Wednesday, July 31, 2013

My Pre-race Workout

Not sure this is the best pre-race workout I ever did...but it was fun.

Thursday, July 25, 2013

Aquamin Trace Minerals plus Vitamin D Stimulate Osteogenesis

A report out of Ireland in Phytotherapy Research sing the virtues of combining trace minerals and vitamin D for improving bone health. This 28 day in vitro study by Widaa et al. found that combining Aquamin, a natural multi-mineral supplement with vitamin D "yeilded a significant increase in ALP [alkaline phosphatase, a marker for increased osteoblast bone building activity] and mineralisation." The researchers concluded that "Aquamin aids osteogenesis, and that its osteogenic response can be enhanced by combining Aquamin with Vitamin D3."

This is why we formulated OsteoMineralBoost to include a hefty 250 mg of Aquamin, the trace mineral supplement derived from the red algae Lithothamnion species. Couple this with our OsteoStim product that packs 1,000 IU of vitamin D plus other important bone healthy ingredients and you get a great one-two punch for building bone.

Widaa, A., et al. 2013. The osteogenic potential of the marine-derived multi-mineral formula Aquamin is enhanced by the presence of vitamin D. Phytother Res doi: 101002/ptr.5038 [Epub ahead of print].

Radio Show: Dr. Mara Karpel & Your Golden Years

Dr. Mara Karpel & Your Golden Years
Just a heads up that this Sunday (July 28) evening I'll be a guest on Dr. Mara Karpel & Your Golden Years radio show. Dr. Karpel is a geriatric clinical psychologist specializing in helping adults navigate through difficult health issues as they age. We will be talking about the stresses of osteoporosis and what can be done to reduce fracture risk. Hope you can tune into Austin's Talk Radio 96.3, Sunday at 7 pm CT/8pm Eastern. Here's the link to the show.

Saturday, July 20, 2013

Fat in your blood increases fat in your bones...Not good for bone strength

In a study out of Massachusetts General Hospital and Harvard Medical School, researchers investigated the association between fat levels in the blood and that within an obese person's bone marrow. High levels of bone marrow fat has previously been shown to correlate to low bone mineral density and increased fracture risk.

Brendella et al. found elevated blood triglyceride and low high-density lipoprotein cholesterol to be associated with a high fat content in bone marrow.

Bredella M.A. et al. 2013. Ectopic and serum lipid levels are positively associated with bone marrow fat in obesity. Radiology doi: 10.1148/radiol.13130375.

Tuesday, July 16, 2013

Last Couple of Miles

Just logging a few final miles before the marathon (July 26th). No place better than Cape Cod.

Sunday, July 14, 2013

Hormone Therapy for Osteoporosis

The loss of estrogen production by the ovaries at menopause can have profound effects on skeletal health. Low estrogen levels in women are directly associated with lower bone mineral density and increased risk for fractures. Doctors have known this for years and in fact hormone replacement therapy (HRT) in the form of estrogen and progestin used to be the treatment of choice for postmenopausal osteoporosis. Then in 2002 the Women's Health Initiative (WHI) study was terminated abruptly when it was discovered that HRT increased the risk of heart attack, stroke, venous blood clots, and breast cancer. With the release of these findings, patients and doctors alike became nervous about HRT and it's use dropped significantly. In fact, the meteoric rise in bisphosphonate use in the early 2000's owes its launch to the WHI findings.

I frequently see patients who I think would benefit from HRT. I suggest that they speak with their medical provider about low dose or ultra low dose estrogen because research indicates it is both effective and safe (unlike the higher doses used in the WHI study) for preserving bone density. If you want to learn more about HRT, I explain its use in my book, The Whole-Body Approach to Osteoporosis. Also, a review article by Sandra Sacco and Wendy Ward is certainly worth the read. Don't let the findings of the WHI sway you from estrogen therapy (low dose, transdermal) if it is indicated.

Sandra M. Sacco and Wendy E. Ward, Revisiting estrogen: efficacy and safety for postmenopausal bone health. Journal of Osteoporosis Vol 2010, Article ID 708931.

Friday, July 12, 2013

Inactivity and Aging...A Bad Combination

Thought for the day:

Inactivity causes a loss of slow twitch muscle fibers.

Aging causes a loss of fast twitch muscle fibers.

Inactivity + Aging = Loss of total muscle mass, weakness and increased risk for falls.

Falls are the number one reason for fractures.

By the end of today, you won't be any younger...

Monday, July 8, 2013

Osteoporosis Risk Factors...What do they tell us?

If you visit the IOF (International Osteoporosis Foundation) web site you will find a short test that can help to determine your risk for osteoporosis.

