Bone Health
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Calcium Dysregulation and Osteoporosis article

Article on herbs used traditionally to promote better bones.

nutritionreview.org/2013/04...

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Very interesting article .... where can you buy Nacre and is there a checklist anywhere for contraindications and side effects. I have managed my osteoporosis successfully with various supplements and exercise for 7 yrs since diagnosis but I was a passenger in a car accident last year and fractured my sternum and suffered two spinal compression fractures. In my view these were not fragility fractures at all. However I had to cancel my gym membership for three months, later in the year I was ill with pneumonia, again a three month hold on my gym membership and exercise. At my last DEXA scan I was found to have lost 10 % bone mass with t-scores dropping from -2.8 to -3.1. Now my endocrinologist and bone specialist at the hospital say I need treatment for my osteoporosis ... I really don’t want to go down this route ... nacre might me an option to consider. Thanks for posting the article.

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I don't know anything about the author Jim English's credentials and whether what he is saying is reliable. It's certainly interesting and I do think Western medicine is missing out on a lot if it dismisses the Eastern approach. The complexity of interactions in Traditional Chinese and oriental medicine is something that Western science has not caught up with yet. Conditions seem to be treated with a range of herbs that are synergistic. Even if all the interactions can't be explained, there are thousands of years of observation, trial and error experience that shouldn't be dismissed quickly.

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Wow, I'm trying to find a capsule that has all these herbs in it. I'm in London and if anyone knows where I can get this nacre tablet please post. Meanwhile thanks for the post and I'll keep looking

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A number of us, myself included, have been able to improve our t-score results simply by consuming the right kind of food, a few readily available supplements, and doing as much as we individually can of appropriate exercise. My biggest expense was buying a high quality weighted walking vest. Also Nordic walking poles. Over time the supplements can also be pricey, but I think worth it. Micronutrients have been proven to have a beneficial effect on bone density:

hindawi.com/journals/jeph/2...

although you don't necessarily have to follow the protocol in the article. I didn't. But I do make sure to get, among other things, Vitamin K2 and enough Vitamin D. I eat loads of leafy greens and fermented foods like kefir, kimchi, sauerkraut and its cousins, yoghurt, kombucha.

While on the subject of the reluctance of Western doctors to accept the ideas of other cultures: Vitamin K2 hasn't been accepted widely, although the Japanese researchers are willing to state unequivocally that natto, the fermented soy which is packed with K2 (and the source of our supplements) is a genuine superfood!

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Along these lines in an article about K2 in the form of MK7.

nutritionjrnl.com/article/S...

The date is a little old but still relevant. Just shows how long this information has been available.

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Interesting. The rheumatologist at a bones workshop I attended at our local hospital said there had been four studies showing Vitamin K was not helpful. These four studies did show up at the top of the google search I did when I got home, and they didn't really distinguish between K1 and K2. But a little further digging (add Japan to the search) and lots of Japanese research about K2 came up, positively finding K2 helped bones. At the time my daughter was a fairly recently minted dietitian and she had never heard about Vitamin K2. The dietitian at the bones workshop knew nothing about it. So it's not yet part of the nutrition curriculum, I guess. More the pity for us patients!

healthline.com/nutrition/vi...

This article is apparently a rewrite of an earlier article I used to share. I don't know if it's quite as unequivocal in its support of K2 as the earlier one was, but nevertheless gives a good overview and does cover things other than bones for which Vitamin K2 is good. It's a bit careless in its use of Vitamin "K" as a term because the two Vitamin Ks really should always be treated as two separate items to avoid confusion. We'd never say Vitamin B, for example, but would talk about the individual B Vitamins by name.

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I think the possible drawback of the diet and exercise approach is that it still does not address the imbalance between the osteoblasts formation and osteoclast activity. The herbs may address this issue whereas diet and exercise may produce some increase in bone formation but not enough to reverse more serious effects of bone density loss quickly. It could take 20 or 30 years to increase bone density significantly and when aging this isn't realistic.

On the other hand, with the traditional medicine approach, the herbs seem to target a range of actions to bring about a better balance, one target seems to be the action of Cathepsin K on breaking down collagen which some of these herbs seem to slow down but not completely block. The other aspect seems to be that some of the herbs encourage differentiation of meshenchymal cells to favour osteoblast formation. I'm not a scientist so can only read information that is accessible in the public domain and can't scientifically assess whether the information is accurate or not.

