House Calls: Supplements and bone health
There is good evidence that dietary components and herbal products can influence the bone processes.
Q: I am a 58 year-old post-menopausal female recently diagnosed with osteoporosis. Are there any foods that could help my condition?
A: Bone metabolism involves a complex balance between the deposition of matrix and mineralization and resorption. Many patients are searching for foods or supplements to help their osteoporosis, and most individuals do not want to take conventional medications due to the side effects. There is good evidence that dietary components and herbal products can influence the bone processes, particularly bone resorption. Common vegetables as onion, garlic, and parsley can inhibit bone resorption. The essential oils derived from sage, rosemary and thyme inhibit osteoclast activity and lead to an increase in bone mineral density. Various traditional herbal formulas in both Chinese and Ayurvedic medicine have demonstrable effects on osteoporosis.
Q: My friend recently told me that I should take glucosamine for joint disease and bone health. What are your thoughts on this?
A: Glucosamine is a natural compound that is found in healthy cartilage. Glucosamine sulfate is a normal constituent in cartilage matrix and synovial fluid of the joints. There are randomized controlled trials to support the use of glucosamine in the treatment of osteoarthritis, especially in the knee. It has been shown that by strengthening the cartilage there are clinical benefits to the synovial fluid. I commonly prescribe glucosamine in conjunction with chondrotin. This combination allows me to reduce the amount of non- steroidal anti-inflammatory drugs the patient takes. The usual dose is 500mg three times a day for a minimum of 60 days. Other studies have used higher doses, 2,000 – 3,000 per day in divided doses. More studies are needed in this area before any firm conclusion can be made.
Ginger rhizomes and stems have played significant roles in Chinese, Japanese, and Indian medicine since the 1500’s
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Q: My grandmother always added ginger to her food. She claimed it helped with her arthritis. Is there any truth to this claim or is it an “old wives’ tale”?
A: I find that many “old wives’ tales” actually do work. My own grandmother soaked a washcloth in vinegar and then applied the cloth to her knees. She said it helped and she even bought a book entitled, The Vinegar Story that supported her wives’ tale. Ginger (Zingiber officianle) rhizomes and stems have played significant roles in Chinese, Japanese, and Indian medicine since the 1500’s. In addition to the anti-inflammatory properties, which help with arthritis, ginger is often used for nausea/vomiting, motion sickness and nausea from chemotherapy. I often combine ginger with turmeric (curcuma longa) for the anti-inflammatory and anti-oxidant action. Ginger has been studied as a treatment for osteoarthritis, but there is limited evidence for its use in rheumatoid arthritis. Turmeric has been used historically to treat rheumatoid conditions and to reduce inflammation. Turmeric must be used with caution in patients taking any blood thinners, such as plavix, coumadin, and aspirin because it inhibits platelets –causing bleeding.
Q: I have been using soy as part of my diet. Do you recommend soy for bone health?
A: The use of soy is very controversial. I recommend reading Kayla Daniels’ book, The Whole Soy Story. Soy is a tropical plant native to southeastern Asia. It is a member of the pea family that forms clusters of 3-5 pods containing 2-4 beans. Soy has been part of the staple diet in Asia for more than 5,000 years. It was introduced to the United States in the 1800’s. Soy and components of soy called isoflavones have been studied for treatment of many health conditions. Because isoflavones (such as genistein) are believed to have estrogen-like effects, they sometimes are called “phyto-estrogens.” It has been studied and theorized that these phyto-estrogens may increase bone mineral density in post-menopausal women. Since the theory of phyto-estrogens is generally accepted, I often use natural hormonal replacement therapies (NHRT) in cream forms to help with osteoporosis.
Q: Can you discuss the use of Vitamin D and the common calcium/mineral formulas for bone health? I am very confused about the amount of vitamin D I should be using.
A: Recently the RDA has increased the amount of Vitamin D. Previously 400 IU were used. Today the recommended dose is 1,200 – 2,000 per day. The use of calcium and magnesium in a 3:1 ratio has been recommended for some time. The best source of calcium is hydroxyappetite. In January 2006, a study in the New England Journal of Medicine was published comparing the efficacy of strontium ranealate to fosomax for reducing fractures of post-menopausal women. The dose of strontium used in the study was 1,000 mg. The study showed that strontium was statistically significant in reducing fractures when compared to the commonly prescribed fosomax. Due to some of the possible side effects of fosomax, such as osteonecrosis of the jaw and gastrointestinal issues, I often prescribe strontium. It is important to allow at least a six-hour interval between taking strontium and taking calcium and magnesium.
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"House Calls: Supplements and bone health"
authored by:
Patrick Fratellone, MD is the Executive Medical Director of Fratellone Medical Associates, LLP in New York City, New York. Before going into private practice, he was the Chief of Medicine and Director of Cardiology of the former Atkins Center for Com...
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