An oz of prevention is price a pound of remedy. It’s a cliché for a cause, however sadly, within the realm of ladies’s healthcare, it nonetheless hasn’t fairly sunk in. Dr. Mary Claire Haver, creator of The New Menopause, emphasised the significance of osteoporosis prevention on Instagram following her 87-year-old mom’s whole hip alternative within the wake of a dementia-induced fall.
“I 100% assure you, she by no means as soon as considered ‘How can I stop osteoporosis or how can I not fracture?’” stated Haver. “I’m completely shocked by the lack of know-how round prevention for illnesses particular to ladies.”
“Many individuals suppose that in the event that they aren’t experiencing ache or fractures, their bones are fantastic. In actuality, osteoporosis typically progresses with none indicators, so by the point a fracture occurs, bone loss might be fairly superior.”
Dr. Navya Mysore, Medical Director of Girls’s Well being at Nurx
Prevention is all of the extra necessary in terms of osteoporosis particularly, in accordance with Dr. Navya Mysore, Medical Director of Girls’s Well being at Nurx, a number one ladies’s healthcare firm. By the point folks understand they’ve the illness, it’s typically too late.
“One of many largest misconceptions about osteoporosis is which you can depend on signs to let you know in case your bones are weak,” she says. “Many individuals suppose that in the event that they aren’t experiencing ache or fractures, their bones are fantastic. In actuality, osteoporosis typically progresses with none indicators, so by the point a fracture occurs, bone loss might be fairly superior.”
Can Osteoporosis Be Reversed?
Catching it early is all of the extra important seeing as, whereas the illness might be managed and even slowed, there isn’t a remedy. “Osteoporosis just isn’t totally reversible,” says Mysore, “that means you may’t fully restore the bone density to what it was earlier than.”
Dr. Holly Ingraham, PhD, a professor of mobile molecular pharmacology at UCSF, agrees. Whereas she just lately led a promising analysis challenge on mice that appeared to point the potential for capitalizing on the bone constructing skill of a maternal hormone current in breastfeeding ladies, “new therapies are wanted to enhance bone formation after you’ve had bone loss,1” she stated.
In her Instagram submit, Haver referred to as above all for her mom’s journey to serve for example. “It’s not too late for us,” she wrote in her caption. “This lack of training is costing us far an excessive amount of, and it’s my struggle to vary that.”
Within the spirit of Dr. Haver’s name for consciousness, right here are some things to learn about stopping osteoporosis.
What Is Osteoporosis?
Over the course of our lives, bone breaks down and rebuilds itself consistently. Osteoporosis is a situation by which bone matter just isn’t changed on the identical charge at which it’s damaged down.
This causes the bones to develop into weak and brittle, to the purpose the place one thing as gentle as a cough can result in breakage, typically within the hips, wrists, or backbone2. In line with Ingraham, research have proven that victims normally break bones of their fingers and toes first, adopted by lengthy bones, adopted by the hips.
The Osteoporosis Downward Spiral
“Whenever you break your hip, that’s whenever you’re actually going to be in bother,” says Ingraham.
“When you begin breaking bones, your morbidity goes up, and your high quality of life goes down.”
Dr. Holly Ingraham, PhD, professor of mobile molecular pharmacology at UCSF
Osteoporosis may have an effect on high quality of life in different methods, in accordance with Mysore. “For instance, vertebral fractures (within the backbone) are widespread in osteoporosis and may result in peak loss, backbone deformities, and power ache,” she says. “These fractures might not at all times be apparent, however they’ll impression posture and mobility.”
Breaks and fractures additionally impression the danger of early loss of life, in accordance with Ingraham. “When you begin breaking bones, your morbidity goes up, and your high quality of life goes down,” she says. An elevated danger of breakage might problem one’s skill or willingness to have interaction in actions like mountaineering or biking. This, she says, results in “a decline in high quality of life that then turns into a bit of bit like a downward spiral.”
“In the event you’re afraid to exit and do issues since you’re afraid to interrupt your bones,” she says, “then you definately’re not utilizing your bones, and your skeletal system.” And this lack of use might enhance the danger of breaks, turning it right into a little bit of a vicious cycle.
What Are the Threat Components for Osteoporosis?
Greater than 200 million folks all over the world have osteoporosis3. Whereas the illness can have an effect on anybody, the danger of creating osteoporosis will increase with age, one thing Ingraham notes means extra persons are residing with the illness than ever earlier than.
“Bone loss is one thing that we’re confronting as our inhabitants ages, as a result of we’re residing longer,” she says. Those that have a household historical past of osteoporosis usually tend to develop it themselves, in accordance with Mysore, and sadly, there’s nothing one can do about genetics. However there are some life-style selections that may cut back the probability.
