Building Strong Bones Through Nutrition

Welcome to Osteo Naturals. We invite you to shop our online store for quality nutritional supplements that promote skeletal health. In addition, our site is full of useful information about osteoporosis and insights about how it can be managed naturally.

Individuals who intend to stay active into retirement will need strong, healthy bones, and a strategy for maintaining muscle strength and coordination. Whatever your age or current condition, it is never too early or too late to make a positive difference. The "Osteo Naturals difference" = natural ingredients chosen for quality, safety, purity and potency.


A Message From the Founder

“It is my hope that we can be of great service to you. Our products are the result of over 10 years of research into the biology of bone, the causes of bone loss, and what it takes for the body to re-capture and maintain bone strength. This journey started after my own diagnosis of severe osteoporosis (T score of -4.3) and multiple fragility fractures that I sustained over a 5-year period. Because of my own challenges in improving bone mineral density, I know how difficult it can be to find the right supplements.

At Osteo Naturals we hope to make it easier for you to achieve a healthy outcome with natural products. With a market flooded with hundreds of calcium and bone health supplements, it can be difficult to decide on which product will best suit your needs. In short, we offer products you can trust: with no “window dressing” ingredients, no cheap or substandard ingredients, and no “hype.” Osteo Naturals is Where Bone Strength Begins. Thank you for visiting us.”

R. Keith McCormick, DC, CCSP

Thursday, August 7, 2014

A Face-Plant at Twenty-Five M.P.H.


Last weekend while competing in a triathlon (swim, bike, run), I experienced an unscheduled strength test of my skeleton that was somewhat unorthodox…I crashed. And just to make sure that you all understand…having a bone mineral density examination is certainly a MUCH safer way to determine fracture risk…but then again, I’m not one to always follow the rules.

As many of you know, the reason I became so interested in osteoporosis was because I myself was diagnosed with this disease 15 years ago. A T-score of -4.3 plus 12 fragility fractures were the impetus for my delving so head long into the study of osteoporosis. My goals were to uncover the cause of my extreme bone fragility and then to find ways to make those bones stronger and healthier. Taking this then one step further by helping others deal with an osteoporosis diagnosis was just the right thing to do. *

I have been an athlete my whole life and I’ve tried to never let osteoporosis impede my activity level, even back in the days when I was frequently breaking bones. (Maybe that’s a clue into why I broke so many bones...hmmm….) I’m now 60 years old and because I continue to race in triathlons I realize the danger quotient is escalating. Traveling at high speeds on my bike, up to 50+ mph down hills, has the potential to cause considerable damage to the skeleton should I crash. I don’t know if any of you have ever raced bicycles but sometimes there can be some unforeseen entanglements with other riders especially when the aggressive factor of racing is high. Such was the case in this race.

The first part of the race, the swim, went well even though my 4% body fat lost the battle against the 60-degree water. Even with my wet suit I was a bit chilly. I exited the water in first place and clipped into my bike for the second leg of the race. I hadn’t gone but two or so miles when it started to rain lightly. I sensed the road getting slick but pushed on at top speed hitting about 40 mph on a moderate downhill. I had driven the course the day before and knew there was a turn after going through a narrow, one-lane, tunnel-like under-pass at about mile 6…but I hadn’t really paid enough attention to the acute sharpness of the turn. As I was coming out of the tunnel I could see just how sharp the turn was and tried desperately to slow down. As I applied my brakes the rear wheel immediately began to fishtail. (I felt like Joseba Beloki in the 2003 Tour de France as I struggled to stay in control.) Four times in quick succession I applied my rear brake and 4 times I fishtailed. Only through sheer luck was I able to keep the bike up-right but, still going 20+ mph, I careened down off the road and into a gravel driveway. Finally I skidded to a stop 30 feet off the road. (Whew…that was close!) I quickly pushed my bike back up the hill, jumped on my bike and started to crank hard, anxious to gain back lost time. The rain continued and the road was becoming slicker, more dangerous.

