Diagnosed with Osteoporosis – What next?

Dear Healing With Plants,

Please help- I am so confused because  I am trying to do all plant based lifestyle but I have osteoporosis & am being treated with Prolia. Doctors nutritionist are trying to insist on about 110-130 gms daily. How do I incorporate ?? I lift weights  & do cardio and thought I had healthy lifestyle but evidently asthma meds played part in osteo. 56 yr old active female — ANY suggestions???

Dear So Confused,

You’re not alone! Medical professionals tell us that osteoporosis affects nearly one in two Americans in their life. The dairy industry tells us that drinking milk and consuming dairy products will keep bones strong to prevent this disease. Drug companies tell us not to worry, there are plenty of pills to treat the condition. But with so many financial interests with stakes in bone disease, how do you know who to trust? What’s the real deal with osteoporosis when all the profit interests are removed?

Bone disease is big business. Check who profits. Graphic by Healing With Plants.

Making Aging Into a Profitable Disease

Osteoporosis is a term first originating in France in the early 1920s to describe a diseased condition of the bone. The term wasn’t seen in English medical vocabulary until the twentieth century and has since been popularized by the dairy and pharmaceutical industries. Before 1990 Osteoporosis was only given as a diagnosis when someone experienced an unexplainable bone fracture. In 1992 pharmaceutical companies backed the creation of a new definition for Osteoporosis based on bone density. This new definition said if your bone density is 2.5 standard deviations below that of an average 30 year-old Caucasian woman, you have osteoporosis. This new medical definition suddenly meant that almost half of Americans suffered this disease. Also, a new condition was invented called Osteopenia that was defined to be having a bone mineral density 1 standard deviation below the peak bone mass of an average 30 year old Caucasian woman. But bone mineral density decline is a normal part of aging, like getting wrinkles in the skin.

According to an analysis by GreenMedInfo,

“In reality, the WHO definitions violate both commonsense and fundamental facts of biological science (sadly, an increasingly prevalent phenomenon within drug company-funded science).  After all, anyone over 30 years of age should have lower bone density than a 30 year old, as this is consistent with the normal and natural healthy aging process.  And yet, according to the WHO definition of osteopenia, the eons-old programming of our bodies to gradually shed bone density as we age, is to be considered a faulty design and/or pathology in need of medical intervention. “

Essentially, these new definitions made aging into a disease so that fearful and naïve people would buy completely unnecessary and often dangerous medications for a fictitious condition with absolutely no symptoms. Still, declining nutrients in food and the trends in eating diets high in acid-forming and processed foods mean that bone health is still a critical health issue to discuss.

Dangers of Bone Medications

If you have been diagnosed with Ostopenia or Ostoperosis it is likely the next conversation with your doctor will be about medications. But bone medication do not have a great reputation. For example Fosamax is one such medication belonging to a class of drugs called bisphosphonates. These drugs work by slowing down the normal process of bone remodeling and are said to increase bone density for at least ten years. But in recent years studies have linked bisphosphonates with osteonecrosis, bone death, of the jaw and atrial fibrillation.  While the medication appears to build bone mass, research shows this drug increases the risk for atypical fractures in long-term patients. These are the kind of fractures that happen spontaneously for no apparent reasons such as to someone standing in their kitchen slicing an apple.

What’s the story with Fosamax?

In November 2008 Harvard Medical School published an article,  “What’s the story with Fosamax?” where the research pointing to the dangers of this drug are summarized:

“In 2008, researchers in Singapore published a report on 17 postmenopausal women, average age 66, who experienced fractures across the thighbone unprovoked by major trauma. All of the women had been taking Fosamax for an average of five years, and 13 of them had leg pain before the fracture developed. The researchers reported similar findings in a smaller study in 2007; they theorized that prolonged suppression of bone remodeling by Fosamax may have encouraged fracture-inducing microdamage to the bone.

