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Showing posts with label Nutrients. Show all posts
Showing posts with label Nutrients. Show all posts

Calcium-rich, marine multi-mineral complex (Aquamin) is superior to calcium carbonate in its ability to slow bone loss

In a recently published study in Calcified Tissue International, Orlaith Brennan (Royal College of Surgeons, Ireland) and colleagues, compared the calcium-rich, marine multi-mineral complex, Aquamin to calcium carbonate in an ovariectomised rat model of osteoporosis. The purpose of the
study was to assess Aquamin's efficacy in preventing bone loss. Aquamin is a natural, multi-mineral supplement derived from the red algae Lithothamnion corallioides. Aquamin is rich in calcium, magnesium, and 72 other trace minerals.

This 20-week study compared Aquamin to calcium carbonate in their influence on the mineralization and metabolic activity of osteoblasts (the cells that form bone) in cell culture. Trabecular architecture, bone composition, and the mechanical strength properties were assessed. The study found that "oral ingestion of Aquamin results in less deterioration of trabecular bone structure, mineral composition and biomechanical properties in the tibia of rats following ovariectomy than calcium carbonate." In this animal model of osteoporosis, Aquamin was shown to be superior to calcium carbonate in its ability to slow down the onset of bone loss.

OsteoNaturals' OsteoMineralBoost supplies 250 mg Aquamin.

Brennan, O., et al. 2017. A natural, calcium-rich marine multi-mineral complex preserves bone structure, composition and strength in an ovariectomised rat model of osteoporosis. Calcif Tissue Int. DOI: 10.1007/s00223-017-0299-7.
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The Similarities Between "Boosting" Athletic Performance and Osteoporosis Outcomes

I must admit, I was a bit lazy last year. After running a 50 mile trail race, I laid low for the rest of the year nursing a heel injury. But I'm healthy now and back training. As per usual, I've set a few goals for the summer...some triathlons and a few running races. There is something about setting goals that keeps me on track--not just in athletics, but in life. Goals are important; they sharpen your vision, give you focus and help steer you to success.

The goals I set for myself are typically lofty ones. Whether it is competing in an Ironman, running up Mt. Kilimanjaro, or improving my bone density naturally through diet and supplements, they usually aren't easy tasks...but that's what makes them interesting. Besides hard work, I am always in search of ways to "boost" my abilities to help reach those goals. Now I am not talking about performance enhancing drugs in athletics or taking osteoporosis medications to temporarily improve bone density at the risk of adverse effects and building poor quality bone. I'm talking about doing things naturally but effectively. I hope you can relate to some of these ideas and use them to boost your own goal outcomes.

Improving Athletic Performance
Improving your performance in athletics, no matter what sport or activity, starts with making sure your body is healthy enough to sustain training for months on end. If you break down a few weeks before a race, all that training goes out the window.

Common sense suggestions:

First, maintain a healthy gut by eating a good diet and taking supplements. Putting high-octane fuel in the tank...lots of good green veggies, quality protein and plenty of minerals and electrolytes...allows the body to rejuvenate after each workout. Second, exercise regularly and focus on quality workouts. Third, get plenty of sleep. It is during the night-time hours that the body repairs itself and you can do a lot of damage to your body in a hard training session. Finally, keep a positive attitude and be patient.

Boost Suggestions:
I have found a few extra little things besides those basics that enhance my performance just enough to put me on a slightly higher playing field...enough to get me from 2nd place to 1st place in a race. For running and competing in triathlons, that edge or boost to performance comes from three things:
1) The nutritional supplement creatine. Creatine is a naturally occurring substance in the body that helps recycle adenosine triphosphate (ATP) energy. But creatine levels decline as we age making it more difficult to effectively utilize ATP.* Not only does creatine help give us more zip DURING a workout but it helps with after-workout recovery.
2) Strength training. This might include the use of free weights, weight machines, elastic resistance bands, and/or simply resisting against your own weight. A well-executed strength-training program contributes to my feeling strong all over, increases total body mass, reduces the risk of sports injuries and improves core stability. **
3) Ensuring adequate electrolytes. For optimal nerve conduction and muscle contractions you need to have plenty of minerals and electrolytes. Nerves fire optimally and muscles respond best when the body is electrically alive and swimming in electrolytes.

Improving Osteoporosis Outcomes
My quest to improve bone health runs parallel to how I approach sports. I treat this goal as a huge challenge that arouses my competitive juices and makes me SO WANT TO SUCCEED. The key is to stay focused every day on the key factors that will keep bones strong and healthy.

Common sense suggestions:
First, maintain a healthy gut (probiotics, fiber, eliminate food allergens and sensitivities, digestive enzymes if needed), eat a good diet and take supplements. Second, engage in weight-bearing exercise regularly. Third, get adequate sleep. Finally, keep a positive attitude and have patience. Sound familiar?

Boost suggestions:
I have found that a boost to improved bone health comes from similar sources as those that I use to enhance my athletic performance:
1) The nutritional supplement creatine.
2) Strength training.
Muscles release myokines, chemical signaling molecules that tell bones to get stronger. This makes sense. Bones have to be strong enough to take the torque produced by muscles; so muscles and bones have to be in close communication with each other. The stronger your muscles, the stronger your bones will be; taking creatine and engaging in frequent strength training are two of the best boosts to this mechanism.
3) Ensure not just adequate minerals but minerals that can be EASILY deposited into bones AND be transformed EASILY into electrolytes.
(Electrolytes are minerals with an electric charge.) In addition to providing one of the best sources of calcium possible for bone building, OsteoMineralBoost*** contains bio-active calcium, magnesium, and 72 trace minerals (from Aquamin red marine algae). It is easily incorporated into bone tissue, helps preserve bone, and is a natural source of electrolytes...perfect for people who suffer from bone loss...and athletes alike. 

It is my hope that you will use some of these ideas in your daily regimen to kick-start or help "boost" your goal attainment. And, if you haven't set goals yet, what are you waiting for?! Whether you are an athlete or an individual who wants to improve health outcomes, the goal-setting process is needed to understand where you are currently, and where you want to go. The fact that you aren't where you want to be, should be enough motivation.

