If you have read my book, The Whole-Body Approach to Osteoporosis, you know that I focus on therapeutic targets (especially lab test results) to design bone-strengthening therapy and monitor progress.
One of the tests I look at when evaluating patients with bone loss is the CBC (complete blood count) and specifically the index, RBC (red blood cell) count. People with osteoporosis often have lower RBC counts than individuals with normal bone density. The reason for this seems to be two fold: 1) lower sex hormones, estradiol and testosterone (a risk factor for osteoporosis), in both women and men is correlated to higher bone marrow fat, and 2) chronic systemic inflammation and higher oxidative stress (also risk factors for osteoporosis) lead to a build-up of bone marrow fat and PPAR-
|More than 50% bone marrow fat (round white objects) in severely osteoporotic bone|
gamma (nuclear) receptors. High levels of bone marrow fat (over 50%) crowds out the hematopoetic stem cells that form RBCs. The PPAR-gamma receptors, when activated, pull a “molecular switch” that converts mesenchymal stem cells into fat cells instead of bone-forming osteoblasts.