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Dr. Michael T. Murray
"If you are concerned about bone loss, OsteoCheck is an absolute must.
It tells you what you need to know."
Introduction
You should ALWAYS consult with a healthcare provider
concerning the attached results and before taking ANY supplement.
This Educational Guide was written by Dr. Michael T. Murray, N.D., a renowned expert in the natural health field and author of over 20 books on health. Information and recommendations provided by Dr. Murray are for informational purposes only and are not intended to be a substitute for consultation with a healthcare provider or other medical professional. Only your healthcare provider should diagnose any health problems you may be experiencing and prescribe treatment as necessary.
BodyBalance, Great Smokies Diagnostic Laboratory, and/or Dr. Michael T. Murray are not responsible or liable for any effects or consequences that may come about as a result of the recommendations contained in this Educational Guide, or BodyBalance health screens. None of the aforementioned parties makes any guarantee, expressed or implied, towards the claims, benefits, or safety of the recommendations and information included in this Educational Guide.
Recommendations from Dr. Murray
Whatever your results, I congratulate you for caring
enough about your health to perform this valuable health
screen. For women, knowing your rate of bone loss and
bone density is just as important as knowing your
cholesterol level, blood pressure, or yearly pap smear results.
Why? Because osteoporosis is just as serious as heart
disease, strokes, and cancer. Attention to your bone health
must be a lifetime goal. You cannot start too young. Because
the best treatment of osteoporosis is prevention, use of
OsteoCheck as a determination of bone breakdown ideally
should be done in a woman's twenties.
Interpreting Your Results
Now that you have your
results, I want to help you clarify them and understand what to do next. If your
result is normal and it is your first OsteoCheck, congratulations. What this
health screen result tells you is that your rate of bone loss is not excessive.
Simply make OsteoCheck a part of your regular check-ups. Be sure to follow all of
the general guidelines given in this Educational Guide. As far as nutritional
supplementation goes, I recommend Level 1 Support as explained later.
Moderately
Elevated First-Time OsteoCheck
You will have to be a
little more aggressive in supporting your bones. I strongly encourage you to
follow my supplement recommendations for Level 2 Support. Another very important
recommendation is to get physical activity, particularly walking. Repeat
OsteoCheck in 3 months. If it is still elevated, you will have to be even more
aggressive to slow down bone loss.
Severely Elevated First-Time OsteoCheck
You will have to be
extremely aggressive in supporting the health of your bones. I recommend Level 2
Support initially. Repeat OsteoCheck in 3 months. If it is still elevated, you
will have to be even more aggressive (Level 3) to slow down bone loss.
Interpretations of Follow-Up
Tests
Normal Repeat OsteoCheck
Congratulations, you are
definitely on the right track. Repeat OsteoCheck yearly or as directed by your
healthcare provider.
Moderately or Severely Elevated Repeat OsteoCheck
Move up a level. If you
were at Level 2 Support previously, go to Level 3 Support. If you have already
been at Level 3, then you will need to discuss additional treatment measures
with your healthcare provider. In addition, I would recommend talking to your
doctor about determining your bone density. There are several techniques to
measure bone density. The one that I recommend is known as dual energy X-ray
absorptiometry (DEXA). In addition to providing the most reliable measurement of
bone density, the DEXA test also exposes a person to considerably less radiation
than other X-ray procedures for measuring bone density. In the DEXA exam, the
measurements will usually be of both the hip and the lumbar spine.
The DEXA tells us how dense your bones are, but it fails to tell you the rate of bone loss - that is the job of OsteoCheck. The DEXA is like knowing how much money you have in the "bone bank" and OsteoCheck tells you how fast you are withdrawing that money. Even if you have plenty of bone in your "bone bank," the critical factor is the rate of withdrawal. Even if the DEXA scan shows above-average bone density, if OsteoCheck shows an elevated rate of bone loss, you will ultimately deplete your savings.
Supplement
Recommendations
Level
1 Support:
Take a high potency
multiple vitamin and mineral formula. The formula should provide
"broad-spectrum" support that includes a minimum amount of the
following nutrients:
Level 2 Support:
You will need to take
higher levels of key nutrients for bone health.
