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Concerns raised over long-term use of bone drugs,                  New York Times Article

The following excerpt is from an article from last weeks New York Times, Concerns raised over long-term use of bone drugs.

“In an unusual move that might prompt millions of women to rethink their use of popular bone-building drugs, the Food and Drug Administration published an analysis Wednesday that suggested caution about long-term use of the drugs but fell short of issuing specific recommendations.

The analysis in The New England Journal of Medicine found little if any benefit from the drugs, known as bisphosphonates, after three to five years of use.

The FDA review was prompted by a growing debate over how long women should continue using the drugs, which have been sold under such brand names as Fosamax, Boniva, Actonel and Reclast. The concern is that after years of use, the drugs might in rare cases actually lead to weaker bones in certain women, contributing to “rare but serious adverse events,” including unusual femur fractures”

In June 2010 I wrote the following article, Osteoporosis Drugs Cause Fractures? Uh-oh!  I think it is worth repeating for anyone who might be taking these medications or for anyone considering medications. Following is the article.

Troubling news is mounting regarding the primary drugs used to treat osteoporosis.  The drugs are classified as bisphosphonates, and some of the common names include Fosamax, Actonel, Boniva and Reclast.

Carole Ames said, “I walked into my husband’s bedroom and my leg just broke and I went down.”

Sue Heller age 60, of Castle Rock, Colo., had been on Fosamax for almost 10 years. She broke both of her femur bones at the same time.

Sandy Potter age 59 of Queens, NY said she was jumping rope when she felt her thighbone snap.

“We are seeing people just walking, walking down the steps, patients who are doing low-energy exercise,” said Dr. Kenneth Egol, professor of orthopedic surgery at NYU Langone Medical Center. “It’s very unusual, the femur is one of the strongest bones in the body.”

One doctor reported on World News with Dianne Sawyer that she had sustained a thigh fracture with no force.  She has started a support group that now includes 31 women and a man who have sustained femur (thigh bone) low force or no force fractures.  Amazingly 1/3 of the people in this group have fractured both of their femurs. Many doctors, including myself believe that this is the tip of the iceberg regarding such fractures.

It may be hard to believe, but this sad outcome was predictable.  How can that be?  Anyone with a basic understanding of how healthy bone stays healthy should know.  Our skeleton is designed to replace itself every 7 years.  There are two specialized bone cells for this process – osteoclasts, chew up old bone and get rid of it while osteoblasts lay down new bone.  Now you know the main secret for healthy bone to maintain being healthy.  Now lets imagine something interfering with that natural process.  Bisphosphonates basically poison osteoclasts.  OK class, let’s guess; what might happen if you disrupt that process for years? You got it; a bunch of old bone, which means brittle bone!  Am I a rocket scientist to have figured this out?  Not really; I simply understand basic physiology.  Why then are medical doctors continuing to prescribe these medications?  Don’t get me started.  You are reading me right, I am angry about all of the needless suffering that mostly women are going through because of the drug companies’ over-inflated selling of these drugs.

The current recommendation for bisphosphonate medications is that no one should stay on bisphosphonates beyond 5 years.  But I think we also need to question the first 5 years.  These medications are biologically active in the bone for years after discontinuing use.  I know many women are in fear of fracturing their bones, particularly those who have taken bisphosphonates for over 5 years.  For these women I feel additional evaluation should be considered including x-rays and or MRIs of the femur bones, especially if pain is experienced in the thigh bones which may indicate micro fractures.

In addition to the horrific side effect of low force fractures, other side effects have also been reported including severe musculoskeletal pain, as well as a serious bone-related jaw disease called osteonecrosis (areas of bone death), and gastro intestinal disturbances or GERD (Gastric esophageal reflux disease).

Now the question is should women even start taking these medications?  If so, what type of case would qualify the use of bisphosphonates where the benefits outweigh the risks?  For certain individuals who have very serious osteoporosis all options should be considered.  For instance a -4 T score, which is approximately 50% less bone mass than the average 35 year old, is very significant while a -2.5 T score is less serious and can easily be managed for most people.

While I am highly skeptical of the use of bisphosphonates, I am open to the idea that they may benefit a certain population.  These are some of my considerations when evaluating a case:

• Each patient should be regarded as an individual – what causes bone loss in one person is not the same as the next.  For instance, one person may be taking medications that result in bone loss while another may have a digestive disorder.
• Complete nutritional analysis is core to any treatment program.
• Proper lab work including bone markers or at least two bone density tests that indicate bone loss or bone stability.
• Has the patient incurred low velocity fractures?
• What is the patient’s age?
• What is the bone density?  Is it marginal or severe?
• There are many medications that might be on the table depending on the particular individual which include:  Bisphosphonates, Forteo, Strontium Ranelate, bio-identical hormones, Selective Estrogen Receptor Modulators, Miacalcin (calcitonin).
• Alternative options include:  Top notch nutritional evaluation and solving any digestive disorders. Exercise programs including whole body vibration, weight training, sound supplement program from reliable companies, hormone balancing that may include bio-identical hormones.  Strontium citrate is getting a lot of attention, and while the studies are still not large enough it very well may pan out.

