DEAR DR. BLONZ: My doctor determined that I have osteoporosis in my back and hips. (I am 67.) She now wants me to take a prescription bisphosphonate drug. I do not take any medications, and would prefer not to begin. I do take many vitamins and supplements, including calcium and magnesium. Is there anything I can use instead of a drug? -- J.B., Oakland, California
DEAR J.B.: I am not a medical doctor; my training is in biochemistry and nutrition, and my focus is on food, nutrition and health. I cannot therefore give you any medical advice.
I respect your preference for not relying on medication, but it is important to understand that osteoporosis is a nasty ailment. It involves a reduced bone-mineral density that takes decades to develop. Ironically, it develops at a time in life when the body’s ability to build and fortify its bones is on the wane. The class of medications known as bisphosphonates have a demonstrated ability to help the body in this regard.
Our bones are being made and disassembled (resorbed) throughout our lives. From infancy toward adulthood, the process favors the net building of bone, but from midlife toward our senior years, the balance shifts and our total bone mass begins to wane. Osteoblasts are the cells that help build bone, and osteoclasts are the cells that help resorb existing bone, releasing its calcium and other components back into the bloodstream.
The bisphosphonate compounds slow bone resorption by inhibiting the action of the osteoclasts. They have an extremely long half-life, which is science-talk for saying that they are slowly broken down by the body. Depending on the particular bisphosphonate compound selected, they may only need to be taken weekly or monthly. Newer bisphosphonates may only need to be given once a year.
These are medications, and while there is research-based evidence to support their efficacy, there are potential side effects. I advise you to do some research and bring all your issues to your physician so that you can make the right decision for your case. Check out the review by Berkeley Wellness at tinyurl.com/y93l7oz9.
In addition, you need to be eating well and possibly take additional supplements to provide the nutrients needed to build and maintain bones. Aside from calcium, the body relies on magnesium, phosphorous, fluoride and vitamins A, B-6 and D for calcium absorption and healthy bones. “Food first” is an essential philosophy: Eating healthful foods provides benefits far beyond the named nutrients in a supplement bottle.
Finally, our bodies get conservative with resources as we age, lowering the priority of things that aren’t used on a regular basis. The “use it or lose it” theme applies to our bones, and weight-bearing exercise sends a message that you expect your bones to remain strong and on the job. Exercises such as walking, stretching and weight training can help strengthen the body, no matter what age they are begun. However, activities need to be appropriate for your particular situation. Don’t overdo it; seek the guidance of a professional before you begin.
Send questions to: “On Nutrition,” Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to firstname.lastname@example.org. Due to the volume of mail, personal replies cannot be provided.