"The silent crippler", as osteoporosis is often called, sneaks up on its victims and, without any pain, gradually causes bones to become more porous and fragile. One day you grab your coat and your wrist snaps; or a friend hugs you and cracks your rib; or you step off a curb and break your hip... Osteoporosis is the chronic loss of bone mass and strength which afflicts over 8 million Americans - one and a half million are subjected to life threatening fractures every year. Of those who endure hip fractures, some 20% die from complications within a year; 60% become dependant on constant help in their daily lives.

It is not strictly a women's disease, though 85% of victims are women. As you age, the need for absorbable calcium, in conjunction with other essential minerals and vitamins, can be increased.

A 2000 statement by an expert panel of National Institutes of Health asserted "Osteoporosis, once thought to be a natural part of aging among women, is no longer considered... gender-dependent." Men start with higher bone density and lose calcium at a slower rate than women, which is why their risk is far lower. Nevertheless, after age 50, bone loss increases, and, according to one 2000 study, more rapidly than previously thought. Men have a 6% risk for hip fracture and between 16% and 25% risk for any fractures related to osteoporosis. And the actual numbers of osteoporosis and fractures in men is bound to grow as baby boomers age. Some risk factors include the following:

Surprisingly, a survey found that even among women with early symptoms of bone loss, including back pain, loss of height, and stooped posture, 82% thought they were not likely to ever suffer the consequences of progressive bone loss. Contradicting these assumptions, most statistics show that nearly 50% of women will suffer an osteoporosis-related fracture sometime during their lives.

Bone mass does not increase beyond a "peak density" after age 35. The loss of bone mass can be slowed and lost bone mass regained somewhat with the right treatments. Dairy product consumption is not an appropriate treatment to accomplish this, as it will ultimately accelerate bone loss. However, this fact is ignored by marketing experts in the milk industry who make certain that women this age and older are targeted consumers for milk and dairy products. Within 5 years of the initial onset of menopause, there is an accelerated rate of loss of bone, particularly from the spine. During this period of time, estrogen replacement is somewhat effective in preventing bone breakdown, but progesterone is needed for creating new bone.

Things to avoid for better bone health

• Avoiding factors that encourage bone loss can be as just as important as calcium intake. Diets high in protein, salt, refined sugar, caffeine, and phosphorous contained in soft drinks, all promote calcium excretion in urine.
• A diet low in green leafy vegetables can be low in vitamin K. Vegetarians may have greater bone mass than meat eaters, but some studies have not found this correlation.
• Other habits to curtail include heavy smoking, excess alcohol consumption, and limited sunshine exposure or vitamin D intake.
• Prescription drugs can increase bone loss. These include cortisone, blood thinners, antacids containing aluminum, chemotherapy, lithium, and certain antibiotics.

Things to do for better bone health

• Reduce animal protein consumption.
• You can reverse bone loss and regain bone mass with calcium, magnesium, vitamin D, and vitamin K. Minimum doses should be in the following ranges: calcium (1200mg), magnesium (400-800mg) vitamin D (400 IU - consider supplementing in the winter months in females), and vitamin K (80mcg). Calcium comes in many forms, so use those which are more absorbable such as hydroxyapatite, citrate, gluconate, and others. Some special preparations have been shown to increase bone density without the use of any other nutrients.
• Building and maintaining bone early in life (up until the 40s) will delay or prevent the appearance of bone loss problems.
• Exercise strengthens bones.
• Estrogen and progesterone are known to provide benefit. The natural forms are best to use for many reasons. As explained below, and when appropriate, they should be used in combination. A recent study, however, has contested the benefit of estrogen use in preventing fractures. Most agree that estrogen does reduce fractures (at several fracture sites) by halting the reduction in bone density. More recent studies have shown that women who start using estrogen in their 70s still have a benefit in their 80s, and that maybe half of the dose of estrogen will do the same job. Estrogens decrease bone resorption, but also decrease bone formation, with an overall effect of reducing loss without substantially increasing bone mass. Natural progesterone, on the other hand, stimulates new bone tissue growth. A three year study of 63 post-menopausal women using progesterone cream for osteoporosis found an average of 7-8% bone mass density increase the first year, 4-5% the second year and 3-4% the third year.
• Trace minerals (zinc, copper, manganese, and boron) are required for strong bone formation.
• There is some evidence that the use of statins is associated with a significantly reduced fracture risk compared with the non-use of these lipid-lowering agents. Further study needs to confirm this.

Monitoring bone health
A bone scan can indicate what your current bone mineral density is. Repeated scans (a year or two apart) can tell if you are gaining, losing or just maintaining bone.

A new urine test utilizes the two most specific markers of bone resorption - the collagen crosslinks pyridinium/pyridinoline (PYD) and deoxypyridinium/deoxypyridinoline (DPYD or DPD) - to identify elevated levels of bone loss before excessive damage occurs. This profile enables regular testing of women for resorption rates, allowing treatment intervention at its most effective - before bone loss has occurred. It also allows easy and rapid monitoring of treatment effectiveness. As valuable as bone scan results can be in the definitive diagnosis of osteoporosis, the evaluation cannot be performed often enough for patients who are losing bone at a fast rate.