Level 3 Support:
Level 2 plus ipriflavone.
Ipriflavone is a naturally occurring plant flavonoid (pigment) that has shown
impressive results in promoting bone health in a number of clinical studies. For
example, in one study, ipriflavone (200 mg three times per day) increased bone
density measurements by 2 percent and 5.8 percent after six and twelve months,
respectively, in 100 women with osteoporosis.9 Longer-term studies are showing
equally
promising results.
Ipriflavone is safe and without any significant side effect. Take 200 mg
three times daily.
Level 4 Support:
Level 3 plus--See
your physician immediately to discuss further treatment options.
About OsteoCheck and Bone Health
OsteoCheck provides the
information necessary to monitor your rate of
bone loss so that you can prevent or reverse osteoporosis. When the rate of
bone breakdown exceeds that of bone
manufacture it can result in a condition known as osteoporosis. Literally, the
word osteoporosis means
"porous bone." Osteoporosis affects more than twenty million people in
the United States including one out of four
postmenopausal women.1
OsteoCheck measures the urine levels of deoxypyridinoline--a compound linked to bone breakdown. Deoxypyridinoline functions in bone in the crosslinking of collagen--the main protein of bone that provides the organic mesh upon which calcium and other minerals are deposited. Increased levels of deoxypyridium in the urine signify loss of both the organic (protein) and inorganic (mineral) phases of bone. The higher the level, the greater the rate of bone loss.2
When most people think of bones, what comes to mind are the lifeless, dead bones of skeletons, but bone is actually a dynamic, living tissue. Healthy bones are dependent on an intricate interplay of many nutritional and hormonal factors. In the human body, there is a constant process of breaking down and remaking of bones. OsteoCheck provides the assurance that you are in the proper balance of that interplay. OsteoCheck can improve the quality of life for women of all ages because it:
Answers to Some Common Questions
What exactly
causes osteoporosis?
Normally, there is a
decline in bone mass after the age of forty in both sexes (about a two percent
loss per year), but women are at a much greater risk for osteoporosis because of
lower bone density prior to age forty. So, the best treatment of osteoporosis is
prevention by making the bones as dense as possible prior to the age of forty.
OsteoCheck is invaluable in this goal because it provides accurate assessment of
the rate of bone breakdown.
Osteoporosis involves both the mineral (inorganic) and non-mineral (organic matrix, composed primarily of protein) components of bone. This is the first clue that there is more to osteoporosis than a lack of dietary calcium. In fact, lack of dietary calcium in adults results in a separate condition known as osteomalacia, or "softening of the bone." The two conditions, osteomalacia and osteoporosis, are different. In osteomalacia, there is only a deficiency of calcium in the bone. In contrast, in osteoporosis, there is a lack of both calcium and other minerals, as well as a decrease in the non-mineral framework of the bone. Little attention has been given to the important role that this organic matrix plays in maintaining bone structure. OsteoCheck provides the answer to the health of this important meshwork.
Where does the bone loss in
osteoporosis occur?
Although the entire
skeleton may be involved in postmenopausal osteoporosis, bone loss is usually
greatest in the spine, hips, and wrists. Since these bones bear a great deal of
weight, they are susceptible to pain, deformity, or fracture. At least 1.5
million fractures occur each year as a direct result of osteoporosis, including
250,000 hip fractures, the most catastrophic of fractures. Hip fracture leads to
death (both directly and indirectly as a result of long-term hospital stays) in
up to twenty percent of cases and precipitates long-term nursing home care for
half of those who survive. Nearly one-third of all women and one-sixth of all
men will fracture their hips in their lifetime. The level of deoxypyridinium, as
measured by OsteoCheck, is a strong predictor of whether a woman is at risk for
hip fracture. The higher the level, the greater the risk.2
When should I become concerned
about my bone health?
If you are female,
attention to bone health must be a lifetime goal. At the absolute minimum, bone
health should be determined prior to menopause. If you are past menopause, I
recommend that you start monitoring the rate of bone loss with OsteoCheck as
soon as possible. If you are a woman at high risk for osteoporosis, you may also
want to talk to your doctor about a DEXA assessment.