* We can obtain creatine from our diet but the best sources are fish and meat which are acidic and large quantities of these foods may not be the best way to ensure adequate creatine levels. Because creatine is only obtained through animal products, vegetarians have difficulty maintaining adequate creatine levels. For these reasons supplementing with creatine, especially if you have bone loss, is a good idea. For more info on creatine go to:  http://www.osteonaturals.com/2015/07/creatine-and-resistance-training.html
** Of course, when any exercise program is undertaken by sedentary individuals, they should first check with their physician. In addition to the cardiovascular concerns of starting an exercise program, caution, especially in the osteoporotic individual, should be taken to avoid undue load on the spine or hips. For example, bending forward or lifting weights overhead can put a heavy load on the spinal vertebrae and if bone density is extremely low, this can result in a compression fracture.
*** OsteoMineralBoost provides one of the best sources of calcium possible for bone building...micro-crystaline hydroxyapatite. MCHA has been shown in research studies to contain growth factors for improved bone building activity in people with osteoporosis. OsteoMineralBoost also contains Aquamin trace minerals from red marine algae. Aquamin won the Ingredient of the Year for Healthy Aging at the 2016 Nutraingredients Awards in Geneva, Switzerland.
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Osteoporosis and Vascular Calcification

In a study published in Climacteric, C.E. Lampropoulos, et al. assessed the correlation between osteoporosis and vascular calcification in postmenopausal women. The goal was to determine not only if there was a correlation (there have been numerous studies linking these as comorbidities) but also to determine if low dose calcium supplementation plus vitamin D contributed to calcification of arteries.

The study concluded that "Calcified plaques were significantly correlated with osteoporosis."  Osteoporotic women were "16 times more likely" to develop calcification of the abdominal aorta and "seven times more likely" to develop plaques and thickening of blood vessels compared to normal individuals. It also concluded that "low doses of supplements do not appear to cause any increase in vascular calcification in osteoporotic women." In other words, although bone loss and calcification of arteries go hand in hand their connection is NOT due to taking calcium supplements. And this is key! We need calcium for our bones to be healthy.

Taking supplemental calcium is safe when used in moderation. Taking huge amounts of any supplement, including calcium, is never advisable. But a sensible intake of 600 to 1,000 mg/day of supplemental calcium (plus another 500 or so from the diet) is important for getting your 1,200 to 1,500 mg calcium/day as recommended by most bone-health experts. Making sure you get adequate vitamins D and K, and magnesium is also a vital part of the equation. You NEED these to ensure that the calcium you take in goes to the right places in your body: muscles, nerves and bone...and NOT settle into the blood vessels!
So what is it that makes women with bone loss be more susceptible to calcification and hardening of the arteries? The answer is INFLAMATION. We at OsteoNaturals know that simply taking in adequate calcium is NOT the total answer to improving bone health. The MOST important thing you can do for better bone health is to reduce inflammation-driven, excessive osteoclastic bone resorption. Inflammation, not a lack of calcium, is usually what fuels excessive bone loss. And that is where OsteoStim comes to the rescue. OsteoNaturals'OsteoStim has ingredients designed to do exactly that: modulate the activity between the osteoclasts and the osteoblasts so that the bone remodeling process comes more into balance. A balanced bone remodeling system is important for the skeleton to renew itself periodically...important for keeping it young, supple, and strong. AND, not only does OsteoStim have ingredients that promote balanced bone remodeling but it also has 200 mg of a very important antioxidant that, yes, you guessed it...helps prevent blood vessel calcification!

And as Lampropoulos, et al. showed in their research, since osteoporotic women are 16 times more likely to develop calcifications it is EXTREMELY important to address this head on! Alpha lipoic acid is THE perfect antioxidant that can help prevent this calcification. Studies such as the one by Ying, et al. demonstrate this beneficial effect. In this 2010  research, published in Life Sciences, Ying, et al. showed that lipoic acid "reduced atherosclerotic plaques in the abdominal aorta".

The combined effect of supplemental calcium, magnesium and other minerals from OsteoSustain and OsteoMineralBoost, plus improved bone remodeling and lowered atherosclerotic risk from our OsteoStim makes OsteoNaturals products your first choice for improved skeletal health.  

Lampropoulos, C.E., et al. 2016. Osteoporosis and vascular calcification in postmenopausal women: a cross-sectional study. Climacteric April 5:1-5.
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A Handful of Broccoli Sprouts A Day / Keeps Bone Imbalance (and Bisphosphonates) Away

