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.