The word osteoporosis means “porous bones.” It is a silent disease that makes bones brittle. If not prevented or left untreated, osteoporosis can progress painlessly until a bone fractures.

There are approximately 1.5 million osteoporosis-related fractures occurring annually in the United States, and over 500,000 of these cases occur in post-menopausal women. Over half of women over age fifty will have an osteoporosis related fracture in their remaining lifetime.

Any bone in the body can be affected, but fractures typically occur in the hip, spine, and wrist. A hip fracture almost always requires major surgery as well as hospitalization. More significantly, one in four hip fracture patients over the age of fifty will die within the year following their fracture.

Millions of Americans are at risk for osteoporosis. An estimated ten million Americans today have osteoporosis and are not even aware of it. Among those, eight million are women, and two million are men. Risk factors of osteoporosis include alcoholism, gastro-intestinal disorders, kidney stones, smoking, lack of physical activity, low exposure to sunlight, age of menarche, overweight, as well as prolonged use of steroids such as cortisone or prednisone.

Men versus Women
Osteoporosis targets more women that men because of their hormonal cycle. In fact, women are four times more likely than men to develop and suffer from the disease and can lose up to 20% of their bone mass from the first five to seven years following menopause.

During menopause, bone loss accelerates due to the steep drop in estrogen levels in the body. This leads to an increase in the resorption (teardown) of the existing bone in the body. At menopause, there is also an even more severe drop in the body’s production of progesterone, and without an adequate level of progesterone, there is a reduction of new bone formation. This imbalanced state is often termed estrogen dominance, where the relative amount of estrogen in the body post-menopausally is actually higher than before menopause due to the severe reduction in progesterone.

Men are also at risk for osteoporosis, although the incidence of fractures is less than that in women. More than two million men in the US have osteoporosis, and it is estimated that another three million are at risk.

Men over age 50 have a greater risk of developing osteoporosis than they do prostate cancer, even though prostate cancer is much more publicized. While women are four times more likely to get osteoporosis than men, men are more likely to develop an extreme form of the disease, which can result in the loss of height by several inches.

Conventional Treatment
Osteoporosis is often diagnosed by x-ray or bone density tests. The conventional choice of treatment is the use of a class of drugs called biphosphates and other “designer” variations of this class of drugs. One such drug in this class is Fosamax®. Fosamax® is made from the same type of chemicals that are used to remove soap scum in your bathtub.

The bone is a living structure, and like any cell in the body, bone cells are constantly breaking down and rebuilding themselves in order to be healthy. Osteoclasts are cells that remove old bone, and they work in conjunction with osteoblasts, which are bone-building cells. When this process is in balance, normal bone density is maintained. Fosamax® kills the osteoclasts, so only the osteoblasts are left.

When the bones are not being broken down, bone density will show an apparent increase. However, as times goes on, this will backfire. As bones become denser due to the lack of healthy, normal breakdown, they actually become weaker, as they have not been allowed to remold themselves and readjust to the constantly changing forces that are applied to the bones. Over time, the rise in bone density slows down, while the risk of fractures actually increases as the bone becomes more brittle.

In addition, the bisphosphonate drugs may also cause serious inflammation in several regions of the eyes. In a study reported in the New England Journal of Medicine on March 20th, 2003, researchers reviewed thousands of cases in which patients were prescribed bisphosphonates, and tracked 314 patients who had also reported to have eye problems. Although side effects were rare, several types of inflammation did occur, leading to the loss of vision and blindness. Other side effects included nausea, heartburn, abdominal pain, muscle cramps, irritability, pain when swallowing, and diarrhea. Aspirin and other non-steroidal, anti-inflammatory drugs such as ibuprofen may also increase the damage to the stomach if taken with Fosamax®.

Osteoporosis Prevention Protocol

1. Diet

Meat - There is little doubt that there is a strong correlation between dietary habits and osteoporosis. As far back as 1968, research has shown that the amount of minerals in the bones varies with the diet. When excessive amounts of meat, refined carbohydrates, and fat are consumed over a long period of time, our body becomes more acidic. The body is not used to this and prefers to be in an alkaline environment most of the time. Much like taking a calcium antacid for heartburn, the body takes calcium and other minerals from the bones and transports them to the rest of the body in an attempt to buffer and neutralize this acidic environment. Some of this calcium goes into the kidney and is excreted out. As a result, there is a net loss of calcium from the body. This is a serious risk for osteoporosis.

