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Osteoporosis Stress overwhelming repair Premature Aging Bone density is long term measure of anabolic / catabolic balance.

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Presentation on theme: "Osteoporosis Stress overwhelming repair Premature Aging Bone density is long term measure of anabolic / catabolic balance."— Presentation transcript:

1 Osteoporosis Stress overwhelming repair Premature Aging Bone density is long term measure of anabolic / catabolic balance.

2 Consequences of Osteoporosis Significant cause of morbidity & mortality. Creates fear of living fully.

3 Modern lifestyle negatively impacts bones Inadequate & imbalanced nutrition, especially too few greens & unsustaining low protein breakfasts. High animal protein diets or soda pop creating an extraordinary bone-depleting acid-load. Lack of exposure to sunlight (low vitamin D). Dieting. Smoking. COPD (chronic obstructive pulmonary disease). Hormonal imbalance. Worry & emotional distress / poor sleep. Lack of exercise. Medication use (even natural diuretics).

4 Diuretics cause mineral loss! Drinking distilled water (Swimming in fresh water pools) Coffee & teas (may reduce absorption 40-80%) Soda pop (carbonic & phosphoric acids) Alcohol Vomiting / Bulimia Diarrhea Excessive urination High animal protein High simple sugars Mega dose Vitamin C (best to take with minerals) Sweating / Sauna

5 Inflammation & stress Reducing burden of inflammation on our bodies is crucial for maintaining optimal bone health. An overactive inflammatory response (generates excess cortisol) can push bone breakdown into overdrive & cause bone loss. Asthma, diabetes, fibromyalgia or other pain syndromes, autoimmune disease (healthy collagen fibers are systematically destroyed), gluten intolerance / sensitivity, or even heart disease are signs that inflammation is likely destroying bone. Cortisol stimulates degradation of amino acids from skin, muscle & bone collagen.

6 Related dental autoimmune diseases with upregulated humoral immunity Tooth decay is an infectious osteoporosis because biofilm became pathogenic (due to lack of reduced glutathione). Periodontal diseases are seen as infectious osteoporotic arthritis with disordered immunity & pathogenic biofilm. TMJ arthritis with osteoporosis may be primarily autoimmune or more biofilm-induced infectious synovitis. TMJ syndrome is expression of fibromyalgia/chronic fatigue. Bruxism reflects distress at the opening of GI tube due to parasites or gut dysbiosis (disordered digestive biofilm) which creates stress, faulty digestion & malnutrition. Osteonecrosis (set up by radiation or bisphosphonates) is created by biofilm becoming pathogenic & infectious.

7 Reactive oxygen species & Inflammation Many pathological conditions are related to reactive oxygen species (ROS) produced in mitochondria. NADPH oxidase (oxidized niacin) is an important ROS. ROS produced from NADPH oxidase trigger genetic inflammatory transcriptional pathways, such as NF-κB. Glutathione plays important roles in antioxidant defense, nutrient metabolism, energy production & regulation of cellular events (including gene expression, DNA & protein synthesis, cell proliferation & apoptosis, signal transduction, cytokine production & immune response & protein glutathionylation). Best insurance against errors when DNA gets copied is glutathione (which nutritionally supports normal cell replication - happening 300 billion times every day!).

8 ROS & Inflammation Phenolic compounds - resveratrol from grapes & wine, curcurmin from turmeric, epigallocatechin (EGCG) from green tea & apocynin from Picrorhiza kurroa (used in Ayurveda) are potent antioxidants that scavenge free radicals. Plant polyphenols also act on specific genetic signaling pathways (stat-1 gene) to down regulate inflammatory responses. Plant-derived phenolic supplements promote general health & prevent age-related diseases in humans hormetically.

9 Negative Mineral Balance Stress makes the body acidic during daily alkaline repair & detoxification tides, clogging tidal flows. Acidity makes scant minerals more available for use (or loss) while relieving pain & irritability. Sodium bicarbonate is a safe buffering alkalizer that preserves bone (as. Acid-forming habits easily become addictive. Minerals are inorganic elements that are necessary for strong bones & teeth. Minerals also control the nervous system & muscle contractions. Minerals are also needed for hormonal functioning, enzyme secretion & fluid balance in tissue compartments.

10 Inflammation is alkaline. Alkalinity ties up minerals. Cortisol is catabolic to muscles, bone & skin while preserving flab & inflammatory phagocytic (gobbling) osteoclasts & chondroclasts. Body uses inflammatory alkalinity confined inside chondroclast or osteoclast to enzymatically saponify & dissolve collagen matrix holding minerals in bone. Circulating pancreatic digestive enzymes become active when drawn to local inflamed alkaline area. Inflammatory crisis (due to lack of acidic hydrogen ion donors ascorbic acid & reduced glutathione) makes entire body alkaline (irritability, chills, spasm & pain).

11 Combat Inflammation & Boost energy Eat a low-glycemic diet (low in toasted or browned grains). Emphasize omega-3 & monounsaturated fats, but keep omega-6s & artificially saturated fats low. Resveratrol, curcurmin, garlic, ginger, green tea, luteolin, pomegranate, lipoic acid, 5-Loxin & vitamins C, D, E & K are powerful antioxidants & anti-inflammatory agents. Avoid eating foods cooked at high temperatures. Mitochondrial energy depletion can result in congestive heart failure, muscle weakness, osteoporosis, adrenal exhaustion, fatigue & neurological disease. Consume mg a day of carnitine in forms of acetyl- l-carnitine, acetyl-l-carnitine arginate, propionyl-l-carnitine, 150–300mg a day of R-lipoic acid, 100–300mg of coenzyme Q10 to optimize mitochondrial energy production.