On the second lap I made it through the tunnel safely but this time, on a straight stretch of road, things got really
squirrely. As I fast approached two slower athletes that I was about to lap, one of them pulled out to the left to pass. I swerved hard to avoid hitting him, crossed the centerline and hit a really bad patch of pot-holed road. At 25 mph I totally lost control and flew off the side of the road. My bike flipped flinging me headlong and performing a perfect face-plant into the road-side vegetation. I hit hard on my forehead and the right side of my chest. The helmet (see photo) saved me I’m sure. I wasn’t knocked out but certainly dazed and lay there for x amount of time. Another competitor stopped to ask if he should call for an ambulance but I said no and got up slowly…looked for my bike (which I couldn’t find at first because it was 10 feet away and under a lot of vegetation)…thanked the blurred racer (I can only barely remember that “being” standing there)…and hopped on my bike. (For any of you bikers out there reading this and worrying more about my bike than you are about me….No, my bike was not damaged…thank goodness!!!)

On the third and final lap with my head and chest a bit sore (but my vision improved) I thought I better slow down and not push my luck. I had already lost at least 3 minutes and I knew that there had to have been a few other competitors that had passed me while I was lounging around on the side of the road in the underbrush. So with first place surely gone…and probably a top five finish for that matter…I just started to relax and enjoy the rest of the race.

As I approached T2 (the transition between the bike and the run) the rain stopped and the sun came out just in time to warm up the run course. I racked my bike, threw on my running shoes and headed out for the final leg of the race, a 6.5 mile run. Since I had backed off on the final lap of the bike portion of the race I felt pretty good heading out on the run. Other than some back spasms as a result of the crash, I was able to keep a steady pace all the way into the finish line.

The whole reason for this long drawn out story is to say that I didn’t break any bones. Walking around after the race, feeling a bit sore in my back, a little confused from the concussion, spitting some blood from a laceration on my tongue, and coughing up some blood that was later diagnosed as a pulmonary contusion (bruised lungs) (a chest x-ray was negative for any real damage)…I was pretty darn happy that I didn’t break anything. I think that’s what makes a person with osteoporosis the happiest….not fracturing when they fall! Sounds a bit strange I know but every time I take a fall and don’t break…I just smile.

Oh…the final pièce de rèsistance after all this? I finished 2nd overall and 1st in my age group. A good day at the races for sure.


* If you would like to learn more about the comprehensive nutritional approach that changed my life, visit www.osteonaturals.com.

Monday, July 14, 2014

Second Chances...Yes, it is Possible for Bone Health

2014 Northeast Champ: Olympic Distance Triathlon
Second chances in life don't just happen...you have to make them happen. When it comes to second chances in health, this can become a little more unpredictable but we still need to "make it happen." When I was diagnosed with severe osteoporosis 15 years ago I not only knew very little about the disease but I was also totally floored because I THOUGHT I was already doing pretty much everything right as far as eating and life style choices were concerned. So WHY would I have poor bone health?

After immersing myself in the study of osteoporosis I quickly realized that there was A LOT I could do to help myself. Now, 15 years later and 60 years old, I feel so much stronger, so much healthier. I'm thankful to have made that second chance happen. Winning the Northeast Championships in triathlon this weekend makes me thank my lucky stars that second chances are possible...but they don't come without work.

You can make it happen too! It is NOT too late. That second chance is there for the taking...but it won't wait until tomorrow. Start making that second chance happen TODAY!


Thursday, July 10, 2014

Osteoporosis: Bone Mineral Density (DXA) Exam vs Risk Factors

Clinical risk factors* for osteopenia and osteoporosis include:

   - Loss of height
   - Low body weight
   - Advanced age
   - Late age at menarche
   - Menopausal
   - Time since menopause
   - Smoking
   - Calcium intake
   - Alcohol intake
   - Medications
   - Inflammatory conditions
   - Prior fragility fracture

But: Risk factor assessment is NOT a substitute for having a bone mineral density examination (DXA). Research shows that 50% of patients with osteoporosis do not have risk factors and 50% of patients with risk factors do not have osteoporosis as per a DXA exam** (T score of -2.5 or worse).

