Updated October 4, 2021
Osteoporosis and Osteopenia (“OP”) are conditions where the bones lose their structural integrity, usually by loss of minerals (such as calcium, magnesium) and matrix (collagen). The usual “cause” of OP is is hormonal, with loss of estrogen and testosterone as we age (moreso in women than men), excess of other hormones (cortisone, parathyroid hormone), inflammation (rheumatoid and psoriatic arthritis), and nutritional deficiencies of calcium, magnesium, vitamin-d, vitamin-k, and vitamin-a. Other less “popular” nutrients such as omega-3 oils (“fish oils”), B-vitamins, strontium, silicon and others contribute to bone health.
Testing for bone density is conventionally done with a Dexascan, a form of xray that looks at the density of the bone in the hip, lumbar spine and wrist. It compares the density to that of a 26-year-old woman, so essentially everyone over this age will show some degree of normal loss. The line between normal bone, osteopenia and osteoporosis is somewhat arbitrarily set by certain values called the T-score. A value of less than -1.0 is the criteria for osteopenia while less than -2.0 is osteoporosis. Dexascan values can be different in the hip, spine and wrist which is why all three areas are evaluated. It is prudent to have a baseline Dexascan around the time of menopause for women, and for men and women when any fracture occurs in a unusual manner. Dexascan values take approximately two years to change for the better or worse, which is why they are recommended at this interval when OP is found. Interventions include nutrition, weight-bearing exercise, medications and correction of underlying metabolic conditions, infections, gut dysfunctions, deficiencies and toxicities. These will be discussed elsewhere.
A thorough evaluation for the cause of OP should include at the least blood tests for Vitamin-D, Magnesium, Zinc, Vitamin-K, inflammation, amino acids that are involved in collagen formation (such as proline and lysine) and hormonal imbalances. While Vitamin C is important for collagen formation, there is no blood test that can accurately assess Vitamin C levels, so other ways to assess Vitamin C status are utilized when indicated.
There are additional tests that are offered by conventional and alternative medicine that can help elucidate the factors involved in unexplained OP. This page will be expanded soon so check back if this topic is important to you.