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Osteoporosis Reversal - A Case History

Karen has been coming to the office for two years now. She first consulted me at the age of 55 with chronic IBS and low energy. Just prior to her initial consultation, she had been experiencing heartburn so an endoscopy was performed and showed mild inflammation of the esophagus. Her gastroenterologist prescribed the acid blocker Prilosec. Her IBS symptoms worsened and she decided to seek out another approach. I won't get into the process that successfully cleared her GI symptoms in this letter, as a more interesting part of the story just emerged.

Just over a year ago, I ordered a DEXA bone density test on her. The results were disappointing but not surprising with her family history and years of malabsorption at play. Her primary care physician received the results and urged her to start Fosomax immediately. Naturally, Karen was more than hesitant about beginning a therapy known for causing GI disturbance and the reports about periodontal breakdown associated with Fosomax had just hit the press.

We talked about options. Her diet was good, but she agreed to add more leafy green vegetables to support Vitamin K. I felt certain that her improved digestion and absorption were going to make a huge impact on her nutrient status. Karen wanted to try a supplement program for a year and repeat the bone density test before considering prescription drug therapy.

After ordering a Vitamin D blood test on her and finding her significantly low in that important nutrient, she began a program of Vitamin D3, Vitamin K1 and other nutrients known to build bone. This past month, after a year on her supplement regimen, I ordered a repeat DEXA scan. The results we just got back were remarkable. All measurements significantly increased. Her Lower Spine gained bone mass and increased by 6.7%. All other measurements, including Lateral Spine, Femoral Neck, Total Hip and Forearm all showed an increase in bone mass by over 3.5%.

This is one of those situations I love as a practitioner. The patient had made huge progress in addressing her GI complaints and had averted a potential decline in digestive ease by avoiding the osteoporosis medication. She adhered to her good diet and long-standing exercise plan and now had shown dramatic improvement in her bone density with the addition of a few nutritional supplements.

In this case I didn't focus on Calcium too much and to be honest, I don't use large amounts of calcium supplementation. There is conflicting information regarding just how much supplemental calcium is necessary. I ask my patients to incorporate large amounts calcium containing foods in their diet such as leafy greens, seeds and nuts and small amounts of acceptable dairy products. Foods can generally supply 300-600mg of dietary calcium which has to be counted when considering supplemental calcium. I tend to keep supplemental calcium at 600mg daily at most. We will be hearing a lot more about this during the coming year as some osteoporosis clinical studies coming to an end will most likely conclude that large amounts of Calcium supplementation are not beneficial. Bone health is not only about Calcium from food or supplements. Proper dietary balance and an adequate intake of supplemental Vitamin D, vitamin K, and Strontium have very important roles in bone health.

In the Journal "Menopause" (2006; 13:799-808), an article on the importance of vitamin K was published, pushing us to eat more leafy greens. With adequate vitamin K, calcium works with other hormones to strengthening bones. It has also been shown that when estrogen levels decline during menopause, the function of vitamin K is impaired making it even more important to get appropriate amounts. It was also noted that although some multivitamin preparations contain vitamin K, few contain enough to prevent or treat osteoporosis. Naturally, patients taking blood thinners like Coumadin should not use vitamin K supplements.