Where did my bones go?

The Problem

As your pharmacist was walking towards Lagom today to open the shop, a beautiful Porsche revved its engine.  As an interested man may do I had to take a glance and give me eyes the pleasure that my ears had just experienced.  In doing so, I missed seeing the ice in front of me and slipped, and got to inspect the ash-fault  at the corner of Aberdeen and Randolph.  Luckily, I am a good faller and proped right back up, went on my way and decided to not gawk at such things of beauty with slippery pavement.  

Cover that up, that might cause accidents!

Cover that up, that might cause accidents!

As I snapped up and brushed off the snow I thought about bone strength and how so many people's lives are changed in an instant  due to a simple lapse of attention to the simple task of walking. 

When we look at the numbers, it is alarming, especially for women.  Worldwide, a woman fractures a bone every 3 seconds.  And believe it or not, this statistic is getting worse.  

Many people with weakened bones, a condition known as osteoporosis are treated with medication, Vitamin-D, and calcium supplementation.  These are great treatments, however, as you could imagine, work slowly.  Your bones are one of the slowest growing tissues in your body.  Therefore, by the time someone is diagnosed, they are in the danger zone for increased fractures before their bones are stronger again.

The Argument

Many environmental factors are contributing to brittle bones.  Before we go there, I am not going to deny that with increased life expectancy, we begin to see more health problems.  However, there is an alarming increased amount of osteopenia (pre-osteoporosis) seen in non-elderly individuals.

There are many environmental factors that may be causing weakening bones.  

  1. Fluoride -- yea that stuff in your toothpaste.  It actually inhibits bone mineralization in higher doses.  In countries where people drink a lot of water and tea made with with high levels of flouride (e.g. China, India) the rate of bone fractures is disproportionatly high
  2. Proton pump inhibitors (PPIs) use is an epidemic.  These medications were designed to be used for 2 to 12 weeks depending on the condition.  Yet people take them for years.  The problem is they severely block the absorption of Calcium.  These are Prilosec, Nexium, Prevacid, etc.
  3. Many young women work out to hard and eat too little which consequently starts them out with a low bone mass that they never recover from
  4. Use of anti-anxiety medication and anti-depressant use has been shown too increase fall risk--especailly in the elderly.  The use  of these medications has skyrocketed.
  5. Sedentary lifestyle today is expanding with  addictions to internet, smartphones and even work environment.  This destroys bone strength.  
  6. Newly adapted diets by individuals do not account for adequate intake of essential calcium and vitamin D.

The Facts

  1. A 50 year old woman has a 16% lifetime risk of experiencing a vertebral fracture 
  2. Nearly 75% of all hip fractures occur in women.   Up to 20% of patients die in the first year following hip fractures  Less than half those who survive the hip fracture regain their previous level of function
  3. A 10% loss of bone mass in the vertebrae can double the risk of vertebral fractures
  4. Worldwide, 1 in 3 women over age 50 will experience osteoporotic fractures, as do 1 in 5 men aged over 50
  5. Evidence suggests that many women who sustain a fragility fracture are not appropriately diagnosed and treated for probable osteoporosis

The Solution

Don't play from behind.  

Supplementation

Make sure you are consuming enough calcium and vitamin D.  If you live farther north or have darker skin, vitamin D supplementation is even more important for you.  

Usual recommended calcium intake.  Lexicomp. 

Usual recommended calcium intake.  Lexicomp. 

 

Medications

You should avoid long term use of medication that depletes calcium absorption (PPIs) and medication that increase fall risks (anti-anxiety medications and certain antidepressants).  

Exercise

Childhood and adolescence is the best time to build bone strength but if you are lagging , there is still something you can do.  

  1. Strengthening back muscles can decrease the chance of vertebral fracture.  
  2. Exercise can improve balance and decrease the chance of falling to begin with.  In addition, when falling, exercisers have a better chance of falling properly.
  3. Weight bearing exercise can build strength
  4. Specifically designed yoga classes can do all three, targeting the back, hips, wrists and ankles.  (shameless plug for Lagom's bone building class)

About the Author

KIRK HEIL, PHARMD IS THE PHARMACIST AND FOUNDER OF LAGOM RX.  HE BELIEVES IN FIXING DIET, EXERCISE AND DAILY HABITS BEFORE ADDING A MEDICATION.   "EVERYTHING IN MY DESIGN OF LAGOM RX WAS DONE TO INSPIRE YOU TO LIVE A LONGER, HEALTHIER, LESS MEDICATED LIFE.  FROM THE SPACE I HAVE CREATED, TO THE TEAM I HAVE ASSEMBLED, TO THE SUPPLEMENTS I HAVE DESIGNED THAT MISSION IS RELENTLESS."

KIRK HEIL, PHARMD IS THE PHARMACIST AND FOUNDER OF LAGOM RX.  HE BELIEVES IN FIXING DIET, EXERCISE AND DAILY HABITS BEFORE ADDING A MEDICATION. 

 "EVERYTHING IN MY DESIGN OF LAGOM RX WAS DONE TO INSPIRE YOU TO LIVE A LONGER, HEALTHIER, LESS MEDICATED LIFE.  FROM THE SPACE I HAVE CREATED, TO THE TEAM I HAVE ASSEMBLED, TO THE SUPPLEMENTS I HAVE DESIGNED THAT MISSION IS RELENTLESS."