In case you had not noticed, pharmaceutical companies are spending enormous sums of money creating television advertisements which are designed to promote fears of ill health in the general population. Without necessarily mentioning the name of any pharmaceutical product for sale, these ads may be designed to increase awareness of the likelihood that some dreaded event may happen to you any time in the next 30 years. The marketing bonanza for the drug companies is based on the premise that a preventive medicine should be taken for life in order to reduce the chances of an uncertain event. In the case of osteoporosis, this is a very tricky presumption. It is true that many older Americans, especially women, will experience a hip fracture in the course of their lifetime. It is also true that approximately half of these occur after the age of 80. So while some degree of bone thinning (osteopenia) is normal in a large percentage of women at age 50, it does not necessarily follow that all of those women need to be taking prescription bone density drugs for life as the television ads may imply. It is important to get advice from a medical professional before relying on television ad information as your impetus to start a prescription.  So while there are many times when a prescription for bone density is important, natural solutions are always in order, and can complement and augment the effects of conventional medicine.  Here are a few of my safe and reliable suggestions:

• If you have not already done so, ask your doctor (or this office if you prefer to have me order your blood tests) for a Vitamin D blood test.  I have found, consistent with national data, that a large number of my patients are deficient, even in the sunny south.  This is a correctable risk for osteoporosis, and I can discuss interventions should your blood level show deficiency.
   
• Nutritional recommendations for bone health include some surprises.  I recommend several servings of soy foods weekly, as scientific evidence supports its benefit for bone health.  I recommend whole soy foods such as edamame, tofu, miso, and unsweetened soy milk, rather than the textured soy protein in powders or made to look like meat.  You can find calcium in cow’s milk, but sometimes cow milk creates problems for humans, so look for other high calcium foods such as calcium fortified orange juice, broccoli, collards, bok choy, and kale. 
   
• Supplements for bone health can be helpful.  Be careful that your multivitamin does not contain preformed vitamin A (retinyl palmitate or retinol) as this can interfere with bone health; look instead for a vitamin with mixed carotenoids as the source for vitamin A.  A minimum daily maintenance supplemental dose of vitamin D3 is 1000 IU (much higher than previous recommendations), and higher doses than that if you are deficient.  Bone thinning is at least in part an inflammatory condition, so I recommend a preventive daily dose of fish oil (omega 3 fats) for almost everyone.  If you are not certain you are getting somewhere around 800 mg calcium per day, a calcium supplement can be good.
   
• Mind-body medicine has no research documenting its effectiveness for osteoporosis, but my experience in practicing clinical hypnosis has suggested it may have powerful effects for many medical conditions where we have no research.  With the unmet need in this area, I am in the process of producing an audio hypnosis program called “Healing Imagery for Strong Bones” which should be in production and ready within a few weeks!  Stay tuned. 
   
• Physical activity is the single most important determinant of bone health over a woman’s lifespan.  Some regular aerobic as well as resistance exercise is crucial to bone health.  Start simple, start easy, and work up from there.
   

Robert Pendergrast, M.D.