In addition to the loss of calcium from the bones, animal proteins, due to the high sulfur content, alter the kidney's re-absorption of calcium, so that more calcium is excreted. Those on high protein diets can lose about 100 mg of calcium a day. In one study, individuals who consumed excessive amounts of protein were found to have a negative calcium balance of 137mg/day. This translates into approximately 50g/year and a potential skeletal mass loss of 4% per year!

Milk - A major concern of those who have been advised to stop drinking milk is, "What will happen to my teeth and bones?" The answer is astoundingly simple, "They will improve."

The majority of the world's population takes in less than half the recommended daily calcium intake of 800 mg a day and yet they have strong bones and healthy teeth. The myth that high amounts of calcium from dairy products are needed in order to maintain strong bones and teeth and prevent osteoporosis must be dispelled. Studies have repeatedly shown that strong bone is due more to a function of optimum amount of magnesium and a low acidic environment in the body, rather than calcium.

While milk provides calcium, it is ironic that pasteurized milk also promotes calcium loss in the body. This is because the consumption of the excessive denatured proteins found in pasteurized cow's milk increases the need for minerals found in the body to neutralize the acid formed from digesting the protein. This is less true of raw milk. As mentioned before, calcium is removed from the bone to the blood in order to neutralize the acid, resulting in the loss of calcium from the bone. In fact, calcium excretion and bone loss increase in proportion to the amount of animal protein consumed.

In short, milk and diary products are acid forming substances. Acidic byproducts that accumulate in the body are also one of the primary causes of accelerated aging and cancer. It is best that our body is slightly alkaline. but the more animal protein is ingested, and the more acidic the body becomes. Vegetarians, for example, need about half as much calcium as meat eaters because they lose much less calcium from their bones.

Cow's milk also contains phosphorous. When calcium and phosphorus reach the intestine at the same time, they compete for absorption. The more phosphorus there is, the less calcium will enter the body. The optimum calcium/phosphorus ratio is important for bone building. The ideal ratio is 2.5 to 1. Too much phosphorus consumed will upset the balance, and will lead to progressive bone loss in the body. The ratio in cow's milk is only 1.3 to 1. In addition, excess phosphorus triggers the release of parathyroid hormone, which also sucks calcium out of the bones.

Not all calcium in food enters the body. Many components of food such as phosphates, vitamin D, fiber, proteins, and hormones alter the absorption of calcium in our diet. For example, Cow's milk contains 1,200 milligram of calcium per quart; human milk contains only 300 milligrams. But the total calcium absorbed in breast-fed babies is higher than in babies fed cow's milk. This is because the phosphates and palmitic acid in cow's milk reduce the absorption of calcium by the body.

Lastly, milk consumption is not helpful in improving bone density for those over 30 years old, because the milk has been pasteurized. The pasteurization process causes a severe destruction of essential nutrients. This is not true of raw milk.

Low-Carb Diet - As more Americans turn to the low-carb, high protein diet to lose weight quickly, some research studies are reporting that such diet can increase the risk of kidney stones as well as the risk of osteoporosis. In a six week study reported in the American Journal of Kidney Disease in 2002, ten healthy adults consumed a regular diet for two weeks, followed by a low-carb, high protein diet for two weeks, and finally followed by a moderately restricted carbohydrate diet for four weeks. It was found that while the volunteers lost nine pounds on average, most developed ketones. These ketones raise the acid level in the blood—some volunteers had their acid level increased by 90%! When exposed to a high acidic environment, the body tries to buffer or neutralize the acid by withdrawing minerals such as calcium from the bones. As such, the body’s calcium stored in the bones is therefore reduced.

Vegetables - The kind of vegetables that are best for osteoporosis prevention include leafy vegetables, legumes, raw nuts (that have been pre-soaked overnight in water), and seeds. All these contain plentiful amounts of calcium. It has been shown that average African women consume only 500mg of calcium a day, mostly from plant sources. However, they have a positive calcium balance because they retain their calcium much better.

