good multivitamin is the foundation of health
and nutrition. Take a look at our scientific reviews of many of
the popular brands for factors such as ingredients, areas of improvement,
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References
1. Osteoporosis Prevention, Diagnosis, and Therapy. NIH Consensus
Statement Online 2000 March 27-29; 17(1):1-36.
2. NIH Consensus Development Panel on Osteoporosis Prevention Diagnosis
and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA.
2001; 285:785-795.
3. Gold DT. The clinical impact of vertebral fractures: quality
of life in women with osteoporosis. Bone. 1996; 18(suppl 3):185S-189S.
4. Black DM, Arden NK, Palermo I, Pearson J, Cummings SR. Prevalent
vertebral deformities predict hip fractures and new vertebral deformities
but not wrist fractures. Study of Osteoporotic Fractures Research
Group. J Bone Miner Res. 1999; 14:821-828.
5. Ray NF, Chan JK, Thamer M, Melton LJ 3rd. Medical expenditures
for the treatment of osteoporotic fractures in the United States
in 1995: report from the National Osteoporosis Foundation. J Bone
Miner Res. 1997; 12:24-35.
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