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Wednesday, March 13, 2024

Beyond Fosamax: Options for Osteoporosis

Osteoporosis is widespread in the senior community, and there is no cure. What options are available to someone looking for more than the usual prescribed drug?

Half of Americans aged 50 and up have low bone density (osteopenia) or full-blown osteoporosis. It’s more common in women (especially after menopause), but guys, you are not immune. A man is more likely to break a bone due to osteoporosis than to get prostate cancer, according to the Bone Health and Osteoporosis Foundation. In fact, the disease causes two million broken bones every year.

Currently, there is no cure. Patients are most often prescribed Fosamax, a biophosphonate that can slow bone loss. However, it has a host of potential side effects including problems with your esophagus and stomach. In rare cases, it may actually cause bone loss in the jaw or femur. 

How is Bone Density Measured? 

There’s a simple way to measure bone density called a DEXA scan. It’s an imaging test that uses very low-level x-rays to show bone health. It’s quick, lasting about 25 minutes, painless and low-cost. Medicare will pay for a DEXA scan every two years, or more if you have special circumstances.

Many older adults with bone loss understandably look further afield for ways to stop the progression of this common disease. Two regimes that are widely supported within the medical community concern diet and exercise. We also examine jump exercise, the use of a weighted vest, aqua therapy, and the use of a vibration plate. Lastly, we look at OsteoStrong clinics.

Osteoporosis Diet

Foods that are good for bone health include dairy products such as milk, yogurt and cheese. Fatty fish like salmon and tuna rate highly, as do many fruits and vegetables. Go here for a complete list. There is some research suggesting that olive oil, blueberries, soybeans and foods containing a lot of omega-3s, such as fish oil and flaxseed oil, provide benefits. 

Foods to be aware of include beans, which contain phytates that can interfere with calcium absorption. And while getting enough protein is important, special high-meat diets can cause your body to lose calcium. Eating too much salt can also cause your body to leach calcium, so aim for a maximum of less than 2,300 mg per day. Oddly, 100% wheat bran decreases calcium absorption. If you eat bran cereal as a “healthy” breakfast option, be aware that it’s preventing your bones from using much of the calcium in the milk you pour over it.

Not surprisingly, heavy drinking is not advised for those with bone loss since it can result in further erosion. Coffee, tea, and soft drinks can decrease calcium absorption. Although the carbonation in soda isn’t harmful, it appears the caffeine and phosphorous (listed as “phosphate” or “phosphoric acid”) can be. Some studies show that colas, and not other soft drinks, are the culprit. Finally, it may just be that replacing milk and other calcium-fortified beverages is the root problem.

Osteo Supplements

Whenever you consider supplements, it’s important to get your doctor’s advice. They can interfere with other drugs, and may worsen certain conditions, such as kidney stones. When you do choose appropriate supplements, make sure what’s in them is what’s on the label.  Getting supplements certified by the United States Pharmacopeia (USP) means they have been tested for ingredients and contaminants.

Bone Workout

Two types of exercise are particularly helpful for anyone with osteoporosis: weight bearing and muscle strengthening. Weight-bearing exercise includes what you do standing up, such as hiking, dancing, walking upstairs and jogging. Low-impact weight-bearing exercise is done using elliptical or stair-step machines, fast walking on treadmills or outside, and low-impact aerobics.

Muscle strengthening is done with free weights or weight machines, using elastic bands or by lifting your own bodyweight. Check here for more information as well as links to exercise videos.

However, not all exercises are appropriate for all people, especially since stress fractures can occur. A growing trend, especially online, is to have specialist osteo coaches and osteo physical therapists. One to try who is highly regarded is Margaret Martin of Canada. You can also find someone you might like by searching for “osteo workout” on youTube. Be sure to get your doctor’s approval before you begin.

Jumping exercise is something easy to do at home, and it offers greater bone-building benefits than jogging, according to a study in the American Journal of Health Promotion. In various studies, jumping was done straight up from the floor, off of a low box, from side to side and from front to back. Some had participants jump 10 times, twice per day. Others had more varied jump workouts, with protocols such as waiting at least 10 seconds between jumps. Ask your doctor before starting a jumping workout; it’s not advised for those with very brittle bones. 

Weighted Vest

One study showed that postmenopausal women who wore a weighted vest while jumping three days per week arrested bone loss in the hip area. Participants continued the regime for more than five years, showing strong compliance. It’s simple to do at home, and a weighted vest is easy to order off the internet. 

At Wake Forest University, Dr. Kristen Beavers is wrapping up a years-long study this April on the benefit of wearing a weighted vest to maintain bone health while losing weight. A pilot study had participants wear a two-pound vest about 6.5 hours a day, adding weight in two-ounce increments to the vest as participants lost it from their body. “With the weighted vest, you’re keeping yourself at an equal load while you lose weight,” Dr. Beavers said. “We know that not all, but a lot, of bone loss that occurs when you drop pounds is because of this ‘unloading effect.’” People who wore the vest in the pilot study reduced loss of hip bone dramatically.

Aquatic Exercise

A meta-analysis of aquatic exercises for people with osteoarthritis may be useful for osteoporosis patients who experience joint pain and dysfunction, or those who are unable to exercise on a hard surface. The buoyancy of water can be particularly helpful for people with excess weight, since the water helps support their bulk. Hydrotherapy can improve gait and posture with minimal joint stress. Go to Hydroworx for specific exercises including warmup and strength training. 

Vibrating Therapy Plates

Marodyne low-intensity vibration (LiV) and the similar US-made Juvent micro-impact platform are non-drug interventions used to treat osteoporosis. Developed for astronauts, it works by standing on a plate that delivers vibration throughout your body. The companies claim their devices redevelop bone and muscle tissue while improving balance and mobility. 

These are different from high-vibrating machines that may be found in some gyms, which can worsen some problems, such as detached retinas. The Marodyne LiV has no contraindications and no known side effects and is a certified Class IIa (intermediate risk) medical device. The Juvent is a Class I (low risk) medical device whose claims have not been cleared by the FDA.

The Marodyne LiV is available for about $3,000, while the Juvent product runs a cool $5,995. You may be able to find a location near you that has one or the other available for a small fee. Talk to your doctor about the risks or benefits of using one of these machines to determine if it is right for you.

OsteoStrong Clinics

Popping up like mushrooms after a rain, OsteoStrong clinics offer a four-device circuit that delivers low-impact exercise. The company claims that one 15-minute session per week is all it takes to improve strength, performance, balance and overall vitality. It uses a process called osteogenic loading to induce axial compression to simulate high impact forces in a safer environment. 

Some OsteoStrong members report improved bone density, balance and strength, as well as reduced joint pain. Some members of the healthcare community have taken issue with some of these results, especially concerning claims to reverse bone loss. Others find that OsteoStrong’s peer-reviewed, science-based program is a valid treatment. It’s worth discussing with your doctor if this treatment could help you.

A growing number of older adults suffer from bone loss – and many don’t even know it until a fracture sends them to the hospital. Ask your doctor if you should get a bone scan. If you’re one of the many with this disease, evaluate your options carefully. There is a lot more you can do than just taking Fosamax. 


Blog posting provided by Society of Certified Senior Advisors