12 Osteopenia (negative mineral balance) Osteopenia is mild decreased bone density caused by a greater bone resorption than bone creation that may lead to frank osteoporosis. Most widely recognized bone mineral density test is dual energy x-ray absorptiometry (DEXA test). First symptoms are tooth sensitivity (irritability / depression) due to lack of water, minerals or EFAs. Degrees of tooth mobility (fremitus begins with lower central incisors) describe severity of osteopenia. Folks with tight teeth typically have breakfast, enjoy many green vegetables, heal well & have strong bones.

13 (One standard deviation) (Two standard deviations) Curve = Parabolic dose-response curve

14 Osteoporosis or "porous bone" is a disease of the skeletal system characterized by low bone mass & deterioration of bone tissue. Osteoporosis leads to an increased risk to bone fractures, typically in the wrist, hip & spine. In trabecular bone the fibrils are arranged to form a bi- continuous network of trabeculae & voids filled by bone marrow. Trabecular bone is found mainly in vertebrae & long bones.

15 Stress hormones When inflammation is treated with cortico­steroid drugs (prednisone & others), bones may be harmed. Corticosteroids weaken bones because they diminish intestinal calcium absorption, increase calcium excreted by the kidneys & can have a toxic effect on osteoblasts. For prednisone-induced osteoporosis with particularly high risk for fracture, Big Pharma recommends a daily synthetic parathyroid hormone injection called teriparatide $16,000-$20,000 / 24 months. Those with injections had fewer spine fractures, but some had periodically elevated blood levels of calcium. Cancer risk (seen in rats) limits Forteo use to 2 years.

16 Steroid hormones & bone Principal factors in the hormonal regulation of bone health are estrogen, testosterone & progesterone (which are down- regulated when stress steroids are promoted). Estrogen is actually a balanced group of 3 estrogenic hormones & their metabolites. Estrogens regulate activity of osteoclasts & slow the process of bone dissolution. Progesterone & testosterone regulate activity of osteoblasts & cause creation of new bone. These hormones (which decline as we age) keep sphincters strong, keeping acid in the stomach for effective digestion. Progesterone opposes toxic effects of estrogen & cortisol. Osteoporosis or sarcopenia (thinning muscles) represents premature aging (as hormone levels diminish with age).

17 Bone density continues to increase after age 35 in folks without periodontal disease (those free of inflammatory autoimmune disease). A flexible 17 year old has lower bone density than a brittle 77 year old, but much lower risk to fracture due to elastic collagen with less age-related cross linking. Beginning increased risk to fracture No Perio

18 Bone Density Loss with Aging Many folks never reach peak bone density at age 35-40, starting their downward trend earlier, increasing risk to fracture..

19 Sunshine – Vitamin D - Parathyroid Low circulating Vitamin D is common worldwide. Vitamin D is an important pleomorphic anabolic steroid hormone useful for all autoimmune disease. Positive association between levels of serum 1,25- dihydroxycholecalciferol & bone mineral density. Meal skipping, mild vitamin D insufficiency (or low ionized calcium or magnesium or high phosphorous) triggers increased parathyroid hormone (PTH) production. PTH increases bone resorption & bone loss. PTH has negative association with bone density. Take time to be grateful & gaze at the sun through closed eye lids, feeling the breeze like a gentle massage & joyfully listening to the melody of moving water or the song of birds.

20 Vitamin K2 Osteocalcin transports calcium to bone. Vitamin K2 (menaquinone-7) is used to solidify this calcium into bone matrix. When Vitamin K2 is lacking, calcium remains in the blood & ends up getting deposited in walls of arteries (or aorta), soft tissues including muscle, breast, kidneys, teeth & even in heel spurs. Vitamin K2 therapy mobilizes calcium out of the arteries & aorta & allows return of normal flexibility & elasticity to these vessels. This restores density to bones, preventing & healing osteoporosis. Vitamin K2 can stop coumadin associated arterial calcification (its primary confounding side-effect). Fermented foods, such as Japanese natto or low fat Dutch cheeses Gouda & Edam have the highest concentration of vitamin K found in human diet & can provide several milligrams of vitamin K2 daily. High doses of this powerful antioxidant Vitamin K2(45-90 mcg daily) are used to treat osteoporosis in Japan. These doses are 1000 times the RDA dosage. No side effects were seen.

21 DHEA the “master hormone” Dehydroepiandrosterone (DHEA) is an androgenic steroidal hormone produced by the adrenal gland. DHEA comes from pregnenolone, made from cholesterol in mitochondria (with vitamin A, thyroid hormone & enzymes). Production starts at birth; between ages 7-8, the human body begins major production of DHEA. By our mid-20’s, DHEA is the most prevalent hormone. As we age, DHEA drops from youthful levels. In young adults, plasma DHEA levels are about 10 times higher than cortisol. With aging, cortisol levels remain high, while DHEA declines. DHEA levels decline during illness, with major depressive disorders & with prolonged stress.

22 DHEA & Pregnenolone Low levels of DHEA in adults seen with increased incidence of autoimmune disease, osteoporosis, cardiovascular disease, breast & endometrial cancer, Alzheimer’s disease & progression of HIV. DHEA & its chemical progenitor, pregnenolone, are often prescribed to treat auto-immune diseases. Both of these OTC hormones are “precursors” to the hormones progesterone, testosterone & estrogens. Morning usual DHEA dose is 5-10mg females (excess in women androgenically grows unwanted hair) & 20-50mg males with supervised doses of mg to treat autoimmune disease. Typical pregnenolone doses are 5-50mg daily (20mg for life extension). During the 1940's, doses given for arthritis were about 500 mg daily, with some controlled trials lasting two years. U-shaped (parabolic) dose-response curve describes a benefit of low dose pregnenolone, a loss of effect with more pregnenolone & a second peak of benefit with even higher doses.