Make sure that you learn all you can about bone if you have been diagnosed with osteoporosis as this will be an ongoing discussion with your health care providers for the rest of your life. If you want to learn more consider one of the programs listed click here

Wait until age 65 to have a bone density? Prune Update

Prune article, scroll down the page.

Wait until age 65 to have a bone density?

The HMO’s have run with this directive from the International Society of Bone Densitometry ISCD). I read a newspaper headline the other day, “Bone density testing Not Necessary until the age of 65.” I have talked with patients whose doctors are telling them they do not need the test without doing a complete history to see if there is a need. The actual directive from the ISCD regarding bone density testing is the following:

Indications for Bone Mineral Density (BMD) Testing

• Women aged 65 and older
• Postmenopausal women under age 65 with risk factors for fracture.
• Women during the menopausal transition with clinical risk factors for fracture, such as low body weight, prior fracture, or high-risk medication use.
• Men aged 70 and older.
• Men under age 70 with clinical risk factors for fracture.
• Adults with a fragility fracture.
• Adults with a disease or condition associated with low bone mass or bone loss.
• Adults taking medications associated with low bone mass or bone loss.
• Anyone being considered for pharmacologic therapy.
• Anyone being treated, to monitor treatment effect.
• Anyone not receiving therapy in whom evidence of bone loss would lead to treatment.
• Women discontinuing estrogen should be considered for bone density testing according to the indications listed above.

There are many reasons to consider bone density testing. Keep in mind that the bulk of our bone mass (about 80%) is laid down by the time we are 18 years of age. So the first question is, did you lay down a good bank account of bone? In my case, I did not lay down a good bank account of bone, which led to borderline osteoporosis before menopause. As a teenager I smoked cigarettes and I did not eat a healthy diet. Add to that, I have small bones and I am thin. This background is enough to request a bone density test before menopause.

After the age of 35, bone loss, especially for women with small frames is .5 to 1% per year. During the menopausal transition it can increase to 1-3% per year. This incremental bone loss adds up. To avoid loss it is critical to resolve gastrointestinal problems and to nurture healthy bones through nutrition and exercise.

Potential Benefits of early testing

Cases of osteoporosis will be caught early through early testing. Knowing you have low bone mass or osteoporosis can be a serious wake up call to resolve digestive issues, eat a healthy bone building diet and maintain an exercise program. Also, if someone has serious low bone mass, proper lab tests can be ordered to determine whether or not bone loss is occurring presently. This is important. Active bone loss is a concern. You can have osteoporosis that is stable, meaning bone loss may have occurred earlier in life or a good bank account of bone was not developed in the first place. A good example is someone who has a history of anorexia or high soda or coffee intake for a period of years. They may not engage in these activities today but such a history, especially in formative years may indicate that the bone did not reach it’s full peak bone mass. This type of history is enough for me to check bone density.

There is a long list of concerns that would make me order a bone density exam based on the patient’s history. The most important time for a woman to consider a bone density exam is before menopause, if she has additional risk factors. Why? Bone loss can be considerable during the years leading up to menopause and up to 10 years after. Age related bone loss (which can be prevented in some people) is .5 to 1% a year and during the menopause transition it can be 1-2% each year or 20% in some women. That is a lot of bone to lose.

Unfortunately, with the headlines reading, “No need for a bone density test until age 65” those who need it most may be over looked. The question you need to ask yourself is whether or not you have risk factors that caused you not to build a good bank account of bone or if you have health issues presently that may be causing the leaching of bone. Osteoporosis is a disease that often is not discovered until a fragility fracture occurs (low trauma fracture). Here is a list of risk factors to consider. If you have any of these risk factors you may have osteoporosis and not know it.

• Caucasian or Asian ethnicity
• Thin women or small bones
• Rheumatoid arthritis
• History of fractures
• History of dieting
• Anorexia or bulimia
• Digestive problems (malabsorption)
• Relatives with osteoporosis
• Parent who sustained non-traumatic fractures
• Early menopause
• Pregnancy – multiple
• Lactation – extended
• Inadequate exercise
• Excessive exercise
• No menses for extended time
• Ovary removal (both)
• Kidney disease
• Hyperparathyroidism
• Hyperthyroidism
• Diabetes
• Chronic stress
• Smoking particularly in formative years
• Heavy alcohol past or present
• Heavy caffeine intake
• Junk food diet – high sugar, processed carbohydrates, high salt
• Carbonated drinks
• Acidic diet
• High or low protein intake
• Vitamin D deficiency
• Low calcium, magnesium intake & other bone nutrients
• Chronic antacid use – we need acid to aid in calcium absorption and protein breakdown
• Medications: Proton pump inhibitors, aromatase inhibitors, corticosteroids, antacids, thyroid medications, Dilantin, SSRIs for treatment of depression

Men’s bone can be depleted from the same conditions above that do not apply to women only. In addition men can also have an increased risk if they are smaller in stature or have hypogonadism with a low testosterone output.

