Treating Osteoporosis

Boosting bone building beyond calcium and vitamin D
By Richard Garian, DC, and Staff Writers

When it comes to aging, one of the most highly valued aspects of living out one’s “golden years” is independence.

Although many conditions associated with aging can impact your quality of life, careful management often allows seniors to live independently and lead active lifestyles despite their symptoms. A handful of these conditions tend to develop unnoticed, weakening your body gradually, and increasing the likelihood of an event that can instantly steal your independence.

Osteoporosis is the most common skeletal condition in the world. Every year, it causes 2 million broken bones and costs our health-care system approximately $15 billion. Most commonly affecting the spine, forearm, or hips, half of all women over age 50 suffer an osteoporotic fracture in her lifetime. One-third of women over the age of 65 will have spinal fractures, and even more devastating, one in four women over age 50 who fracture a hip due to osteoporosis will die within one year.

About Osteoporosis

The National Osteoporosis Foundation defines the condition as a loss of bone mineral and a loss of bone matrix or tissue. Bone tissue provides the framework to which calcium and other minerals bind. Without this framework, minerals, such as calcium and strontium, fail to adhere, passing through the body with little clinical benefit.

The causes of osteoporosis are numerous and include connective tissue, endocrine, and gastrointestinal diseases; bone marrow disorders; and lifestyle choices. After age 40, there is a gradual decline of bone mass over time. Men lose five to eight percent of their bone mass every decade after age 40, compared with women, who may lose 10 to 15 percent per year, and even more in the perimenopausal phase.

There are two distinct phases of bone loss. A slow age-related phase occurs in both sexes. An accelerated phase, by contrast, occurs in post-menopausal women. The slow phase begins around age 35 and continues well into old age. In this phase, the rate of bone loss is similar in both sexes, resulting in equal losses of cortical bone, found predominantly in the extremities, and cancellous bone, which is concentrated in the skeleton.

Racial and sexual differences occur in osteoporosis incidence. White women have the least dense skeletons while African-American men have the densest skeletons. White men and African-American women have skeletons of intermediate density. Women of short stature and of northern-European heritage tend to have less dense skeletons and an increased incidence of osteoporosis later in life.

Treatment

In treating osteoporosis, the medical and healthcare community has used calcium, estrogen, and pharmaceutical products known as bisphosphonates (Fosamax, Actonel, and Boniva). These antiresorptive drugs bind to bones, preventing the cells which break down old bone (osteoclasts) from working. While at first this seems like a good health strategy, impeding these cells often leads to reduction in the cells which produce new bone tissue (osteoblasts). The net result of this strategy is old, brittle bones that may actually be more susceptible to fracture. In as many as five percent of bisphosphonate users, a medical condition known as osteonecrosis (dead bone) also develops.

Until recently, the only non-prescription action which chiropractors and naturopathic physicians could offer their patients was calcium, calcium with vitamin D3, calcium with magnesium, or some other mineral-based product such as strontium. According to the New England Journal of Medicine, the best results calcium and vitamin D3 have shown is about a one-percent improvement—after five years of supplementation. While some have tried to paint calcium supplementation with a negative paintbrush, you must realize that fortifying with minerals is only half the picture. As the National Osteoporosis Foundation points out, bone tissue must be growing for the minerals to stick.

For the last 25 years, surgeons have used specific proteins to grow bone and cartilage.These proteins are known as bone morphogenetic proteins (BMPs). BMPs were first discovered by Marshall Urist, MD, who was head of orthopedic research at the University of California–Los Angeles. He discovered that a natural protein complex containing BMPs activated key cells which, in turn, grew bone and cartilage tissue. Urist published his findings in the Journal of Science in 1965. It wasn’t until 1983 that researchers were able to prove conclusively that the proteins Urist identified were actually the factor responsible for the bone-building effects he described. Overall, cell and molecular biologists have learned that BMPs are really a family of proteins encompassing 22 different forms that exist within the body. BMPs 2 through 10 are concentrated in the bone and responsible for keeping our bones and joints healthy.

How Bone Morphogenetic Proteins Work

In the case of both original bone growth and bone repair/remodeling, the mechanism is largely the same. Bone is unique to the body in that when it is injured, regenerated bone is identical to the original cells. In nearly every other instance, damaged soft tissue in the body is knitted together with connective cells, rather than the original variety of cells that were damaged.

At the site of new growth, stem cells, secreted by the soft tissues surrounding the site and by bone marrow, interact with BMPs to produce osteoprogenitor cells. In turn, these cells are converted by the body into osteoclasts and osteoblasts, depending upon the situation. Osteoblasts produce bone matrix, which then captures minerals from the bloodstream to complete the growth of new bone.

Supplementation

Surgical use of BMPs is a direct application of the proteins to damaged bone. Use of BMPs in supplementation becomes problematic, as the two primary routes into the body for over-the-counter solutions, oral ingestion and topical application, fail to deliver the proteins to bone sites or break down the proteins before delivery. In addition, BMPs are water-soluble and diffuse very easily in body fluids. In order to survive the harsh stomach passage required by oral supplentation, BMPs must be protected by some other carrier substance.

Type I collagen is one of the most abundant proteins in the body. It is found in bone, skin, and connective tissue, and by its own merit, has been shown to promote bone health in its hydrolyzed form. Together, BMPs and type I collagen offer proven bone-building benefits that complement simple supplementation with vitamins and minerals.

Louis Freedman, DC, associate professor of life sciences at Palmer College explains, “Generally, when it comes to protein ingestion, we are taught that proteins break down into amino acids, di-, and tri- peptides for passive absorption through the gastrointestinal (GI) tract into the body.”

But Freedman says recent research shows that there are receptors within the GI tract specifically for the BMPs within this complex “providing a very different mechanism of action for absorption than what we traditionally think of with proteins.”

Chief Scientific Officer at ZyCal Bioceuticals, Inc, Daniel Tripodi, PhD, considers the bone and joint healing effects of BMPs to be exceptional and notes that benefits are observed for conditions such as arthritis, fibromyalgia, and rheumatoid arthritis in addition to osteoporosis. When explaining the effectiveness of the BMPs within ZyCal’s supplement, Ostinol, Tripodi says, “The rapid onset of action can only be explained by some immunologic response. We know that the BMPs within Ostinol have a natural immunoprotective effect against the pathways which cause inflammation and the associated pain. So, what we have here is a protein-based product, which naturally resists breakdown in the gut, activates stem cells, and protects the body from inflammation, resulting in very rapid onset of action while stimulating the bone and cartilage growth. Truly a remarkable, natural product.”

Used in combination with traditional bone-health supplements—calcium, magnesium, strontium, vitamin D3, and vitamin K2—and a regular exercise program that includes an impact-related action such as walking or jogging, a BMP supplement can make a significant difference in either preventing or slowing down osteoporosis.