Bone Health

Bone Loss – It’s not just a concern for the elderly

Osteoporosis and other disorders characterized by a weakening or loss of bone mass are increasing in prevalence, and the increase isn’t entirely due to our aging population. Most people under the age of 50 give little thought to their risk for hip fractures or developing osteoporosis.  We tend to think of these problems as affecting the elderly – specifically post-menopausal, small-boned Caucasian women.  However, bone disorders don’t suddenly become an issue when you reach a certain age, and they definitely don’t just strike a particular group of individuals.  Bone loss may accelerate faster in women, especially after menopause; but past the age of 20, most of us will start to lose more bone than we make.[1] Because women have smaller bones to begin with, this natural bone loss is more pronounced in women, and as a result of some notable environmental and lifestyle factors, physicians are beginning to report seeing signs of low bone mass in women in their 20s, 30s and 40s.  This trend should be a concern for all of us, both men and women.

Many people, especially women, are not getting the proper nutrients during childhood and adolescence that are essential for bone development.  They are not only consuming fewer calcium and vitamin D-rich foods, but they are often substituting the bone strengthening food or drink with one that actually depletes nutrients, such as carbonated beverages or coffee.[2]

Other significant factors contributing to demineralization and a decrease in bone density include  yo-yo dieting and eating disorders, as well as chronic stress.  Factors that can affect a woman’s menstrual cycle and estrogen production including overexercising, injectable contraceptives and menopause, can also contribute to bone loss.  Bone health may be compromised by medications such as thyroid drugs, diuretics, steroids, antibiotics such as tetracycline, anticonvulsants, chemotherapy drugs and proton pump inhibitors.  Sedatives and antidepressants that have a sedative effect can also increase the risk for falling, which can result in fractures, especially for those whose bones are already weakened by other factors.

However, there are some lesser known elements that are currently being studied for their potential for having a negative impact on bone health.  Our exposure to these may be inadvertent and come from a variety of sources.  Heavy metals fall into this category.  Many of us are familiar with the dangers associated with exposure to lead, and to a lesser extent, mercury and cadmium, but may not be aware that bone loss is one of the dangers attributed to exposure to lead and other metals.  Fortunately, there is a general awareness of the toxic nature of most of these metals and there are laws that are aimed at minimizing our exposure.  These laws may not extend to protecting us from overexposure to some other metals, however.

One of these is aluminum.  This metal is found throughout nature and is also used commercially in everything from cookware to antiperspirants, to over-the-counter antacids.   Human studies have been inconsistent, but animal studies have demonstrated a negative effect on bone mineralization.  This may in part be due to its effect on parathyroid hormone (PTH) synthesis and release.  The principal function of PTH is to regulate very closely the blood levels of calcium.  Most of us think that calcium’s primary role is to provide the rigidity for our bones and teeth.  However, calcium is also necessary for nerve conduction and therefore is vital for brain functioning and muscle contraction.  If serum calcium levels begin to drop, PTH is released from the parathyroid and functions to move calcium from the bones and into the bloodstream to restore serum calcium levels.  PTH is also involved in dietary calcium absorption in the intestine, at least partially by stimulating the synthesis of a biologically active form of Vitamin D, which then stimulates transport of both calcium and phosphate.  It is known that aluminum absorption and accumulation in the brain, bone and parathyroid gland  is increased when circulating PTH is elevated and that elevated levels of aluminum in turn cause a suppression in PTH secretion and possibly also its production.  This disruption in PTH functioning may not only impact bone calcium levels but also phosphorus as well, because PTH is also indirectly involved in regulating phosphate levels and maintaining homeostasis between calcium and phosphorus.

Though the interaction is complex and not thoroughly researched, aluminum’s effect on PTH could have a significant negative impact on bone health especially when other contributing factors are involved, such as low calcium and Vitamin D consumption or renal disease.[3]   It is possible, if not likely, that exposure to substances such as aluminum may not be enough to significantly impact bone health on their own.  However, in combination with other bone-depleting sources, there may be a compounding negative effect.

Maintaining healthy bones should be an active goal for all of us.  Diet and lifestyle choices, genetics, environment, disease and medication all play a role in determining the health of our skeletal system, and we must each make a concerted effort to do what we can to protect our bones and guard against bone loss.

We can’t control all of the factors that can harm our bones, but we can control our diet, our exercise plan and our choice of the right bone-support supplement.  Just like not all diets are healthy and not all exercise provides the benefits we expect, so also not all bone health supplements are equal.  A calcium supplement consisting of a tablet of calcium carbonate  from an unknown source may not provide any benefit whatsoever.  It is important to “research the research” and make sure that the supplement you choose contains a form of calcium that is highly bioavailable, an appropriate amount of elemental calcium and other bone-building ingredients, such as vitamin D and magnesium, and that it has been demonstrated through research studies to be optimally efficacious.  A strong bone structure can provide just the “support” we need to enjoy a  longer, healthier and more active lifestyle.