Bone remodeling in an adult is the biological mechanism where old bone is removed by osteoclasts and new bone is formed by osteoblasts at an equal rate. In other words, these cells function "in sync" with each other. The result, when all is healthy, is a continual renewal of bone without any substantial overall loss in bone density as a person ages. But if the osteoblasts are unable to effectively produce new bone, and/or the osteoclasts are overly aggressive and resorb too much old bone, then they are "out of sync" and there becomes a deficit. When this deficit continues for years, bone density declines and will eventually lead to osteoporosis. A number of factors can increase or decrease the likelihood of imbalance in the bone remodeling process. In this blog I would like to review four important factors.
1) An "out of sync" situation occurs with Bisphosphonates*, the drugs commonly used to COMBAT osteoporosis. These medications are so powerful that they not only poison the osteoclast cells but they also dramatically interfere with the ability of osteoblasts to form bone. The result is that the skeleton becomes more brittle, "older", and more prone to breaking. Continued use of these drugs also puts a person at risk of serious adverse effects such as atypical femur fractures, non-union fractures, and osteonecrosis of the jaw.
2) An “in sync” situation occurs with the consumption of fruits and vegetables. Eating 5 to 8 helpings of fruits and vegetables each day not only helps reduce excessive bone resorption but it is important for boosting osteoblastic activity. Fruits and vegetables help alkalinize the body which promotes bone formation and they also provide polyphenols (most noted for their anti-cancer properties). These powerful phytochemicals are antioxidants that provide great protection against bone loss. The flavonoid kaempferol, found in high amounts in onions, and another flavonoid quercetin, found in dried plums, both have beneficial effects on bone and have been used in the treatment of osteoporosis.
3) Another ‘In sync’ situation involves epigenetics – external modifications to DNA that turn genes “on” or “off”.  The DNA sequence is not changed, but the modifications affect how cells “read” the genes and subsequently how they produce proteins. When bone cells interact to build and maintain bone, these processes are orchestrated by regulators of gene expression. A person may have genes for strong bones but the regulators of how those genes manifest are, for some reason or other, not turned on or off correctly and the bone strength is not realized. It is the epigenetics, or how genes are expressed, that becomes important with nutrition. Good nutrition allows a person's genetic make up to be expressed fully...to its full potential. But poor nutrition may lead to an under-expression of a person's genetic expression. And such is the case with bone health.
One particular phytochemical that can orchestrate gene expression and provide benefits for treating
Broccoli Sprouts
osteoporosis is
sulforaphane – a naturally occurring isothiocyanate. In the Journal of Biological Chemistry, Thaler et al. reports that sulforaphane, found in high concentrations in cruciferous vegetables such as broccoli (especially broccoli sprouts), cabbage and kale, had substantial positive effects on the epigenetics of bone remodeling. In Thaler's study on mice, he found that sulforaphane helps to increase bone volume and reduce bone loss caused by a loss of estrogen. Sulforaphane acts as an epigenetic bone anabolic (building) agent and has a "two-pronged effect on bone formation and homeostasis by acting differently on osteoblasts and osteoclasts." Sulforaphane turns on genes involved in matrix mineralization and enhanced expression of osteoblastic activity. It also significantly decreases the expression of the osteoclast activator RANKL in osteocytes. The effect is that sulforaphane inhibits the production and activation of osteoclasts.
4) One final “in sync” factor is the promotion of a BALANCED bone remodeling system by promoting a RE-BALANCING of the remodeling process. Bone should be ENCOURAGED to GENTLY gain density, to enhance restructure and improved bone quality, and to gain strength. It should not be forced into an unnatural accrual of density without improvement in bone quality. OsteoNaturals’ OsteoStim contains ingredients that help reduce (not stop) EXCESSIVE osteoclastic activity and others to stimulate osteoblasts to build bone. The overall effect is that OsteoStim helps BALANCE bone remodeling. It helps encourage better bone QUALITY, not by destroying osteoclasts but by curtailing their activity and NUDGING osteoblasts to build new strong healthy bone. This is the key to OsteoStim's success. As a nutritional supplement for bone loss, OsteoStim isn't your source for minerals (those are found in OsteoSustain and OsteoMineralBoost); its job is to tackle remodeling. Without a balanced bone remodeling system, taking all the best minerals in the world won't do much good. A balanced bone remodeling process is key to supplemental minerals being effective and successfully combating bone loss.
Other strategies that MUST be included in one's quest to regain skeletal health include: a consistent regimen of physical activity, a diet that includes 60 to 90 grams of quality protein on a daily basis, supplementing with creatine and/or DHEA (when advised by a health care provider), reducing chronic systemic inflammation, and curtailing catabolic (cell destroying) lifestyle activities (such as smoking and heavy alcohol use).
The takeaway: there are lifestyle changes that you can make that actually alter the expression of your genes and your bone health; consider medications carefully; promote bone quality with OsteoNaturals' OsteoStim and eat your fruits and vegetables! For a double punch to overcoming osteoporosis, add broccoli spouts to your daily diet. It may help your genes, through epigenetic mechanisms, to boost bone building activity and reduce bone destruction.
* alendronate (Fosamax), residronate (Actonel), ibandronate (Boniva) and zolodronic acid (Reclast)
Thaler, R., et al. Anabolic and anti-resorptive modulation of bone homeostasis by the epigenetic modulator sulforaphane, a naturally occurring isothiocyanate. J Biol Chem. Jan 12, 2016.
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OsteoStim: Now has Apolactoferrin

On March 8th you will finally be able to place your order for OsteoStim. It has been a long arduous
process, but getting things right sometimes takes time...and this certainly took more time than expected. From procuring ingredients, to manufacturing, and even to printing labels, we seemed to run into production delays all the way. But production is finally complete and we are just waiting for labels to be affixed to the bottles and shipped. We couldn't be more excited about the final product.

As many of you know from previous Newsletters, OsteoStim will now contain another ingredient. In an ongoing effort to bring you the most effective nutrition product available for improving skeletal health, we have added a low-iron form of lactoferrin to OsteoStim.

Lactoferrin is a naturally occurring glycoprotein found in milk. It is an important part of the immune system and helps the body's innate immune defense fight against harmful bacteria, viruses, and fungi. In addition to its antimicrobial activity, lactoferrin also helps normalize bone remodeling activity as seen in the reduction of bone resorption markers (N-telopeptide and deoxypyridinoline) and increase in bone formation markers (osteocalcin and alkaline phosphatase). (1) 

With its normalizing impact on the immune system, lactoferrin reduces chronic systemic inflammation (2) which is common in people suffering from osteoporosis. This type of inflammation is often the cause of excessive osteoclastic bone resorption and bone loss. Lactoferrin not only reduces osteoclastic activity but it is one of the few compounds that can also stimulate osteoblast cells for improved bone formation. (3) The reason we see so much periodontal disease, small bowel bacterial overgrowth, candida infections, joint inflammation, muscle pain, elevated blood sugar, depression, and fatigue in patients with osteoporosis is because these are all signs and symptoms of chronic systemic inflammation. But if we reduce the chronic inflammation (and lactoferrin does a great job at this) we also REDUCE EXCESS OSTEOCLASTIC BONE RESORPTION and improve bone, and overall, health.

But...there is one drawback to lactoferrin, especially in postmenopausal women. Lactoferrin increases iron levels in the body. With no more blood loss from monthly periods, postmenopausal women should not be taking in excess iron. For this reason, we are using a special form of lactoferrin called Bioferrin 1000 (Bioferrin is a registered trademark of Glanbia Nutritionals). Bioferrin 1000 is a low-iron form of lactoferrin called apolactoferrin. In fact, for each 100 grams of Bioferrin 1000 there is less than 15 milligrams iron. In three capsules of OsteoStim there is a therapeutic dose of 250 milligrams apolactoferrin which makes this dosage virtually iron free.

We are very proud to be able to provide you with this product.


1) Bharadwaj, S., et al. 2009. Milk ribonuclease-enriched lactoferrin induces positive effects on bone turnover markers in postmenopausal women. Osteoporosis Int 20(9):1603-11.

2) Bharadwaj, S., et al. 2010. Inflammatory responses improve with milk ribonuclease-enriched lactoferrin supplementation in postmenopausal women. Inflammatory Research 59(11):971-8.   