23 Omega 3s – anti-inflammatory hormones Omega 3 fat (DHA & EPA ) content in diet helps build healthy bone. Most everyone reduces inflammation by taking an animal-based omega 3 fat (krill or cod liver oil). Dietary intake of omega-3 fats reduces pro- inflammatory prostaglandins E2 & F2α (increase corticotrophin-releasing hormone RNA expression). To balance omega 3 / omega 6 ratio, reduce consumption of processed vegetable oils. Corn, safflower & soy oils are mostly omega 6’s.

24 GLA – anti-inflammatory omega 6 Evening primrose, black currant & borage oils contain conditionally essential fatty acid gamma linolenic acid (GLA), which is useful for treating arthritic pain. Dry skin is a strong indicator of GLA need. In 37 RA patients, at 1.4gms GLA / day reduced number of tender joints by 36%, joint tenderness down 45%, swollen joints down 28% & degree of joint swelling reduced 41%. Best anti-inflammatory supplementation ratio is 2/3 EPA & DHA with 1/3 GLA.

25 Melatonin Melatonin at pharmacologic doses in mice causes less bone resorption & increases bone mass. Resorption is suppressed by down-regulating RANKL/RANK/OPG system (receptor activator of inflammatory NF-kb /nuclear factor- kappa beta ligand) triggered osteoclast formation & activation. Melatonin is a powerful antioxidant that helps promote optimism & healing sleep in humans. Taken at night before bedtime at 1- 20mg, it increases release of reparative growth hormone & improves cortisol rhythm, modulating its release. Present in high quantities in bone marrow, where bone cell precursors are located, melatonin dose-dependently helps protein incorporation into bone matrix, like procollagen type I c-peptide. Osteoprotegerin, an osteoblastic protein that inhibits differentiation of osteoclasts is also augmented by melatonin Fibroblast growth factor-2 facilitates proliferation of osteoblasts. When growth factor added to melatonin, titanium implant osseointegration in rats is promoted.

26 Bone Bone is a composite of a protein matrix impregnated by minerals & penetrated by blood vessels. Collagen components are piezoelectric crystalline structures. Piezoelectric current results from mechanical stresses applied to the protein matrix of collagen within bone. Bending these organic ‘crystalline’ structures generates an electrical charge. Potentials occur when many collagen molecules are similarly stressed displacing significant numbers of the charge carriers from the inside to the surface. This electric field stimulates the deposition of minerals along lines of stress. Physical exercise creates strong bones & lack of exercise causes loss of bone density due to piezoelectric effect.

27 Peroxisome proliferator-activated receptors (PPARs) Accumulated damage to mitochondrial DNA is a major cause of age related, degenerative disease. Aging causes bone loss leading to less bone mineral density & disruption of bone microarchitecture. Mitochondrial DNA deletions & free radical induced apoptosis of bone cells create age related bone loss. Peroxisome proliferator-activated receptors (PPARs) regulate cellular differentiation, development & metabolism (carbohydrate, lipid & protein) by controlling biogenesis of peroxisomes & mitochondria.

28 Peroxisome proliferator-activated receptors (PPARs) All PPARs heterodimerize with the liver X receptor, which then heterodimerizes with the ‘steroid’ retinoid X receptor & binds to DNA specific regions of target genes. Alpha PPARs (fibrates like lopid) lower cholesterol, boost HDLs, build bone & lean body mass by increasing mitochondrial biogenesis & function. Alpha PPARs are also activated by leukotriene B 4, exercise & nitric oxide (also boosted by arginine & alpha-ketoglutarate), resveratrol or quercitin (SIRT1 ‘fasting’ gene) & lipoic acid plus biotin (through AMPK ‘fuel sensor’ pathway). Gamma PPARs (avandia & actos are drug agonists) control blood sugar but decrease bone formation & bone mineral density while increasing accumulation of fat cells in the marrow, resulting in anemia & cardiac hypertrophy (increasing risk to heart attack); are activated by prostaglandin PGJ 2. Negative gamma PPAR effects are enhanced by glucocorticoids.

29 Bone strength Structural bone’s function is to resist mechanical forces & fractures. Bone strength depends partly on quantity but more on quality (determined by geometry & shape of bones, micro architecture of trabecular bones, mineral turnover, hydration of ground substance & collagen tensile strength). Different processes of maturation of collagen occur in bone, enzymatic & non-enzymatic processes (AGEs). Enzymatic process involves activation of lysyl oxidase, which forms immature & mature cross linking chemical bonds that stabilize & strengthen collagen fibrils.

30 Reducing rigid glycosylated AGEs Two type of non-enzymatic stiffening occur in type I collagen which are age-related & impair mechanical properties of bone. One is the formation of AGEs (advanced glycosylation or glycation end products) due to the accumulation of reduced sugars in bone matrix. Second process is racemization & isomerization in the telopeptide of collagen. To counteract, take 1000mg per day of carnosine, 50– 150mg per day of benfotiamine (fat-soluble thiamine), lots of antioxidants & avoid high temperature cooking.