So: Make sure you get a bone density examination (DXA)! Please do not rely on risk factors because they DO NOT predict your chances of having osteoporosis.

*Riggs B.L. and Melton L.J., NEJM. 1986;314:1676-1686.
**Delmas, P.D. et al. Impact Trial, JBMR. 2005; 20:557-563.

Tuesday, July 8, 2014

Exercise and Osteoporosis...Make it a Priority

As I was cruising to the finish line in a recent triathlon (finishing 1st in my age group [60-64] and 4th overall), a surge of great pleasure ran through me. "This is who I am...someone who uses his body to the max." I ABSOLUTELY love it. I love being an athlete. It really IS WHO I AM! The interesting byline here is that I also have--or at least HAD-- severe osteoporosis. I would be miserable if I couldn't train and compete hard.

That brought to mind a recent posting on an osteoporosis chat line where a woman wrote "I have advanced osteoporosis and it is an exercise limitation." She went on to explain that there were many things that she could not do because of her bone loss and increased fracture risk.

This not only saddened me but reminded me of the dreaded fear of "breaking" that the diagnosis of osteoporosis carries with it. My initial diagnosis at the age of 45 seems like eons ago. My T-score was -4.3 and I experienced a lot of fractures. The fear of ongoing fracturing was HUGE, but thankfully none of that seemed to stop me. The key here is that from the very beginning I was in a fighting mode. I never let the diagnosis stop me. I fought back. Of course most of you know by now that OsteoNaturals is the result of this fight and the ingredients in our products are what turned things around for me. I now have my bone health under control and, thankfully, OsteoNaturals has become an integral weapon for others in their fight to reclaim skeletal health. The really great thing is that these people are winning too.  Onward!

Thursday, July 3, 2014

More on Prolia (denosumab) for the Treatment of Osteoporosis

Back in 2012 I wrote a post on Prolia (denosumab), a drug that had recently been introduced for the treatment of osteoporosis. (I have included the article here in case you missed it and/or would like to refresh your memory as to how it works.) Prolia has proved to be effective for the treatment of osteoporosis but has three major drawbacks. One: once you start taking this medication you have to stay on it...forever. It has the unfortunate drawback of causing a rebound effect that actually increases a person's bone loss if they should discontinue its use. Two: there are quite a few adverse effects associated with Prolia, the most common ones being low blood calcium levels, back pain, muscle and bone pain, rashes, and painful urination. And three: Prolia is extremely expensive.

The reason why Prolia works is that it interferes with the inflammatory cascade involving the protein
RANKL, a key signaling molecule that promotes osteoclastic bone resorption. Except in desperate situations (which are rare), I have never understood why anyone would choose to go on this medication especially when there are ways to reduce RANKL naturally. For example (and this is the BEST example you are going to find), our OsteoNaturals product OsteoStim has been formulated to help reduce RANKL and normalize the bone remodeling cycle (plus there are no side effects and it is inexpensive). OsteoStim includes therapeutic amounts of alpha-lipoic acid, berberine, and milk thistle that have been shown to help balance RANKL signaling and reduce osteoclast bone resorption. It also contains vitamin D to increase calcium absorption, vitamin K2 (MK4 and MK7) to promote bone crystal formation, and milk basic protein and N-acetyl cysteine to promote osteoblast bone formation. 

If you ask any doctor how they can tell if Prolia is working to reduce fracture risk, they will tell you that on repeat testing of bone resorption markers (NTX, CTX or DPD) (for more info on these test please check out page 34 in my book, The Whole Body Approach to Osteoporosis) there will be a drop in the amount of bone-collagen cross-links after antiresorptive treatment is initiated. This is standard for monitoring the effectiveness of bisphosphonates or Prolia in the treatment of osteoporosis patients.