3) Naot, D., et al. 2005. Lactoferrin - A novel bone growth factor. Clinical Medicine & Research 3(2):93-101.
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Becoming Anabolic in the Face of Osteoporosis - Even While Running 50 miles at the 2016 Pinelands Salomon Trail Running Festival


Reducing fracture risk is about more than just making bones denser with calcium. It is also about: 1) reducing chronic systemic inflammation, 2) staying strong and supple, and 3) remaining positive as you navigate through life. 

As I was slogging through a 50-mile race in Maine a few days ago, I began to wonder if what I was doing was really a good idea. After all, going non-stop for over 10 hours....eating M&Ms, potato chips, pretzels and guzzling down gallons of disgusting sugary drinks as I beat my joints and muscles to a pulp...intuitively doesn't SEEM like a smart thing to do to reduce systemic inflammation! And, as far doing things to promote strength and suppleness...well, just watch the short video on our OsteoNaturals Facebook Page (please "like" us while you're there!) as I slowly hobble across the finish line, and you will see that running 50 miles at one clip doesn't promote suppleness (especially

when you have achilles pain that started at mile 2). Strength of will, maybe, but suppleness, certainly not!

OK, so last weekend I failed miserably at accomplishing the first two things that I say are so important for bone health. But what about the third?...the "remaining positive" bit? My thought is that ONCE IN A WHILE it is OK to indulge in TOTALLY WACKY THINGS to keep your engines running on all cylinders. I know what you are thinking..."Didn't Dr. M just go up Mt. Kilimanjaro last month and didn't he just do an Ironman last year?", and "Is this REALLY a 'once in a while' thing that he does?" Well for me, a guy who just 17 years ago was breaking so many bones from osteoporosis that running 50 miles, doing Ironmans, or going up Mt. Kilimanjaro were not only out of the question but total pipe dreams....these are all REALLY important things for me to do for promoting my positiveness factor.

While I may have questioned my sanity as I slogged through the miles at the 2016 Salomon Trail Running Festival, I also relished at how lucky I was to be able to do such a crazy thing once again in my life. Years of struggling with osteoporosis, breaking bone after bone, was quite a challenge. I know many of you have face a similar challenge. And that is why I founded OsteoNaturals. And that is why I write these crazy newsletters. I want you to know that there ARE solutions and that people CAN bounce back from osteoporosis. That YOU CAN bounce back from bone fragility and regain physical confidence. It took me years of constant vigilance to diet and consistently taking important healing supplements such as OsteoNaturals, but my bones are now strong enough to push the envelope again (on a limited basis). Yes, I get incredible satisfaction from these adventures, but what I am most proud of is when I receive letters from people who have been taking OsteoNaturals products and hear how well they are doing. THAT is the best! I did it...they are doing it...and you can do it.

In my book, The Whole-Body Approach to Osteoporosis, I cover all the key points you need to know about creating an anabolic body for improved bone health. I talk about the importance of exercise (sane exercise), diet (no, no M&Ms or potato chips), gut health, and taking nutritional supplementation for reducing chronic systemic inflammation and improving bone health. Some of the most critical supplements I talk about are: calcium, magnesium, vitamins D and K, alpha-lipoic acid, N-acetyl cysteine, and berberine. My book explains how these and other important vitamins, minerals, and herbs can help reduce chronic systemic inflammation and improve skeletal health. Our OsteoNaturals products combine all of these ingredients, in just the right ratios, making it easy to ensure you are getting exactly what you need for better bone health.

So last weekend I may have failed miserably in reducing systemic inflammation and promoting suppleness but I made up for it with an overdose of the "remaining positive" thing. I'm not saying I will ever do another 50 miler but I will certainly do many more wild and crazy adventures in my life. Now back to being anabolic by eating better, getting lots of sleep, and taking my OsteoNaturals supplements. Rock on and stay tuned for more adventures!
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Probiotics May Be Repurposed for Therapy in Osteoporosis


In my book, The Whole-Body Approach to Osteoporosis,I write about the importance of gut health when treating osteoporosis. An unhealthy digestive tract can not only interfere with optimal nutrient absorption but it disrupts the immune system and can lead to chronic systemic inflammation. As with the loss of estrogen at menopause, another common cause of osteoporosis is when theimmune system gets out of balance (especially in postmenopausal women). Since 70% of the immune system is housed in the gut, keeping it healthy is critical for skeletal health. In a study published recently in The Journal of Clinical Investigation, researchers (Jau-Yi Li et al) working with mice reaffirm this premise and suggest that giving the mice probiotics improved the immune response and improved bone density. In this blog, I would like to help readers better understand how a healthy gut keeps chronic systemic inflammation at bay, and why it is so important to keep inflammation to a minimum if you want healthy bones.


The gastrointestinal tract is home to literally billions of bugs. Some good...some not so good. When the gut is over run by the not so good ones, (often due to a poor diet, allergies to foods and/or frequent use of antibiotics) it can be damaged and begin to leak. A chronically inflamed digestive tract causes gaps to form through which partially digested food particles and microbes can pass. Now, instead of being a protective barrier, this "leaky gut" becomes a portal to ill health. The particulate and microbial toxins that filter through these newly opened gaps set off reactions, which are a constant source of inflammation that insidiously permeate the entire body. This "leaking gut syndrome" or intestinal dysbiosis not only causes a chronic inflammatory reaction and a disruption of proper immune function in the person but when the gut is damaged it can no longer absorb nutrients effectively. So we NEED "good" bacteria to thrive in the gut. When healthy microbiota predominate in the gastrointestinal tract we are much healthier and so are our bones.


Our immune system and bone cells use the same signaling molecules (cytokines) to relay messages. When the immune system is out of balance it sends out way too many abnormal signaling molecules and the bone cells, especially the osteoclasts (the cells that break down bone), "hear" these abnormal signals and become hyper aggressive, eating up excessive amounts of bone. In chronic systemic inflammation, a condition I talk a lot about in my book, the "out of wack" immune system ends up being the cause of excessive bone loss. With too much inflammation in the body the osteoclasts become turned on ALL the time and the result is bone loss...osteoporosis. People often think that the most important thing they can do for osteoporosis is to take supplemental calcium. Yes, calcium is important but it isn't the whole story. We need to take in approximately 1,200 mg/day which is best achieved through a combination of dietary and supplemental sources. But we also need to make sure we get enough magnesium and vitamins D and K. AND we also must make sure our gut and immune systems are functioning optimally. Having all the nutrients available won't help much if the gut can't absorb them or if there are so many inflammatory cytokines circulating in the blood that the osteoclasts just destroy all the bone that is being made. When we give the body the minerals and vitamins it needs, PLUS have a healthy gut and immune system...then better bones will follow. Take out just one of those from the equation and the whole system falls apart.