Prompted by the Singapore findings, clinicians at New York’s Hospital for Special Surgery identified 70 patients who had suffered low-energy fractures between 2002 and 2007. (Low-energy fractures occur from a fall from standing height or less.) Twenty-five (36%) had been taking Fosamax. Of these, 20 had suffered a fracture across the femur, and 19 of those fractures occurred in patients who had been taking Fosamax the longest — on average, seven years. The researchers concluded that long-term Fosamax use is a significant risk factor for low-energy fractures of the femur.”

Fosamax is a drug, prescribed to treat osteoperosis, with high profits. Graphic from NPR story.

A year later, in 2009, NPR published the insightful story, “How a bone disease grew to fit the prescription,” telling of how Merck was unable to sell Fosamax when it was first released and how they went to great lengths to manufacture a market for a very profitable drug . They even formed a nonprofit, the Bone Measurement Institute, as a public-interest front group to help drum up a market for their drug. However, the negative attention Fosamax has received has led to declining sales in recent years.

What’s the story with Prolia?

As for Prolia, the drug your doctor has prescribed, my limited research has raised questions as to whether this drug may do more harm than good.  Prolia’s safety was assessed in a 3-year double-blind, randomized, placebo-controlled study of over 7,808 postmenopausal women ages 60-91 years. Roughly half of the women were administered Prolia and half were given a placebo. While all-cause mortality incidence was slightly higher in the placebo group (2.3% of women taking placebo died vs 1.8% taking Prolia), the Prolia group had more nonfatal serious adverse events (24.2% of women taking placebo and 25% taking Prolia) and more patients taking Prolia (2.4% of Prolia patients vs 2.1% taking the placebo) withdrew from the study because of adverse affects . Here is the chart summarizing the differences between the group taking Prolia and the placebo group.

Table 1: Adverse Reactions Occurring in ≥ 2% of Patients with Osteoporosis and More Frequently than in Placebo-treated Patients
SYSTEM ORGAN CLASS
PREFERRED TERM
PROLIA
(N = 3886)
N (%)
PLACEBO
(N = 3876)
N (%)
BLOOD AND LYMPHATIC SYSTEM DISORDERS
  Anemia 129 (3.3) 107 (2.8)
CARDIAC DISORDERS
  Angina pectoris 101 (2.6) 87 (2.2)
  Atrial fibrillation 79 (2.0) 77 (2.0)
EAR AND LABYRINTH DISORDERS
  Vertigo 195 (5.0) 187 (4.8)
GASTROINTESTINAL DISORDERS
  Abdominal pain upper 129 (3.3) 111 (2.9)
  Flatulence 84 (2.2) 53 (1.4)
  Gastroesophageal reflux disease 80 (2.1) 66 (1.7)
GENERAL DISORDERS AND ADMINISTRATION SITE CONDITIONS
  Edema peripheral 189 (4.9) 155 (4.0)
  Asthenia 90 (2.3) 73 (1.9)
INFECTIONS AND INFESTATIONS
  Cystitis 228 (5.9) 225 (5.8)
  Upper respiratory tract infection 190 (4.9) 167 (4.3)
  Pneumonia 152 (3.9) 150 (3.9)
  Pharyngitis 91 (2.3) 78 (2.0)
  Herpes zoster 79 (2.0) 72 (1.9)
METABOLISM AND NUTRITION DISORDERS
  Hypercholesterolemia 280 (7.2) 236 (6.1)
MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS
  Back pain 1347 (34.7) 1340 (34.6)
  Pain in extremity 453 (11.7) 430 (11.1)
  Musculoskeletal pain 297 (7.6) 291 (7.5)
  Bone pain 142 (3.7) 117 (3.0)
  Myalgia 114 (2.9) 94 (2.4)
  Spinal osteoarthritis 82 (2.1) 64 (1.7)
NERVOUS SYSTEM DISORDERS
  Sciatica 178 (4.6) 149 (3.8)
PSYCHIATRIC DISORDERS
  Insomnia 126 (3.2) 122 (3.1)
SKIN AND SUBCUTANEOUS TISSUE DISORDERS
  Rash 96 (2.5) 79 (2.0)
  Pruritus 87 (2.2) 82 (2.1)
Source: RxList

Building  Strong Bones

What to Avoid

To preserve and build bone mineral density you will want to stay away from these substances which are known to increase risk for osteoporosis by drawing nutrients out of the bones.