I use similar monitoring when I recommend OsteoStim to my patients with bone loss. I get a baseline NTX, CTX or DPD (you don't have to get all three...one is suffice) and then after four months of being on OsteoStim, plus a calcium/magnesium supplement (for example our OsteoSustain and/or OsteoMineralBoost), and improving the person's diet (lots of fruits and vegetables) and implementing an exercise program, we repeat the test. Time and time again I find that we can avoid the pitfalls of taking harsh medications such as Prolia. OsteoStim helps to normalize bone remodeling and this is reflected in the lowering of bone resorption markers on repeat testing. Also, by implementing a whole treatment program that emphasizes diet and life-style changes, the person feels WAY better! To me, it just makes total sense to try this more natural approach BEFORE resorting to drug therapy.

Here is my prior blog on Prolia:

For more than 10 years, the use of bisphosphonate therapy has been the “osteoporosis treatment of choice” when medication is absolutely necessary. You have likely heard of the names alendronate (Fosamax®), residronate (Actonel®), ibandronate (Boniva®), and the most recent zoledronic acid (Reclast® approved in 2007). When the bone remodeling process has gone awry due to to chronic systemic inflammation, too much resorptive activity (bone degrading) by osteoclasts and too little bone formation by osteoblasts create the perfect storm for osteoporosis.  When bisphosphonates are used for therapy, they eliminate existing osteoclasts, thereby slowing bone loss and improving bone density. 


Over time, we have learned that there are adverse effects that need to be considered when using these medications. For instance, bisphosphonates have a high affinity for bone and are sequestered or held within calcium crystals, posing both beneficial and detrimental effects. Beneficial because bisphosphonates continue to suppress osteoclastic bone resorption long after a patient has discontinued their use. Detrimental because long-term suppression of osteoclasts can lead to low bone-turnover disorders such as osteonecrosis of the jaw and increased bone fragility with a heightened risk for atypical femur fractures. Stopping use of these drugs does nothing to help rectify these situations because of sequestered drug levels.
With new medication always comes new hope. 
Denosumab (Prolia®) was introduced for the treatment of osteoporosis in 2010, two years ago. Like bisphosphonates, this new medication limits the bone degrading activity of osteoclasts, but it uses a different mechanism. Denosumab is an antibody to RANKL, a natural signaling molecule in the body. When produced in normal amounts RANKL keeps the immune and skeletal systems functioning normally. But in excess (seen when the immune system gets out of balance), RANKL can cause havoc, spilling into the bone marrow and hyper-stimulating osteoclast cell formation/activation. Over time, this hyper-stimulation of osteoclastic bone resorption leads to osteoporosis. Being an antibody to RANKL, denosumab prevents bone loss by grabbing RANKL, neutralizing it, and preventing it from activating osteoclasts. (Note: If you want to learn more about RANKL and its involvement in bone loss, I give a more in-depth explanation in my book, The Whole-Body Approach to Osteoporosis.)
Unlike bisphosphonates, denosumab is not sequestered in bone and therefore does not have the same long-lasting effects after treatment has been discontinued. However, even with such a short track record, we are already beginning to see that denosumab has a dark side with long-term use.  So hopes for denosumab, like all medications, must be kept in perspective. We need to use medications to our benefit, but always be aware that they can carry risks. Here is what we have so far:
PROS
  • Denosumab is administered subcutaneously every 6 months (better than having to take bisphosphonates orally or through infusions). 
  • It works. Osteoclastic bone resorption is profoundly suppressed by denosumab and results in similar increases in bone mineral density when compared to bisphosphonates.  (Spine: 3% 5% after 1 year; 6% to 7% after two years; 8% to 10% after 3 years, 13% after 5 years) ( Hip: 1% to 3% after 1 year, 3% to 5% after 2 years, 5% to 6% after 3 years, 7% after 5 years)
  • Denosumab significantly reduces vertebral and nonvertebral fractures (similar to the rates of bisphosphonates).
  • Effective in patients with impaired kidney function.
CONS
  • Denosumab may disturb immune function and increase susceptibility to infections although in a two-year extension of the FREEDOM trial (a total treatment duration of seven years) researchers did not see an increase in infectious events.
  • There are concerns that denosumab may increase the risks of cancer. Anastasilakis et al. state, "numerically more cases of neoplasms, including those of the breast, ovary and gastrointestinal tract, have been reported." But since other trials have "failed to detect a statistically significant difference" with denosumab use compared to placebo, "long-term use of denosumab in a large post-marketing base would clarify this putative risk."
  • There is a significant risk of developing cutaneous allergic and inflammatory hypersensitivity skin reactions including eczema, dermatitis, and rashes.
  • There is a significant risk (7%) of developing high blood cholesterol levels.
  • Possible increased risk of vascular calcification and cardiovascular disease.
  • Increased risk for low blood calcium (hypocalcemia).
  • Because denosumab is such a potent suppressor of osteoclastic bone resorption and bone remodeling in general, it carries similar concerns of "frozen bone" types of adverse effects as the bisphosphonates. Atypical fractures of the femur and osteonecrosis of the jaw are of concern. In fact, Health Canada has just released a health advisory alerting the public of the association of Prolia with the increased risk of atypical femoral fractures.
UNKNOWNS
According to a review article in Therapeutics and Clinical Risk Management by Anastasilakis et al., when denosumab is discontinued "bone markers rise to above pretreatment levels within 12 months." In other words, if you stop using denosumab you quickly loose the density that was accrued. Not only that, but you loose it at a rate faster than that seen before treatment was initiated. This "rebound," or hyper-increase-in-bone-loss effect, lasts for approximately two years. Clinical studies have not determined the full implications of this rebound effect but when a person elects to begin treatment with denosumab they probably shouldn't stop. Any "drug holiday," such as that which is becoming common after 3 to 5 years of bisphosphonate therapy, may actually escalate fracture risk to a level even higher than that which the individual had before denosumab treatment was initiated. 
Anastasilakis et al. concluded "denosumab is reasonably safe for all subgroups of patients with postmenopausal osteoporosis, with the exception of those with hepatic or stage 5 renal insufficiency. However, given the lack of pharmacovigilance data for this agent as yet and its brief post-marketing period, it would be prudent to be vigilant for adverse events related to the putative effect of RANKL inhibition in tissues other than bone, as well as those related to bone turnover oversuppression."
Bottom line:  Osteoporosis medication should be used only when absolutely necessary – when fracture risk is moderately or severely elevated.
 