Postmenopausal osteoporosis is typically the result of two things: 1) the loss of estrogen production from the ovaries, and 2) chronic systemic inflammation. Often, these go together as estrogen helps to reduce inflammation. In the published study using mice, researchers found that with the loss of estrogen there was an increase in ‘gut leakage’ and the subsequent inflammation resulted in increased osteoclastic or bone resorbing activity. After giving the mice probiotics, there was improvement in the immune response and improved bone density. 


Taking oral probiotics and eating fermented or cultured foods such as yogurt, kefir, sauerkraut, and miso encourages healthy gut microbiota which in turn helps gut function (as a barrier to pathogens and for improved digestion and absorption of nutrients) and regulation of the body's immune system. The bottom line from this study is that the use of probiotics has potential in the treatment of postmenopausal osteoporosis.

 Jau-Yi Li, et al. Sex steroid deficiency-associated bone loss is microbiota dependent and prevented by probiotics. The Journal of Clinical Investigations. 2016;10.1172/JCI86062.
 

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Magnesium is Important for Healthy Bones and RBCs Even if You Are NOT Tackling Mount Kilimanjaro on the Run



I've been a runner since I was about 6 years old. It was just something I did, naturally. I would look at hills or mountains off in the distance and run to them. Half the time my mother never knew where I was. Usually I didn't follow roads...I would just cut though fields and woods while keeping the hill in site the best I could. It might take an hour, or half a day, if it was far away. The distance really didn't mater to me...I just wanted to get to the top. They were magical and drew me to them like a magnet. 

Mount Kilimanjaro is the highest free-standing mountain in the world, looming 19,341 feet high  
over the surrounding Tanzania plains, and its magic is drawing me. This majestic mountain is Africa's most-visited trekking destination, attracting tens of thousands of tourists and adventurers every year. While you don't have to be a technical climber, you need to be pretty physically fit to attempt the 5 to 6 day hike to the summit. Typical issues include fatigue, dehydration, muscle strains, knee pain, bonking (lack of sufficient energy stores) and, of course, the potential for sprained ankles and falls. But the biggest challenge is the altitude. Approximately 75% of the 25,000 people who make the attempt each year develop some form of altitude sickness (1), and only 60% succeed in summiting.

If you prefer running to hiking, the challenge is even greater. Yes, in April, I will attempt a speed ascent and decent of Mt. Kilimanjaro in one day (under 14 hours of daylight).  I love physical tests and running (instead of hiking) Mt. K sounds like a cool one to tackle. Cool yes, but also one fraught with some extreme physiological challenges that I have never dealt with before - ultramarathoning at high altitudes. (2)

Those of you who know me are aware that I can be fairly tenacious.  When I was first diagnosed with severe osteoporosis in my 40’s and sustained 12 fragility fractures over a 5-year period, I did not take it well. I did the research to learn about everything that impacts bone health. I experimented with a myriad of minerals, vitamins, and herbs sifting through all the hype and finding out what really would make a difference to bone health. I became an expert on the subject and developed my own nutritional supplements using natural ingredients chosen for their safety and efficacy. Today, my bone health has improved and I’m back to competing in triathlons and not breaking bones. That said, I have given this Mt. K decision a great deal of thought and deliberation – most specifically the altitude issue, and the endurance consideration. 

Altitude and Oxygen Circulation:
Red blood cells (RBCs) carry and distribute oxygen to your body. People with osteoporosis often have a lower RBC count and therefore a slightly reduced capacity to carry oxygen to their tissues (3). When expending a lot of energy, such a person might feel weak and tired and experience shortness of breath. At the altitude of 19,341 feet there is 49% less oxygen than at sea level, so the potential danger is obvious. To compensate for this paucity of oxygen carrying red blood cells, the heart has to work harder. It beats more rapidly. Up to 20 beats per minute faster than normal. Not only does this take a considerable amount of additional energy but it also places a huge mechanical strain on the heart when calculated over time. The good news is that I have been able to increase my RBC count slightly as I have improved my health AND I have optimized the function of the RBCs that I have. (4)

Most people know that iron is important for blood's oxygen carrying ability. What they don't know is that magnesium also plays a huge role in this capacity. Magnesium is one of the most important nutrients in your body and is a major component of bone. Magnesium is vital for cell energy metabolism, blood glucose control, nerve conduction, cell membrane integrity, electrolyte balance, and the proper functioning of over 300 enzymes. Specific to bones, magnesium helps osteoblast cells make new bone. And, it is extremely important to have adequate amounts of magnesium for the production and release of calcitonin (from the thyroid gland) and parathormone (from the parathyroid glands), for maintaining a balanced bone remodeling system.

Magnesium is also a vital component of RBCs ability to hold on to oxygen molecules. Optimal levels of magnesium in the body are necessary for blood to be able to transport oxygen. Magnesium helps transport nutrients into RBCs so that they can do their job. If a person is deficient in magnesium his or her heart will either have to beat faster and/or they need to take in more oxygen (breath more times per minute) to get the same job done as someone with good magnesium stores. This is why magnesium supplementation often helps lower a person's blood pressure.

Strong Bones and Endurance:
I have to admit that my muscle mass is declining (as is the case with everyone as they get older). I can see muscles starting to sag here and there and just don't feel as strong as I used to. Less muscle leads to less power and with the increased body fat that goes along with aging it will be more dead weight for me to drag up the mountain. The good news is that I have done 3 important things to help keep my "fitness age" substantially lower than my real age.

First, I have been able to maintain a fairly steady training regimen over the years. I am always training for something; whether it is a triathlon or running race; I never let my fitness level drop too much. I’m also pretty consistent about getting to the gym for strength training with weights. The feeling I get from this and the benefit to my bones are what motivate me to keep it up. I feel more "put together" when I lift regularly. Even if it is only 20 minutes a day 3 times a week (although I usually get in 45 minutes, 5 days a week) I feel I get great benefits from strength training.

