If we believe what the media has been telling us, we would think that calcium loss is the only cause of osteoporosis and that simply taking doses of calcium would solve the problem. Unfortunately this is not true – calcium alone will not reverse or halt bone loss in most cases. Actually, studies using calcium alone have shown bone loss, not bone gain. Hormones, our immune system, stress reduction and good nutrition combine to maintain proper bone health.
People with low stomach acid will have a difficult time absorbing calcium carbonate, the most common calcium used in supplements. Less than 10 percent of calcium carbonate is absorbed in those with low stomach acid. Calcium citrate, aspartate and orotate are much better absorbed. Calcium concentration in the body is controlled by several hormones (including calcitonin secreted by the thyroid gland) and is influenced by our immune system.
Vitamin D also plays an important role in the formation of bone. Vitamin D interacts with the cells of the immune system by reducing inflammatory cytokines, specifically IL-1 and IL-12. Carl Germano, RD, and William Cabot, MD, state in The Osteoporosis Solution that, “In some research circles, osteoporosis is thought to be a type of autoimmune disease.”
The inflammatory cytokines of the immune system, specifically IL-1 and IL-6, can cause calcium to be pulled from bone. When we are under stress, our stress hormone, cortisol, is secreted. Cortisol release signals the T-helper-2 cells to secrete IL-1 and IL-6. As well, when cortisol levels go up, our anti-aging and immune regulating hormone, DHEA, decreases. The body is designed to deal with short-term stressors, but when they become a regular occurrence, the connection between cortisol and IL-1/IL-6 causes bone to break down faster than it can be rebuilt.
Osteoporosis can also be influenced by an overactive immune system. When macrophages eat invaders in the course of their daily surveillance, they release nitric oxide and IL-1. Nitric oxide in small amounts protects against bone loss. But when the immune system is fighting infection, macrophages release nitric oxide in large amounts, promoting the breakdown of bone. The drug Fosamax is designed to reduce nitric oxide, although with some terrible side effects. As mentioned earlier, we know that IL-1 also promotes bone loss so not only does vitamin D have to be available to control the secretion of IL-1, but our macrophages have to be kept in balance as well. Nitric oxide, like vitamin D, is key to regulating bone.
Estrogen protects the body from excessive secretion of IL-1 and IL-6. Lack of healthy estrogen in women with adrenal exhaustion, who have had hysterectomies, or top-level athletes with suppressed menses, is associated with abnormally high levels of IL-1 (which promotes bone loss) and low levels of interferon gamma (which prevents bone loss).
The thyroid hormone thyroxin activates bone breakdown, so long-term elevated levels of the hormone for a prolonged period either, through hyperthyroidism or over-medication for hypothyroidism, also results in bone loss. Sub-clinical low thyroid function, where not enough thyroid hormone is available, also promotes bone loss.
Use of medications can also contribute to osteoporosis: corticosteroid drugs decrease absorption of calcium, and antidepressants have been linked to increased risk of hip fractures. Drugs such as diuretics, antacids, anti-convulsants, warfarin and lithium can also contribute to bone weakening.
Other factors promoting osteoporosis include genetic predisposition (Asians and Caucasians are at higher risk), hyperparathyroidism, hypothyroidism, excessive alcohol consumption, leanness, never being pregnant, side effects of prescription medication, immobility or lack of exercise and not getting enough sunlight. Smoking increases inflammatory immune factors promoting bone loss.
Calcium to Magnesium Ratio: Research shows that the body requires twice as much calcium as magnesium. Taking more magnesium than calcium can actually suppress calcium levels and increase bone loss by decreasing the production of the thyroid hormone calcitonin. Magnesium in excess acts as a calcium blocker. There are times when we would want extra magnesium (e.g., for for restless leg syndrome, constipation, painful periods or heart palpitations) but we should then take the magnesium in divided doses and at a different time than the calcium supplement.