When protein intake is reduced to a modest level, and especially if protein can be derived from plant sources, the level of calcium intake can be reduced.

Soy - Soy is high in phytoestrogen, a plant estrogen precursor. The effect of soy in the body is still controversial, but many experts believe that soy blocks excessive estrogen from being absorbed and acts like estrogen when it is deficient, thus providing the best of both worlds.

Interesting studies have been conducted, including one from Italy involving 90 women aged 53-65. It was found that ipriflavone and calcium supplementation was able to increase bone mineral density by 2% after 6 months and 5.8% after 12 months, with the added bonus of significant decrease in pain: 45% in 6 months, and 62% at 12 months. However, it should be noted that soy does have a dark side. Excessive amounts of unfermented soy intake such as tofu can lead to thyroid disturbances. Women who are in post-menopausal period should therefore be careful when using soy as a supplementation for osteoporosis. Fermented soy products such as miso or tempeh do not have this problem and can be taken liberally.

Caffeine - Avoid stimulatory drinks that contains caffeine, which acidifies the body and causes calcium to be withdrawn from the bone. Avoid coffee and tea. Distilled water should also be avoided. Decaffeinated coffee and decaffeinated tea is acceptable in moderate amounts. Herbal tea is acceptable.

2. Exercise
Weight bearing exercises is as close as one can get when one is searching for a magic bullet in the prevention of osteoporosis. The positive effect of exercise on bone density is greatest in adults who have been sedentary and are just starting to exercise. Studies have shown that even elderly adults over age 80 who have done active exercise and weight bearing programs can significantly increase their bone density over a shot period of time. Weight bearing exercises such as walking, running, jogging, dancing, are especially important. While swimming is a great exercise for cardiovascular diseases, it is not as good for bone health when compared to walking and jogging.

Bone is a live tissue and it responds to stress placed upon it. When a person becomes sedentary, the normal stress placed on the bones is removed. The bone will lose its density and become brittle over time. It comes as no surprise that a patient with spinal cord injuries will have significant loss of bone density if proactive steps are not taken. The opposite is also true; athletes have stronger bones than the average adult.

Exercise is a life long activity. Its effect on bone mass will decrease when one stops to exercise. Therefore, exercise needs to be done on an ongoing basis. 30 minutes of weight bearing exercise daily will improve bone density, heart health, muscle strength, coordination, and balance. The good news is that studies have now shown that the 30 minutes of exercise can be broken down into ten-minute blocks without sacrificing results.

Remember to warm up and cool down always. It is also wise to combine several different kinds of weight bearing exercises. Incorporate exercises that build strength, and increase resistance in weight to the program. Lastly, drink plenty of water to prevent dehydration.

3. Nutritional Supplements
Fifty years ago, nutritional supplementation for bone building consisted of the single element calcium. Later, it was found that magnesium and vitamin D are important components as well. The latest nutritional research now points to three other important team players: strontium, vitamin K, and collagen.

Bone building is no longer about any one single nutrient. The best program consists of a cocktail with all six nutrients working concurrently.

Calcium - Calcium is a basic building block of bones. The average adult has about 3 pounds of it in their bones, teeth, and blood. The use of calcium supplementation to treat post-menopausal osteoporosis has increased significantly since 1987, which is the year the National Institute of Health increased the recommended daily intake of calcium to 1500mg for the prevention of primary post-menopausal osteoporosis (PPMO). There is significant controversy surrounding this recommendation because it was made despite conflicting research by some clinical studies presented to the NIH. Some of the studies show no significant effect of calcium intake on mineral density on trabecular bone and only a slight effect on cortical bone.

Since PPMO is predominantly a condition due to the demineralization of trabecular bone, there is no justification for calcium megadosing for postmenopausal women. In fact, soft tissue calcification can be a serious risk factor arising from calcium megadosing under certain conditions. Most research and trials using calcium in the prevention of post-menopausal osteoporosis also involve the use of vitamin D, which makes it difficult to attribute the benefit to calcium alone.

It is also interesting to note that the bone density increase found in the first two years of calcium supplementation may not substantially increase over a long period of time. In contrast to most clinical data, a great number of studies did not find a significant association between calcium intake and a reduced risk of bone loss fracture. It is well known that calcium at low or moderate doses is largely dependant on the action of vitamin D for active support. Insufficient vitamin D leads to less calcium absorption, elevated blood concentration of parathyroid hormone, as well as an increased rate of bone absorption. All these can eventually lead to a bone fracture if not corrected in time.