31 Collagen Synthesis Collagen is created by fibroblasts, specialized dendritic cells derived from bone marrow stem cells. Fibroblasts also produce other structural proteins like elastin & keratin. GAGs (glycosaminoglycans) are highly negatively charged molecules, with an extended brush-like shape that imparts high viscosity to solutions. GAGs form the ground substance (extracellular matrix) that keeps us hydrated & resilient. Most GAGs in the body are bonded to core proteins, forming proteoglycans (also called mucopolysaccharides). Structural proteins of fibroblast cells are created when their membrane receptors are excited by molecular signals. Fibroblast growth factors (FGFs), trigger production of collagen as does TGF-b (transformation growth factor-beta).

32 Hyaluronic acid (HA) Hyaluronan is synthesized without a protein core & is "spun out" by cell surface enzymes into the extracellular space. HA is unique among GAGs by not containing sulfate & is not covalently attached to proteins (as a proteoglycan). However HA forms non-covalently formed complexes with proteoglycans in the extra cellular matrix. Hyaluronic acid polymers are very large (with molecular weights of 100, ,000,000) & displace a large volume of water, making them excellent lubricators & shock absorbers. Small molecular size (hydrolyzed) HA is available & more absorbable as an oral supplement. A new high molecular weight HA lozenge provides a highly bioavailable form of HA that is well absorbed through the oral mucosa. HA is used to relieve joint pain & hydrate the skin, reducing wrinkles.

33 Glucosamine & chondroitin sulfates Glucosamine & chondroitin are the major GAGS in joints. Among most prescribed supplements in veterinary medicine. Average human might take 1500mg glucosamine sulfate & 1200mg chondroitin sulfate daily. Indications for glucosamine include the treatment of intervertebral disk disease, recurrent cystitis (bladder inflammation) & severe inflammatory bowel disease. GAGS function by decreasing production of harmful proinflammatory compounds including prostaglandins that may degrade cartilage matrix. GAGS also serve as structural building blocks of new joint cartilage, giving them double benefit in the management of degenerative joint disease & osteoarthritis. GAGS increase synthesis of proteoglycans, hyaluronic acid (which acts as a joint lubricant) & collagen.

34 The amount of non-fibrillar and unmineralized organic matrix in trabecular bone varies. Images are taken within 2x2 mm on the same bone sample: (A) Fibrils coated with a large amount of non-fibrillar organic material. Particles can still be seen through smooth cover layer. (B) Unmineralized collagen fibrils showing the characteristic 67 nm banding pattern. Some particles are between the fibrils but fibrils are not fully mineralized. (D) Crack formation in an area with large amounts of non-fibrillar organic matrix. The non-fibrillar organic matrix spans crack & resists separation of mineralized fibrils. (C) Mineralized fibrils without non-fibrillar matrix.

35 The organic matrix functions as a glue. Sacrificial chemical bonds are present within bone matrix. In abalone nacre, organic material glues aragonite plates together, contributing to >3000-fold increase in fracture toughness of the composite relative to the mineral alone. These sacrificial bonds are weak, reformable bonds that increase the energy required to stretch molecules & increase the energy that is required to break the molecules. When strain on the material is removed, these sacrificial bonds can reform (providing a mechanism for repeatable energy dissipation). The glue between mineralized fibrils acts same way. In order for the mineralized fibrils to separate, glue bonds between the mineralized fibrils must be broken. This mechanism is reversible if glue bonds reform when the micro crack relaxes.

36 Building bone Over 18 nutrients are required by osteoblasts to build bone. Calcium is the most abundant element in bone, but without other critical minerals new bone cannot be built regardless of how much calcium is available. Necessary are calcium, phosphorus, magnesium, manganese, zinc, copper, boron, silica, strontium, chromium, vitamins A, C, D, B6, B12, K, folic acid, essential fatty acids & protein. The body uses minerals well only when in proper balance. An excess of phosphorus can cause loss of bone calcium & reduced bone mass. (Substantial quantities of phosphorus are found in processed meats, foods & soft drinks.) An excess of calcium (1000mg chalk) reduces availability of magnesium, manganese, zinc, copper, boron & chromium.

37 Hydrolyzed collagen - Gelatin The body can create proline & glycine (mostly during alpha waves of sleep cycles - promoted by theanine, passion flower & GABA). Neither proline or glycine is considered "essential." The ability to manufacture these amino acids easily & abundantly as needed, however, is probably true only for people enjoying radiant good health. If suffering from stiff joints, fibromyalgia, skin diseases & other collagen, connective tissue & cartilage disorders, one might easily have shortfalls of proline, glycine & other conditionally needed nutrients. Collagen cytokines are a major stimulant of stem cells & catalyst for growth & repair of nearly all body tissues.

38 ‘Ostinol’ Partially hydrolyzed collagen & associated proteins (taken as mg tablet once per day). Contains bone morphogenic proteins (BMP), TGF-b, PDGF, IGF & bFGF. Osteoinduction via stimulation of mesenchymal stem cells to make osteoblasts & chondrocytes to create bone matrix. ‘Genecol’ is a concentrated enzymatic hydrolisat of collagen that promotes many types of collagen (1-3 x 400mg capsules at bedtime).

39 Natural Eggshell Membrane (NEM) Contains naturally occurring glycosaminoglycans & proteins essential for maintaining healthy articular cartilage & surrounding synovia. Eggshell membrane is a natural source of combined glucosamine, chondroitin & hyaluronic acid. Supplementation with 500 mg/d of NEM significantly reduced both joint pain & stiffness compared to placebo at 10, 30 & 60 days. Clinical Rheumatology (2009). NEM components benefit joint & connective tissue flexibility, comfort & range of motion with no known adverse side effects.

