There is one thing stronger than all the armies in the world, and that is an idea whose time has come.
Victor Hugo1
It was an unsettling revelation to me that osteoporosis can begin as early as fifteen years prior to the first signs of menopause—often around the middle to late thirties.2 By the time most women reach their postmenopausal years, the majority will suffer from this disease—a fact that has made it the most common metabolic bone disease in this country.
In other words, osteoporosis starts much earlier than most people think. In fact, Dr. John Lee says a woman can “lose 20 percent or more of her bone mass before menopause.”3 The gradual loss of bone, perhaps 1 percent each year at first, accelerates to a rate of 3 to 5 percent per year during menopause and then reverts to about 1 to 1.5 percent a year thereafter.4 This association of accelerated bone loss with menopause, first recognized more than fifty years ago, led medical doctors to prescribe estrogen supplements during menopause to reduce these chances. Unfortunately, however, there are some problems with this approach. Of great importance are the significant side effects that start appearing in a woman’s body when supplemental estrogen, unopposed by natural progesterone, is introduced. They constitute a long list, ranging from increased blood clotting and water retention to liver dysfunction and greater risk of endometrial and breast cancer.
As if that weren’t bad enough, it also turns out that this estrogen therapy doesn’t really do very much good. Nevertheless, standard medical wisdom continues to support this approach and to assume that it is the most effective treatment. There is ample evidence in the medical literature that the therapy is of some limited value, at best, during the menopausal years. However, according to Sandra Cabot, M.D., “when estrogen is discontinued, calcium loss resumes.”5 So we need to look much more closely at the conventional method of treatment.
Dr. John Lee suggests that this escalating bone loss is due to decreasing levels of progesterone, caused by failure to ovulate during some menstrual cycles—for progesterone is mainly produced in the process of ovulation. In nonpregnant ovulating women, the ovaries can produce up to 40 mg of progesterone daily during the second half of the menstrual cycle.6 During pregnancy the placenta becomes the main producer of progesterone, making ever-increasing amounts, so that by the last three months of pregnancy, it is making 300 to 400 mg a day. Failure to produce these levels of progesterone naturally can lead to trouble. Even though estrogen aids somewhat in slowing down bone loss, progesterone could be called proactive, since studies verify that its stimulatory effect on the osteoblastic cells actually encourages new bone growth.7, 8
The onset of irregular periods is an indicator that progesterone levels are becoming depleted with respect to estrogen. When menopause is upon us (that is, when we have stopped ovulating), our progesterone level will decline to almost zero.9 A reasonable question would be, “Why do some women experience this sooner than others?” Researchers tell us that stress, injury, poor diet, lack of exercise, and trauma all may play a role in the degree to which ovulation becomes sporadic and then tapers off at menopause.10
To these Dr. John Lee would add the damage done to the ovaries by any of the many human-made estrogenic chemicals in the environment (see chapter 5). Such exposure to the female fetus or very early in life may damage the ovarian follicles to the extent that in adulthood they can no longer make progesterone as they should. Follicle dysfunction induced by these so-called xenoestrogens may well be the primary cause of the progesterone deficiency that often occurs fifteen years or more before actual menopause.
In addition, as is widely reported in the press these days, the way you treat your body in general can contribute to premature bone loss. Smoking and excessive consumption of alcohol, caffeine, soft drinks, and meat protein, as well as the use of certain anti-inflammatory or antiseizure medications or thyroid hormone replacements, may all place you at higher risk. And some factors can’t be avoided: thin, small-boned women and those of Caucasian descent have a higher risk of osteoporosis.11
In the United States, approximately 24 million people are affected by osteoporosis, at a medical cost of over $10 billion and as many as 1.5 million fractures12 leading to disability, deterioration, and, for too many, death. Today, the annual number of fractures attributable to osteoporosis continues to escalate as our exposure to estrogen from various sources has drastically increased.13 But, as Dr. Robert Lindsay has said, “The problem is, nobody feels the bone they’re losing until it’s too late…. Osteoporosis is without symptoms until it becomes disease.”14 According to Dr. Patricia Allen, when the “acceleration of bone loss begins, risks for coronary artery disease start to increase [and] atrophy of breast and genital tissue starts. And so most doctors now believe that a woman who is bothered by menopausal symptoms should be treated before the cessation of her periods.”15
Jerilynn C. Prior, M.D., and her associates found evidence of progesterone’s possible role in countering osteoporosis in a study of sixty-six premenopausal women between twenty-one and forty-one years of age. All these women were long-distance marathon runners. It was observed after twelve months that
the average spinal bone density decreased by about 2%…. However, women who developed ovulation disturbances during the study lost 4.2% of their bone mass in one year. While there was no correlation between the rate of bone losses and serum levels of estrogen, there was a close relationship between indicators of progesterone status and bone loss.16
Now this is news! And then Medical Hypotheses claims that the use of natural progesterone is not only safer but less expensive than using its synthetic formulation, Provera (medroxyprogesterone), and that “progesterone and not estrogen is the missing factor… in reversing osteoporosis.”
The journal continues:
The presence or absence of estrogen supplements had no discernible effect on osteoporosis benefits…. Progesterone deficiency rather than estrogen deficiency is a major factor in the pathogenesis of menopausal osteoporosis. Other factors promoting osteoporosis are excess protein intake, lack of exercise, cigarette smoking, and inadequate vitamins A, D, and C.17
Dr. Majid Ali says that the use of estrogen to prevent osteoporosis is really quite “frivolous.”18 Osteoporosis is a disease we can do much to prevent. With the knowledge we presently have, it is imperative that women take active steps toward a healthier lifestyle. We must take to heart what author Gail Sheehy says in The Silent Passage: Menopause:
Nearly half of all people over age seventy-five will be affected by porous bones causing the risk of fractures of many kinds. The National Osteoporosis Foundation in the U.S. says that almost a third of women aged sixty-five and over will suffer spinal fractures. And of those who fall and fracture a hip, one in five will not survive a year (usually because of postsurgical complications).19
It has been estimated that twice as many serious fractures occur today than thirty years ago. How long will it take us to grasp the truth of the matter, so we can help ourselves and the aging population? “Clearly,” says Dr. Alan Gaby, “there is something wrong with our bone health, something that the medical profession has not been able to do much about. There is more to preventing bone loss than calcium supplements, estrogen replacement therapy and exercise.”20
Following the publication of the first edition of this book, a woman in her late seventies called to tell me her doctor had put her on estrogen to protect her heart and her bones. She said, “I’ve had three heart attacks since being on estrogen and have also been diagnosed with osteoporosis. Now, after reading your book, I understand that I can reverse and even prevent these conditions with regular use of natural progesterone.”
These reminders about the decline in bone mass as we age make me think of my own family gatherings during the holidays, when we are at long last in the company of several generations of family members. Someone usually says, “Haven’t you grown!” In our family we take it a step further: someone stands next to Mom, and then Mom next to Grandma—and, sure enough, there is a definite change! But it’s in the opposite direction. Soon a grandchild will say, “ Wait a minute, Grandma, aren’t you shrinking?” It seems that these changes start earlier than we may think and are more crippling than we realize.
Is this a topic we can continue to take lightly? Not according to Robert P. Heaney, M.D., professor of medicine at Creighton University School of Medicine in Nebraska. In commenting on the medical community’s having overlooked the importance of progesterone in osteoporosis, he expressed the hope that research will “galvanize the field into taking the matter seriously.”21 Perhaps statements such as his will begin to reeducate the very doctors who think they know all there is to know about this most vital subject.
It is a mystery that so much focus has been placed on declining estrogen levels; it seems the emphasis has been on the wrong hormone. The October 14, 1993, issue of the New England Journal of Medicine makes it clear that taking estrogen for five or ten years after menopause will not protect a woman from having a hip fracture in her later years.22 Why should we wait ten to twenty years for the results of the studies that are now in progress? We have already been counseled by many medical experts. Now is the time to make the change from an estrogen replacement program to one based on natural progesterone therapy.
We should ask ourselves, “Why would we use a hormone that has not worked for generations past?” The traditional and often one-sided references to estrogen decline have created a body of misinformation that has sentenced many to poor health and needless distress. Even though evidence clearly shows that progesterone stimulates active new bone formation and estrogen merely delays bone loss,23, 24 mainstream medicine promotes an entirely different hypothesis to patients and consumers. It seems irresponsible that the medical world is not doing double-blind studies, utilizing baseline and follow-up bone mineral density tests, and natural progesterone.