Anastasilakis et al., 2012. Long-term treatment of osteoporosis: safety and efficacy appraisal of denosumab. Therapeutics and Clinical Risk Management, 8:295-306.

Wednesday, June 25, 2014

Bisphosphonates and Osteonecrosis of the Jaw

Osteonecrosis of the jaw (ONJ) (a painful, refractory condition where a portion of the jaw bone dies and becomes exposed) has been linked to bisphosphonate therapy in the treatment of osteoporosis. Numerous studies over the past ten years have been unsatisfactory in demonstrating the actual incidence of oral bisphosphonate-related ONJ and therefore the level of risk remains controversial. A new study out of Australia may bring us closer to understanding this association. Gorromeo, et al. showed a "strong, significant association between oral bisphosphonate use and delayed dental healing and jaw osteonecrosis."*

"The most significant finding of this study was the 13-fold increased odds of developing delayed dental healing in individuals on oral bisphosphonate therapy (11.6-fold after adjusting for smoking)." "There was no association of bisphosphonate exposure with osteonecrosis risk independently of a predisposing dental intervention, thereby highlighting the importance of a thorough dental assessment at the outset of bisphosphonate therapy."

Other studies have shown smoking and diabetes to increase the risk for ONJ in patients being treated with bisphosphonates.

*Delayed dental healing is defined as a failure to heal within 6 weeks. This condition is considered a precursor to ONJ. ONJ is defined as exposed jaw bone of greater than 8 weeks duration. 

Borromeo, G.L. et al. 2014. A large case-control study reveals a positive association between bisphosphonate use and delayed dental healing and osteonecrosis of the jaw. J Bone and Mineral Res 29(6):1363-1368.

Wednesday, June 18, 2014

Our New Supply of OsteoNaturals Products is Here

Our new products are here. Thank you all for your patience. OsteoSustain, OsteoMineralBoost, and OsteoStim had been back ordered for way too long...but they are all now available!
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