“Small, skinny people, these with poor diets (low in calcium and vitamin D), those that lack train and those that smoke or drink excessively are at elevated danger,” explains Mysore, who additionally cites sure drugs, like corticosteroids, anticonvulsants, or sure most cancers therapies, as potential danger components.
Certainly, a 2022 analysis evaluation within the Worldwide Journal of Molecular Sciences famous that glucocorticoids, which the researchers categorized as “essentially the most broadly used anti-inflammatory drug all over the world,” contribute “substantial” danger of osteoporosis, particularly inside the first six months of use4. However maybe the largest danger issue? Being a girl.
The Hyperlink Between Hormones and Osteoporosis
Osteoporosis impacts much more ladies than males, particularly within the leadup to menopause. In line with the Endocrine Society, roughly one in ten ladies over the age of 60 are affected by osteoporosis worldwide, and one in two postmenopausal ladies will endure from osteoporosis.
That is as a result of function of estrogen in bone formation and density. The hyperlink between osteoporosis and estrogen, Ingraham explains, stems from the truth that estrogen is an anabolic hormone for bone5. “In different phrases,” she says, “it’s principally going to assist bone formation happen. Dropping that’s going to result in bone loss.”
“Menopausal and perimenopausal ladies should be particularly conscious of osteoporosis and bone density.”
Dr. Navya Mysore, Medical Director of Girls’s Well being at Nurx
The identical Worldwide Journal of Molecular Sciences analysis evaluation illustrated this hyperlink, noting that the danger of osteoporosis for girls started at 3.3% within the latter half of the 40s, with dangers doubling roughly each 5 years and reaching 50% in ladies 85 and older4.
“Estrogen performs an important function in sustaining bone density,” explains Mysore, “in order its ranges drop, bone loss accelerates, resulting in weaker bones which are extra prone to fractures. Hormonal modifications additionally have an effect on the bone transforming course of, the place outdated bone is damaged down sooner than new bone might be shaped, additional weakening bones.” In consequence, she says, “menopausal and perimenopausal ladies should be particularly conscious of osteoporosis and bone density.”
This, Ingraham notes, is especially true for breast most cancers survivors or those that, as a consequence of BRCA1 or BRCA2 mutations, select to have their ovaries eliminated. For these ladies, she says, “all the pieces goes to be accelerated.”
“There’s a considerable variety of ladies who’ve breast most cancers, who’ve needed to go on anti-estrogens, particularly these ladies who weren’t pre-menopausal, however proper across the time the place they might be thought-about peri-menopausal,” she says. “They’re placed on anti-hormone remedy for 5 to 10 years. And in order that has a dramatic impact in your bones.”
How Can I Lower My Threat of Growing Osteoporosis?
Some danger components, like gender and genetics, are insurmountable. “There’s many ladies who, it doesn’t matter what they do, they’re gonna have bone loss,” says Ingraham. “Some ladies protect their bone fairly nicely, like my mom did, after which there are others that basically lose it rapidly.”
That stated, there are some life-style selections that may mitigate the dangers.
Select the Proper Form of Exercise
Train can have useful results on the musculoskeletal system, and particular workout routines for osteoporosis might assist cut back the danger of osteoporosis-induced breaks later in life. The specialists at Harvard Medical Faculty advocate specializing in a mix of weight-bearing workout routines like strolling and climbing stairs, muscle-strengthening workout routines like free weights or lifting, stability workout routines like tai chi and yoga, and adaptability workout routines like stretching5.
Mysore agrees. “Weight-bearing workout routines, reminiscent of strolling or jogging, stimulate bone formation by placing strain on the bones,” she says. “Energy coaching, or resistance workout routines like lifting weights, additionally helps construct bone mass and enhance muscle energy. Steadiness and adaptability workout routines, reminiscent of yoga or tai chi, enhance coordination and cut back the probability of falls, that are a typical explanation for fractures in folks with osteoporosis.”
Dave Asprey, Writer of Closely Meditated, Well being Science and Biotech Entrepreneur, echoes these suggestions. “Resistance coaching promotes bone density in addition to common motion like strolling,” he says.
He additionally recommends focused packages, reminiscent of OsteoStrong, which depends on “osteogenic loading” to enhance bone energy. “The machine applies temporary, intense power to totally different components of your physique,” he explains. “Below the steering of a coach, you push or pull as laborious as you may for a number of seconds on every machine, aiming to succeed in a power of 4.2 occasions your physique weight to stimulate bone progress and enhance energy.”
Complete physique vibration like Energy Plate might also assist enhance bone energy, he says. “It entails standing on a plate that vibrates 30 occasions per second,” he says. “Research verify that complete physique vibration improves bone density in postmenopausal ladies.”