BONE QUALITY

Bone density is part of bone quality but bone quality extends way beyond density alone. That is why some people with osteoporosis fracture easily while other people do not. Example: Stacy has borderline osteoporosis and she has a malabsorption problem that has robbed her of nutrients needed to build and maintain healthy bone. She fractured her hip at age 65 with minimal trauma. What is minimal trauma? Falling from a standing height and breaking a bone or breaking a bone with minimal trauma. Most people with healthy bones would not sustain a fracture from minimal trauma. If you have had a fracture, ask yourself if the fracture seemed reasonable given the forces placed upon the bone.

Can you have osteoporosis and have a normal bone density test? YES!

Bone density is not everything and osteoporosis experts are trying to get doctors to think about the disease in many ways. Fractures trump bone density. So, if someone has had fragility regardless of the bone density there is a major bone problem. So, you can have normal bone density and fracture. This means that the bone quality is not good and that the bone is brittle for some reason. To be clear most people who sustain an osteoporosis related fracture also have low bone density.

Prune (Dried plum) update

My own prune experiment plus the response from many of my readers has resulted in some new thoughts and guidelines about bone healthy prunes. Prunes are mildly to moderately acid forming. Since many people run acidic which can also leach bone, it is important to balance prunes with alkaline foods. Here are some tips and thoughts about prunes (dried plums).

• Put 12 or more prunes in a small Mason jar and cover them with boiling water. Let them cool to room temperature (30-60 minutes) and refrigerate. This will make the prunes soft and they will be easier to digest.
• My article on prunes (hot link) noted a study that demonstrated an increase in bone density using 100 grams/day or about 12 medium sized prunes. A lot of people will not be able to tolerate so many prunes. For me 4-6 each day feels right as part of my bone healthy diet.
• Prunes are OK for diabetics in small amounts as the fiber slows down the sugar from dumping into the system all at once. If you have a blood sugar problem try one or two and test your blood sugar to see if prunes are right for you.
• Prunes are certain varieties of plums that have been allowed to fully ripen on the tree until they develop their maximum amount of sweetness. Then, once they are harvested, they are dried for up to 24 hours to remove most of the water.
• When you buy whole prunes in the store, make sure they are moist which means they are fresh. If you buy in bulk, select prunes that are moist and flexible. Their skin should be a kind of bluish black with no blemishes.
• Storing prunes – Store in airtight containers in a cool, dry place. In the refrigerator they’ll last about nine months and can be frozen for about a year.

Prunes are indeed a bone healthy food as are many other foods.

 

 

No Longer Poo-pooing Prunes!

I was skeptical of the animal studies regarding increased bone density and prunes. The evidence regarding the bone benefits of prunes is mounting so, I am not longer poo-pooing prunes – I know I am supposed to say dried plums and at times in this article I manage to write the newer term, but honestly, they will always be prunes to me.

Dried plums are one of the world’s healthiest foods. It appears that they are packed with bone-building phenolic compounds, boron and potassium, all of which play important roles in bone health. Following is a human study that looked at bone markers and bone density exams.

Comparative effects of dried plum and dried apple on bone in postmenopausal women

Journal of Nutrition September 2011 - Hooshmand S, Chai SC, Saadat RL, Payton ME, Brummel-Smith K, Arjmandi BH.

Breakdown of the study in a nutshell

Study appeared in the Journal of Nutrition, September 2011

• 236 women were recruited who were 1-10 years postmenopausal. 160 women qualified and they were randomly assigned to: 100 grams/day dried plum (about 12) or dried apple.
• Participants were not on hormone replacement or any other medication known to influence bone metabolism
• Participants received 500 mg calcium plus 400 IU vitamin D daily
• Bone mineral density (BMD) of lumbar spine, forearm, hip and whole body was assessed at baseline and at the end of the study using dual-energy X-ray absorptiometry.
• Blood samples were collected at baseline, 3, 6 and 12 months to assess bone bio-markers.
• Physical activity recall and 1-week FFQ were obtained at baseline, 3, 6 and 12 months to examine physical activity and dietary confounders as potential covariates

Findings

• Dried plum significantly increased BMD of the ulna (forearm bone) and spine in comparison with dried apple.
• Only dried plum significantly decreased serum levels of bone turnover markers including bone-specific alkaline phosphatase and tartrate-resistant acid phosphatase-5b.

Conclusion of authors

• The findings of the present study confirmed the ability of dried plum in improving BMD in postmenopausal women in part due to suppressing the rate of bone turnover.

Opinion of authors

Among the nutritional factors, dried plum or prunes (Prunus domestica L.) is the most effective fruit in both preventing and reversing bone loss.

Dr. Lani’s comments:

While this is still a small study, it is another study showing that prunes may very well impact bone in a positive way in some individuals. I contacted the lead researcher, Dr. Hooshmand to discuss a few key points. One, dried plums cause many people gastrointestinal distress and loose stools. How well did participants maintain compliance? She said she started participants slowly until they reached 12 per day. The apple group was fine and did not need lead-in time. The other question I had about the study was what was the increase in bone density and was it statistically significant? I viewed the study data and from their posted findings, I do think there was a true increase in bone density in the distal ulna of about 4% on average and the lumbar spine about 2-3% on average. No change in the hip, which is expected. The first place bone density will show change is in the inner bone (cancellous bone) and the spine and distal ulna contains a high amount of cancellous bone. Bone markers (lab testing) also showed positive bone building findings in the prune group but not the apple group.