Conventional wisdom is that a high dose of calcium is necessary for the prevention of post- menopausal osteoporosis, as well as for the building of strong bones for children and elderly. Long term studies however have not been able to confirm that calcium alone can get the job done without the help of other nutrients, especially in the case of PPMO.

Current Recommended Dietary Allowance (RDA) is 1000 mg of calcium for younger adults, and 1200 mg for people over the age of 50. These numbers reflect the total calcium needed for a diet that is high in protein and fat (typical of the young American diet). Such a diet also produces a body that is acidic, and as a result, calcium is drawn out of the bones to neutralize this acidic environment.

This recommendation of 1000 to 1500 mg calcium is not suitable in the case of people whose diet is high in green, leafy vegetables. In this type of diet, the amount of calcium required in terms of supplementation is much reduced. If you have a high calcium intake from food sources, then less supplemental calcium will be needed. A diet high in green, leafy vegetables leads to an alkaline internal environment. As a result, only 500 mg is required, if accompanied by the right dose of magnesium.

Megadosing calcium in excess of 1000 mg per day has little correlation with increase in bone density. In fact, taking too much calcium can inhibit the absorption and utilization of other important bone nutrients, such as zinc and copper. In fact, megadosing calcium can be detrimental to your health, leading to the eventual formation of bone spurs. Excess calcium also can serve as a cardiac irritant and can lead to cardiac arrhythmias.

Multiple studies have shown that calcium supplements—such as calcium gluconate, calcium citrate, calcium carbonate, and even calcium citrate-malate—slow, but do not halt or reverse, post-menopausal bone loss, whether taken alone or with vitamin D. Even a total daily calcium intake of 3000 milligrams of calcium alone isn't enough to stop bone loss. The bone will not be able to take in more calcium than it is capable of if other supporting nutrients are not present. An osteoporosis program focusing largely on calcium intake is a recipe for failure.

Calcium can be found in vegetables and milk. Traditionally, milk is not helpful in improving bone density because it is pasteurized. Raw milk on the other hand, is very different and beneficial, but not everybody has access to this however. You can get an ample supply of calcium from green leafy vegetables.

Magnesium - Magnesium balances the calcium in our body, much like progesterone balances the effect of estrogen, and omega-3 balances omega-6 fatty acids. Without magnesium and other trace minerals, calcium ingested, especially if excessive, will be deposited not in the bone but perhaps in the wall of our arteries or in our kidneys.

Magnesium regulates the active calcium transport. It has been shown that magnesium has a fracture prevention effect, and is able to increase bone density when taken on an ongoing basis. Magnesium deficiency has been shown to be a significant risk factor for post-menopausal osteoporosis, and this may due to the fact that magnesium deficiency alters calcium metabolism and the hormones that regulate calcium.

Magnesium has been shown to prevent the formation of calcium oxalate crystals, the most common cause of kidney stones. Studies have shown that 500 mg a day of magnesium is able to reduce the recurrence rate of kidney stones by as much as 90%. Magnesium is also nature's "calcium channel blocker," preventing the entry of excessive calcium into the cell resulting in contractions, chest pain, hypertension, and arrhythmias.

One researcher, Dr. Guy Abraham, postulated that a dietary program emphasizing magnesium as well as calcium would be more effective in preventing bone loss. His concern for low magnesium for osteoporosis is similar to his concern for women with premenstrual tension syndrome. To test Dr. Abraham’s hypothesis, 19 post-menopausal women on hormone replacement therapy were given a supplement consisting of 500 mg of calcium (50% of RDA), and 600 mg of magnesium (200% of RDA). Studies were conducted every 3 months. Subjects receiving the treatment showed an 11% increase in bone density versus 0.7% in the untreated group. Results also showed that in post-menopausal women on hormone replacement therapy, the magnesium-emphasized program was able to produce calcaneous bone density 16 times greater than that of the dietary advice alone. At the start of the study, 15 subjects were below the fracture threshold. After a year of treatment with magnesium supplementation, in conjunction with calcium supplementation, only 7 of them were below the fracture threshold.