What can be done to maintain
bone health and prevent osteoporosis?
Recently there has been
an incredible push for increasing dietary calcium intake to prevent
osteoporosis. While this appears to be sound medical advice for many,
osteoporosis represents much more than a lack of dietary calcium. It is a
complex condition involving hormonal, lifestyle, and nutritional factors. A
comprehensive plan that addresses these factors offers the greatest protection
against developing osteoporosis.
The primary goals in the treatment and prevention of osteoporosis are to:
What lifestyle factors are
important for maintaining bone health?
Certain lifestyle
factors are extremely important to bone health. For example, coffee, alcohol,
and smoking cause a negative calcium balance (more calcium being lost than taken
in) and are associated with an increased risk of developing osteoporosis, while
regular exercise reduces that risk.3-5
In fact, exercise is the most critical
factor for maintaining healthy bones. Physical exercise, consisting of one hour
of moderate activity three times a week, has not only been shown to prevent bone
loss, but also to increase bone mass in postmenopausal women.
What are the key dietary
factors to maintain bone health?
Many general dietary
factors have been suggested as a cause of osteoporosis, including:
low-calcium-high-phosphorus intake, high-protein diet, high-acid-ash diet, high salt
intake, and trace-mineral deficiencies.6,7
Considering that the average American consumes too much sugar, as well as soft drinks loaded with phosphates, and large quantities of protein, it is little wonder that there are so many people suffering from osteoporosis in this country. When lifestyle factors are also taken into consideration, it is apparent why osteoporosis has become a major medical problem.
One of the best things you can do for your bone health is to stay away from soft drinks. Soft drinks have long been suspected of leading to lower calcium levels and higher phosphate levels in the blood. When phosphate levels are high and calcium levels are low, calcium is depleted from the bones. The phosphate content of soft drinks is very high, and they contain virtually no calcium. The high phosphate level is required for dissolving the sugar and contributing to the taste. The United States ranks first among countries in soft-drink consumption. The per-capita consumption of soft drinks is in excess of 150 quarts per year, or about 3 quarts per week.
Is calcium supplementation
important in preventing and treating osteoporosis?
Yes, absolutely. But,
preventing and reversing osteoporosis involves much more than calcium. Bone is
dependent on a constant supply of many nutrients. A deficiency of any of a
number of nutrients such as boron, magnesium, vitamin K, and others will
adversely affect bone health. To truly support bone health in my patients at
high risk for osteoporosis, I first recommend a high potency multiple vitamin
and mineral formula (based upon age and sex). Next, I recommend a bone-building
supplement that provides the high quality nutrition required to maintain and
build healthy bones. At the bare minimum, women showing signs of bone loss need
to take 1,000 mg supplemental calcium per day. In my patients with existing
osteoporosis, I recommend adding ipriflavone to the program. In another one-year
study of women with osteoporosis, ipriflavone (600 mg per day) produced a six-
percent increase in bone mineral density after twelve months, while the
placebo group lost 0.3 percent in bone density.10
Longer-term studies are
showing equally promising results given the safety and apparent efficacy of
ipriflavone.11,12
When should a
woman start taking calcium?
There is a strong correlation between
pre-menopausal bone density and the risk of osteoporosis. In other words, how
dense the bones are prior to menopause is a significant factor in determining
whether or not a woman develops osteoporosis. That being the case, building
strong bones should be a lifelong goal beginning in childhood. However, the
reality is that most women probably are not that concerned about osteoporosis
until a couple of years before menopause.
Fortunately, even taking calcium just prior to the onset of menopause has been shown to produce considerable benefit in increasing bone density. For example, in a two-year study, 214 women near the age of menopause received either 1,000 or 2,000 mg of calcium or a placebo.13 While the control group actually lost 3.2% of their bone density of their spine, the calcium-treated groups increased the density by 1.6% (there was no significant difference between the two calcium groups). These results highlight the importance of calcium supplementation prior to menopause in the battle against osteoporosis.
