The People's Perspective on Medicine

Show 1093: How to Keep Your Bones Strong

Learn how to keep your bones strong throughout your life and what you can do to counteract osteoporosis if you develop it.
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How to Keep Your Bones Strong

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Osteoporosis, weakened bones, affects about 10 million Americans. But low bone density is even more common. According to the National Osteoporosis Foundation, about half of adults over 50 are at risk for a fracture. How can you minimize your risk and keep your bones strong?

Preventing Osteoporosis:

Some of the factors that lead to osteoporosis can’t be avoided. Genetics is chief among these. If your grandparents and parents suffered from weak bones and fractures, your chances of osteoporosis are higher than average.

Beyond Genetics to Many Risk Factors:

That doesn’t mean there is nothing you can do, however. It just may mean you’ll have to try harder to keep your bones strong. Getting adequate amounts of vitamin D and calcium is important. Not smoking-or quitting if you do smoke-is just as critical.

Exercise throughout our lives sends crucial signals to our bones that we need them and helps keep them strong. To get the best benefit from exercise, it should be something in which the foot hits the ground: walking, skipping, jumping, dancing, tennis, etc. Other forms of exercise such as swimming or biking are also good for your health, but they do less to keep your bones strong.

Learn how doctors detect osteoporosis with DXA technology, and how they treat it if they discover you have it. You’ll also find out why men too need to be concerned about bone health.

This Week’s Guest:

Abby G. Abelson, MD, FACR, is Chair of the Department of Rheumatic and Immunologic Diseases of the Orthopaedic and Rheumatology Institute and Education Program Director in the Department of Rheumatologic and Immunologic Diseases at Cleveland Clinic. Her book is The Cleveland Clinic Guide to Osteoporosis.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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I have tried most of these drugs since 1996, starting with Fosamax which I started because of a thyroid condition. It put me in the hospital. In 2008 I took Forteo for two years. Then the doctor wanted me to start Prolia. I refused.

I am glad I did. I recently found and article on the BetterBones web sight, written by Doctor Brown, titled Is Prolia a blockbuster bone drug–or a bust. She stated the finding that patients were more susceptible to having vertebral fractures after discontinuing Prolia than patients who’d never take the drug at all. You can find this article with all the medical references, at her BetterBones sight. I highly recommend it.

Learned nothing from this article or any article about osteoporosis per Peoples Pharmacy. Prescription medications for osteoporosis have many dangerous side effects and I suffered for years trying to take them, no increase of bone density from Bisphosphonates, Evista, or Prolia. After blood clots from one of those medications I tried Strontium Citrate, gained 60 % bone density and I still take Strontium, OTC and low cost.

Before starting Strontium I had 2 back fractures and since I have had NO fractures. Now taking Strontium 6 years and likely for the rest of my life.

I also have osteoporosis. I don’t want to take drugs. Where do you get your strontium citrate? Thx!

Good to know. I am looking into Strontium Citrate right now. Thanks!

Jeannie W.

I was disappointed that nothing was mentioned about the benefits of yoga in strengthening bones. But of course that is not a drug so she probably thought it was not helpful.

I was very disappointed that you didn’t address the topic of PPI’s and their documented negative effect on bones. My DEXA scan was totally normal in the spine and hips and it was done a couple months before PPI’s were started for GERD. I took them for 9 years and they never solved the problem despite combining all the life style recommendations. After 9 years I did the 24 hour monitoring and turns out the number of refluxes were normal but half of them were base (pepsin) which is not normal and half went up to the larynx (again not normal). I had tapered the PPI’s for several months prior to the test and never went back on them–this was 5 years ago. Instead I continued all the life style recs, avoided my personal triggers and followed a low acid diet. My recent endoscopy showed zero inflammation. It was never that good on PPI’s.

Unfortunately those 9 years of PPI use despite high dietary calcium and also the supplements my doc said I must take—left my spine especially with osteoporosis and the hips with osteopenia. Not saying I might have had some osteopenia but I am convinced the spinal osteoporosis is due to the PPI’s as I have a long history of regular weight lifting , aerobic exercise and good dietary practices. This should have been mentioned in the podcast. Not just steroids but many medications mess with bones.