As far as I understand it, bisphosphonates simply stop the formation of osteoclasts, however, they don't address imbalance and stopping the formation of osteoclasts with bisphosphonates leads to a form of petrification as osteoblasts only form with the removal of old bone cells. It doesn't sound like a good approach does it?

It seems as though the Oriental approach has not been tested to the standards that western medicine demands and there isn't conclusive proof of efficacy via double blind cross-over trials (the gold standard for western scientific experiments).

It might be impossible to produce medicines that meet the demands of Western medicines quality control criterion because the way Traditional medicine works is not by the use of one active ingredient that affects one target but by a number of herbs that have synergistic effects and affect numerous chemical interactions in the human body.

I think if anyone tries the Traditional herbal approach, they have to accept that there is no conclusive evidence or proof that it will work. However, from what I've read of Bisphosphonates, they only help 1 in every 100 woman or so, is that right? Is it the case that many people may be taking Bisphosphonates to no avail but risking the attendant side effects? Also, I can't help wondering if the long term side effects are a time-bomb waiting to emerge...Bisphosphonates are still relatively new. I truely hope not. Oriental medicine however, has been used for over 2000 years.

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All I was trying to point out was it may not be necessary to go to a lot of trouble to buy more obscure treatments if items readily available do the trick. I am now 71 and I improved my t-score and also lowered my fracture risk during the year between 68 and 69, so I think that's old enough to show even the elderly can do this. Not due for another scan until end of 2019.

Personally I wouldn't go near any of the Western bone meds, and so far I've been doing fine. But it's a much more difficult choice for people who've already suffered genuine fragility fractures or have a very dire t-score. Certainly we miss the boat if we dismiss knowledge from other cultures. We also need to be very careful that the source of herbal treatment is completely transparent because there is known contamination of some Chinese medicines in particular with such things as undisclosed levels of steroids, etc. This won't be an issue with a standardized pill, I shouldn't think, especially if there's been some government oversight.

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Possibly it's more difficult for people diagnosed with severe osteoporosis when relatively young, before 60 for example, because the length of time for deterioration is much increased.

This is an interesting paper on how the inhibition of cathepsin K effects bone resorption and bone rebuilding. I'm just wading through it. I agree about unregulated Chinese medicines, one has to be careful about unreliable sources.

ncbi.nlm.nih.gov/pmc/articl...

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Yes, it's true, individual circumstances change things a great deal. I can only speak from the perspective of an older woman who experienced normal menopause and as an additional fracture risk has been taking low dose prednisone for polymyalgia for three years. I also had a fracture four years ago, tibial plateau, but I don't believe it was a true fragility fracture although they counted it as such for the risk calculations.

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Interesting now I've read the article in the link above that they discontinued odanacatib which was a cathepsin K inhibitor due to risk of stroke. It seems from reading, that Chinese herbs inhibit Cathepsin K but due, perhaps, to multiple actions in the herbs, they don't seem to have the adverse affects that appeared in this study.

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Seriously, one needs a degree in biochemistry these days - even to eat properly!

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True!! Another aspect that emerged from the study into odanacatib was a rebound effect. So something I would like to find out is whether Chinese herbs could have a rebound effect or whether there is any research to evidence that they function differently. For example, although studies have shown that Salvia Miltiorrhiza has an inhibitory effect on Cathepsin K's breakdown of collagen and that it increases bone density in female mice without ovaries, the experiments conducted on mice have been short term and therefore no rebound effect could be inferred from these experiments. I haven't been able to find really good information on the lasting effect on humans and whether if taken in high enough doses to impact bone density, whether there would be a rebound effect at end of treatment. I really like the illustration in the link that shows the difference between the various osteoporosis treatments like Bisphosphonates, denusomab and Cathepsin K inhibitors. Helps to understand the concepts involved in developing treatments.

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Isn’t it all such a minefield, I think it is drug interactions that concern me at the moment, this without the complication of deciding on an OP treatment. Chinese medicine has much to offer but I take so many prescribed medications and supplements, I am not too confident about advice on adverse effects and interactions. In addition to OP I also have osteoarthritis and only this I have agreed to a trapieziectomy on my right thumb. The thought of having to commit to an OP medication when I see my bone specialist at the end of July makes me feel really anxious, I don’t want to contend with both thumb surgery and OP drug side effects. At the moment I’m veering towards digging my heels in and saying no thank you. I’d be happy if I could just maintain my present bone density level and T-scores and I am considering continuing with a bone healthy diet, supplements, appropriate exercise and more regular wearing of my weighted vest.

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