Second, I train for a multi-sport event...triathlon...which also puts me ahead of the game. Research shows that people who vary their training have more muscular power and higher endurance capacity than athletes who constantly do the same workouts day in and day out.

Third, I often "put the pedal to the metal" during my various training sessions. This habit of "red-lining" with multiple high-intensity workouts each week helps me maintain a good lactate threshold. By doing so, my body's chemistry is able to neutralize and eliminate lactate levels fairly rapidly because I've trained my enzyme systems to do this. 

Physical and Mental Well-being:
I did not accomplish what I set out to do in my last challenge (the Ironman World Championships in Hawaii) - mainly due to a bout of flu.  The good news is that my positive attitude is still intact.  I also eat fairly well and take nutritional supplements. Eating lots of fruits and vegetables (and taking OsteoMineralWhey for its powerful alkalinizing effect) each day helps me stay alkaline and gives me the trace minerals I need to process fats and sugars for energy. One of the most important nutrients I take in everyday is magnesium (available in our OsteoSustain and OsteoMineralBoost). Magnesium, it's not just for skeletal health...your red blood cells need it too. I will certainly be putting both to the test in a few weeks.

Having weighed the pros and cons of this one-day speed ascent/descent attempt, I am relying on my positive attitude, my improved skeletal and over-all health, and my diet and nutritional supplementation to get me through this. I think that I’ve been able to limit some of the normal decline seen with aging and that this will translate into more power and speed up the mountain. I am holding on to the confidence that I’ve been able to keep my body more on the anabolic side of the aging curve and less on the catabolic side. I’m also holding on to a quote from Barry Finlay in his book Kilimanjaro and Beyond:  “Every mountain top is within reach if you just keep climbing.”  I'm hoping that together these will give me the edge I need to succeed in this venture. 

I hope that when you read my next blog that it will tell of my success in finding this next mountain top. But most of all, I hope I have you all thinking about your own next goals: places you would like to see, activities you would like to do, things you would like to accomplish, adventures you would like to tackle. It is an amazing world out there. Go have fun. And don't forget…while you are doing all this, make sure you get your daily quota of magnesium, it will help you reach your own mountain top.


(1) Altitude sickness comes in 3 forms:  Acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACA).  AMS is the mildest form of altitude sickness, causing headaches, nausea, diarrhea, vomiting, and loss of appetite. Not pleasant but bearable. HAPE and HACA (fluid on the lungs/brain) are not just unpleasant, they are life threatening.



(2) When I race in Ironman competitions I often get nauseous to the point of throwing up. The reason for this is that the stomach is constantly being jostled and there is a shunting of blood away from the stomach and toward the muscles in your legs where it is really needed. When there is no blood going to the stomach, any food or liquid you take in just sits there. If it just sits there and you keep cramming it in sooner or later it’s going to come back up the other way. This often leads to extreme gastric distress causing both vomiting and diarrhea. Add into the mix extreme altitude (which in and of itself causes nausea) and I have quite a few nutritional challenges in store for me.



When a trained athlete runs at or just below his or her anaerobic threshold, they have only 3 hours of glycogen stores in their legs. Since I am expecting this run to take a good portion of 14 hours, I will need to consume a lot of calories throughout the day to prevent bonking. My goal is to take in 200 to 250 calories plus 18 to 25 ounces of fluid each hour… and try hard to not throw it all up. I've never run above 14,000 feet before and all I have to train on here in Massachusetts is 1,200 foot Mt. Tom, so this will be all new territory.



(3) Next time you get your Complete Blood Count (CBC) taken by your doctor, check out your RBCs. If you have osteoporosis, your RBC count will more than likely be on the low side. When I was diagnosed with severe osteoporosis 16 years ago, one of the procedures I had performed was a bone biopsy. The severity of my bone loss, my relatively young age at the time of diagnosis, the fact that I am a male, and, that I've been an athlete all my life all made the endocrinologist extremely concerned that I may have a rare form of bone cancer that was the cause of my osteoporosis. To rule this out, he took a core sample of bone from my pelvis and analyzed it under a microscope. What he found was not cancer (thank goodness) but extremely poor bone quality (thus the 12 fractures over a 5 year period) and LOTS of FAT in my bone marrow. All this fat makes for less room for hematopoietic stem cells; the cells that make RBCs.  



Typically, having a somewhat reduced amount of RBCs isn't a huge problem in people with osteoporosis. It is just one of those "interesting" medical facts when looking at someone's lab results. But when the person relies on getting the most out of his or her body as an athlete, then it does present somewhat of an obstacle....especially when planning a run up into the clouds of Mt. Kilimanjaro.



(4) In my 20s, I was a professional athlete competing for the United States in World Championships and the Olympic Games. I had my VO2 max (maximum oxygen consumption) assessed 5 times during those years. A person's VO2 max is a measure of how well he or she utilizes oxygen and for the most part it is genetic. A person can improve it slightly with hard work but in general "you got what you got"...and there is very little you can do to substantially change it. VO2 max is a huge determinate of how well you will do as an endurance athlete. And genetics, when it comes to VO2 max, is really important. At 56 mL, my VO2 max was never that great. Most of my athlete buddies who I competed with had VO2 max's in the 70s and one guy was in the low 80s (thus my excuse for never being a real hot shot). I mention VO2 max for obvious reasons in that if I am attempting a run up Mt. K with its rareified air, having a low VO2 max puts me at somewhat of a disadvantage. The fact that VO2 max begins to tumble at age 40....and I'm 61, presents an even bigger problem. The reason why VO2 max declines is because our heart isn't able to beat as fast as it used to as we get older. If we take me as an example, when I was in my 20s I could regularly get my heart rate up to just over 200 beats per minute during hard workouts. Now, I have trouble getting it to 175.
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Supplemental Calcium - Concerns Addressed

Two of the most frequently asked questions I field from patients: #1) Are there safety issues with
supplemental calcium...and specifically...is there an increased risk for heart disease from taking calcium in a pill form? And, #2) Do calcium supplements cause kidney stones?

My response to both is, "no". Calcium supplements ARE safe and especially if you make sure your body has enough magnesium, and vitamins D and K. And, no, there is no convincing evidence that calcium supplements cause stones.    