However, we can be grateful to the many doctors who have searched the archives for the truth of the matter. We now have reliable evidence that despite declining estrogen levels, bone loss accelerates when progesterone levels decline, and bone minerals can be restored with natural progesterone replacement therapy.25–28 Yet, the message women receive from their medical doctors is that “estrogen is the single most potent factor in prevention of bone loss.”29 This belief has been handed down from one generation to the next. But now, when it’s been found that estrogen (ERT) is not as effective as originally alleged and bone fractures occurred in spite of such therapy, other drugs were prescribed in combination with estrogen or alone, such as Evista (Raloxifene), Bisphosphonates (Alendronate), Calcitonin, Fluoride, etc.30 For contraindications regarding Fosamax see pages 114 and 115. Fortunately, recently published studies and books are now challenging these medical theories and bringing more light to the subject of preventing osteoporosis (see appendices D, E, F, and G).
A case in point is the book Preventing and Reversing Osteoporosis, written by medical doctor Alan Gaby. I became so absorbed in it that I could not put it down—nor will you, when you find that, yes, osteoporosis can be reversed. Much of what Dr. Gaby says would be beneficial to many and should be shared. He cautions that despite the preventive measures of calcium supplementation and exercise, and despite medical intervention with estrogen therapy, osteoporosis is getting worse: “At least 1.2 million women suffer fractures each year as a direct result of osteoporosis…. Fractures seem to be increasing, … and this difference cannot be explained by the aging of the population.”31
Let us hope that more medical doctors are getting away from the mainstream of drug therapy and are discovering natural remedies that seem to work more efficiently for such problems in the long run. Dr. Gaby, for instance, with over two decades of medical research and clinical practice, writes that many of the most significant advances and effective treatments have been those discovered or administered outside the auspices of the traditional medical community.
Dr. John Lee comments that modern medicine “strangely persists in the single-minded belief that estrogen is the mainstay of osteoporosis treatment for women.” Strange, indeed, that doctors should think like this, when even medical textbooks such as Harrison’s Principles of Internal Medicine (12th edition, 1991) and Cecil’s Textbook of Medicine (18th edition, 1988) don’t back up this theory.32 Along the same lines, Dr. Lee also quotes the 1991 Scientific American Medicine:
“Estrogens decrease bone resorption” but “associated with the decrease in bone resorption is a decrease in bone formation. Therefore, estrogens should not be expected to increase bone mass.” The authors also discuss estrogen side effects including the risk of endometrial cancer which “is increased six-fold in women who receive estrogen therapy for up to five years; the risk is increased 15-fold in long-term users.”33
Although there are many forms and ways to take natural progesterone, Dr. Lee acquaints us with the transdermal method. By carefully observing his patients over the course of fifteen years, he proved the effectiveness of transdermal progesterone cream. His work confirmed its safety and its remarkable benefits to his osteoporotic patients who had a history of cancer of the uterus or breast and to those who had diabetes, vascular disorders, and other conditions.
Dr. Lee had hoped that the progesterone would strengthen his patients’ bones. To his surprise, it did; their bone mineral density tests showed progressive improvement and the number of his patients suffering osteoporotic fracture dropped nearly to zero.34
Dr. Lee is perplexed at “the reluctance of contemporary medicine to adopt the use of natural progesterone.” It’s his impression, however, that “the news is spreading and change is on the way.” In the publication Natural Solutions, Dr. Lee voices true dismay with his orthopedic colleagues who chose not to use the progesterone cream in their patients’ care “but did put their own wives on the cream.”35
Dr. Lee points out that the “conventional treatment of osteoporosis with estrogen, with or without supplemental calcium and vitamin D, tends to delay bone mass loss, but not reverse it.”36 His investigation into using transdermal progesterone cream instead of a synthetic estrogen replacement treatment demonstrates that “osteoporosis subsided, musculoskeletal strength and mobility increased, and monthly vaginal bleeding did not occur.”37 Most striking were the results of the dual-photon densitometry test (DEXA), which measured a 10 to 15 percent increase in bone mineral density, most notably in women who had experienced menopause twenty-five years earlier.38
After years of researching transdermal progesterone supplementation, Dr. Lee observed in his patients “a progressive increase in bone mineral density and definite clinical improvement including fracture prevention….” He concluded that “osteoporosis reversal is a clinical reality using a natural form of progesterone derived from yams that is safe, uncomplicated and inexpensive.”39 Unfortunately, by the time many of us are ready to deal with the impact of osteoporosis it has already done considerable damage, as it is symptomless until the fractures begin. If you think that you can afford to wait to deal with brittle bones until after you get through the inconvenience of hot flashes and night sweats, you need to think again.
It is an enigma to me that our nation’s supposedly up-to-date medical researchers continue to be oblivious to the evidence that progesterone stimulates new bone formation by the osteoblasts, the bone-building cells.40 Think of the many aging women who could benefit from this information and be freed from unnecessary pain and spared their disability. As Gail Sheehy observes, osteoporosis “often leaves older women frail, susceptible to falls and broken bones…. [It] makes it painful merely to sit.” Many elderly osteoporotic women die of secondary infections following hip surgery.41 These infections are what makes osteoporosis victims subject to death, not the osteoporosis itself.
Reading about this reminded me again of my mother’s fragile condition as her hip bones grew so weak she could hardly get out of a chair. The longer she sat in one place, the more pain she felt. Before long she had to depend on a wheelchair to get around, and in an even shorter time she yielded to a hospital bed in our home. We felt blessed that she at least did not have to enter a nursing home, as so many do.
Establishing a baseline bone mineral density (BMD) is of vital importance for all women as they make the transition from monthly ovulatory cycles to the early menopausal stage that heralds the onset of accelerated bone loss. Currently, the most precise test with the least radiation dose is dual X-ray absorptiometry (DEXA or DXA), which yields an accuracy of 98 to 99 percent on a study of the lumbar spine and hips.42 Another highly reliable scan is the dual photon absorptiometry (DPA) test, which is 95 to 98 percent accurate and uses photons (high-intensity light beams) to determine the density of your bone. The importance of such testing cannot be overemphasized, as osteoporosis is asymptomatic in its earlier stages. Multiple scans, several years apart, from the mid-forties (baseline evaluation) to the mid-sixties will give women an accurate picture of their BMD status as well as feedback regarding the efficacy of the HRT program they are using. (Please see chapter 7 for additional diagnostic resources.)
Dr. Lee has found these tests extremely useful. One woman in her seventies consulted him for her advanced osteoporosis and spinal compression fractures:
She had previously avoided hormone therapy because of a long history of fibrocystic breasts prior to menopause. With natural progesterone applications, her BMD (bone mineral density test) rose gratifyingly, her back pains disappeared, and she resumed normal activities such as hiking, boating, gardening, etc.43
The women who received the best results from the progesterone studies were those who seemed to need it the most. In other words, as progesterone was administered to women with all levels of bone loss, regardless of age (whether seventy or thirty-five), those with the lowest initial bone densities had the greatest increases in bone mass.44
I’m pleased to say that I myself can be counted among the success stories. I happened to attend a health fair and had the chance for on-the-spot bone mineral density testing. The mini DEXA screening test assesses the BMD of the middle finger or the heel of the foot.
Apprehensively I took advantage of this opportunity, fearing the worst because of my age (64) and my family history. But after years of adhering faithfully to the many nutritional guidelines I’d learned about while researching this book (including the use of progesterone, of course), I had to know what effect my own lifestyle choices were having on my bone mass.
To my great surprise and relief, tests on both my finger and my foot confirmed that my bone density was better not only than that of most women my age, but of normal, healthy women who are much younger! Here is my scoring:
Bone Mineral Density (BMD)
Age-Matched BMD: 117%
(17% higher than others of similar age)
Young Healthy Normals (YHN): 109%
(9% higher than others who are considered to be young healthy normals)
Dr. Lee cautions against relying on the hair analysis testing some laboratories do supposedly to diagnose osteoporosis. The reason is that at this point in the resorption process, calcium will naturally register high—because all the calcium that has been released from the bone is now circulating in the bloodstream and is being picked up by the hair. When the lab reports you have a good level of calcium and there is no need to worry about osteoporosis, be wary; he says it is wrong to use this test to measure whether or not osteoporosis is present and extra magnesium and calcium are needed.