This study, along with many animal studies observing the effects of dried plums on bone, seems to be adding credibility to the conclusion that the shriveled up fruit benefits bone health.

What about sugar content? The following is from Diabeticcooking.com:

Some people with diabetes probably think they can’t have fruit, especially dried fruit like prunes, because of naturally occurring fruit sugars. However, prunes (also called dried plums) have a lot more going for them than their well-known laxative effect. Let’s take a fresh look at this underrated fruit, which humans have been eating since the days of the Roman Empire.

One serving of prunes, 1/4 cup, has just 100 calories, 26 grams of carbohydrate, and 3 grams of fiber. Prunes are fat-free, cholesterol-free, and low in sodium, and they have a low glycemic index, which means they are less likely to cause spikes in blood glucose when eaten alone. They also contain antioxidants, which research suggests may help prevent a number of chronic diseases.

Most people with diabetes should be able to fit fruit into their individualized eating plan. To enjoy fruit safely, make sure that your portion sizes are accurate. And if fruit raises your blood sugar during snack time, then opt for different foods at those times and work fruit into your eating plan at different times, or in combination with other foods. Prunes can be found in the dried fruits section of supermarkets. Choose soft fruits that have blue-black skins free from imperfection. They can be stored for up to six months in a cool, dry place if kept in an airtight container.

The obvious way to eat prunes is out of hand, but we have some other ideas. Chop them up and add them to your favorite green salad for a burst of sweet flavor, or stir them into a bowl of steaming Irish steel-cut oatmeal. Also consider using prune purée as a substitute for some or all of the fat in baked goods—this dramatically reduces fat and cholesterol.

Prune challenge – Please report back how prunes work or don’t work for you

Should you take prunes for your bones? They are a super food for your overall health and bone health too. The studies used 100 grams, which is equivalent to 10-12 medium sized prunes. For some, this dose of prunes can cause digestive problems, including loose stools. For those who suffer constipation it may work out very well, eliminating constipation. Start with 2-4 a day for a while and work your way up to 12 and report back on this blog what you discover. I was so excited after reading this study that I ate 6 prunes – bloat city! I am now happily eating 2 prunes twice daily and my plan is to add another prune every other day until I reach 12.

Will Dried Plums Reverse Osteoporosis? A Cautionary Note

Oh, if it were only that easy! The causes of osteoporosis is staggering including hormone imbalance, gastrointestinal problems resulting in poor digestion of nutrients, past history of an eating disorder, vitamin D deficiency and medications known to result in bone loss such as proton pump inhibitors (Nexium and Prilosec), SSRIs to name a few. A woman’s risk for accelerated bone loss increases significantly just before menopause and for three to ten years after menopause. If you have been diagnosed with osteoporosis or osteopenia make sure that your doctor has evaluated your case properly. How do you know whether or not your case has been diagnosed correctly? It is difficult for the layperson to know, however your doctor should specialize in osteoporosis and take a complete history, order lab work and keenly evaluate your diet and discuss the importance of digestive healthy.

Bone is not dry, it is alive and dynamic!
Finding my new voice

What a delicious day! On March 18, I gave my first public workshop in many years. Dr. Rae Lyn Winblad offered her lovely office space for the event and the presentation Down to the BONE! felt so right. In the past my talks about bone always had osteoporosis in the title and it simply did not pull people in. People view osteoporosis as a condition that only, much older people have. Last December a friend, Heather Munroe-Pierce, suggested that I give a talk at the Berkeley YMCA. I thought maybe 20 people would show up, but instead over 100, mostly women showed up for the talk. Evelyn Larson who handles the speaker program is a fantastic promoter (and fitness guru) so, I thought it was a fluke. As it turned out, Mary D’Elia (another fitness guru) from the Albany YMCA happened to be there and she asked if I would present the same talk for the Albany YMCA. On a Monday at noon, the room was again packed and standing room only.

At the last minute I decided to offer a six-hour bone workshop. Thirty women signed up (room capacity) and for me, the day was magical. For the past 12 years I have taught continuing education seminars for acupuncturists, chiropractors, naturopaths and nurses. But, I found that I wanted to reach out to the people who need it most. At the March 18 workshop, women were eager to learn about bone, as most had been diagnosed with osteopenia or osteoporosis. The topic of bone is NOW! We tend to think more about our muscles and joints because they will cause pain more frequently than bone. Bone is not painful unless something is seriously wrong, such as a fracture or long-term vitamin D deficiency, which can result in a painful condition in adults called osteomalacia.

I am deeply passionate about bone and love teaching about these 206 bones that must carry us through a lifetime. At the workshop my friend and meditation teacher, Patricia Ellsberg led us in a Down to the BONE mindfulness meditation that was wonderful. Women who have been diagnosed with osteoporosis or people who have suffered an osteoporosis related fracture (fragility fracture – a fracture that should not have happened) are deeply concerned and frightened. The workshop’s aim is to teach lay people the language of bone. This is essential to understanding the flood of information and opinions that they will be receiving regarding medications, nutrition, supplements and herbs. There is a glut of information out there and sadly, much of it is not accurate or downright false.