Can calcium supplementation
increase bone density in postmenopausal women with osteoporosis?
Not by itself.
In women
who have passed through menopause, supplementation of calcium has only been
shown to be effective in reducing bone loss. Although on its own, calcium
supplementation does not completely halt the process, it does slow the rate down
by at least 30% to 50% and offers significant protection against hip fractures.14-16
While menopausal and postmenopausal women are often told that without
hormone replacement therapy they will most definitely get osteoporosis, several
studies contradict this commonly held view. Although calcium alone is less
effective than when it is combined with estrogen, calcium supplementation poses
less health risks than estrogen supplementation. Thus, this study reinforces the
opinion that hormone replacement therapies that include estrogen should
definitely be reserved for women at significant risk for osteoporosis.
For women with confirmed osteoporosis, I recommend strongly that they discuss treatment options with their healthcare providers. I also recommend, regardless of the treatment chosen, that proper monitoring with OsteoCheck be performed to validate the effectiveness of treatment. Ipriflavone is an exciting natural approach to maintaining bone health. Several double-blind studies have shown that this naturally-occurring plant pigment can dramatically halt the progression of bone loss when used daily in combination with 1,000 mg of calcium.9-12 The typical dosage of ipriflavone is 200 mg three times daily.
What is an
Effective Dosage of Calcium?
The effectiveness of
calcium supplementation at a particular dosage is ultimately dependent upon the
woman's diet and lifestyle. Bone health and osteoporosis treatment/prevention
involves much more than calcium. That being said, an effective dosage for
supplemental calcium is 600 to 1,200 mg per day for most women. If there is
significant bone loss, the dosage may need to be in the 1,000 to 1,500 mg.
range.
What is the Best Form of Calcium?
Calcium bound to citrate
and other Krebs cycle intermediates such as fumarate, malate, succinate, and
aspartate appear to be the best overall form of calcium, although refined
calcium carbonate is still an excellent form for the majority of women. The
additional benefit with using minerals bound to Krebs cycle intermediates is
that over 95% of the Krebs cycle intermediates ingested are used to produce
cellular energy with the remainder being excreted in urine, where they may act
to prevent kidney stone formation. The Krebs cycle intermediates fulfill every
requirement for an optimum calcium chelating agent: (a) they are easily ionized,
(b) they are almost completely degraded, (c) they have
virtually no toxicity, and (d) they have been shown to increase the absorption
of calcium and other minerals as well.
In short, refined calcium carbonate has the lowest lead content, but calcium bound to Krebs cycle compounds appear to be better absorbed especially in women with low gastric acid output than other forms of calcium. The problem with calcium supplements bound to the Krebs cycle compounds is their bulk--it basically requires three to four times as many capsules or tablets to provide the same level of calcium compared to calcium carbonate sources. Providing a combination of calcium carbonate and Krebs cycle calcium appears to be a reasonable solution.
Final Comment
Although nutritional
factors are important, the best thing a person can do to strengthen their
bones is to stay active. It is now a well-accepted fact that physical fitness is the
major determinant of bone density. Physical exercise, consisting of one hour
of moderate activity (such as, walking) three times a week, has been shown to
prevent bone loss and increase bone mass in postmenopausal women. In contrast
to exercise, lack of physical activity doubles the rate of calcium lost from
the system.
Quick Review
OsteoCheck can improve
the quality of life for women of all ages because it:
Glossary
Anticonvulsants--An agent that prevents or relieves convulsions (Violent, involuntary muscle contractions).
Calcium hydroxyapatite--Although there may be undesirable effects as a result of possible excess lead levels, this is used as a calcium supplement, this inorganic (that which is not made of plant or animal) compound helps give bones and teeth their rigidity.
Chelating agent-Used in treatments for metal poisoning, chelating agents work to draw the toxin out of the body by bonding the metal with a molecule.
Dolomite--Limestone, and like calcium hydroxyapatite, is a calcium supplement that can be used, but may have excess lead levels.
Double-blind studies--A clinical trial or experiment in which the subject nor the administrator of the test knows which treatment the subject is receiving.