A study was conducted with a hundred patients who ranged in age from thirty-eight to eighty-three years. They were all menopausal or postmenopausal. The majority of these women had already noticed a loss of height due to compression fracture of the spinal vertebrae from age-related bone thinning. Dr. Lee calls this “a cardinal sign of osteoporosis.” A number had also experienced fractures of other skeletal bones, such as hips or ribs. We read in Medical Hypotheses:
Since the U.S. medical insurance does not include payment for dual photon bone density tests …,* only 63 of the patients were [covered for] serial testing. Thus, 37 patients could be followed only by clinical signs, i.e., relief of osteoporotic symptoms and reduction in expected fracture incidence. Even so, the benefits from the treatment program [see below] were so obvious to these patients that no problems with patient compliance arose. No side-effects or adverse alterations in blood lipids were observed. Each patient was followed a minimum of 3 years.45
Of the hundred patients in this group, the report states that “height loss was stabilized” and there was an associated relief from osteoporotic pains. The amazing findings of the test given to determine bone density measurements of the lumbar vertebrae (serial DPA) included (1) reduction in fracture incidence and (2) increase in bone density. Most of these women were responding to a transdermal progesterone dose of only 240 mg per month or 10 mg per day. In the sixty-three women given natural progesterone, the benefit proved to be extraordinary—showing that in three years, instead of losing 4.5 percent of bone as expected, some subjects actually increased their bone density by 15.4 percent, regardless of their age. This report confirms that the greatest relative improvement was made by those with the lowest bone density to begin with.46
Further, the study refuted the myth that osteoporosis is irreversible for older women, or even that it is more difficult to correct. Indeed, test subjects over the age of seventy (the oldest was eighty-three) showed somewhat better results than those under the age of seventy. The former responded to the progesterone therapy regimen with an average increase in bone density over the three-year period of 14.4 percent, while the younger women showed an increase of just 14.0 percent.47
Many similar studies can be found in the International Clinical Nutrition Review. In them, not only were the benefits to skeletal strength observed, but patient complaints such as gastric irritation, joint stiffness, moodiness, and headaches were also relieved. Aside from the safety and effectiveness of using a natural progesterone, it has proven to be extremely cost-efficient—about one-tenth the cost of the same dosage of medroxyprogesterone (Provera), and it comes with no side effects.48
We need to reiterate, then, the important point that Dr. Lee makes in the International Clinical Nutrition Review. Natural transdermal progesterone cream, he says, “is the missing link in healthy bone building in postmenopausal women.” Concerning osteoporosis he says, “Reversal has been demonstrated by the bone density tests and by the clinical results. This cannot be said of any other conventional therapy for osteoporosis.”49
The conclusion of twelve different reports is that progesterone deficiency rather than estrogen deficiency is one of the main factors in the development of menopausal osteoporosis. Dr. Lee found the best overall results when his patients combined use of the natural progesterone with optimal nutrition. Women were given a “low protein, high vegetable diet, modest exercise and vitamin supplementation.” Dr. Lee recommended supplemental estrogen in the form of estriol only when his patients experienced hot flashes, cystitis, or vaginal dryness that did not subside after three to six months of natural progesterone treatment.50 (Also see chapter 3 and appendix A.)
Dr. Lee informs us that “age is not the cause of osteoporosis; poor nutrition, lack of exercise, and progesterone deficiency are the major factors.”51 He says osteoporosis seems to be more common in “white women of northern European extraction who are relatively thin” or who smoke cigarettes, are under-exercised, are deficient in vitamins A, D, or C, calcium, or magnesium, or whose diet is meat-based rather than vegetable- (especially alkalinizing greens) and whole grain-based.52 Dr. Gaby confirms some of these observations on the basis of numerous studies. It was found that the most comprehensive program (one that included proper diet, botanical progesterone, and a broad spectrum of vitamins and minerals) produced an astounding 11 percent increase in bone mineral content in postmenopausal women in less than one year. Any one aspect of treatment used alone could never have come close to bringing such improvement in such a short period of time.53
Jonathan V. Wright, M.D., an expert in nutritional biochemistry, applauds Dr. Gaby for going “beyond the calcium craze to a holistic approach to healthy bones.” He says, “What’s good for the bones is good for the heart, the skin, the breasts, the stomach, and even crucial for future generations.”54
We need to take these experts’ advice and question the end result of the extra protein we eat. “A nutritional program that is more than 30 percent protein increases calcium excretion,” says Serafina Corsello, M.D., “because metabolism of the protein acidifies the body, which then tries to achieve normal alkaline balance by excreting calcium.”55
Both kidney stones and kidney failure are an indication that acidosis may be silently weakening our bones as well as impacting the kidneys. In the periodical Health Science, we learn that meat eaters have a much higher rate of osteoporosis than vegetarians, even though vegetarians have a lower calcium intake. The conclusion from this research is that the best prevention for osteoporosis is a relatively low-protein diet and plenty of fresh fruits and vegetables. This may provide enough calcium without the need for dairy products. In fact, who would believe that a half cup of sesame seeds contains 870 mg of calcium?56
According to Joel Fuhrman, M.D., protein from meat also contains a large quantity of disulfide bonds, which, “while undergoing oxidation when broken down, create sulfate and hydrogen ions that further increase the acid load in the blood. To neutralize this acid load, the body calls on its bony stores of calcium to provide basic [alkaline] calcium salts…. In addition, urea and other waste products from excess protein digestion cause the kidney to work harder and excrete more fluid and with this increased function more calcium is lost in the process.”57 Under these conditions the kidney is not able to reabsorb calcium before it is evacuated, and the consequence is more calcium lost via the urine.
Dr. Fuhrman cautions that calcium loss is stimulated in a variety of ways. For instance, with cigarette smoking, the nicotine disrupts hormone communication to the kidneys, curtailing calcium reabsorption. Antacids (with aluminum added), diuretics, and antibiotics also contribute to the loss.58 And most significant, affecting young and old alike, are soft drinks. Read the labels before you quench your thirst. Many sodas contain not only caffeine but sodium and phosphoric acid—all of which contribute to bone loss in different ways.59 As Dr. Fuhrman tells us in Health Science:
Phosphates have been shown to increase the release of parathyroid hormones, which mobilizes skeletal calcium reserves. The phosphoric acid found in carbonated drinks is particularly damaging, and is more powerful in inducing calcium excretion than is the phosphorus contained in natural foods.60
People who habitually drink soda are oblivious to the fact that many brands contain this dangerous ingredient. Unknown to most consumers, the phosphoric acid is insidiously robbing calcium from our teeth and bones. Phosphates are even added to processed foods such as cheeses and meats. If soda drinkers also eat too much meat (high in phosphorus), they are adding to an already serious problem.61 This aspect of malnutrition may be causing unsuspected bone loss as well as other degenerative disorders in many thousands of Americans. To moniter how much calcium is being lost in the urine, please see chapter 7, pages 191–192, where we talk about a home urine test kit.
The widespread use of phosphate additives in processed foods can create a phosphorus overload that disrupts the body chemistry, especially when the typical American diet also includes plenty of other sources of this mineral.62 A sampling of foods relatively high in phosphorus includes processed meats, turkey, ham, pork, fried potatoes, crackers, legumes, nuts, salmon, eggs, brewer’s yeast, asparagus, and whole grains.63, 64 The Herb Quarterly suggests avoiding the following to prevent osteoporosis: dairy products, coffee, alcohol, salt, and sugar; and that eating “a diet rich in dark-green leafy vegetables, nuts, seeds, tofu, [and] molasses”65 will assist in reversing osteoporosis.
A key benefit to eating plenty of raw vegetables is their effect on the body’s acid-alkaline (pH) balance. When certain foods (such as dairy products, meat, cooked foods, coffee and tea, and refined flour, sugar, and table salt) are metabolized, they create an acidic effect in the body.66 Others, such as many fruits and vegetables, as well as some whole grains, have an alkaline effect when metabolized.
Joel Robbins, M.D., N.D., D.C., lectures his patients that the secret to health is to try to consume approximately 80 percent of our diet in “alkaline” foods and 20 percent in acid-producing foods. When the alkaline percentage drops below 80, we lack sufficient catalyst minerals to keep the cells healthy. The body, in its innate wisdom, thus compensates by robbing from other areas, such as the bones, to neutralize the excess acidity. That’s why an acid-alkaline imbalance plays such a large role in the onset of the osteoporotic process.67
Dr. Robbins says it’s unfortunate that of the foods we commonly eat, far more than 20 percent cause an acidic response when metabolized. But if we concentrate on keeping the alkaline percentage in the 80s, we will ensure that there will be enough nutrients to balance the 20 percent of acid-producing food we may wish to consume, including meats and other foods.68 Dietary supplements such as wheatgrass, green barley, and kelp are high in minerals and chlorophyll69, 70 and go a long way to help restore the body’s pH balance.