My deep gratitude to Dr. Rae Lyn Winblad who offered her lovely, peaceful office space for the March workshop. Her positive, healing energy is inspiring to all who know her.

Is osteoporosis caused by low calcium intake?

We hear a lot about calcium and our bones. In a recent newsletter I wrote an article, Calcium , the Double Edged Sword. Yes, we need calcium for our bones, but it is not the whole story. When I attend osteoporosis conferences nutrition is barely mentioned. When it is covered, the only nutrients typically mentioned are calcium (Tum’s no less) and vitamin D. Occasionally, vitamin K is mentioned, but by and large, the emphasis is on research involving medications or new discoveries regarding bone cells. The following is an excerpt from anthropologist Susan Brown, Ph.D.. She suggests that the notion that osteoporosis is caused by low calcium intake is a myth.

“Increasing calcium is certainly one way to strengthen bone — but we have to look at it in context. It’s been the opinion of Western researchers for decades that low calcium intake leads to osteoporosis. Because bone is composed largely of calcium, it might appear logical to link calcium intake directly with bone health. But in reality calcium depends on other nutrients to do its work, and so just increasing calcium without other bone-building nutrients may cause more harm than good. What’s interesting is a glance at the cross-cultural data, which shows us that most areas of the world have lower calcium intake than we do, yet have lower rates of osteoporosis. In fact, it has been documented that the countries with the highest calcium intake have the highest hip fracture incidence. So more calcium doesn’t automatically equal stronger bone.

All researchers agree that adequate calcium is absolutely essential for development and maintenance of bone health. The question so often asked is, how much calcium is adequate? The data I’ve looked at indicate that there is no one standard ideal calcium intake, but that it varies based on a number of other coexisting factors. These factors include digestive health; intake of other bone-building nutrients; consumption of potentially calcium-depleting substances like excess protein, salt, fat, and sugar; the use of some drugs, alcohol and tobacco; the level of physical activity; exposure to sunlight; environmental toxins and stress; ovary and uterus removal; and many other factors that limit absorption and endocrine gland functioning.”

Dr. Lani’s comments

I couldn’t agree more with her analysis. Bone is very complex, so to dumb it down to one nutrient is simply wrong. What is abundantly clear is that each case of osteoporosis is different than the next. Many of my patients who have osteoporosis do in fact need calcium supplements. Some have dairy allergies and some have digestive problems that lead to malabsorption of calcium. Calcium needs to be balanced with other bone healthy nutrients including, magnesium, vitamins, D, K and A (too much vitamin A or the wrong form can result in bone loss too) and more. Too much or too little protein is not good for bone either.

I encourage anyone who has been diagnosed with osteoporosis or osteopenia (low bone mass) to learn about bone. This is so important because every health practitioner that you see for the rest of your life will have an opinion and recommendation regarding medications supplements and so on.

As Dr. Brown points out in other articles, osteoporosis is not seen in some cultures until they take on a more western style of living including junk food and sedentary life style.

 

FIGS – good for your heart and your bones

Figs contain approximately 80 milligrams of calcium (79 milligrams in an 8 oz-wt serving), a mineral that has many functions including promoting bone density. Additionally, figs’ potassium may also counteract the increased urinary calcium loss caused by the high-salt diets typical of most Americans, thus helping to further prevent bones from thinning out at a fast rate.

Cardiovascular Effects

In animal studies, fig leaves have been shown to lower levels of triglycerides (a form in which fats circulate in the bloodstream), while in in vitro studies, fig leaves inhibited the growth of certain types of cancer cells. Researchers have not yet determined exactly which substances in fig leaves are responsible for these remarkable healing effects.

• California dried figs are an excellent source of dietary fiber. Just 3 – 5 dried or fresh provide 5 grams of dietary fiber.
• The calcium content of dried figs is over 100% greater than other dried fruits. 5 figs contain 80 – 125 mg of calcium.
• Super Potassium – on an equal weight basis, dried figs have nearly 80 percent more potassium than bananas. potassium may also counteract the increased urinary calcium loss caused by the high-salt diets typical of most Americans, thus helping to further prevent bones from thinning out at a fast rate.

More goodness!

Dried figs outrank most fruits when comparing calcium, iron, magnesium, phosphorus, copper, manganese and other important nutritional components!

USDA USDA Nutrient Database

Source: Whole Foods

SSRIs | Serotonin | Osteoporosis

If you are interested in learning more about how to keep your bones healthy please attend, DOWN TO THE BONE! January 28th online webinar live event. Can’t make it? It will be taped for future viewing.

SSRI Antidepressants Linked to Decreases in Bone Density

Over the last several years, a number of studies have found a relationship between decreased bone mineral density and long-term use of SSRI antidepressants. The theory behind this association is that serotonin is part of the system that regulates signaling in bone cells and that medicines that affect the serotonin system could change bone metabolism.

At the American Psychiatric Association meeting in 2010 researchers from Canada presented a large, well designed study that provides more evidence that bone density can be reduced in people taking SSRI’s for long periods of time.

The two faces of serotonin in bone biology.

Following is an excerpt from an abstract from Cell Biology October 2010 Ducy P Karsenty.