I also think your guest speaker really minimized the negative effects of those drugs. I know real life people who ended up with GERD from the fosamax type drugs and then were ironically prescribed PPI’s which ended up messing with their bone density.

I know others that because of the PPI’s prescribed for a bone drug side effect ended up with MAC–mycobacteria avian complex. Because of her decreased stomach acid she could not fight this ubiquitous organism and it ended up getting in to her lung and now she has a chronic lung disease.

The guest minimized the atypical fractures and yet if you are the one this happens to—it is significant. And the biggest problem drugs that seem to work like forteo have is that you must follow them with the bis type drugs or prolia etc or you risk losing gains made. your speaker didn’t address the obscene costs that many of these drugs have attached to it for those of us where insurance won’t cover. A BIG NO THANK YOU TO ANY OF IT.

I will stick to improving my strength and balance and all the lifestyle stuff. Won’t go near any of the medications out there to date because I don’t think the side effects are worth the benefits

what is your view of plant-sourced whole-food calcium versus calcium derived from limestone???

P.S. Bone strength take care by New Chapter

Agree with other posters. I have Osteoporosis and have had three Reclast infusions. Now I’m scared. Reclast affects kidneys too. My jaw is cracking like crazy and I read up on the femur fractures caused by Reclast. The only symptom of the femur fractures are slight pain and ache and then the bone suddenly fractures.

After three treatments and my latest Dexa, my Rheumatologist states that the Osteoporosis is ‘improved.’ Well, I’ve decided that if that’s the best Reclast can do after three infusions, I’d rather try other, more natural things like Stronium, Calicum, Vit D, Vit K, Mag, etc. I’m not taking any more chances, especially with my jaw cracking the way it’s been doing. Nope, all done ….

Astronauts lose bones density. NASA deals with this through weight-bearing exercises and on Earth weights. An easy way for an older person to preserve core bone density is to wear a weighted backpack or vest for an hour or two a day. It even works when sitting upright at a desk or table. I put 10 pounds of weights in a small backpack. Sports equipment stores sell weighted vests.

I had read on Medline that rats that swam had stronger bones so it was thought that swimming also strengthened bones

A competent recitation of the standard practices and treatments in the field. Good questions from Joe and Terry; the potential issues they raised were answered with non-specific assurances, basically , “Trust me, I’m a Doctor.”

In 2006, my scan showed osteoporosis and I stopped the scans. No point charging Medicare to keep saying it. I tried Boniva but my AFib went nuts. Dr. said they all had that side effect. So I walk 1/2 mile on the treadmill- not outside that much but use a cane. Inside, lots of things to grab onto as I do have imbalance; taking D3 and always had/have high calcium diet, never smoked/drank and my weight is probably a bit under where it should be. I have annual physical. I’m on Warfarin so can’t eat the leafy foods I like, but staying on it. All is well so far.

Interesting, genetic considerations are always included these days. The good doctor was in her meilu (however you spell it). You were fabulous also.

But what about the study that indicated women who drink beer have stronger bones? Has that been debunked or determined why? Can the beer be non-alcoholic?

Hi Joe and Terry, I am a longtime fan of your show, but I hope you will bring on another guest in the future with a different perspective from Dr. Abelson. Many of her assertions struck me as outdated by more recent research. Consider bringing, for example, Thomas E. Levy, MD, JD on your show. A brilliant cardiologist, Dr. Levy argues that supplemental calcium–in anything other than food form–is detrimental to both bones and heart. Calcification of veins and organs is the source of many contemporary health problems. Abelson was also off the mark about magnesium: most people are deficient. When someone is wheeled into the emergency room with a heart attack, the first thing they do is inject them with supplemental magnesium in large doses! She also missed the mark on Vitamin K2, which plays a much larger role than she acknowledged in our bone health. Her overall advice to start thinking about bone health early in life is very true, and kudos to her for saying so. But she is behind the times in some of her other thinking. Please consider interviewing Dr. Levy for an alternate view. Warm regards from a longtime fan in Virginia

Unless you are lactose intolerant, DRINK WHOLE MILK … I followed the lead of my partents who lived into their 90’s without any ‘bone’ problems … drinking about 3 glasses of milk each day.