According to the American Journal of Clinical Nutrition, studies involving sixteen hundred women disclosed that those who eat “a vegetarian diet for at least 20 years have 18 percent less bone mineral by age 80, whereas meat eaters have 35 percent less bone mineral.”71 Other interesting statistics have appeared in many nutritional reviews, such as this one from the Center for Women’s Health at Columbia-Presbyterian Medical Center in New York: A diet containing more vegetables and fewer of the harmful kinds of fats72 (such as hydrogenated and polyunsaturated oils) has been associated with fewer female disorders identified with PMS or menopause.73–75 However, if you do include meat in your diet, take a little time to ask your grocer to purchase your meat from one of the free-range and organic meat producers listed in appendix E. Most of these brands of meat are free of antibiotics, growth hormone stimulants, herbicides, and pesticides.
Many American women are being told by their physicians that one of the most efficient and inexpensive ways to supplement their calcium intake to prevent osteoporosis is with ordinary antacid medications (such as Tums). These mainly contain calcium carbonate, which may be inexpensive but is also one of the forms most poorly absorbed by the body.76 According to John Mills, Total Quality Manager at the Highland Laboratory (Mt. Angel, Oregon), if your stomach is not functioning normally the calcium carbonate in the antacid will not remain dissolved long enough to be absorbed in the intestine and then be conveyed to where it is needed in the body (bones, teeth, and muscles). It will pass through the intestines without being assimilated, contributing to constipation.77 (A more usable form of calcium is discussed below.)
Antacids in general may temporarily relieve symptoms of indigestion, but they do more harm than good in the long run as they may “contain aluminum, silicone, sugar, and a long list of dyes and preservatives, none of which will help you and may even harm you,” reports Dr. John Lee.78 He warns us, regardless of what your pharmacist or doctor says, not to try to obtain extra calcium by taking antacid tablets, as their side effects may far outweigh any benefits you would gain from their use.79
Other well-intentioned measures in common practice are also suspect. John McDougall, M.D., notes cases in which people took calcium without understanding what else contributes to its absorption or loss. Consumption of too much protein can result in excessive calcium excretion and cause the body’s calcium reserve in the bones to be at risk. “Experiments have shown that when subjects consumed 75 grams of protein daily, even with an intake as high as 1400 milligrams of calcium, more calcium was lost in the urine than was actually absorbed.”80
Bones are dependent upon much more than just calcium. In his book on preventing osteoporosis, Dr. Gaby explains in detail:
Magnesium is necessary to promote normal bone mineralization; silicon, manganese, and vitamin C are also essential for proper formation of cartilage and other organic components of bone; vitamin K is needed to attract calcium to the bones. It plays a role in remodeling and repair; vitamin D is necessary for absorption of calcium from the diet; zinc and copper are involved in repair mechanisms, presumably including those that occur in bone.81
Today we are finding that due to low levels of vitamin D, calcium is not being utilized properly. A vitamin D deficiency can decrease insulin levels as well as increase its resistance—both of these factors are linked with diabetes and cardiovascular problems. Dr. David Williams states that “any amount of vitamin D intake under 800 I.U. [isn’t] enough to prevent a vitamin deficiency.” This is another important consideration in preventing osteoporosis and other related diseases. It is interesting to note that this amount is almost twice as much as the daily amount recommended by the U.S. Food and Nutrition board.82
The importance of magnesium is easy to underestimate. As Dr. Lee says, “If magnesium is deficient, calcium is less likely to become bone and more likely to appear as calcification of tendon insertion points … leading to tendinitis, bursitis, arthritis, and bone spurs.”83
Magnesium plays a fundamental role throughout the body as an enzyme catalyst for the skeletal uptake of calcium and potassium.84, 85 It’s an essential partner of calcium and can be taken as a supplement in at least equal amounts.86 And since stress, such as that brought on by drugs or by physical or emotional strain, is known to deplete magnesium, many practitioners recommend an even higher magnesium-to-calcium ratio.87 Dr. Gaby’s findings suggest that “boron has a powerful influence on the metabolism of calcium, magnesium and some hormones.”88
Sucrose and refined carbohydrates will also deplete us of the minerals we may think we are getting from our diet,89 as well as alter the mineral ration in the blood.90 High glucose ingestion (from refined carbohydrates) interferes with mineral metabolism by reducing calcium resorption in the kidneys and increasing its urinary excretion. This in turn leads to a magnesium deficiency and eventually affects the health of the bones.91–93
It is advised by some that if we choose to take calcium supplements, we should take twice as much magnesium as calcium on a daily basis (approximately 800 mg of calcium and 1,500 mg of magnesium).94 Dr. Gaby says that magnesium has been a forgotten mineral and that at least a one-to-one ratio of magnesium to calcium (if not two-to-one) would lead to stronger bones and less inappropriate calcium deposition in places where calcium does not belong.95 When he put his patients with premenstrual syndrome on only 400 mg of calcium plus 800 mg of magnesium, he saw improvement as well.96
Dr. Guy Abraham, a gynecologist in Torrance, California, also reversed the calcium-to-magnesium formula in a trial of twenty-six postmenopausal women. They were given daily supplements of 600 mg of magnesium (oxide) and 500 mg of calcium (citrate). The women were also on a high-vegetable, low-protein diet and their supplements included C, B complex, D, zinc, copper, manganese, and boron. After eight to nine months the women’s bone mineral density increased 11 percent with these higher amounts of magnesium.97
David Smallbone, M.D., of Buxton, England, further increases the amount of magnesium for women who are under a lot of stress (1,800 mg magnesium with 1,600 mg calcium).98 He also suggests taking calcium before bedtime.
Sodium, too, should not be overlooked. Dr. Bernard Jensen says that it’s the elemental sodium from vegetables that we need, and that another excellent source is whey,99 not the overused table salt that only causes further metabolic imbalances. While an excess of sodium in the body may lead to calcium depletion, however, it is also not unusual to be lacking in this vital mineral, one of whose functions is to neutralize body acids. When we are deficient in sodium, calcium is pulled out of solution for this purpose and often ends up in the joints and tissues instead of supporting our osseous framework.
In all, there are seventeen minerals that Nancy Appleton, Ph.D., a well-known author and nutritional consultant calls “essential in human nutrition. If there is a shortage of just one of these,” she writes, “the balance of activity in the entire system can be thrown off.”100 James Balch, M.D., and Phyllis Balch, C.N.C., state in Prescription for Nutritional Healing that “a proper balance of magnesium, calcium, and phosphorus should be maintained at all times,”101 along with the various other minerals and vitamins that work synergistically with one another as catalysts and promote the assimilation of nutrients. This, according to the Balchs, “is why taking a single vitamin or mineral may be ineffective, or even dangerous.”102
It’s becoming abundantly clear, then, that concentrating on calcium alone can cause serious problems. Dr. Morton Walker, too, knows that for calcium to be properly metabolized, the right amounts of magnesium, phosphorus, and vitamins D (the “sunshine vitamin”), C, and A must also be present.
When properly absorbed, he says, calcium is the nutrient that “helps to overcome cramping in the legs and feet.”103
To prevent brittle bones, Dr. Carlton Fredricks recommends cod liver oil as an excellent food source for high quality vitamin D. It is suggested by Dr. Raymond Peat that vitamin E should always be taken with D as the vitamin D in cod liver oil somewhat increases one’s need for vitamin E.104, 105 Researcher and author Elaine Hollingsworth says that “vitamin D in the form of cod liver oil… contains all of the Omega-3 and vitamin A that is needed each day.”106 It’s important to learn that the best brands are those that obtain their cod liver oil from codfish in the deep, unpolluted waters near Norway.* Krispin Sullivan, a clinical nutritionist, says that Norwegian cod liver oil is naturally rich in vitamin A, vitamin D3, EPA, and DHA. Only codfish caught during the winter and early spring are used, as the liver oil content is highest at this time of year.
Sullivan says that “in Northern California 80% of clients tested in winter months have serious D deficiency … This problem increases dramatically in more northern latitudes.” Even in Southern California a lack of vitamind D is possible due to so many people avoiding the midday sunlight and slathering themselves with sunscreens. For more information on the dos and don’ts of vitamin D, how much to take and what to take it with, take a look at the Web site www.carlsonlabs.com or call (800) 323-4141.