The serotonin molecule has some remarkable properties. It is synthesized by two different genes at two different sites, and, surprisingly, plays antagonistic functions on bone mass accrual at these two sites. When produced peripherally, serotonin acts as a hormone to inhibit bone formation. In contrast, when produced in the brain, serotonin acts as a neurotransmitter to exert a positive and dominant effect on bone mass accrual by enhancing bone formation and limiting bone resorption.

Dr. Lani’s comments:

If you are taking SSRI’s make sure you are not doing other things that rob you of much needed bone mass. I personally believe that anti-depressants are overprescribed, like many other medications. Many people who experience depression eat a depressing diet – high sugar and low on nutrient value. Gastrointestinal problems may also result in depression over time. Now let’s add in menopause with hormonal changes. It takes time for a doctor to sort out the root cause of depression, which should include a good history and nutritional analysis. Some patients I see have been on these medications for years, without trying to get off to see if they actually, “need” them. I know there is wise use for SSRI’s, and some people may need them. If you are considering trying to wean off these medications it is critical that you work with your doctor. And, if your doctor does not work with nutrition find someone who does and make sure you are well supported nutritionally before attempting the weaning process.

Vitamin K and bone

Vitamin K is essential for healthy heart and bones. Which form is best? Can you get enough from the food you eat? What do the studies indicate for osteoporosis? Can it reverse osteoporosis? Dr. Lani will discuss the role of vitamin K for bone and Heart health at a free webinar with Kate Rhéaume-Bleue, ND. Author of, Vitamin K2 and the Calcium Paradox: How a Little Known Vitamin Could Save Your Life. Webinar February 1st – see side bar on left to sign up for this free webinar

Antacids, Proton pump inhibitors, and Bone! Oh My!

Are Antacids the Answer?

Tums, Tum, Tum Tums Tuuuuuuummmmms! Those of you who remember the words from this advertisement know that Tums is advertised as an antacid, but is it a good source of calcium? NO! Could chronic antacid use result in poor uptake of calcium and other digestive problems? While studies are scant in this area let’s review the importance of the stomach acid that Tums and other antacids neutralize. We need stomach acid (HCL) to break down protein as well as aid in the absorption of calcium. It does not make sense to take antacids on a regular basis. Many people do suffer from burning sensations (heart burn) and some have gastric reflux (GERD), which is a regurgitation of stomach acid up into the esophagus. GERD is all to common, but the answer is not taking antacids, the answer is deeper than that and usually involves dietary changes.

Proton pump inhibitors (PPIs) are a group of drugs (Nexium, Prilosec) whose main action is a pronounced and long-lasting reduction of gastric acid production. Studies have shown that over time bone loss can occur. I have patients who have been on these medications for years. If someone has been on these meds for years can they get off these drugs successfully? Yes, but with great care. The diet needs to be cleaned up first and then the weaning process can begin, slowly. Most people will experience a rebound effect of excessive stomach acid production for a period of time.

I, like many other alternative doctors see the importance of a healthy digestive system. Hydrochloric acid is critical for digesting food and aiding in the absorption of nutrients. Don’t just pop these pills and treat the symptoms, find a doctor who works with nutrition to resolve the condition permanently.

 

There is still time! Join our 3-week, 2012 cleanse challenge In-person meetings or live webinar meetings with Dr. Lani

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Patients With Normal Bone Density Can Delay Retests, Study Suggests

This is the leading headline of an article posted in today’s New York Times.

“The study followed nearly 5,000 women ages 67 and older for more than a decade. The women had a bone density test when they entered the study and did not have osteoporosis. (In a separate national study by the Centers for Disease Control and Prevention, about 70 percent of women over age 65 did not have osteoporosis.)

The researchers report that fewer than 1 percent of women with normal bone density when they entered the study, and fewer than 5 percent with mildly low bone density, developed osteoporosis in the ensuing 15 years. But of those with substantially low bone density at the study’s start, close to the cutoff point for osteoporosis of fewer than 2.5 standard deviations from the reference level, 10 percent progressed to osteoporosis in about a year.”

Dr. Lani’s comments:

I agree that those who have a normal bone density test who are over the age of 65 do not need another test for many years, unless there is reason to assume bone loss may have occurred due to medications or some other potential cause of active bone loss. What I am concerned about is people misreading this study. I find that people with known risk factors are not being tested for bone density. Those who have the biggest risk of bone loss are women who are approaching menopause. Some women can lose 20% bone mass in the 10 years just before and following menopause. Estrogen, takes a dive after menopause. Estrogen keeps the bone cells (osteoclasts) that get rid of old bone cells in check. So when estrogen levels decrease, bone loss can be excessive in some people. More often than not, women who suffer from osteoporosis have similar body types. Women who are small-boned with low body fat run the greatest risk of bone loss during this time. This is because extra weight protects bones and fat cells produce some estrogen.

If a woman is nearing menopause and she has any of the following risk factors I recommend a baseline bone density exam for women. Women who have a history of; an eating disorder, smoking, drug or alcohol abuse, fractures, digestive disorders resulting in malabsorption of nutrients, lack of weight-bearing exercise or excessive exercise, vitamin D deficiency and many other nutrient deficiencies including vitamins K, magnesium, calcium. Many medications can also result in bone loss including, proton pump inhibitors, corticosteroids (use ever over a three month period) and other medications. If you are taking medications, check to see if bone loss is a side effect.