I have not consumed dairy products for 40 years, but my bones are strong. I also cannot take Vitamin D or calcium because I get heart palpitations and leg cramps from them. I think I can contribute my strong bones to my vigorous exercise, including Yoga (I am 85 years old). I am not sure calcium supplements are necessary for strong bones.

I think this whole Osteoporosis stuff is questionable. I spent my teens doing competitive and distance swimming, bowling, playing volleyball, playing basketball, walking 3-4 miles daily, hiking and backpacking. I continued physical activity into my current age in the late 60’s. I garden, weight lift, volunteer in the woods, hike, camp, carry laundry baskets up and down, hang clothes on the line and overall get a lot of exercise.

DEX scan says I have Osteoporosis. Really? DEX scans compare your bone density to a 30 year old. DEX scans were an invention of the Pharma company that promos its Osteoporosis drug

Yup I agree! See my comments.

One can make an educated guess, without listening to this podcast, as to “how doctors detect osteoporosis with DXA technology, and how they treat it if they discover you have it.”

The main purpose of the DXA exam, if it turns out to be positive for osteoporosis, is to prescribe one of a class of drugs known as bisphosphonates. These drugs have a staggeringly long “half-life” of up to ten years, meaning they stay in your system for that long, for good or for ill. If you happen to experience what doctors continue to insist is one of the “very rare” major, debilitating side effects, you’ll have little if any recourse for relief until the drug eventually clears out of your system. Heading the list of these adverse effects are fracture of the femur, caused by the very drug intended to prevent it, and osteonecrosis of the jaw, known as ONJ. More common side effects include esophageal irritation and muscle pain.

Studies contradicting the “rarity” of the major, debilitating side effects are starting to emerge, as well as challenges concerning the unimpressive risk:benefit ratio of these drugs; a very high number of people must be treated to (hypothetically) prevent even one fracture.

Don’t take my word for any of the above; do a Google search. An article “Osteoporosis: The Emperor Has No Clothes,” published in the Journal of Internal Medicine in 2015, by Jarvinen et al., is worth reading. Also read the torrent of reader comments — I think there were around 800 — that poured in after NY Times ran a front-page “puff piece” decrying how “millions” were losing out on the drugs’ alleged benefits because of what “doctors” characterized as irrational fear of the “very rare” side effects. The overwhelming majority of the comments were from people who had experienced some of these “very rare” effects firsthand or who had a family member or friend who had incurred them.

Yup I agree. See my comments.

I’ve read so many things about this over the years, and I’m very skeptical. Everyone has a bone density scanner, and they push patients to have a regular scan. Along with that, they want patients to take medications that have some horrible side effects.

I kept getting notifications that I was due for a scan until I finally told them to stop. I was not going to take the drugs so no sense in spending money on an expensive scan. And I find it weird that my insurance somehow covers 100% of this, when so many other things are not fully covered. Why is that?

Yup I agree and while they cover the scans they don’t necessarily cover the drugs especially the expensive injections.

I so agree with you. Supposedly I have 25% bone “loss” according to my previous three dexascans, and even my naturopathic doc keeps pushing me to at least consider hormone replacement therapy, even though he admits there are huge studies that contradict the osteoporosis myths. In fact, an author out of New Zealand (often you have to look for studies done outside of the US for balanced reporting), Gillian Sanson wrote a book called The Myth Of Osteoporosis.

She draws on many credible studies that make one question the integrity of this invented epidemic. Yes, there is examples of some older people becoming fragile and deformed, and have porous bones, but naturally occurring porous bones don’t necessarily mean “fragile” bones. Think bamboo. There’s evidence that even very dense bones tend to be more fragile! Think glass!

Sir just engage in 1 to 2 short sessions of Low Velocity High Tension strength training exercise .Each session should last 12 to 18 minutes.Thanks Dago.

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