Questions regarding the safety of supplemental calcium arose 7 years ago when a researcher (Bolland, 2008) announced that taking calcium supplements could modestly increase a person's risk for a heart attack. This literally shocked the nutrition and osteoporosis research worlds. But close scrutiny by other researchers (check out my earlier blog on this topic) called into question both the design of this study, as well as the way Bolland interpreted his results. There has been a raging debate and LOTS of misinformation being disseminated ever since. Some professionals say "just get your calcium through food" while others say "taking supplemental calcium is not only perfectly safe but can be very beneficial to your bones".  

With so many people taking calcium to improve their bone health, the Council for Responsible Nutrition (CRN) stepped in last year to take a good look at all the evidence. Their results:
"Although there was no overall indication of a connection between calcium intake and atherosclerotic heart disease or stroke, a few of the cited studies showed a weak but statistically significant positive association of calcium intake and cardiovascular disease, whereas a similar number show the opposite (protective) effects. Because of these mixed results, Heaney and colleagues determined that the findings from available clinical trials and prospective cohort studies indicated that there is no significant effect of calcium supplements on cardiovascular disease (Heaney, et al., 2012)."
The CRN went on to say: "A wide range of clinical and epidemiological studies discussed by the IOM, the EC SCF, the EVM and several published reviews and meta-analysis have shown no adverse effects with calcium intakes of 2,000 mg or less in adults ages 51 years or older. Based on the judgement of the IOM, the calcium UL for persons aged 19 through 50 years should be 2,500 mg, which is the midpoint between the value for individuals ages 51 years and older and the 3,000 mg UL for adolescents. Considering the quite variable calcium intake from foods, dairy products, and fortified foods, CRN agrees with the EVM that a maximum supplement level for adults should be 1,500 mg. Thus, the CRN UL for supplemental calcium is set at 1,500 mg per day for adults."
When I went to the 2013 American Society for Bone and Mineral Research Annual Meeting in Baltimore, Maryland the question over the safety of supplemental calcium was a huge topic. I spoke with several researchers and the answer was always the same. "Supplemental calcium is safe." A sampling:
Douglas Bauer, et al. Dietary and supplemental calcium intake and the risk of mortality in older men: the MrOS study concluded: "...there was no evidence that supplements increased the risk of mortality among those with the highest dietary calcium intake..." and, "...calcium supplements and the combination of high dietary calcium intake and supplement use were not associated with total or cardiovascular mortality."
Joshua Lewis, et al. The cardiovascular safety of calcium supplementation with or without vitamin D in elderly women: A collaborative meta-analysis of published and unpublished trial level evidence from randomized controlled trials concluded: "The data from this meta-analysis does not support the concept that calcium supplementation with or without vitamin D increase the risk of ischemic heart disease or total mortality in elderly women."
I hope this helps clarify the question about the safety of calcium supplements. Our OsteoSustain has 525 mg of calcium in three caplets. That is 175 mg in each caplet. This amount was chosen for a reason during the formulation process of this product. Obtaining adequate calcium is vital for skeletal health but we also know that it is not good to ingest high amounts of calcium all at once. Since it is virtually impossible to obtain adequate calcium and magnesium from one's diet alone, we need to supplement. This is ESPECIALLY true if you are osteoporotic. But we also want to avoid a "spike" in blood calcium levels...a problem that could potentially interfere with normal heart rhythms. This has been shown (although research has not determined if this has any long term detrimental effect) when a person ingests 500 mg or more of calcium all at once.

Our OsteoMineralBoost contains 140 mg calcium in each caplet. Once again, a very manageable amount of calcium for the body to assimilate without causing any excess spike of calcium in the blood. Taking 3 caplets of OsteoSustain throughout the day (not all at once)* and 1 to 2 caplets of OsteoMineralBoost (also spread throughout the day)* gives a person between 665 mg and 805 mg supplemental calcium. With another 600 mg or so of calcium from the diet, this is PERFECT for someone with bone loss. In addition, with OsteoSustain and OsteoMineralBoost you are also getting bioavailable magnesium, vitamins D and K, and trace minerals...all important for utilizing the calcium and helping your body put this vital mineral where it belongs...in your bones.

For the second question: Do calcium supplements cause kidney stones? With literally hundreds of research studies asking this exact question over the past 25 years you would think we would know the answer to this question. But studies have been conflicting. In an attempt to analyze all of this material, Candelas et al. (2012) did a systematic review from three sources to determine the answer. Candelas examined: 1) Medline and Embase from 1991 to 2010. 2) Cochrane Centered register of Controlled Trials up to 2010, and 3) Abstracts from the annual meetings of the American College of Rheumatology and the European League Against Rheumatism from 2008 thru 2010. Candelas' conclusion: "Calcium supplements in the treatment of osteoporosis alone or in combination with another type of treatment does not significantly increase the risk of nephrolithiasis or renal colic."

From both my clinical and personal experience, I know how important it is for people with osteoporosis to consume (and absorb) adequate calcium. This mineral is vital for improving bone health. But so too are vitamins D and K, and trace minerals. When taken on a regular basis, these nutrients will provide a safe and effective approach to improving skeletal health.  

*If you choose to take 3 OsteoSustain and 2 OsteoMineralBoost per day it is difficult to completely spread these 5 caplets out throughout the day by taking them one at a time. Therefore, it would be perfectly fine to take 2 caplets at a time. For example: Breakfast - 2 OsteoSustain, Lunch - 2 OsteoMineralBoost, Dinner - 1 OsteoSustain. (or any other combination you desire)  


Boland, M.J., et al. 2008. Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial. BMJ. Feb 2,336(7638):262-6.

Boland M.J. and Reid I.R. 2011. Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women's Health Initiative limited access data set and meta-analysis. BMJ. 342:d2040.

Hathcock, J.N. 2014. Vitamin and Mineral Safety, 3rd Edition. Council for Responsible Nutrition, pp 104-110.