Referring to a study in Acta Endocrinologica, Dr. Gaby comments that the mineral zinc “enhances the biochemical actions of vitamin D, which is itself involved in calcium absorption and osteoporosis prevention. Because of its essential role in DNA and protein synthesis, zinc is required for the formation of osteoblasts and osteoclasts, as well as for the synthesis of various proteins found in bone tissue.” In another investigation drawn from Acta Medica Scan-dinavica, Dr. Gaby tells us that “zinc levels were found to be low in the serum and bone of elderly individuals with osteoporosis…. The most efficiently absorbed types of zinc,” he advises, “are zinc picolinate, citrate and chelated.”107
Dr. Lee adds that “zinc is essential as a co-catalyst for enzymes which convert betacarotene to vitamin A within cells. This is especially important in building the collagen matrix of cartilage and bone. As with magnesium, zinc is one of the minerals lost in the ‘refining’ of grain. As a result, the typical American diet is deficient in zinc and modest supplementation (15–30 mg/day) is recommended.”108
Other nutrients with an important role in calcium absorption include silica and pectin.109 Found in unpeeled apples, citrus fruits, the cabbage and broccoli family, and many other fruits and vegetables, pectin transports calcium molecules to the large intestine for slow absorption into the body (as well as neutralization of potentially cancerous toxins). The authors of The Calcium Connection, Drs. Cedric and Frank Garland, also stress the importance of drinking plenty of water to help dissolve and absorb dietary or supplemental calcium.110
Concerning calcium and hormones, Gail Sheehy advises that just taking calcium is not enough and that exercise by itself is also ineffective in preventing bone loss.111 The combination of weight-bearing exercise, proper diet, and the appropriate kind of calcium (see “Misconceptions about Calcium and Diet,” this chapter), along with natural hormone replacement therapy, has been shown to increase bone mass and decrease symptoms of insomnia and hot flashes. Citing a study from the Netherlands, Gail Sheehy also notes that “vitamin K has been found to inhibit the precipitous loss of calcium in postmenopausal women by up to 50 percent…. Dark green leafy vegetables like broccoli and Brussels sprouts are sources of vitamin K.”112
We might want to think twice before a “professional” directs us to calcium supplements alone and consider Nancy Appleton’s warning about the possible harmful aspects of calcium supplementation. “Excess calcium,” she says, “can be redistributed in the body and is often deposited in soft tissues, possibly causing arthritis, arteriosclerosis, glaucoma, kidney stones and other problems.”113
Furthermore, says Ruth Sackman in Cancer Forum, “Fragmented supplements [e.g., calcium that has been separated from other natural components of food] can actually cause a deficiency of the very supplement that is being used because it robs the body’s storage areas (bones, nails, muscles, hair, etc.) in order to reconstruct the natural complex found in nature. To avoid the risk of bone loss from calcium deprivation, why not use foods rich in calcium?” From raw almonds to dried beans to parsley, many valuable foods are identified by books on nutrition.114 Dr. Lee, pointing out that “cows get the calcium for their bones and their milk from plants they eat,” says that among the best sources of dietary calcium are fruits and, especially, broadleaf vegetables.115 For example, one cup of collard greens contains 289 mg of functional calcium, one cup of kale 210 mg, and one cup of spinach 200 mg. From a four-ounce serving of scallops we can get 110 mg, and as much as 500 mg from sardines.116
When women are told to take high doses of only calcium, it’s a real cause for concern. Calcium supplements taken without the necessary co-minerals have the potential to cause harm and even contribute to osteoporosis,117, 118 the very disease one is trying to prevent. Minerals, vitamins, and enzymes perform synergistically with each other,119, 120 and “work as catalysts, promoting the absorption and assimilation of other vitamins and minerals.”121 Indeed, Nancy Appleton says that such imbalances can cause arthritis, kidney stones, or gallstones.122
In the past, however, when I did use a calcium supplement I deliberately chose one without phosphorus as an ingredient, and I noticed that this mineral is generally not included in commercial daily multivitamin/mineral products or most calcium/magnesium supplements. I assumed I was getting enough from my diet, which included foods rich in this mineral. By the same token I had tried to avoid those that are high in phosphoric acid, knowing that its metabolites may upset the mineral balance.123 One authority even states that we need at least 2 to 2½ times as much dietary calcium as phosphorus,124 yet the Recommended Dietary Allowances (RDAs) for adults have for years called for approximately a one-to-one ratio of calcium to phosphorus.125
We learn that an excess of phosphorus can create a calcium deficiency by binding calcium in the gut and rendering it useless, just as it can also bind up other important minerals.126 Studies reported in the Journal of Nutrition confirm that high intakes of phosphorus (or its metabolites) may lead to overstimulation of the parathyroid gland, impaired synthesis of the active form of vitamin D, and (especially in older women) a disruption of calcium homeostasis, all of which eventually lead to bone loss.127 However, if one’s dietary phosphorus intakes were lower than the normal, and then if one’s calcium intake were increased without a change in the phosphorus level, the surplus calcium could become toxic,128 says Dr. Appleton.
Even though the typical American diet contains an excess of phosphorus (perhaps the reason the majority of supplement products do not include this mineral), it seems that certain types of diets may actually be deficient in phosphorus. As a guideline for modifying or supplementing your diet, Dr. Appleton provides a home test kit (P.O. Box 3083, Santa Monica, CA 90403) for determining your own calcium/phosphorus status, which can be used as an indicator of your mineral ratio.
Although many more objective studies are needed, especially concerning the calcium/phosphorus ratio, I believe that if one is to take mineral supplements, the research supports including all the minerals as needed and in their correct ratio for proper calcium absorption. Incidentally, it’s worth noting that since many “trace” minerals can be toxic in nonphysiological doses, a natural source such as sea vegetable capsules or green food extracts, like spirulina, barley green, chlorella, or sea vegetation, taken as directed, may be one way of obtaining a safer balance.
All this investigation has made me focus on the likelihood that, in addition to osteoporosis, joint disorders such as temporomandibular joint syndrome (TMJ) and bone spurs might also be exacerbated by an imbalance in the mineral ratio. My research into this subject has uncovered a wealth of important information on joint health, which motivated me to write Preventing and Reversing Arthritis Naturally in order to explain how, once again, the quality of our lives depends upon the nutritional choices we make.
It’s important to understand what our bodies need, since it is currently predicted that one out of every three women will eventually suffer from low bone mass and structural weakness leading to fractures and possible skeletal deformity.129 Women face at least a 15 percent risk of hip fracture. The annual cost of this trauma, which could be reduced by preventive efforts, is estimated at $7.3 billion in the United States—an amount that is rising each year. We need to focus on what we can do to circumvent such statistics in our lives—to achieve a healthy state of mind and body so as to have the energy to pursue our creative passions and goals to their fullest.
These figures constitute a national tragedy, considering that many of these women were faithfully subjecting themselves to synthetic HRT (with all its side effects)—and to what end? Their hips fractured just like those of the women who chose not to use any estrogen at all. This will seem even more of a crime when you read the following discussion of the role progesterone plays in bone formation.
This report, dealing with the prevention of osteoporosis, comes from the Canadian Journal of OB/Gyn & Women’s Health Care. The authors, of the Division of Endocrinology and Metabolism at the University of British Columbia in Vancouver, state:
Progesterone acts on bone, even though estrogen activity is low or absent. Because progesterone appears to work on the osteoblast to increase bone formation, it would complement the actions of estrogen to decrease bone resorption.130
The authors go on to explain that progesterone fastens to receptors on the osteoblasts (the bone-building cells) and “increases the rate of bone remodeling.”131 It is interesting to note once again that the role of estrogen is to slow down bone loss, while natural progesterone actually promotes bone production. Dr. Lee concludes from several studies that (1) estrogen slows down the dissolving of bone by the “osteoclast” (bone-resorbing) cells, (2) natural progesterone stimulates the formation of new bone, and (3) certain progestins may also cause the osteoblasts to create a limited amount of new bone.132
However, some studies have shown that the synthetic progestins normally prescribed by our doctors may actually diminish our supply of natural progesterone.133 Many of our gynecologists do realize the destructive effect these synthetic progestins have on the body. This may be a major factor in why they prescribe estrogen alone.
I believe we must always be on guard against any over-the-counter or prescription drugs that speed the dissolving of bone—a process called resorption. Trien Susan Falmholtz, in her book Change of Life, speaks about various commonly prescribed drugs that are known to lead to the dreaded condition of osteoporosis. These include thyroid replacement drugs such as synthroid; “heparin (an anticoagulant); cortisone preparations (such as prednisone); aluminumcontaining antacids; anti-convulsants; and the antibiotic drug tetracycline.”134
At the University of Massachusetts, a research project centered on the use of levothyroxine for treating thyroid problems. In certain circumstances this commonly prescribed hormone was found to cause as much as 13 percent bone loss.135 A thyroid specialist I spoke with, however, says that this report has been quoted out of context and blown out of proportion. The main point to keep in mind is that dosages should never be prescribed in excess of demonstrated need, or for the wrong reason (such as for weight loss, when the gain was not caused by a thyroid deficiency).