Eat a Food regimen That’s Good for Your Bones
Anybody who grew up within the “Received Milk” marketing campaign period is aware of that calcium is important for good bone well being. However stopping osteoporosis is far more sophisticated than ingesting a glass of milk and calling it a day.
“One of many largest misconceptions is that it’s all about calcium deficiency,” says Asprey. “The reality is it’s much more complicated than that — you want the best minerals and fat-soluble nutritional vitamins in the best types and quantities.”
Calcium continues to be an excellent place to begin — in accordance with Mysore, it’s “important” for bone energy. To make sure you’re getting sufficient, she recommends consuming not simply dairy, but additionally leafy greens and tofu.
Pairing calcium with nutritional vitamins like vitamin D and vitamin Okay assist help the mineral’s absorption, explains Asprey. “Vitamin D3 helps you take up calcium and vitamin K2 directs the calcium the place it must go — in your bones and enamel as a substitute of in your tissues or arteries,” he explains. You will discover vitamin D in fatty fish, egg yolks, or by daylight publicity, and vitamin Okay is current in leafy greens like kale, spinach, and broccoli. Magnesium is one other mineral that aids in calcium absorption that’s current in nuts, seeds, complete grains, and leafy greens.
That stated, eating regimen will not be sufficient — particularly for these consuming a primarily plant-based eating regimen.
“Vitamins from plant meals are a lot much less bioavailable than these from animal meals,” explains Asprey. “Additionally, our soil isn’t the identical because it was once. It accommodates so much much less minerals than it used to.” Soil depletion has led to lowered mineral content material in lots of crops6, main some specialists to advocate supplementation to make sure you’re getting the important nutritional vitamins and minerals you want7.
Along with including healthful meals to your eating regimen, Mysore provides that it’s important to scale back the consumption of meals or drinks, like extreme caffeine and alcohol, that may intervene with calcium absorption.
Make Life-style Adjustments that Assist Bone Energy
In line with Mysore, there are different life-style selections which will assist impression hormone well being and thus bone well being. These embrace managing stress by rest methods and getting sufficient sleep — and the latter is much more important when you’re a girl.
The well-known suggestion of seven to eight hours of sleep per night time stem from analysis achieved on males — ladies want extra. Analysis printed within the American Sociological Overview in 2013 indicated that ladies want a median of 11 minutes extra sleep than males7, whereas newer analysis on ladies’s longer circadian rhythms8 has led specialists like Dr. Patrick Flynn to advocate ladies stand up to 10 hours of sleep an evening9.
It’s additionally important to remain knowledgeable concerning the state of your bone density. “Common bone density testing is essential for monitoring bone well being and catching osteoporosis early, permitting for well timed intervention,” says Mysore.
The Contentious Query of HRT
Some specialists additionally advocate hormone alternative remedy, or supplementation with bioidentical synthetic hormones, as a preventative measure for osteoporosis. This observe is considerably controversial, as a result of elevated danger of blood clotting issues, heart problems, breast most cancers, or stroke related to HRT. The Cleveland Clinic additionally notes that some hormones, notably compounded bioidentical hormones, lack FDA oversight concerning their purity and security10.
Regardless of these issues, HRT can mitigate the consequences of osteoporosis and even stop the illness, in accordance with Mysore. “Hormone Substitute Remedy (HRT) can assist handle the decline in estrogen ranges throughout menopause, which performs a key function in sustaining bone density,” she says. And Ingraham provides that along with train, sustaining estrogen ranges so long as doable is “the one factor that I’d say that most likely does make a distinction” in mitigating osteoporosis danger.
Mysore recommends that ladies communicate with a healthcare supplier about whether or not HRT for osteoporosis is an effective choice for them, and Asprey provides that common superior hormone labs ought to develop into a behavior for girls as they method menopause. “This manner, you may establish and repair potential points lengthy earlier than they develop into an issue,” he says.
Sources:
- https://www.nia.nih.gov/information/maternal-brain-hormone-key-strengthening-bones-could-help-treat-osteoporosis-bone-fractures
- https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968
- https://www.nia.nih.gov/information/maternal-brain-hormone-key-strengthening-bones-could-help-treat-osteoporosis-bone-fractures
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8836058/
- https://www.well being.harvard.edu/newsletter_article/effective-exercises-for-osteoporosis
- https://pmc.ncbi.nlm.nih.gov/articles/PMC7917752/
- https://www.mayoclinic.org/drugs-supplements/magnesium-supplement-oral-route/description/drg-20070730
- https://pmc.ncbi.nlm.nih.gov/articles/PMC4868418/
- https://www.instagram.com/p/CptD9-BJvHN/?hl=en&img_index=2
- https://my.clevelandclinic.org/well being/therapies/15660-bioidentical-hormones
