In my book, The Whole-Body Approach to Osteoporosis, I outline a sophisticated method for using signs, symptoms and laboratory biomarkers to help understand the causes of bone loss and to manage an individual’s therapy. The biomarkers I advocate are a combination of bone-specific (such as N-telopeptide) and non-specific (hsCRP, homocysteine, etc.) tests. Why the non-specific tests? Higher bone density scores tell us only one thing: that an individual’s bones are harder. They are not necessarily healthier.
Improving bone density with medications such as bisphosphonates may temporarily reduce fracture risk (which may be of utmost importance in certain high risk individuals) but they are not doing anything to improve bone or overall health. It is my contention that what goes on biologically in the skeleton is not separate from the physiology of the rest of the body. Far from it! Factors such as body pH, level of inflammation, gut health, vitamin and mineral status, and hormone levels are all important. By simply taking a few steps back and observing the physiology of the whole body, we will reap greater returns in improved health.
Over the past several years scientists have thankfully begun to take a more comprehensive view of the skeleton’s role in maintaining body function (even if doctors tend to lag behind this trend). Bones, they realize, are not static entities. They are vitally important to our overall health. No longer are bones seen simply as anchors for muscles, support for posture, and depots for mineral reserves. Researchers are now exploring bone biology through a whole-body approach and it is paying rich dividends. For example, we now know that our bones actually act as endocrine organs by releasing a hormone that helps insulin from the pancreas regulate energy and blood glucose levels.
A whole-body approach to the diagnosis and treatment of osteoporosis is the only way to improve bone health. As I say in my book, “Osteoporosis is not just the weakening of bones; it is a weakening of the body’s entire physiology.” “When you have a chronic disease, you have to treat your whole body.”