Researchers such as Dr. Abraham postulate that PPMO is predominantly a skeletal manifestation of chronic magnesium deficiency facilitated by estrogen withdrawal during the post-menopausal period. He suggests raising the RDA of magnesium to 1000 mg a day and lowering the RDA of calcium to 500 mg a day.

The ratio of magnesium to calcium should be one to one (1:1) or even two to one (2:1) for strong bones, according to many researchers. Over 80% of adults in America do not consume even the 300 mg of magnesium recommended.

Vitamin K - Vitamin K is an essential nutrient, best known for its role in blood clotting. There is significant emerging evidence that vitamin K plays a protective role in fighting age-related bone loss.

There are three types of Vitamin K. The primary source of Vitamin K is phylloquinone, and can be found in green vegetables and certain plant oils. Vitamin K2, also called menaquinone, is made by the bacteria that line the gastrointestinal tract of our body.

Numerous studies have now shown that people with the lowest intake of vitamin K have a higher chance of hip fractures than those who have higher intakes of vitamin K. Another study involving 800 elderly men and women found that people with the highest vitamin K intake only has 35% of the risk of hip fracture experienced by those with the lowest dietary intake of vitamin K. In fact, vitamin K has been approved for the treatment of osteoporosis in Japan since 1995.

Recent studies on Vitamin K have been impressive. 72 osteoporotic women taking a first-generation biphosphonate drug called Didronel for two years were compared to those taking vitamin K for the same period of time. There was no difference found in the bone fracture rates between women taking vitamin K and those taking the biphosphonate drug for osteoporosis.

Vitamin K has the additional benefit of being a protector of our cardiovascular system as well as fighting cancer. One study published in the September 2003 issue of the International Journal of Oncology found that vitamin K2 was able to slow the growth of cancer cells in lung cancer patients.

Vitamin K can be found naturally from a variety of foods including collar greens (440mcg/100g), spinach (380mcg/100g), salad greens (315mcg/100g), kale (270mcg/100), broccoli (180mcg/100g), Brussel sprouts (177mcg/100g), olive oil (55mcg/100g) green beans (33mcg/100g), and lentils (22mcg/100g). Unfortunately, you have to eat more than a pound of green leafy vegetables per day just to get enough vitamin K into your diet.

Those who have experienced strokes and cardiac arrest, as well as those who are on blood thinning medication should consult their physicians first before taking vitamin K. Many may already have a vitamin K deficiency brought on primarily by environmental and lifestyle factors and not know it. Many prescription drugs and antibiotics such as penicillin, tetracycline, and warfarin deplete this valuable vitamin. Other causes of vitamin K deficiency include smoking, excessive use of alcohol and caffeine, chemotherapy, x-rays, frozen foods, aspirin, air pollution, lactose intolerance. Unfortunately, most multi-vitamins do not contain any vitamin K at all.

Both Vitamin K1 and K2 are safe, natural, and needed for strong bones. Vitamin K3, or menadione, is a synthetic form that is manmade in the laboratory. Only Vitamin K1 and K2 are recommended from a nutritional supplementation perspective.

Vitamin K supplements greater than 65 mcg should not be taken by those on blood thinners, or who are pregnant or nursing mothers, unless monitored by a health care professional.

Vitamin D - Vitamin D, calciferol, is a fat soluble vitamin. It is found in food and can also be made in the body after exposure to ultra-violet rays from the sun. If you are exposed to the sun for more than 40 minutes a week, your body is able to produce the needed Vitamin D.

Vitamin D prevents rickets in children and osteomalacia in adults. In the US, fortified food is the major source of Vitamin D. Exposure to sunlight is an important source, but sunscreen with sun protection factor (spf) of 8 or greater will block the UV rays that cause the body to produce vitamin D. Vitamin D supplementation is therefore recommended.

Season, latitude, time of day, cloud cover, smog, and sunscreens affect UV ray exposure. For example, in Boston the average amount of sunlight is insufficient to produce significant amount of vitamin D synthesis in the skin from November through February.

Vitamin D supplements are often recommended for exclusively breast-fed infants because human milk may not contain adequate vitamin D.