40 Stomach acid Body's ability to absorb calcium & other minerals is strongly influenced by stomach availability of HCl acid. Antibiotics kill off commensal intestinal bacteria that are normally protective against outside pathogens. Acid in the stomach also has an antibacterial effect. Taking antacids & antibiotics removes both these protective barriers & leaves the body defenseless. Taking acid blocking drugs triples the risk to serious bowel infection (Clostridium difficle) or increases risk 4.5 times to pneumonia over those who never used them. Prescribed proton pump blockers (to mitigate GI bleed due to recommended aspirin or plavix) double risk to second heart attack.

41 Stomach acid Low stomach acid creates inability to properly digest protein & folic acid, B6, B12, vitamins A & Es & minerals, especially calcium & iron. Lack of stomach acid is common, due to aging, genetics, use of certain medications & more factors. Acid-blocking proton pump inhibitors almost triple the risk to hip fracture. Low stomach acid contributes to asthma, diabetes, food allergies, osteoporosis, iron deficiency anemia, pernicious anemia, candida, rheumatoid arthritis, intestinal infections, psoriasis, vitiligo, hives, eczema, herpetiform dermatitis & acne.

42 Absorbability of different forms of minerals varies greatly. Calcium is often recommended as calcium carbonate (oyster shell, chalk, dolomite, limestone or egg shell) in 1000mg supplements (to supply a single day’s potential net loss -10mg) because this form is inexpensive. Calcium carbonate is insoluble in water & is only about 1/5th as absorbable as calcium citrate. Citrate forms are very soluble & absorbable, requiring much lower doses to keep balance with other minerals. Citrate/malate complex is even more absorbable & amino acid chelates are also highly absorbable.

43 1,000mg of calcium can confound Large amounts of single minerals taken as supplements can lower stomach acid & overwhelmingly compete for absorption with other needed minerals. Taking a total daily dose of minerals all at once creates metabolic stress. Small frequent doses of multi ‑ minerals are balancing & beneficial (absorption enhanced with vitamins C & D). When taken with water throughout the day, extra water intake encourages hydrated efficient cells! Ascorbic acid (vitamin C), lipoic acid & betaine HCl (trimethyl glycine) enhance absorption of minerals.

44 Calcium excess creates functional magnesium deficiency!

45 Microcystalline Hydroxyapatite (MCHC) Excellent form of calcium for building bone. MCHC is mostly calcium & phosphorus. This unique extract contains the bone crystal, calcium hydroxyapatite. MCHC is extracted from BSE free, grass fed, free range cattle bones. MCHC also contains about 40 different minerals, amino acids & growth factors in similar proportions to those found in our bones.

46 Himalayan or clay-dried sea salts Bone is composed of at least a dozen minerals & if you mostly supplement calcium, density is likely to worsen. Overconsumption of calcium with goal of preventing osteoporosis creates other mineral deficiencies & imbalances, increasing risk to heart disease, kidney stones, gallstones, osteoarthritis, hypothyroidism, obesity & type 2 diabetes. Almost everyone needs trace minerals, not just calcium. We simply cannot get all needed nutrients from food grown in mineral depleted soils. Ionic trace minerals catalyze many important functions. Himalayan salts fuel stomach acid & contain vitally important trace minerals from ancient oceans (not contaminated with modern toxins). Clay salt-drying beds effectively absorb most heavy metals from modern sea salts.

47 Acid Blockers Histamine-blocking drugs such as some kinds of antihistamines or H2 blockers (Axid, Pepcid, Tagamet & Zantac) often cause mental confusion. Taking these medications for a long time (more than 2 years) more than doubles the odds of having dementia or mild cognitive impairment. Reducing bacteriocidal stomach acid, increases risk to dangerous clostridia difficle diarrhea or pneumonia. By blocking stomach acid, H2 blockers interfere with absorption of proteins & minerals & vitamin B-12, all important for bone formation, pain relief & mental function. (Is the tongue smooth & red?) Acidic mineral disassociation is compromised with irritability / depression leading to osteoporosis.

48 GERD (gastroesophageal reflux disease) Most indigestion symptoms (heartburn) occur when acidic stomach chyme refluxes (squirts) back up into the esophagus through lower esophageal sphincter. Avoid esophageal sphincter relaxers: caffeine, chocolate, mint, peppermint or spearmint. We need an acidic stomach for proper digestion. Complete nutrition allows the body to make & restore the mucous lining that protects the stomach lining. When symptomatic from eating immune-inappropriate foods, we have been programmed to reach for a pill for quick relief that turns off our stomach acid. Better to heal gut & use bone soups & gelatin, soaked chia or flax seeds, enzymes, DGL licorice & mastic gum.

49 Gelatin & Digestion Gelatin peptides reinforce resistance of stomach mucous tunic to ethanol & stress, decreasing ulcers. Gelatin improves digestion because of its ability to normalize both HCl acid deficiencies & excesses. Gelatin is "peptogenic" (favoring the flow of gastric juices), promoting digestion. Dysbiosis (imbalances of "good" & "bad" bacteria in GI tract) & common fermentative disturbances are linked to allergies to common dried grains and/or excessive consumption of toasted or glycated carbohydrates. Use of gelatin (not digestively fermented) as supportive foodstuff is therapeutically effective in treating bacterial infections of the intestinal tract.

50 Serum pyridinoline as a specific marker of collagen breakdown & bone metabolism Type I collagen is more than 90% of bone matrix. Quantitative analysis of collagen cross-link molecules such as pyridinoline (PYD) provides valuable information on bone resorption rate. Serum PYD values were compared with 3 other serum markers of bone metabolism, intact PTH, bone-specific alkaline phosphatase & osteocalcin. Bone formation parameters correlated with serum PYD levels & with serum bone-specific alkaline phosphatase better than with either serum intact PTH or osteocalcin concentrations. J Bone Miner Res Jun;10(6):932-9.

