Our bodies constantly regenerate on a cellular level. Indeed, bones are no exception. Sometimes bones become porous, brittle and less dense as a result of bone mass loss. We call this osteoporosis.

Seeing that it develops over time, this is one of the silent diseases that we look out for as a side effect of ageing.

Healthy bone looks very much like a honeycomb under a microscope. However, when one has osteoporosis, the holes and spaces in the honeycomb are much larger.

The image below shows healthy bone on the left and increasingly more severe levels of osteoporosis to the right.

Is osteoporosis serious?

On the whole, yes. There are several risks linked to osteoporosis. The first is a predisposition to breaking bones. Your bones are just not as strong as those with healthy bones. A fall can thus easily cause a break.

The most affected areas include the hips, wrists and spine, although other bones can also break.

One can also suffer from permanent pain because of osteoporosis. When the spinal vertebrae are affected it can lead to a hunched posture. This is something that many people associate with the disease.

What causes osteoporosis?

There are several factors that can lead to osteoporosis. For the most part, other medical conditions and medicines can leech calcium from the bones.

This puts us in a challenging position since those medicines are taken to address something else. But I’m getting ahead of myself - we will look at how to mitigate risk shortly.

10 contributors to Osteoporosis

1. Hormonal disorders such as hyperthyroidism, premature menopause and irregular periods in women, low levels of estrogen and testosterone in men, thyrotoxicosis and Cushing’s syndrome.
2. Autoimmune disorders such as rheumatoid arthritis, lupus, fibromyalgia, multiple sclerosis and ankylosing spondylitis.
3. Digestive and gastrointestinal disorders such as Celiac disease, Chron’s disease inflammatory bowel disease and weight-loss surgeries.
4. Cancer, especially breast- and prostate cancer.
5. Blood disorders such as leukaemia, lymphoma, multiple myeloma and sickle cell disease.
6. Mental illness including depression and eating disorders.
7. Blood and bone marrow disorders such as thalassemia.
8. Neurological and nervous system disorders such as multiple sclerosis, Parkinson’s disease, stroke and spinal cord injuries.
9. Lifestyle changes and challenges such as weight loss, poor diet, excessive alcohol use, tobacco smoking, excessive coffee consumption and malnutrition
10. Side effects of medications such as lithium, methotrexate, chemotherapy drugs, aluminium-containing antacids, aromatase inhibitors, heparin, proton pump inhibitors, steroids, selective serotonin reuptake inhibitors, tamoxifen, excess thyroid hormones

Can we test bone density?

If you suspect that you might have osteoporosis, please visit your healthcare provider to have your bone density tested. This can be an x-ray or sonar-based.

How do I protect myself?

If you are at risk for osteoporosis, there are several things you can do to protect and strengthen your bones. Let’s break down the factors that can affect osteoporosis:

Factors affecting osteoporosis

Calcium

• Increase dietary sources of calcium (cruciferous vegetables, legumes, nuts, sardines, salmon, whole grains and dairy)
• Decrease foods that contain phosphorus, which displaces calcium (animal protein, cola soft drinks)
• Minimise foods that increase calcium excretion (caffeine, alcohol, salt)

Magnesium

• Involved in calcium metabolism, synthesis of Vitamin D and formation of bone
• Magnesium deficiency impairs the release and action of Parathyroid Hormone

Vitamin D

• A primary regulator of calcium absorption
• Sources include fish, eggs, dairy foods and adequate sunlight

Vitamin K

• Necessary for the production of osteocalcin, a protein that attracts calcium to crystallisation sites
• Inhibits apoptosis of osteoblasts
• Found in cruciferous vegetables

Oestrogen

• Promotes apoptosis of osteoclasts
• Shown to decrease bone resorption
• After menopause, oestrogen levels drop and periodic NTx testing and Baseline
• Hormone Profiles are effective ways to ensure that the post-menopausal decrease in oestrogen is not increasing the risk of osteoporosis

Progesterone

• Evidence suggests that progesterone may stimulate osteoblastic activity

Testosterone

• Builds bone density

Exercise

• Weight-bearing exercise stimulates bone remodelling

Boron

• Influences metabolism of calcium, magnesium and Vitamin D

Manganese

• Vital for bone matrix support

Lead

• Displaces calcium from bones and interferes with magnesium and zinc

Aluminium

• Interferes with osteoblastic and osteoclastic activity resulting in accelerated bone loss
• Increases urinary excretion of calcium

Cadmium

• Increases urinary excretion of calcium

Supplements that may help prevent or treat osteporosis

• Arginine
• Phosphorus (not in excess)
• Multimineral
• Vitamin C
• Quercetin
• Carnitine
• Folic acid
• Vitamin B12
• Vitamin D
• EGCG
• Alpha Lipoic Acid

Salmon bone booster

This delicious recipe contains many of the building blocks for healthy bones!

For this recipe you will need:

• 4 skinless salmon fillets, about 175g
• 1 lime
• 3 tbsp clear honey
• 1 tbsp wholegrain mustard
• 3 x 410g cans butter beans, rinsed
• 25g butter
• 5 tbsp crème fraîche
• 1 garlic clove, crushed
• 100g bag spinach, chopped

Method:

1. Grill the salmon fillets flesh-side up on the grill highest setting.
2. Finely grate the zest of the lime into a bowl, then squeeze in the juice and stir in the honey, mustard and a good pinch of salt.
3. Pour the mixture over the salmon and grill, without turning, for 5-6 minutes until it’s golden on top and cooked through (check the centre with a fork).
4. While that is happening, tip the beans into a saucepan and add the butter, crème fraîche, garlic and plenty of salt and pepper.
5. Turn the heat on to moderate and coarsely mash everything together with a masher until hot and bubbling.
6. Tip in the spinach and stir into the mash until it’s hot and just wilted.

Serve the salmon on the mash, drizzled with the cooking juices.

Is there hope?

The straight answer is yes - there is hope for the treatment and even reversal of osteoporosis. Bone health can be maintained and regained!