Another example is giving thyroid medication simply for a low basal body temperature (a test often used by adherents of Dr. Broda Barnes), without other clear evidence of thyroid insufficiency. This type of test is also used for fertility problems to determine the time of ovulation and thus reflects a woman’s progesterone level. Progesterone and thyroid are very much interrelated, but in some cases all that is needed is natural progesterone to correct an abnormally low body temperature. Dr. Peat believes that the mechanism by which progesterone raises the temperature prevents estrogen from blocking the action of thyroid hormone, because only in women is progesterone thermogenic.136
Dr. John Lee makes the point that a doctor who does not understand progesterone deficiency may give thyroid medication to someone who doesn’t need it. This excess thyroid will increase the rate of bone resorption. However, when thyroid hormone is replaced for the purpose of restoring it to normal, it doesn’t cause bone loss. In fact, the right dosage will improve bone density. As Dr. Lee explained to me, “It’s not the thyroid that should be feared; it’s the doctor who gives thyroid when you don’t need it.”
Noting another medicinal hazard, Dr. Alan Gaby describes a study of twenty patients who were scheduled for brain surgery. Some of them were given Maalox 70 to prevent stress and ulcers. This antacid is rich in aluminum, and the research team found, after analyzing brain and bone tissue, that this toxic substance had been absorbed into the body and deposited in the osseous tissues resulting in increased bone resorption. Dr. Gaby recapitulates information from the studies, saying that “the accumulation of aluminum in bone appears to reduce the formation of osteoid [areas of new bone], while at the same time increasing the amount of bone resorption. The result of this dual action of aluminum would be to accelerate bone loss.”137
This is a good place to say just a word about the dangers of taking the latest “miracle” drug to prevent bone loss. We are always reading or hearing in the media about experimental drugs, new hormones, or even new compounds that activate bone growth. Highly advertised drugs come onto the market quickly and sometimes, fortunately, leave with just as much speed.
In case you have been considering the drug of the day, Fosamax, for osteoporosis, please reconsider. First of all, Dr. John Lee reports that when women take Fosamax, “The old bone remains in place and over time begins to crumble, and eventually this is likely to cause the fracture rate to sharply increase.”138 Like estrogen replacement therapy, Fosamax only helps to slow bone breakdown and does not stimulate the buildup of new bone. This temporary saving of the bone (even registering as an increase on BMD tests) only appears to be preventing osteoporosis; in reality it’s a temporary crutch and an advertising gimmick that took years to promote. Over time, the preservation of our older, more brittle bone will take its toll.
Clinical trials show that after approximately five years the “apparent” bone density retention reverses itself and the fracture rate increases, even over that of women taking a placebo.139 In the case of Fosamax, in spite of misleading statistics in the product advertisements, not only does this drug not lessen the chances of hip fracture, but it actually increases the risk of wrist fractures.140–142
We need to consider the potential side effects from the use of Fosamax as well. These include musculoskeletal pain, headache, and gastrointestinal problems, especially ulceration of the esophagus and stomach that may result in permanent damage. This drug comes with explicit instructions that you must not lie down for thirty minutes after its ingestion. As consumers of such products, we women are beginning to question why we are encouraged to take a drug that invites such risks and whose supposed benefits are not even guaranteed!
Dr. Lee goes on to tell us that “Fosamax also causes deficiencies of calcium, magnesium, and vitamin D, all essential to the bone-building process,”143 and that “rats given high doses [of Fosamax] develop thyroid and adrenal tumors.”144 According to Amy McWilliams, Pharm.D. and Jason Sauberan, Pharm.D., we have insufficient data about its long-term adverse effects or its use in osteoporosis prevention, and Fosamax should not be used if you are deficient in calcium or vitamin D. Note that it unnaturally inhibits the osteoclasts and has not been shown to reduce the risk of cardiovascular disease.145
Our doctors and the advertising media are also now heavily promoting another drug to postmenopausal women supposedly to combat osteoporosis. Evista (raloxifene hydrochloride) is known as a “selective estrogen receptor modulator (SERM)” and comes with a multitude of what Samuel S. Epstein, M.D. refers to as “reckless claims.”146 SERMs have gained acceptance on the sole basis of their impact on the estrogen receptors, without regard to their unknown long-term effects. Another concern is the fact that the estrogens they are attempting to control are known to operate via various metabolic and neurological pathways and not just through the estrogen receptors.147, 148
In the “Information for the Patient” leaflet that comes with Evista are noted the adverse events that occurred during clinical trials: breast pain, vaginal bleeding, flatulence, hot flashes, infection, abdominal pain, and chest pain.149 Other pharmaceutical literature cautions about liver problems, blood clotting in the veins, leg cramps, chest pain, coughing up blood from the lungs, and eye disturbances from Evista (due to possible formation of blood clots).150 Breast and uterine cancer studies were conducted over a period of only three years or less, and the manufacturer even states that the drug “has not been adequately studied in women with a prior history of breast cancer.”151 Additionally, like many synthetic drugs, Evista is formulated in a base containing substances such as aluminum, carnauba wax, preservatives, and artificial coloring. Many of these compounds not only cause allergic reactions but may also be carcinogenic.
Nor does the company warn of the “serious risks of ovarian cancer,” says Dr. Epstein, who notes that its premarket clearance study “clearly shows that Evista induces ovarian cancer in both mice and rats. Furthermore, carcinogenic effects were noted at dosages extending well below the recommended therapeutic level.”152 This critical information, along with an admission that Evista’s effect on fractures is not yet known, is absent from both the full-page colored ads and the “Warnings” to patients and doctors. Dr. Epstein believes the manufacturer owes free, lifelong ovarian cancer screening to the over 12,000 women who participated in the clinical trials with uninformed consent. He concludes, “This drug should be withdrawn from the world market immediately.”153
The ongoing parade of fashionable new drugs orchestrated by the drug companies will no doubt continue in the coming years, with the ones we are now talking about being replaced by others because these will have been found to be harmful, and, in the long run, futile attempts at treating or preventing osteoporosis. History reveals over and over that the whole business of developing new drugs is about profit, not about health.
We can always take our cue from the manufacturer’s recital of potential effects. Unless facing an emergency situation, we’d do well to consider the risks and look long and hard at all available alternatives. As Dr. Udo Erasmus reminds us, “Drugs are foreign to the body and therefore all drugs are toxic.”154 Perhaps we also need to remember Hippocrates’ wise advice advocating letting food be our medicine and medicine be our food.
In exploring the importance of enzymes and vitamins to aid in the digestion of meat protein so that calcium will not be lost in the blood, I came across some information regarding salmon calcitonin that at first reading seemed to make it another good choice for those who are suffering from severe bone loss. Few physicians seem to be aware of salmon calcitonin, which slows calcium resorption. Calcitonin is “found in humans (as well as in salmon, pigs, eels and sheep),”155 according to an article in Prevention magazine. The author, Sydney Bonnick, says that calcitonin is a hormone that is manufactured by the thyroid gland. Its function is to deter the movement of calcium from the bone to the blood. Calcitonin has even been found to “relieve pain from fractured bones, and [it] may actually stimulate the formation of new bone.”156
The reason it is not used more readily for those suffering from osteoporosis is that it is extremely expensive, costing approximately $2,700 per year; and it is quite inconvenient to administer via intramuscular or subcutaneous injections.157 In the United States it is currently delivered by means of a daily injection of 100 I.U.158 Although the synthetic versions of calcitonin, such as Calcimar, have been approved by the FDA for the treatment of osteoporosis, the literature on these products discusses possible severe allergic reactions, including anaphylactic shock, as well as nausea, vomiting,159 and other possible side effects.
The above studies should make us more cautious when we hear about osteoporosis study groups that provide free medication. The other day such an experiment was announced on the radio, touting a miraculous “breakthrough in medicine” that sounded like the wonder drug of the century for the prevention of osteoporosis.
Curiosity had gotten the better of me. Being most interested in the subject, I had to call the toll-free number and ask the name of the drug. The person who answered said, “You are probably well aware that estrogen is needed for all women suffering from osteoporosis.” She went on to say that estrogen is essential for the building of bones, and without its use we will increase our chances of osteoporosis. She then invited me to become part of this study group that, as it turns out, was for raloxifene. Learning that it was a synthetic drug quickly ended my curiosity—but not my desire to want to reach those who would say “yes” to this proposal.
All of this highlights the potentially catastrophic consequences of not being informed about natural health care. Not long ago I met a woman in my workplace who must have been in her sixties. She was walking with a lot of difficulty. I was telling her what I’d learned about hormones and osteoporosis. She said to me that she had always refused to take pills of any kind; in fact, she was quite vehement about this. She told me that ten years earlier she’d had a hip replacement, and because her other hip was now showing the same signs and giving her trouble, she had been asked to be a candidate for a national double-blind osteoporosis study group.