51 Vitamin C makes collagen & recycles glutathione, reducing inflammation. Vitamin C (silica, glycine & proline) needed to make collagen. Vitamin C increases production of collagen. Exposure of human connective-tissue cells to vitamin C stimulated an eight-fold increase in collagen synthesis (Murad et al., 1981). Vitamin C deficiency allows glutathione exhaustion causing scurvy, a life-threatening & painful condition in which defective collagen prevents the formation of strong connective tissue. Gums deteriorate & bleed, with loss of teeth; skin discolors & wounds do not heal during scurvy. Vitamin C recycles oxidized glutathione into its reduced version, our most important hydrogen ion donor. Lack of reduced glutathione is the ‘septic switch’, shutting down cellular immunity. Then humoral immunity is turned on, allowing viral expression & autoimmune destruction.

52 Homocysteine (metabolite of methionine) High homocysteine is associated with degenerative diseases including cognitive decline, cancer, heart disease, hardening of the arteries & osteoporosis (partly because it signals a methylation block in recycling glutathione). High homocysteine levels cause osteoporosis by creating defective bone (protein) matrix. Check homocysteine levels if tongue is too smooth & red. Methylation is foundational process for maintenance & repair. Homocysteine is normally detoxified into methionine by methyl donors (folic mcg/day, 1-40mg/day, mg/day, mg/day & TMG mg/day. Methionine encourages recycling of reduced glutathione as does lipoic 400–1200mg per day of SAMe (s- adenosyl-methionine) & 900mg or more per day of silymarin.

53 Collagen Type 1 Bone with sufficient collagen is elastic & stronger than steel. Bones lacking collagen are dry, brittle, easily broken. Osteoblasts secrete osteoid which is 90% collagen type I. Osteoid combines with calcium & phosphorus  bone. Collagen type I is body’s most abundant collagen protein. It makes up 90% of bone mass & is found in bones, tendons, connective tissue, muscle, hair, skin, teeth & nails. Collagen type 1 is the primary organic connective structural protein, glue that strengthens our bodies (the word collagen is derived from the Greek word kolla which means glue). Supplementing collagen burns fat, builds lean muscle & thickens hair, skin & nails.

54 Collagen Matrix Calcium, several trace minerals & vitamins D & K2, act together to generate strong, complex matrix structure. Supplementation with collagen calcium chelate improved bone strength more than similar amounts of calcium & collagen either given separately or together but in non-chelated form. (Tokyo University) Specific improvements with collagen calcium chelate were seen not only in bone mineral density but more importantly in bone weight, bone collagen production & bone flexibility & strength. Improve collagen status by adding dietary gelatin in gelatin-rich broth used in bone soups, stews & sauces.

55 Vegan Gelatin Alternatives (Gelatin rhymes with skeleton) Agar-Agar is a flavorless gelling agent that sets without chilling, made from cooked & pressed seaweed. Substitute powdered agar-agar for gelatin equally. Enzymes in fresh kiwi, mangoes, papaya & pineapple digest agar-agar’s protein-driven gelling ability so that it will not set. Cooking denatures enzymes, allowing set. Irish moss (carrageenan) seaweed is rich in minerals & best used for making softer gels & puddings. Some kosher gelatins are vegan. Try Emes’ Plain Kosher-Jel, Lieber’s unflavored gel, Carmel’s unsweetened gel, KoJel’s unflavored gel or Hain’s Superfruits.

56 Silica (choline stabilized orthosilicic acid) Silica is absolutely essential for the body to create & maintain collagen (keratin & elastin) for hair, skin, nails, tendons, ligaments, joints, muscles, bones & teeth. Strong collagen prevents: joint deterioration, brittle bones, hardening of the arteries, thin dry skin, inability to digest food properly, weakened teeth & gums & atrophying organs. Bone strengthening & support via enhancing calcium absorption. Within bone, silica is the essential component creating collagen matrix for deposition of calcium crystal. Need both calcium & silica to form bone.

57 Strontium Repeatedly taking stable strontium can gradually eliminate radioactive strontium-90 from the body. Strontium metabolism is closely tied to calcium metabolism & concentrates in the skeletal system. It supports the function of osteoblasts (which form new bone) while reducing differentiation & activity of osteoclasts (which resorb old bone). Extensive evidence supports a role for strontium citrate, ranelate or gluconate in skeletal health. It strongly stimulates proteoglycan production. Strontium reduces the incidence of tooth decay. A typical diet provides 2-3 mg/day of strontium. Doses of 680 mg/day elemental strontium appear to be optimum. Lower doses are also clinically effective.

58 Boron Small molecule with characteristics of both metals & non metals. It forms complexes with many organic compounds, such as carbohydrates, vitamins, enzymes, nucleotides & oxygen. Boron influences many biological systems & coordinates major nutrients involved in bone health: vitamin D, calcium, magnesium & phosphorus. Boron affects strength of bones & joints by cross-linking the inorganic mineral & organic bone/joint matrix. In post menopausal women who took 3 mg of boron a day, urinary calcium excretion was reduced by 44%. Low dietary boron causes elevated urinary calcium excretion. Boron activates estrogen, testosterone & vitamin D. Boron relieves arthritic pain & discomfort & makes harder bones. There are lower boron concentrations in femur heads, bones & synovial fluid of people with arthritis than from those without inflammatory arthritis.