High-acid ash diet--A diet primarily consisting of meats, grains, and dairy products, high in animal proteins.
Hyperparathyroidism--Excess parathyroid hormone (which regulates calcium and phosphorus metabolism) production. This condition causes generally tender bones, calcium deposits and can lead to osteoporosis, as well as muscle weakness, gastrointestinal problems, vomiting and nausea.
Hyperthyroidism--Excess thyroid hormone production. The thyroid hormone works primarily with metabolism regulation. This condition causes high blood pressure, fatigue, nervousness, weight loss, and muscle weakness.
Krebs Cycle intermediates--An important energy-producing cellular process that can assist in calcium production for those concerned about osteoporosis.
Long-term glucocorticosteroid therapy--Used in hormone replacement therapy and for anti-inflammatory purposes. This therapy influences carbohydrate, fat, and protein metabolism in the body.
Lumbar spine--The middle to lower back, where DEXA exams check for bone density.
Phosphates--Acidic substances often found in sodas/colas. High levels of phosphates, like those found carbonated beverages, refined sugars, and overall sugar intake can contribute to osteoporosis by lower calcium levels.
Placebo--A dummy medical treatment used mostly for the psychophysiological (deals with physical health processes on the mental state) effects of the treatment.
Protein matrix--An enclosure of a mass of protein cells which serve as enzymes (protein molecules that increases the chemical reactions of substances), hormones and for use in other body activities.
Toxicity--An excess level of an element or substance.
References
1. Dempster DW and Lindsay R. Pathogenesis of osteoporosis. Lancet 1993; 341:797-805.
2. Ross PD and Knowlton W. Rapid bone loss is associated with increased levels of biochemical markers. J Bone Min Res 1998; 13:297-302.
3. Aloia JF, et al. Risk factors for postmenopausal osteoporosis. Am J Med 1985; 78:95-100.
4. Jaglar SB, Kreiger N and Darlington G. Past and recent physical activity and the risk of osteoporosis. Am J Epidemiol 1993; 138:107-118.
5. Opriot JC, et al. Physical activity as therapy for osteoporosis. Can Med Assoc J 1996; 155:940-4.
6. Eaton-Evans J. Osteoporosis and the role of diet. Br J Biomedical Sci 1994; 51:358-70.
7. Saltman PD and Strause LG. The role of trace minerals in osteoporosis. J Am Coll Nutr 1993; 4:384-9.
8. Feskanich D, et al. Milk, dietary calcium, and bone fractures in women: A 12-year prospective study. Am J Public Health 1997; 87:992-7.
9. Moscarinie M, et al. New perspectives in the treatment of postmenopausal osteoporosis. Ipriflavone Gynecol Endocrinol 1994; 8:203-7.
10. Passeri M, et al. Effect of ipriflavone on bone mass in elderly osteoporotic women. Bone Miner 1992; 19(Suppl.1):S57-62.
11. Agnusdei D, et al. A double blind, placebo-controlled trial of ipriflavone for prevention of postmenopausal spinal bone loss. Calcif Tissue Int 1997; 61:142-7.
12. Adami S, et al. Ipriflavone prevents radial bone loss in postmenopausal women with low bone mass over 2 years. Osteoporos Int 1997; 7:119-25,
13. Elders PJM, et al. Long-term effect of calcium supplementation on bone loss in perimenopausal women. J Bone Min Res 1994; 9:963-70.
14. Aloia JF, et al. Calcium supplementation with and without hormone replacement therapy to prevent postmenopausal bone loss. Annals Intern Med 1994; 120:97-103.
15.
Reid IR, et al.
Long-term effects of calcium supplementation on bone loss and fractures in postmenopausal
women:
A randomized controlled trial. Am J Med 1995; 98:331-5.
16. Devine A, et al. A 4-year follow-up study of the effects of calcium supplementation on bone density in elderly postmenopausal women. Osteoporos Int 1997; 7:23-8.
17. Bourgoin BP, et al. Lead content in 70 brands of dietary calcium supplements. Am J Public Health 1993; 83:1155-60.
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