Men too can suffer bone loss for the same risk factors above and also should be considered for bone density testing if warranted.

Bone is very complex and those at risk should be evaluated for bone density. Nutritional and digestive health is a must for healthy bone. Healthy bone means good quality bone and quality bone requires a healthy digestive system and a bone healthy eating plan.

2012 – Dump the JUNK Cleanse

In-person meetings start Sunday January 22nd 3:00 PM

On-line live webinar meetings start Thursday (TONIGHT) January 26th 7:00 PM Can’t make it tonight? No worries, sign up and we will send you the tape for tonight’s webinar and join us live next week.

It is time to sign up today! I always start the New Year with a cleanse. While we may not be able to maintain a clean diet all year round a cleanse provides the structure and support you need to be successful. Last year I ran several, 3-week cleanse programs. They were a huge success! I attribute the success to the program and products. This cleanse is a great way to jump-start your healthy eating and exercise plan. We are here to help you be successful. Dr. Lani will personally lead each group with a primary focus on lifestyle changes, recipes and tips so that you can be successful. This cleanse is sensible and doable. No, you will not starve.

Will you lose weight? While the goal of the cleanse is not to lose weight, most people do. However, if you do not want to lose weight you can be on a modified cleanse. On a personal level, the cleanse was a huge success for me and my family members who participated. When something works well for my family, I want others to know about it as well. When we get healthy, it is contagious – our friends and patients all want to join in too!

This is not a diet, it’s a lifestyle change!
Starts January 2012
All webinars are recorded so if you cannot make it in person you can still join in.

Why it works

• The products are excellent and consist of a pea based protein meal replacement (gluten and dairy free), high quality cleanse supplements, top-notch bio-available greens and high quality fiber.
• The attendees were ready to dump the junk and get on the health bandwagon.
• During each webinar we entertain questions live from the audience.
• In addition you will receive supportive emails each week to keep you on track.
• Dr. Lani will also teach you about conscious eating drawing on her years of Vipassana (mindfulness meditation) practice.
• The webinar is taught by nutritionist Beth Gillespie and myself.

Why cleanse?

We are exposed to so many toxins, including some of the foods we eat on a daily basis. You know what I am talking about; sodas, coffee, alcohol and sugar. The idea of cutting out these foods may make you nervous at first, but take a deep breath. Here are some of the results you may experience:

Benefits from the cleanse:

• More energy
• Thinking more clearly
• Less food sensitivities
• Improved digestion
• Overall sense of well-being
• Feelings of gratitude to yourself for having completed the program
• Less feelings of anxiety and depression
• Decreased PMS symptoms
• Decreased Peri-menopause symptoms
• Less colds and flu
• Excitement to continue with the program for your health and the health of your family.
• Bonus food meditation w/ Dr. Simpson – get ready to be connected with the food you buy and the food you consume.

Are you ready to experience a cleanse that works? Are you ready to dump the junk? Are you sick and tired of feeling sick and tired? Then join us for our 2012 cleanse.

To purchase any of the cleanse programs or the Osteoporosis program click the green button order button above on the left

Two cleanses starting in January

On-line live webinar group starts Thursday, January 26th 7:00 PM PST- four consecutive Thursdays
Time: 7:00 PM PST  Thursday
Dates: Starts January 26th – runs 4 Thursdays in a row, all one hour except 1st one which is 90 minutes
Tuition: $295 – this price includes the entire program – all products including 14 meal replacements. These products will be mailed to your home or office or you can pick them up.

Do you live in the Bay Area? Dr. Lani will be running a second – in-person cleanse starting Sunday January 22nd at 3:00 PM in Berkeley near Alcatraz and College Time: 3:00pm PST Sunday
Dates: January 22nd – four in-person, one hour meetings – except the first meeting which is 90 minutes
Tuition: $295 – this price includes the entire program – all products including 14 meal replacements. These products will be mailed to your home or office or you can pick them up.

Click here for printable information on the cleanse products and program

Here are a few testimonials from our 2011 New Years Cleanse:

My energy is higher after dumping the junk! I enjoyed the discipline of not having to think too much about food and meal planning, just one easy cooked meal each day. Less shopping, less dish-washing and the products taste great! – Hadas

My bloating and digestive problems are resolved! Dr. Simpson and Beth make a good team. Thank you for all the support and meal suggestions. The webinar program fit my needs perfectly. I felt connected with the group and did not have to drive anywhere! The meal replacement is excellent and the added protein made a big difference in my energy. I am continuing with the products. Thanks again! – Bonnie

I enjoyed the program and look forward to the Spring Cleanse. My energy level improved significantly. – Sonia

FAQ

What if I miss a meeting? No worries, the meetings will be posted the following day for you to watch at your convenience.

Are you ready to have support to turn your healthy food choices into reality? Then here is an offer you can’t refuse!

First meeting – you will learn how to prepare for the cleanse and how to clean out your cupboards – having those irresistible foods around will only sabotage your efforts.