59 Bisphosphonates Fosamax, Actonel, Boniva, Zometa The most common side effect of these medications used to treat osteoporosis, is reflux  acid blockers. Interfere with osteoclasts. Resorption (natural process of clearing out old bone) is inhibited, so that existing older brittle bone stays put. Creates false denser ‘look’ on X ray. Osteoblasts (bone-builder cells) are inhibited by bisphosphonates. This also stops healing. After taking one year, markers for bone turnover (growth & resorption) go down dramatically. Statins also inhibit HMG-CoA reductase pathway.

60 Adverse side effects of bisphosphonates Interferes with prenylation (basic attachment of lipid chains to proteins to facilitate their interaction with cell membrane). Some important prenylation chains are geranylgeraniol, farnesol & dolichol (products of HMG-CoA reductase metabolic pathway) & steroid hormones. Esophageal ulcers & upper GI irritation Irregular heartbeat Fractures of the femur Low blood calcium Skin rash Joint, bone & muscle pain (very common with statins) Jaw bone osteonecrosis (4-6%) Increased parathyroid hormone (PTH) Cognitive decline & memory problems

61 American Dental Association & National Osteoporosis Foundation New pamphlet produced in cooperation between ADA & front for Big Pharma called National Osteoporosis Foundation now available at discount (April 2009). 94% of folks with osteonecrosis are cancer patients who received large doses of IV bisphosphonates. Only 6% of folks who take oral bisphosphonates get osteonecrosis. “According to the ADA, the benefits of osteoporosis medications (like bisphosphonates) greatly outweigh the risks of osteonecrosis of the jaw.” Shame on those letter organizations! There are better natural ways to strengthen bone that promote healing.

62 Other osteoporosis drugs Calcitonin (Miacalcin) nasal spray is a weaker anti-resorptive medication than ‘estrogenic’ bisphosphonates. Calcitonin (reserved for those 5 years past menopause, who cannot take or will not consider taking other medications). Raloxifene (selective estrogen receptor modulator) is a ‘weaker medication’ (in improving bone density or preventing fractures) compared to estrogen or bisphosphonates. Hot flashes, sweating or leg cramps may occur. Raloxifene may infrequently cause serious blood clots to form in legs or lungs, if history of blood clots (e.g., deep venous thrombosis or pulmonary embolism). Discuss risk factors for developing strokes (sometimes fatal) while taking raloxifene (Evista).

63 Tamoxifen (Nolvadex) Synthetic hormone used to treat breast cancer. Now being given to certain high-risk women to help reduce their chances of developing breast cancer. Tamoxifen blocks estrogen's effect on breast tissue, but has estrogen-like effect on other cells in body, including bone cells. Tamoxifen may reduce risk of fractures in women over age 50. Sulphoraphanes: DIM (diindolmethanol) or I3C (indole- 3-carbinol) instead promote healthy estrogen metabolites.

64 Best sources of minerals to build bone Deep green vegetables, especially sea vegetables - with supplements of alfalfa, blue-green algae, spirulina, chlorella, barley or wheat grass. Fresh fruit, especially low-sugar richly-pigmented berries. Seeds, nuts & grains, especially soaked. Complex carbohydrates, especially soaked. Glass of wine or beer (not "lite"). Multiple small doses of chelated multiminerals (in physiologic ratio) with water & vitamins C & D.

65 Nibbling is the answer Small & frequent meals keep mineral rich foods present in the small intestines where they are absorbed. If there are no minerals present in the ileum, the body must undergo catabolic stress & steal minerals from structural skin, gums, muscles, bones & teeth. There can be no more significant stressor than inadequate minerals (suspended in water) for cellular function. Hormonal stress response to low minerals includes beta- adrenergic stimulation to all stress hormones with functional parathyroid elevation (nutritional hyperparathyroidism) eventually opening calcium channels. Proof positive is that beta-blockers & calcium-channel blockers are among the most commonly prescribed drugs.

66 XYLITOL – SUGAR THAT’S GOOD FOR YOU! Low glycemic index (about 7). Recommended for diabetics. Does not cause insulin resistance. Stabilizes hormone balance. Builds immunity. Increases absorption of calcium & other nutrients. 2-3 teaspoonfuls per day may reverse bone loss.

67 XYLITOL – SUGAR THAT’S GOOD FOR YOU! Inhibits bacteria growth (strep, c. difficle, salmonella). Inhibits Candida yeast & H. Pylori growth. Heals & repairs tissue. Anti-aging properties. Prevents tooth decay up to 80%. Enhances mineralization of tooth enamel. 5-carbon ring reduces plaque formation.

68 XYLITOL – SUGAR THAT’S GOOD FOR YOU! Prevents 40% of Ear, Nose & Throat infections. Prevents up to 93% of Ear, Nose & Throat infections (when used in nasal spray) WITHOUT antibiotics. 40% LESS calories than regular sugar. 70% LESS digested carbohydrates than regular sugar. More than 1500 research studies completed. Tastes just like sugar with no "metallic" aftertaste. Used one-to-one ratio (use just like regular sugar for sweetening or baking). Excessive use naturally limited by loose stools & gas.