Fortified foods are the major dietary sources of vitamin D. Prior to the fortification of milk products in the 1930s, rickets (a bone disease seen in children) was a major public health problem in the United States. Milk in the United States is fortified with 10 micrograms (400 IU) of vitamin D per quart, and rickets is now uncommon in the U.S.

Vitamin D actually exists in several different forms and each has its own activities. The main biological function of vitamin D is to maintain normal blood levels of calcium and phosphate. Vitamin D helps the absorption of calcium, and without the proper amount of it, calcium is not able to do its job.

Having a normal level of vitamin D in the body helps the bones to be strong. Vitamin D deficiency has been associated with greater incidences of bone fracture, and severe deficiency can lead to rickets and osteomaliacia. Vitamin D deficiency has also been associated with obesity, auto-immune disease, fatigue, depression, arthritis, heart disease, as well as metabolic syndrome. Steroids may impair the vitamin D metabolism, further contributing to the loss of bone and the development for osteoporosis.

Strontium - Strontium is an essential element that was discovered in 1808, and it is one of the most abundant elements on earth. In fact, there is more strontium in the earth crust than there is carbon. It is also the most abundant trace mineral in seawater. Strontium is not a new element to us. In the body, strontium tends to accumulate in bones where the remodeling process is actively taking place.

Strontium's properties are quite similar to those of calcium. Strontium is a very strong mineral. Research has long suggested that it may be an essential nutrient required for the normal development of bone structure. Because of its structural similarity to calcium, strontium can replace calcium to some extent in various biochiemical processes in the body. Not only does strontium add strength to the calcium in bones, it also is able to draw extra calcium into the bones.

Clinical trials on the use of strontium and osteoporosis have been conducted since the 1940s. Unfortunately, there was a significant amount of bad press given to this mineral in the late 50s. At that time, it was confused with another form called strontium-90, which is a very dangerous and radioactive component of nuclear fallouts produced during the testing of nuclear weapons in the mid 50s. Strontium-90 is radioactive and has cancer causing abilities. Stable elemental strontium, on the other hand, is not radioactive and non-toxic, even when given in large doses over a long period of time. In fact it is one of the most effective substances for the treatment and prevention of osteoporosis.

Numerous studies have been done on the effect of strontium supplementation. Dr. Stanley Skoryna of McGill University in Montreal conducted a small-scale study in 1985 in the use of strontium for the treatment of humans with osteoporosis. A total of 6 subjects, 3 women and 3 men, were given 600-700mg of strontium carbonate. Bone biopsies were taken before and after 6 months of treatment. The study showed a 172% increase in bone formation after strontium therapy.

Recently, a study on the use of strontium ranelate for the prevention and treatment of post-menopausal osteoporosis was carried out on 353 osteoporotic women with at least 1 vertebral bone fracture and low lumbar bone density score. The subjects received a placebo or strontium ranelate in doses of 170, 340, 680mg a day for 2 years. It was shown that there was a significant positive change in bone metabolism and a reduction of vertebral fracture in the second year of the group receiving 680mg a day. There is little doubt that strontium ranelate therapy is able to increase hipbone mineral density and reduce the incidence of vertebral fracture.

Another large study of 1649 osteoporotic, post-menopausal women showed that those receiving 2 grams a day of strontium ranelate (providing 680 mg together with calcium and Vitamin D) suffered 49% fewer fractures in the first year of treatment and 41% reduction over the 3 year period. There was an average increase in bone density of 14.4% in the lumbar zone as well as an 8.3% increase in the neck area.

Strontium has also been used to treat patients with a metastatic cancer that has spread to the bones, using a dose as low as 274 mg a day. In addition, strontium can reduce the incidence of cavities. In a 10-year study, the United States Navy conducted an examination of 270,000 naval recruits and found that only 360 were completely free of cavities. Curiously, 10% of those came from a small area in Ohio, where the water has an unusually high concentration of strontium. There have also been studies done in animals showing that the administration of strontium reduces the incidences of cavities.

Strontium in doses of up to 1.5 g a day appears to offer a safe and cost effective approach in preventing and reversing osteoporosis. Most of the studies done involved dosage of 680 mg per day. Although most of the recent studies use strontium renalate, early studies used other forms of strontium including strontium carbonate, strontium lactate, and strontium gluconate.  It is clear that the active ingredient is strontium and not the salt. The salt used is not as important when compared to the amount of actual strontium consumed.