Most of you know by now that I was diagnosed with severe osteoporosis at age 45 and sustained 12 fragility fractures over the next 5 years. I'm now 59 and no longer fracturing but just out of curiosity I decided to take the test. I pretended that I was still 45 and had not started breaking yet. I just wanted to see if the test would tell me I was at risk.


It is called: "The NEW Interactive IOF One-Minute Osteoporosis Risk Test"


"Are you among the one in three women, and the one in five men over the age of 50 who will be affected by osteoporosis in their lifetimes?
Osteoporosis weakens bones and leads to fractures. It causes severe disability. But osteoporosis can be detected early. It can be treated.
If you knew something that could harm you was coming, wouldn't you avoid it?"

Now this sounds great...of course I would like to know of something harmful is coming my way. Who wouldn't, especially if things can be done to avoid it. The test began by first asking for my family history:

     Had either of my parents been diagnosed with osteoporosis or broken a bone in a minor fall?    No.

     Did either of my parents have a dowager’s hump?    No.

Then it asked for my personal clinical factors:

     Am I 40 years old or older?    Yes.

     Had I ever broken a bone in a minor fall as an adult?    No.   Other than a few broken bones from major impacts such as being slugged in the jaw and having my horse fall when I was jumping a 4 foot fence while traveling 20 mph, I had never sustained what would be called a low-impact or fragility fracture.

     Did I fall frequently?    No.

     Had I lost over an inch in height?     No.

     Was I underweight?    No. I weighed 153 pounds and was 5’11” when I was 45. (I still weigh the same.)

     Had I ever taken corticosteroids?     No.   In fact, I had never taken any medications.

     Did I have rheumatoid arthritis?    No.

     Did I have over-active thyroid or parathyroid glands?    No.

     Did I have impotence or low testosterone?    No.  I had my testosterone level tested several times and it was always above 700 (high normal).

Then the questionnaire went on to lifestyle factors:

     Did I drink alcohol?    No. I once drank 3 sips of a beer when I was about 20 years old. I was out at a ranch shoeing 5 horses and had forgotten to bring water. All the rancher had to offer me was a cold beer. It tasted terrible.

     Did I smoke?    No. When I was about 8 years old my dad forced me to smoke a Japanese cigarette he had acquired while serving in the Army during the Korean War. He figured it would make me so sick I would never want to smoke. I guess his tactic worked.

     Was my level of physical activity less than 30 minutes per day?”    No.  I began running, swimming, and riding horses at age 6 and never quit. I’ve trained for elite competition including the Olympic Games and Ironman triathlon competitions my whole life…and still do.

     Did I avoid milk or was I allergic to it?    No. I literally drank gallons of milk each week. I loved milk so much growing up that I remember having dreams of diving into a swimming pool filled with milk and being able to drink in as much as I wanted. We would go to the Hess farm each week and get 4 gallons of raw milk. I’ll never forget the first time I took a sip of pasteurized homogenized milk at the school cafeteria in 5th grade. Uggghhh…it tasted awful.

     Did I spend less than 10 minutes a day out side?    No.  I practically lived outside and still do.

When I completed the test it then said to "Print the summary." A window popped-up saying that I had answered yes to one question (that I was over 40). It said "This does not mean that you have osteoporosis. Positive answers simply mean that you have clinically proven risk factors which may lead to osteoporosis and fractures." It told me that I should print out the results of this test and show my physician or health care professional.

Hmmm.... That's 15 "noes" and 1 "yes." I would venture to say that about 99.9% of doctors would say that I had a very low risk for developing osteoporosis. I would also venture to say that with those test results none of them would be willing to write me a requisition for a bone density examination. Being a male, an Olympic athlete, only 45 years old and no history of fragility fractures...nope, none of them would. Yet it is at that age that I began to sustain multiple fragility fractures due to severe osteoporosis. I had a T-score of -4.3 of my spine.

Where does this leave us? What is the point of this blog? This test may have missed me...but hey, I'm only one guy. And who cares about "just one" guy...after all, we are trying to do what is best for our society as a whole here. The individual?...  So what's the big deal?
Not sure if I mentioned an article I read back in 2001 by Watts et al. It was published in Arthritis & Rheumatism (44:S56) and mentioned a study called the IMPACT trial. Of the participants in this study, 48% with osteoporosis had no risk factors and the 53% who did have risk factors did not have osteoporosis. My take...bone density exams are for everyone. And I'm all for having one between the ages of 40 - 45. 

I think the cost of a bone density exam these days is about $250.00....even if insurance doesn't pay for it, it's worth the peace of mind.




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