I felt so sad for her, because she’d been so determined to stay healthy by not taking any medicine—and now here she was, desperately taking pills every morning and evening. She was not even allowed to know whether she was taking a placebo or an active substance. She was living day to day with little hope—only the fear that her other hip would also need to be replaced. She looked at me and said, “What you’re saying about hormone deficiency is interesting, because all my problems started when I was in my forties, right after my hysterectomy.”
I thought to myself, “For twenty years she has had no hormone replacement therapy.” This woman, prior to her hysterectomy, had been very active and pain-free, and I could tell she had so much inner drive and energy that she was no longer able to express. I tried to picture in my mind what she would have been like now had she received natural hormone therapy before all these permanent changes occurred. Her devastating situation deeply influenced my determination to write this book.
Another account that fueled my interest in sharing this needed information came from a dear friend in her seventies. She was a former surgical nurse and, needless to say, had always been health conscious, trying to follow her doctors’ orders to the letter. Well, my friend had just heard from her orthopedic surgeon the shocking news that she had quite a lot of bone loss. He proposed that she be thinking about a hip replacement. She recalls driving home with tears of disbelief at this news thinking: “How could this be, when I’ve always taken preventive cautions so as to avoid this dreaded diagnosis of osteoporosis?”
She finally telephoned me and said, “I don’t understand why I’m having bone loss. I’ve been taking my estrogen for over twenty-five years, thinking that this was good for my bones.” How do you tell a nurse that she has been on the wrong hormone all these years? And that estrogen’s role is only to slow down the bone breakdown, while progesterone is the hormone that plays the major role in building bone mineral density? As she read a draft of this chapter and learned of the importance of progesterone as it works on osteoblast cells to increase bone mass, she related her ambivalent feelings. On the one hand, she felt robbed of her health because she had used the wrong hormone for so long; but on the other, she was relieved to realize her problems could be reversed.
If we recognize the signs of hormone imbalance and understand how and why hormone replacement therapy can correct such an imbalance, we’ll be spared a lot of grief in years to come. Who wouldn’t get tired of going from one doctor to another for headaches, fatigue, heart palpitations, hot flashes, heavy bleeding, irregular periods, spotting, anxiety, moodiness, night sweats, depression, or just feeling rotten? Many doctors still don’t recognize that many of these problems are related to menopause or other stressful times—such as after childbirth or hysterectomy.
Just like the woman in the story above, many of us simply endure these symptoms and learn to live with them by keeping busy, trying to eat right, and so on—completely unaware of the harmful effects of progressive progesterone deficiency. Medicine is triumphant in emergencies and trauma, but it often falters in the management of degenerative diseases and preventive health care. The very drugs your doctor prescribes may mask an underlying hormone deficiency. Sooner or later, when the symptoms get bad enough, you may have to supplement Mother Nature’s gifts with what she is no longer adequately providing. Why not use a natural progesterone product instead of taking such risks?
No wonder osteoporosis is so prevalent. Have we indeed been given the wrong hormone—a hormone that medical doctors have been prescribing for over five decades? Since 1942, when estrogen was approved by the FDA for production by Wyeth-Ayerst Laboratory and introduced to the market, it has been demonstrated to be of little worth in the prevention of osteoporosis. It seems that women have been under a theoretical HRT system that has been extensively prescribed without necessary checks and balances. No wonder osteoporosis is called “the silent killer.” There comes a time when we may become too old to feel comfortable voicing complaints, and our bone loss, fractures, and joint problems continue as a generational plague.
Try as we may to create all the right conditions to avoid osteoporosis—the right kind of hormones, the right kind of calcium, and the nutrients needed for its assimilation—we might also want to be more aware of a chemical that is added to our water and of its effect on bone mass. The threat posed by fluoride may very well obliterate all our good intentions.
The Holistic Dental Digest tells us that in addition to devitalizing the tooth enamel and possibly leading to periodontal disease, fluoride actually causes the bones to become more brittle and weak—even though they appear denser on X-ray films similar to the illusion created by estrogen and Fosamax. One study reports that “the risk of fractures for women in high-fluoride communities [is] more than double.”160
Another study reviewed in the Journal of the American Medical Association found that fluoridation increases the rate of hip fracture by about 30 percent in women and 40 percent in men.161 Despite false claims by some public health officials to the contrary, there are no legitimate studies to indicate any hip fracture protection from fluoride. Fluoride is toxic to bones in any amount, including the level found in fluoridated water.162
It is also harmful to the thyroid and is a known cause of cancer and other diseases. Japanese researchers reported in 1982 that “sodium fluoride, which is being used to prevent dental caries [cavities], produces chromosomal aberrations and irregular synthesis of DNA.” The latest studies in the United States confirm the frightening truth that “malignant transformation of cells is induced by sodium fluoride.”163
Over three decades ago we were warned of these dangers in The American Fluoridation Experiment by Frederick B. Exner, M.D., an X-ray diagnostician, biologist, chemist, physicist, and pathologist.164 And the American Medical Association published data in the Archives of Environmental Health in February 1961, showing that fluorides have been found in diseased tissue from tumors, the aorta, and cataracts.165
Yet, from that day to this, says Cancer Forum, the U.S. Public Health Service has encouraged the Environmental Protection Agency to keep assuring American citizens that fluoridation is effective and safe, in spite of the fact that there is “not a shred of scientific evidence to support that claim.”166 It would be in our best interest to mount a national letter-writing campaign to convince Congress and the EPA to remove this hazard from our public water supply.
When we are trying to sort out the facts on how to maintain an adequate calcium level, let’s acquire our information from unbiased sources rather than from those associated with the dairy, cattle, and poultry industries. A dramatic example appears in Health Science, where Dr. Joel Fuhrman states: “If your calcium intake is very high but you constantly excrete more calcium than you absorb, you are in a negative balance and osteoporosis will result in time. On the other hand, if your calcium intake is relatively low but your body is efficient at absorbing it, you are in a positive balance and your skeleton will not be stripped of its calcium stores.”167 Drs. Cedric and Frank Garland (The Calcium Connection) and Nancy Appleton, Ph.D. (Lick the Sugar Habit) agree that excessive dietary sugar intake increases calcium excretion in the urine, upsetting the body’s mineral balance.168
From an academic viewpoint, when we refer to calcium and other minerals in our chemistry classes, the words “organic” and “inorganic” have a strictly applied definition. However, writers on nutrition use the term organic more loosely to mean alive or bioavailable. It is in this sense that numerous studies have been made regarding organic and inorganic minerals and their use to, or abuse of, the body.
Dr. M. T. Morter Jr., cautions against depending on unreliable types of calcium. He is convinced that the body cannot dissolve the strong “ionic” bonds of “inorganic” calcium, such as dolomite or oyster shell. Nor, in spite of dairy industry advertising, can it utilize the calcium found in cow’s milk; because unless the milk is consumed raw, its calcium has been altered by the pasteurization process into a hard, unusable form, which will be deposited in the wrong areas of the body. Dr. Morter points out that women who consume large amounts of dairy products are actually among the high-risk groups for osteoporosis.169
Along this same vein, Norman W. Walker, D.Sc., in his book Fresh Vegetable and Fruit Juices, gives us some excellent thoughts to live by concerning oxalic acid and its relation to calcium assimilation:
When food is raw, whether whole or in the form of juice, every atom in such food is vital [i.e.,] ORGANIC and is replete with enzymes. Therefore, the oxalic acid in our raw vegetables and their juices is organic, and as such is … essential for the physiological functions of the body…. The oxalic acid in cooked and processed foods, however, is definitely dead, or INORGANIC, and as such is both pernicious and destructive. Oxalic acid readily combines with calcium. If these are both organic, the result is a beneficial constructive combination, as the former helps the digestive assimilation of the latter, at the same time stimulating the peristaltic functions in the body.170
Please note that this advice may be contrary to what you have read elsewhere, but it really makes sense—and its author has much experience as well as credibility. Dr. Walker, after all, lived to be one hundred and nine years of age by practicing what he preached; his wife died in her nineties. He is the only person I’ve known to explain the distinction between raw and cooked foods containing oxalic acid:
When the oxalic acid has become INORGANIC by cooking or processing the foods that contain it, then this acid forms an interlocking compound with the calcium even combining with the calcium in other foods eaten during the same meal, destroying the nourishing value of both. This results in such a serious deficiency of calcium that it has been known to cause decomposition of the bones. This is the reason I never eat cooked or canned spinach.171
Dr. Walker tells us that the most plentiful quantities of organic oxalic acid are found in fresh raw spinach, kale, collards, mustard greens, turnips, Swiss chard, and beet greens.172 Other sources include almonds, asparagus, and parsley.