Candelas, G., et al. 2012. Calcium supplementation and kidney stone risk in osteoporosis: a systematic literature review. Clinical and experimental rheumatology. Nov-Dec., 30(6):954-61.
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Bone Health, Digestion, and the Need for Resistant Starch

A good place to start improving bone health is in your gut. Poor digestion and rotting food in your intestinal tract provides both a smorgasbord and a breeding ground for pathogens. This causes gas, bloating, abdominal pain, belching, and lots of flatulence. If you have these signs and symptoms your digestion is impaired, your gut is full of toxins, and you are not able to absorb the nutrients you need for good bone health. In addition to reduced absorption, an unhealthy gut causes the immune system to go into overdrive. This creates a continuous outflow of pro-inflammatory substances from the intestinal mucosa. When this happens for an extended period of time it can lead to a condition called chronic inflammation, one of the most common causes of osteoporosis.

Improving gut health starts with a better diet. Reduce your sugar intake, cut back on the alcohol, and stop eating processed foods. After that, you may need to try taking hydrochloric acid (HCL) and/or digestive enzymes with your meals to aid digestion. Many of us, especially as we age, don't produce enough HCL to fully digest our food. The third step is to supplement with probiotics (live cultures of microorganisms) either in supplemental form or by drinking cultured milk called kefir. (Check out my blog on kefir and bone health.) Reinoculating your gut with "good" bacteria will help prevent gut colonization by pathogens and other opportunistic bacteria. We want to keep our digestive tract healthy, not only for better nutrient absorption but also as a way of reducing inflammation.

If you read chapter 5 in my book, The Whole-Body Approach to Osteoporosis, you will get a better understanding about how all this works and why it is so important for improving bone health. In addition to probiotics, it's a good idea to make sure the probiotics you are putting into your gut have something to eat so they can thrive. This is where "pre"biotics come into play. Prebiotics are non-digestible fibers that act as a food source for the good bacteria in your gut. If you want to learn more about the importance of prebiotics check out this great video from The Hungry Microbiome. And if you REALLY want to learn more about the importance of prebiotics, and specifically the use of potato starch for promoting gut health, check out Richard Nikoley's two part article on resistant starch.
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Alpha-Lipoic Acid Lowers Oxidative Stress and Bone Loss


Bone loss often begins in our late 30’s. This is long before a woman looses most of her estrogen at menopause or a man begins to decline in testosterone levels at andropause. So what gives? Both estrogen and testosterone ARE important for bone health but there must be something else going on if bone loss begins before these hormones begin to decline. And you are right, there is. It is called oxidative stress (OS).

The term OS is used to define the unhealthy state in the body where it is unable to neutralize free radicals such as reactive oxygen species (ROS). In other words, when it is being overrun by free radicals. Without adequate antioxidant mechanisms to neutralize ROS, progressive cellular damage results and the body is placed at a much greater risk for disease.

Normally, the body can adequately neutralize ROS. But pollution, heavy metal toxicity, chronic physiological stress, and gastrointestinal dysfunction can, and often does, place the body into overwhelming oxidative stress.

For bone, this can lead to insufficient production of bone-forming osteoblasts and the hyper-stimulation of bone-degrading osteoclasts. Oxidative stress, therefore, is a critical contributor to accelerated aging of bone and muscle.

In 2007 Grassi, et al., reported that there is a rise in ROS in bone marrow when estrogen levels are low. This excess ROS increases white blood cell and T cell activity fivefold. The T cells then begin releasing copious amounts of RANKL, the potent signaling molecule that stimulates the formation and activation of osteoclasts. This is why we see a dramatic rise in bone loss for at least 5 years past menopause.

So how can women and men reduce their risk of osteoporosis during these critical years? One way is by neutralizing excess ROS production by eating a healthy vegetable-rich low-inflammatory diet. Another is to supplement with antioxidants such as alpha-lipoic acid (ALA). (Our OsteoStim contains 300 mg ALA.) ALA protects against oxidative damage and since it is both water and fat soluble it is capable of going EVERYWHERE in the body. This is important because it can get into the fat-infiltrated bone marrow we often see in osteoporotic individuals. ALA can also help decrease excess blood glucose levels (a risk factor for increased fracture risk) and it is an essential cofactor for mitochondrial activity and energy production.

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C-Reactive Protein: Its Relationship to Fracture Risk and Bone Density

We have known for years that low-grade chronic systemic inflammation is associated with higher fracture risk. In my book, The Whole Body Approach to Osteoporosis, I explain this relationship in full. But what we do not fully understand is how this inflammation relates to bone mineral density (BMD).

This is exactly the question researchers from Norway set out to explore. In a study of 1902 women and 1648 men between the ages of 55 and 74, researchers tested the relationship of inflammation, as indicated by a biomarker called C-reactive protein (hs-CRP), to bone density and non-vertebral fractures.

The study showed an inverse relationship between hs-CRP and bone density in men (but not women). The higher the hs-CRP in men, the lower was their bone density. They also determined that elevated hs-CRP predicted increased fracture risk for both men and women. The authors concluded that inflammation influences fracture risk in both men and women.

So what can you do to lower chronic inflammation and reduce your fracture risk? A low-inflammatory diet rich in vegetables is a great way to start. Then try OsteoStim. This OsteoNaturals product is a potent blend of antioxidants, vitamins and medicinal herbs designed to limit the adverse effects of chronic inflammation on bone and encourage normal bone metabolism (as seen through the reduction in NTX, CTX, and/or DPD -- biomarkers that reflect the activity level of bone-resorbing osteoteoclasts).

One of the ingredients in OsteoStim is alpha-lipoic acid (ALA). This powerful antioxidant is an essential co-factor for cellular energy production. ALA also helps reduce the damaging effects of pro-inflammatory cytokines (Il-1, Il-6, TNF alpha, and NF-KB) and their tendency to spur on aggressive osteoclastic bone-resorbing activity.

In a recent article published in the European Journal of Pharmacology, researchers evaluated the protective effect of ALA on rat bone metabolism. They monitored pro-inflammatory cytokines (Il-1, IL-6, and TNF) to observe the inflammation process and how it was affected by ALA. The researchers concluded that "ALA had a protective effect on both senile and postmenopausal osteoporosis." "...ALA may be a candidate for radical osteoporosis treatment both in senile and postmenopausal types..."

Dahl, K., et al. 2014. High-sensitivity c-reactive protein is an independent risk factor for non-vertebral fractures in women and men: the Tromso Study. Bone Nov. 20. 

Polat, B., et al. 2013. The effect of alpha-lipoic acid in ovariectomy and inflammation-mediated osteoporosis on the skeletal status of rat bone. European Journal of Pharmacology 718(1-3):469-74.
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