—Here’s more useful information on osteoporosis.

Basic Multicellular Unit (BMU)

A BMU is the worksite where osteoclasts are busily tearing down old, worn bone and the osteoblasts are coming along right behind to form new bone, which is then hardened with crystalline mineral salts (hydroxyapatite) to give it strength. This remodeling process is graphically depicted in the diagram. At any one moment, millions of BMUs within our skeletal system are actively making strong new bone in an effort to eliminate microfractured areas that result from the wear and tear of normal daily living.

Catabolic vs. Anabolic

A number of important physiological conditions must be present for BMUs to function optimally. For bone to grow and remodel, there must be balance within the endocrine and immune systems, and good communication between bone cells. Vitamins, minerals, and protein must be available in sufficient quantities, as well as a healthy digestive system from which they can be absorbed. Finally, for proper enzymatic function and mineral homeostasis, the body needs a fairly neutral pH. When all these elements are present, we have an “anabolic environment—a healing atmosphere where there can be a positive state of tissue-building activity. If, on the other hand, the body harbors low-level, chronic inflammation, has a struggling immune system, or severe pH imbalance, then bone formation will lag behind bone resorption with the overall effect of bone tissue loss. This undesirable condition is known as a “catabolic” environment—a destructive atmosphere where the metabolic system is severely compromised. And osteoporosis is the classic catabolic state.

Medication

Unfortunately, bisphosphonate therapy has become the current osteoporosis treatment of choice. Bisphosphonates (Fosamax, Boniva, among others) do nothing to put the body into an anabolic state, and they actually eliminate the remodeling process. Bisphosphonates destroy osteoclasts, thereby stopping resorption and the stimulation of osteoblastic new bone formation. And these medications carry their own risks. They have the potential to increase fractures later in life, and they can have dangerous side effects including osteonecrosis of the jaw (ONJ). The hope of reducing fracture risk through improved density with bisphosphonates is sometimes overly optimistic. (Click here for more information on bisphosphonates.)

If, instead, we use diet and nutrition to optimize the whole body’s function and to moderate factors involved in the remodeling process, bone quality can be improved naturally. This should be the first line of treatment. Unlike some other diseases, osteoporosis is chronic and slow moving, and there is usually time, if caught early enough, to try a natural method for improving your bone density. Each person is unique, and the decision to approach low bone density through diet and supplemental support, or through drug intervention, or a combination of the two must be made on an individual basis and with the help of your physician.

Nutritional Support

Based on physical signs and symptoms and on information gathered from standard laboratory tests, called biomarkers, Dr. McCormick helps his patients set up a treatment program that will modify their lifestyle and diet and will probably include supplemental nutrition in order to help the whole physiology. In most cases, bone loss is just one symptom of a greater story of ill health—one that must be approached through a sophisticated, evidence-based platform.

To understand how nutritional support can help, let’s look again at the biology of bone tissue. The communication system between bone cells is a series of linked stimuli and responses. Problems in bone biology arise when signals are either blocked or amplified. If signals are muffled or slowed, or if they are inappropriately amplified, the balance between the remodeling cells (osteoclasts and osteoblasts) falters and both bone density and quality are lost. The molecules that conduct this communication system are cytokines, growth factors, and glycoproteins. These molecules are all woven throughout a bone’s collagen foundation, and they orchestrate the periods of active remodeling.

The molecules we will look at here are the cytokines. These proteins are veritable multitaskers that are involved in many different functions throughout the body. Cytokines stimulate or inhibit cascades of biochemical interactions that affect the bone-remodeling process. They are also actively involved in the body’s immune response to injury. This response is inflammation. No matter where an inflammatory response originates—autoimmune problems, toxic gut, glucose imbalances, oxidative stress—the immune system’s response will always be the same; it will flood the body with a deluge of specific cytokines that add to the total inflammatory response. These are called “pro-inflammatory” cytokines, and they are the reason for the intimate relationship between the immune system and the health of our bones. Some of the same pro-inflammatory cytokines that are involved in immune reactions are also involved in bone resorption. Cytokines such as interleukin-1 (Il-1), interleukin-6 (Il-6), and tumor necrosis factor (TNF) are all pro-inflammatory cytokines involved in the excessive loss of bone tissue.

Sometimes learning about bone biology can be overwhelming, but if there were only one molecule whose name was important to remember, it would be “receptor activator nuclear kappa-B ligand,” or RANKL for short. RANKL stimulates increased osteoclastic bone resorption, and if we are concerned about osteoporosis, then we want to decrease the effects of RANKL. Excess RANKL is caused by two factors—an overabundance of pro-inflammatory cytokines from chronic, low-level inflammation, and a struggling immune system; this unhealthy combination will result in excessive bone loss. Abnormal levels of pro-inflammatory cytokines and RANKL can be lessened by changing your diet and adding to it specific nutritional supplements.

Improving bone density and reducing the risk for fracture requires more than just increasing your intake of calcium, vitamin D, and maintaining a good weight-bearing exercise program. Dr. McCormick’s goal is to optimize key physiological functions and reduce excess production of pro-inflammatory cytokines and RANKL, thereby improving your bone quantity, quality, and strength. Most of the nutritional supplements he might prescribe are available for purchase at the front desk.

Discovering why someone has excessive bone loss is not simple—nor is improving his or her structural soundness. Osteoporosis is a complex polygenic disease with multiple pathogenic mechanisms, but Dr. McCormick uses many diagnostic tools to track its insidious effects. Much can be done to improve the health and strength of your bones, but it takes teamwork, financial commitment, and patience. Nutritional supportive therapy requires effort and attention, but it is a direct path to whole body wellness; this would include, of course, your bones.