Collagen - Collagen is the most abundant and most important protein in the body. It forms an integral part of the body’s organs, and is especially important for bones and joints. Bone also has a high amount of collagen. Approximately 90% of the organic matrix of bone is Type I collagen, cross-linked to increase strength and rigidity. Collagen acts as an external fiber that wraps around the bone matrices to increase its tensile strength. Without an adequate amount of collagen, bone strength is weakened. Osteoporosis depletes both calcium and collagen from the bones.

Nutritional Supplement Recommendation: 500 mg to 5,000 mg of mixed Collagen Types 1 and 3. Also take synergistic nutrients that enhance collagen production, including L-lysine, L-proline, citrus bioflavonoids, pine bark extract, and L-carnitine.

Natural Progesterone - There is only one compound that we currently know of that will increase bone strength and density by promoting the growth of osteoblast, and this is natural progesterone. The use of natural progesterone to treat osteoporosis was pioneered by Dr. John Lee, who suggested that osteoporosis in women is due to the decreasing level of progesterone and not estrogen. Dr. Lee’s research points out that most women over 65 still have adequate estrogen to inhibit bone loss (though not enough to cause ovaluation). But by the age of approximately 35, the body’s progesterone production declines drastically. By age 50, the body’s progesterone level is extremely low.

Dr. Jerilyn Prior found evidence of progesterone’s possible role in countering the effect of osteoporosis in a study of 66 pre-menopausal women aged between 21and 41. All of these women were long distance marathon runners. It was observed that after 12 months of therapy that their average spinal bone density decreased by about 2%. However, women who developed ovulation disturbances lost 4.2% of their bone mass in one year.

While there is no correlation between the rate of bone loss and serum level of estrogen, there was a close relationship between the indicators of progesterone status and bone loss. It appears that the progesterone deficiency rather than estrogen deficiency is the major factor in the pathogenesis of menopausal osteoporosis. Dr. Lee believes that a transdermal method is the best way to get natural progesterone safely into the body.

The efficacy of natural progesterone is verified by a three-year study of 63 post-menopausal women with osteoporosis. Women using transdermal progesterone cream experienced an average 7-8% bone mass density increase in the first year, 4-5% the second year, and 3-4%, the third year. The untreated women in this age category typically lose 0.7- 2% bone density per year.

Progesterone Recommendation: Postmenopausal women - 20 mg of USP Natural Progesterone a day for 25 days a month. Pre or Peri-menopausal women - 20 mg of USP Natural Progesterone a day for Day 14-28 of a 28-day cycle. Men - 5 mg of USP Natural Progesterone a day everyday of the month.

Conclusion
Osteoporosis is not a debilitating disease if one starts on the prevention protocol as early as age 35, when bone loss starts to become significant. From a nutrition perspective, a diet that is high in alkaline forming foods, such as fruits, vegetables, nuts, and seeds, is preferred to an acidic forming diet of animal proteins and sugar, which causes minerals to be leached out of the bones.

Weight bearing exercises have repeatedly been proven to be important for stimulating osteoblasts and bone formation. From a nutritional perspective, a cocktail consisting of the right balance of calcium, magnesium, and vitamin D is important. Along with these foundational building blocks, Vitamin K, strontium and collagen will synergistically help the bone formation. Natural progesterone cream should also be considered to round out the program.

Nutritional supplements used for osteoporosis prevention should contain the following and be taken on a daily basis with meals:

• Calcium blend (carbonate, hydroxyapatite, and citrate): 500 mg. (Calcium may be increased to 1000-1500 mg if the diet is high in meat and protein)
• Magnesium: 500-1000 mg in a 1 to 1 ratio with calcium
  
• Strontium carbonate: 1100mg (yielding 650 mg of elemental strontium)
• Vitamin K1 and K2 blend: 1000 mcg (Do not use if taking blood thinners)
  
• Vitamin D3: 600 I.U.
• Vitamin C: 145 mg
• Collagen Types 1 and 3: 500 mg
• L-Lysine: 150 mg
• L-Proline: 50 mg
• N-acetyl-cysteine: 100 mg