DEAR DR. BLONZ: My husband was on a steroid (prednisone) for a number of years. He is now off of it, but it has had an apparent effect on his bones, causing osteopenia. Some calcium products advertised online make claims about regaining lost bone and I don't know whether to be skeptical or not. I am asking you because I want as complete a recovery as possible for my husband, and can't get many specifics from the doctor. -- F.B., Oakland, Calif.
DEAR F.B.: Prednisone is a common type of corticosteroid drug that can affect the efficiency with which the body absorbs dietary calcium. Those on steroids will often have a higher calcium requirement. Your physician or pharmacist should have information regarding these drug-nutrient interactions. Osteopenia is a condition where bone density is decreased, but not to the point where it is diagnosed as osteoporosis. There is general information about these topics, and about medications that can cause bone loss at the National Osteoporosis Foundation (tinyurl.com/8uyv4sf).
As regards nutrient sources, most dairy foods contain a rich supply of calcium per serving. For those choosing to avoid dairy, calcium is available from vegetables such as broccoli, cauliflower and dark green leafy vegetables, such as kale and turnip greens; calcium-set tofu; calcium-fortified soy milk and orange juice; almonds, figs and some legumes. It makes sense for a number of reasons to include green leafy vegetables in the diet.
In your husband's case, it would be reasonable to consider a calcium containing multi-mineral supplement as well. Calcium citrate or calcium citrate-malate are among the best absorbed, but calcium carbonate works well when taken with meals. Remember that it takes more than calcium. Bones are about 90 percent calcium by weight, but other minerals such as magnesium, phosphorous, boron and silicon are needed, and vitamin D is critical to the process. It is also important to maintain a program of weight-bearing exercise as this helps to slow bone loss.
As for regaining lost bone mass, our bones exist in a dynamic state, balanced between the actions of bone-building cells called osteoblasts, and the bone-resorbing actions of calls called osteoclasts. In the first 35 years of life there is a net increas in bone density, which explains why that period is critical to bone health in our later decades of life. Sometime during the fourth decade, this shifts toward the negative. The speed at which we lose our bones depends on diet, lifestyle and genetic predisposition, but it can also be influenced by medications.
In recent years we have learned more about the precise processes at play with the building and breakdown of bone tissue. Through the use of specialized hormones and new medications, we have learned how to slow down the bone-resorbing action of the osteoclasts, while not affecting the bone-building action of the osteoblasts, resulting in a net increase of calcium and other minerals in the bones. There isn't one compound that works in all situations, but it makes sense to speak with your physician to see if anything might be appropriate for your husband.
Send questions to: "On Nutrition," Ed Blonz, c/o Universal Uclick, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to email@example.com. Due to the volume of mail, personal replies cannot be provided.