69 Gotu kola Gotu kola has many uses & is of special benefit for chronic, degenerative diseases. Without equal in treating general debility & decline. Digestion is strengthened (aided by its bitter properties) & food is better utilized, with overall metabolism increased. Helps: ADD, peptic ulcers, auto-immune, diseases, stress, gynecological, disorders, asthma, low thyroid, osteoporosis, neuritis, male tonic, menopausal problems, eczema, scrofula, cirrhosis, diarrhea, high blood pressure, laryngitis, stomach ache, muscular atrophy, fatigue, sore throat, thrombosis, brain tonic, respiratory ailments, influenza, blood purifier, food poisoning, diabetes, baldness, wounds, age spots, nervous break down, poor circulation, insomnia, retinal detachment, to increase energy, epilepsy, premenstrual pain, hair loss, blood disorders, mycosis fungoides, dementia, infections, periodontal disease, colds, coughing or vomiting blood, senility & hemorrhoids.

70 Horsetail Horsetail is used topically to heal hemorrhoids & stop nosebleeds. Taken internally it is a folk remedy for heavy menstruation & bleeding ulcers. It contains flavonoids, alkaloids (including equisitine & tiny amounts of nicotine), saponins, tannins, fatty acids & sterols (primarily beta-sitosterol, campesterol & isofucosterol). Horsetail is rich source of minerals, including potassium, selenium & silica (promoting its wound-healing action). Recommended for osteoporosis, gout, rheumatism, arthritis & joint pain, as well as Urinary problems (bladder infections & some forms of incontinence), especially bed-wetting in children. Try a horsetail gargle for sore throats. The herb is also used for fevers & hair loss.

71 Dandelion vinegar Make & consume dandelion vinegar as a rich source of calcium, magnesium & other minerals necessary for strong, healthy bones. Pour room temperature apple cider vinegar over dandelion roots to the rim of the jar, cover it, and place it in a cupboard for at least 6 weeks. After straining, use this vinegar in salad dressings, marinades & sprinkled over cooked greens. Each delicious tablespoon contains more than 175mg of easily absorbable calcium.

72 Making an Herbal Infusion Use stinging nettle greens (rich in silica), oats, slippery elm, peppermint, red raspberry leaves or sweet red clover blossoms. Take a small handful of dried herb and place in a ceramic pot or glass canning jar. Cover with a quart of boiling water, stir briskly, cover tightly & let sit for 2-4 hours, or overnight. Strain & drink 2-4 cups daily. Infusion can be reheated if you prefer it warm, but never boil it.

73 Bone & joint health Herbs associated with bone & joint health include Ashwagandha root & guggal (a traditional Ayurvedic anti-arthritic with anti-inflammatory effects). Turmeric root (curcurmin) is anti-inflammatory. Willow bark reduces pain, fever & inflammation. St. John’s wort is used for many mildly painful conditions, including osteoarthritis. Sulfur compounds such as glucosamine sulfate, MSM (methylsulfonylmethane) & SAMe (S- adenosylmethionine) help rebuild joint cartilage & otherwise benefit osteoarthritis sufferers.

74 Herbs for bone & joint health Liver supporting herbs such as burdock root, (which also has estrogenic effects), dandelion & yellow dock may help build bone. Other herbs with helpful estrogenic effects include dong quai, blue cohosh, black cohosh, sage, alfalfa (enhances mineralization) & motherwort. Isoflavone extracts of red clover are used to treat both menopausal symptoms & osteoporosis.

75 Colostrum Growth factors in colostrum can help repair, heal & rebuild the GI tract & help stop leaky gut syndrome. Provides benefits for the growth of good bacteria & helps promote digestion & absorption of nutrients. Transforming growth factor (TGF) found in colostrum can help strengthen bones & prevent osteoporosis. Colostrum contains insulin-like growth factors (IgF) which stimulates cellular growth & repair, transforming growth factors (TGF) which promote the synthesis & repair of RNA & DNA & repair of muscle tissue (helpful for athletes) & epithelial growth factor (EfG) which stimulates normal skin growth.

76 Coconut water – from young coconuts Coconut water is high in potassium, manganese, calcium & alkalizing minerals (& even better as kefir). It is the best known fluid for re-hydrating the body. Coconut water is used as an alternative therapy for skin disorders, osteoporosis & bone diseases & menstrual cramps. Coconut water improves calcium & magnesium absorption supporting development of strong bones & teeth. It improves insulin secretion & utilization of blood glucose. Coconuts are anti-viral, anti-fungal & anti-microbial, due to lauric acid. Lauric acid in coconuts is also heals digestive tract disorders such as leaky gut & promotes better digestion for all. Coconut water is a natural diuretic. It also supports thyroid function, increasing the body’s metabolic rate which will help with weight loss.

77 Royal jelly from the bee hive Royal jelly beneficially affects metabolism, growth & cellular renewal for the queen & within the human body. Full of nutrients & energy, 97% of the components in royal jelly have been identified. It is 13% protein, 14% carbohydrates, 6% beneficial lipids, & a full spectrum of vitamins, including pantothenic & folic acids. The minerals royal jelly supplies include calcium, copper, iron, phosphorous, potassium, silicon & sulfur. It also contains at least 18 amino acids & cholinesterase; phosphatase; choline; acetylcholine, for nerve cell function. Contains gamma-globulin, which helps immunity. Royal jelly is only known source of 10-hydroxy-2dekenoic acid (10-HAD) providing anti-cancer & antimicrobial qualities.

78 BOOSTING MINERALS & WATER REDUCES IRRITABILITY & INFLAMMATION Build imperturbability & stay cool with stronger gums, skin, nails, muscles, hair, teeth & bone! Enjoy walking in the sun. Nibble on green things all day long! Aim for 4-5 fistfuls, half cooked, half raw. Vegetables from land & sea are the best source of minerals in your meals! Other good leaves can come from broccoli, cauliflower, snap beans, beets (chard), carrots & sweet potatoes.


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