Osteoporosis Flashcards
Osteoporosis
Low bone mass and micro architectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk.
Osteoporosis: Signs and symptoms
- Asymptomatic until a fracture occurs.
- Most common fracture locations: vertebrae, hip (femur), distal radius.
- Vertebral ‘crush’ fractures results in loss of height and kyphosis.
- Hip fractures in particular correlate with an increase in
mortality . The mortality after 1 year of a hip fracture is between 20 and 40%.
Bone remodeling
- Bone is an active tissue that undergoes remodelling throughout life.
- Osteoclasts (OC) OC)↑ the production of enzymes
that dissolve minerals and protein in bone. - Osteoblasts (OB) create a protein matrix primarily of collagen, resulting in remineralisation of the bone.
- Various substances affect this balance, e.g., PTH, oestrogen , vitamin D, corticosteroids, acidosis
- Osteoporosis results from OC bone resorption not being compensated by OB bone formation.
Osteoporosis: Cause and risk factors
- Ageing
- Female/post menopause
- Low body weight
- Dairy and meat
- Nutrient deficiencies: Vit D, Calcium, magnesium
- Soda
- Caffeine/alcohol
- Smoking
- Inactivity
- Hypochlorhydra
- Inflammation
- Drugs - Steroids
- Gut dysbiosis
Osteoporosis: Natural Approach
CNM Naturopathic Diet, with a focus to:
* Avoid / limit: Dairy products, carbonated beverages,
coffee, alcohol, limit red meat intake.
* Eat / include:
‒ Anti-inflammatory foods
‒ Green leafy vegetables
‒ Phytoestrogens
* Adequate dietary protein
* Address other risk factors
Osteoporosis: Supplements
Calcium
Vitamin D
Vitamin K2
Magnesium
Boron
Zinc
Manganese
Osteoporosis: Calcium
Dose: 500mg/d
- Needed to mineralise bone architecture.
- Calcium must be ionised to be absorbed in the intestines (dependent on gastric HCl ) support as needed with bitters, betaine HCl etc.
- Avoid a high intake of phytates which impair absorption ( esp. wheat bran which reduces intestinal absorption).
- Salt increases urinary calcium loss (by 4‒5 % for each 500 mg of sodium ingested).
Osteoporosis: Vitamin D
Vitamin D facilitates calcium absorption in the intestine and is involved directly in bone turnover.
Osteoporosis: Vitamin K2
Dose: 50-100mcg
- Required for the production of osteocalcin, which draws calcium into bone tissue and provides the protein matrix for mineralisation .
- Osteocalcin synthesis by osteoblasts is regulated by active vitamin D
Osteoporosis: Magnesium
Dose: 200-400mcg
- A co-factor for alkaline phosphatase, which plays a role in bone mineralisation
- A co- factor for the enzyme responsible for the conversion of 25 –(OH)D3 to 1,25 –(OH)