Many of these same foods are high in calcium as well, and indeed, the first source we should look to for our calcium requirements should be our daily diet. But as we’ve seen from Dr. Morter’s views earlier, the customary idea of milk as one of the most important sources of calcium is coming into much debate these days. In fact, you will assimilate more calcium from ingesting kale than from drinking milk, according to Frederik Khachik, a researcher at the U.S. Department of Agriculture.173
It would seem that the very foods we are told to consume for calcium are those that often cause allergies and other serious problems. By way of illustration, cardiologist Kurt Oster conducted extensive research into the xanthine oxidase in homogenized cow’s milk. This substance was shown to damage arteries and promote atherosclerosis. He found no such correlation associated with the intake of butter or cheese, presumably because they contain little or no biologically active xanthine oxidase. Oster makes a reasonable case that one of the causes of atherosclerosis is the consumption of homogenized milk.174
There are valid concerns, too, about skim milk. Butterfat actually provides an excellent source of vitamins A and D, is anticarcinogenic, and allows the minerals and other nutrients in milk to be absorbed and utilized. One researcher observes, “The plague of osteoporosis in milk-drinking western nations may be due to the fact that most people choose skim milk over whole, thinking it is good for them.”175
Synthetic vitamin D, added to replace the natural, is toxic to the liver. Nonfat dried milk, which is added to 1 percent and 2 percent milk and to nonfat commercial yogurt, contains heart-damaging rancid cholesterol and high levels of nitrites and galactose (milk sugar linked with development of cataracts, glaucoma, and ovarian cancer). Thus, for several reasons, whole milk products may be preferable.176
A further commentary on milk comes from How to Get Well, a useful health book that provides practical information on nutrition and drugless treatment. Dr. Paavo Airola writes:
Today’s pasteurized supermarket-sold milk is loaded with toxic and dangerous drugs, chemicals and residues of pesticides, herbicides and detergents—such milk is not suitable for human consumption. If you are fortunate enough to get real milk, fresh, raw, “farmer” milk from healthy cows fed organic food, then you can add milk to your diet.177
To his list we might add the synthetic hormones that are often present in commercial milk products. Dr. Airola says that the preferred way of consuming milk is as acidophilus milk, yogurt, or other soured (predigested) forms, because they “help to maintain a healthy intestinal flora and prevent intestinal putrefaction and constipation.”178 Look for plain, unsweetened yogurt (preferably organically produced) with active lactobacillus cultures or for cultured buttermilk. In some places unhomogenized commercial yogurt is available; homemade whole milk yogurt would be even better.179
However, if you do decide to use a calcium supplement (particularly after menopause), many authorities recommend one such as calcium citrate180 over the more common calcium carbonate. The latter can be hard to assimilate, especially in older persons and those deficient in hydrochloric acid. But remember also the importance of magnesium and the trace nutrients mentioned earlier in the chapter, which facilitate calcium uptake by the bone.
And as another option, microcrystalline hydroxyapatite (MCHC), which the Textbook of Medical Physiology refers to as the “primary form of calcium in our bones,”181 is a highly-absorbable compound that has been found effective in improving bone density. Because it contains a variety of minerals, vitamins, and proteins, it is becoming valuable therapy in the use of preventing osteoporosis.182–184
And what else do we need to know about the health of our bones? Dr. Alan Gaby discusses the influence of vitamin B6, pointing out that “this vitamin is a cofactor for the enzyme lysyl oxidase, which crosslinks proteins and connective tissue. Adequate vitamin B6 is therefore required to provide tensile strength and structure to collagen … in bone tissue.” He also mentions a study by Nelson, Lyons, and Evans, which “suggests that vitamin B6 enhances the production or the effectiveness of progesterone. To the extent that progesterone is important for bone health, adequate intake of vitamin B6 is also essential.”185 Studies confirm that low levels of this vitamin can create abnormal bone growth as well as create the risk of developing osteoporotic bone disease.186, 187 Today the effects of much of modern technology are creating environmental chemicals that are causing a deficiency of B6 and thus disrupting the necessary biochemical interactions that this nutrient provides for our body.188
The Center for Women’s Health at Columbia-Presbyterian Medical Center surveyed women who exercised three or more times a week and found that they reported fewer osteoporotic symptoms than those who exercise twice a week or less.189 But what kind of exercise would help us prevent osteoporosis? The importance of an exercise program is discussed in Dr. Gaby’s book Preventing and Reversing Osteoporosis. He states that weight-bearing exercise, which forces the body to work against gravity, helps in building bone density. For older women, swimming may be most appropriate, as there is less risk of injury.190
Dr. Gaby observes that urinary calcium excretion was found to be quite extensive in astronauts following their time in space. Furthermore, patients restricted to bed for back pain demonstrated rapid bone loss: “bone mineral content of the lumbar spine decreased at an astounding 0.9% per week.” Dr. Gaby emphasizes, therefore, that “physical activity plays a crucial role in maintaining bone mass.”191
The role of exercise in preventing and reversing bone depletion cannot be overstated, nor can exercise alone make all the difference. As we have mentioned again and again, it is the combination of factors that has the greatest impact on our total health and specifically on our bone mineral density. In planning your exercise program, remember that it, like dietary changes, needs to be incorporated into your daily routine—for the rest of your life. Just as crash diets yield only temporary weight loss, sporadic exercise is not going to have any significant impact on your bone density.
Your body will give you clues as to the right kind and amount of exercise for you. Dr. Ray Peat points out in Nutrition for Women that women athletes are sometimes chronically deficient in progesterone (and may miss periods), probably because the stress of hard exercise causes the conversion of progesterone to cortisone.192 He also observes that excessive stress and so-called aerobic exercise that leaves one breathless are common causes of hypothyroidism193 and may contribute to premature aging. Thus, we must find that happy medium.
Here are a few guidelines to keep in mind when planning an exercise program:
It is not difficult to be overwhelmed by the health decisions that confront us. Modern-day medicines include never-ending lists of names for “new and improved” synthetic drugs and hormones. (See appendix B for a sampling of the many synthetic hormones commonly prescribed today.) Because the terms for the complex chemicals we are consuming are often incomprehensible, we too often rely completely on our medical doctors for treatment decisions.
What a contrast, and what an awakening, to discover information that is understandable! It seems almost too simple to be true—but then, isn’t truth often found in the simpler forms of nature?
What we have learned so far may require some assertive action. With these alternatives to artificial hormones we now have an opportunity to become less dependent on drugs that lead us away from a sound body, mind, and soul. Prepared, we can responsibly choose a path less traveled—one that may lead to a better quality of life.
In appendix E, you will find a form letter you can give to a prospective doctor explaining your concerns about synthetic hormones. He or she should know how you feel about toxic drugs and the unwanted side effects of the synthetic hormones that cause so much distress. It is imperative that your health provider understand that your body does require, and can assimilate, natural progesterone.
It is important to note that the cream used in Dr. Lee’s studies specifically contained USP progesterone, which is referred to as “natural” progesterone in most of the current literature. We are often asked if there is any difference between this and the many wild yam creams available today. The answer is that, to date, no large-scale clinical studies have been done to validate the use of wild yam extract without USP modification.
With respect to the treatment and prevention of osteoporosis, so far only USP progesterone has been clinically tested and evaluated. However, for the treatment of many of the other debilitating and draining symptoms of PMS and menopause (cramping, irritability, hot flashes, fibroids, etc.) patient after patient reports relief using a product containing the sterol from either the wild yam (diosgenin) or soybean (stigmasterol) without conversion to the USP progesterone. (See appendix A for more information). Some women have found that alternating the two types (or using a cream that combines both) gives the best results. (See appendix G.) Others alternate the cream with sublingual drops or tablets.
Dr. Judi Gerstung is interested in assessing long-term response to various treatments for increasing bone mineral density. If you would like to assist her with this project, please send a brief description of your health care program, a copy of your initial bone mineral density test, and results of any follow-up studies to: Dr. Judi Gerstung, c/o Inner Traditions International, One Park Street, P.O. Box 388, Rochester, VT 05767.
* Some insurance plans now offer coverage for osteoporosis testing. Unfortunately, they may require your doctor to certify that you are estrogen-deficient, with no consideration of progesterone levels.
* Check the ingredients lebels on the cod liver oil and vitamin E capsule bottles to make sure that they do not also contain soy. (See chapter 6 for more information on soy.)