  • Steroids
  • Gluten
  • Processed foods
  • Alcohol
  • Processed oils
For Strong Bones – Do Supplements Help?

The first thing you may be advised to take is Calcium. But don’t let the dairy industry advertising get the best of you. Research has shown calcium supplements may do more harm than good increasing your risk for heart attacks and cardiovascular disease. Other artificial vitamin supplements have been shown to work more against human health than for it. It ‘s easy to see with a common sense look at human biology and nutrition. People were designed biologically to consume a diet mainly of whole plant foods that are rich in vitamins, minerals, fiber, water, and energy. These foods contain all the macro and micronutrients our bodies need to thrive.

The lack of vegetable consumption in the U.S. has no doubt contributed to a population starving for nutrients. Insufficient consumption of nutrients has been linked to conditions ranging from obesity and cancer to osteoporosis. Graph by CDC.

They are also nature’s perfect vitamin delivery vehicles. When you break whole foods apart and attempt to isolate minerals into pills, it makes sense that these pills may not be the right formula for our bodies. Walk into any health supplement store and they will probably recommend to you supplements derived from whole foods as superior. But the whole foods are themselves superior, and more affordable, than any artificially made supplement.

The Importance of a Whole Foods Plant Based Diet

Osteoporosis has been linked to diets high in animal products that promote an acidic internal environment. Because of this the body draws calcium out of the bones to neutralize the acid in the blood. This is why osteoporosis is a condition seen more in developed countries consuming diets higher in animal products. To reverse this condition and jumpstart healing, you will want to restore your body’s internal chemistry to an alkaline state by consuming a whole foods plant based diet. Focus on counting nutrients, not calories.

Chia seeds are nutrient-packed powerhouses that far surpass dairy products in calcium and other essential nutrients.

For most of human history people have eaten diets rich in fruits from trees, bushes and vines, fresh greens, starchy roots, and oil rich seeds. These plant foods are some of the most nutrient dense choice foods available. You will get more vitamins and minerals into your body by eating a variety of fruits, vegetables, nuts, seeds, and roots – than from any other diet. To jumpstart your nutrient-building journey to wellness, consider adding juicing to your routine. Green juices are especially good at restoring the body’s internal balance and delivering a nutrient-packed punch. Also consider super foods like chia seeds which  contain 6x more calcium than milk and 100% more Omega-3 Fatty Acid than salmon.

Magnesium is essential for Calcium absorption and can be found in many plant foods including spinach and most beans, seeds, and nuts.

Plant based sources of Magnesium. Graphic from RebelDietician.us

Besides avoiding acid-forming foods that draw minerals from bones and eating a diet rich in plant based nutrients, exercise, and proper sunlight exposure are also essential to long-term bone health. Regular physical activity including resistance training, as you are engaged in, has been shown to be one of the best ways to keep your bones strong as you age. Your path to wellness is up to you. Remember, I am a holistic health writer and researcher, not a medical professional or dietician. Any perceived advice here should not substitute for your own research, common sense, and informed decision-making. I hope this helps erase some of your confusion over pills vs. plants for bone health. Wishing you the best strengthening your bones and improving your health through a plant based diet.

Sources for this article include:
1.World Health Organization: Population nutrient intake goals for preventing diet-related chronic diseases
2.NY Times Danger of Too Much Calcium
3.National Institute of Health: "How does physical activity help build healthy bones?"
4.Rheumatologist salary
5.Medical costs osteoporosis 
6.Harvard Health's "What's the Story with Fosamax"
7.NPR "How a Bone Disease Grew to Fit a Prescription" 
8.Fosamax annual sales, 
9.Prolix research from Rxlist.com, 
10.Green Med Info "Osteoporosis Myth." 
11.CDC graphic adapted from LiveScience.com 
12.Other graphics from RebelDietician.us and LiveLoveFruit.com.

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