What if I am taking medications for an illness? Is a cleanse okay for me?

If there is any question you should discus this with your doctor and you can run the plan by them after you purchase the program. You can have a full refund if you do not attend the program.

Can I do this alone – without family members being on board? YES, often when one person gets on board others follow. It is great to have a family sit down and have an honest discussion about your food and exercise choices. Doing this as a family will have a synergistic effect but if they are not ready to join you now – do it anyway, it’s your time!

Will I be able to have ongoing support to make sure I keep on the right track?

Yes, you will be able to opt in to a special on-going support group led by Dr. Simpson.

Calcium is a Double Edged Sword

Insufficient calcium leads to bone loss, muscle cramps and insomnia. Too much calcium may result in calcium being deposited in unwanted areas of the body such as the arteries. So, where is the sweet spot for calcium intake? The chart at the end of this article from the National Institute of Health (NIH) lists the recommended daily allowance for calcium needed to insure good health for all ages. Following is some information about calcium to help you understand this vital mineral:

• According to the NIH adults need about 1,000 – 1,200 mg. of calcium each day, from all sources! That means foods and supplements. I think this range is good for most people, unless there is some reason that an individual is not absorbing calcium. Osteoporosis is one example of a condition where higher amounts of calcium may be needed.
• Calcium absorption is increased by as much as 50% if you have enough vitamin D on board. I have covered vitamin D in past articles but a blood level of 45-55 ng/ml is a good amount. Most people do need supplemental vitamin D to obtain this amount. Without testing, 2,000 IU is safe for healthy people. Unhealthy people may need more or less vitamin D depending on their condition and should be tested.
• Too much calcium can cause constipation.
• Magnesium is needed to balance calcium. There are different opinions ranging from a 2:1 ratio (calcium / magnesium) to 1:1. I favor somewhere in between depending on the patient. Too much magnesium can cause loose stools. Since most people I see suffer from constipation the added magnesium to the diet is usually a welcome relief.
• Calcium is best when taken in smaller, more frequent doses and taken with meals.
• Calcium supplements – calcium citrate or calcium malate is absorbed better than calcium carbonate because it has an acid component and you need acid to digest calcium.
• If you do take a calcium supplement only take as much as you would get from a serving of yogurt or a glass of milk – 200-300 mg. at one time.
• Only about 30% of the calcium we ingest is absorbed

Elemental calcium and magnesium

Supplemental calcium comes in the form of a compound. The most common calcium supplement is calcium carbonate. Calcium carbonate is 40% calcium by weight and calcium citrate is 20-25% calcium by weight. Some supplements list elemental calcium and some do not. This is important because a supplement stating 500 mg. calcium may only contain 200 mg. of elemental calcium. On the other hand, if it is elemental, then 500 mg. is a hefty dose – too much for one dose. Know your source.

Are you getting too much calcium?

I have found that many of my patients do consume too much calcium – especially those who eat a lot of dairy. On top of this some are taking very high doses of calcium supplements thinking if the RDA is 1,200 mg. then they should take 1,200 mg. of supplemental calcium. Remember 1,000 – 1,200 mg. total, from all sources.

Some people with malabsorption problems do need higher doses but this should be worked out with someone who knows nutrition.

Calcium Sources

Dairy is high in calcium, however a lot of people are lactose intolerant or allergic to dairy. One 6 – 8 ounce serving of yogurt or milk contains ~ 300 mg. of calcium. Some of my favorite non-dairy calcium rich sources include: Sardines, salmon, sesame seeds, almonds, collard greens and figs. The herb nettles is an amazing source of calcium – If you are interested in making infusions of nettles there is an article on my website under osteoporosis articles. Tahini (sesame seeds) dressing is loaded with calcium and great for salads and veggies.

The International Osteoporosis Foundation has a food chart to look up foods that contain calcium www.iofbonehealth.org    search – calcium-rich foods

Supplemental Calcium

As noted above, calcium citrate absorbs better than calcium carbonate because it has an acid component – you need acid to digest calcium. Calcium carbonate is not the best for most people because you need to take it with food and it dilutes the acid needed not only for calcium absorption but also for protein and other foods that need acid to break down. Many people take the antacid Tums as their supplement. This practice may actually lead to bone lose years down the road. Remember that you must balance your calcium with magnesium. The best supplemental magnesium source is magnesium citrate or magnesium glycinate.

What is the best time to take calcium?

I am dairy-free and a light eater so I do take a calcium and magnesium supplement. I found a liquid product of calcium citrate and magnesium citrate. One tablespoon = 250 mg. calcium and 170 mg. of magnesium. I always take one tablespoon before bed. Why before bed? Bone loss occurs more during the night and I have low bone mass. Calcium and magnesium also help with sleep. As mentioned above, small amounts throughout the day of calcium rich foods is the best and adding a supplement if necessary.

Who should be concerned about getting enough calcium?

• People who have been diagnosed with osteoporosis or low bone mass.
• Those who consume a diet high in foods that increase acidity in the body are at risk of not absorbing enough calcium. The top foods to avoid, are the same ones we hear about all the time: Sugar and processed carbohydrates – you know these non-foods. When considering sugary drinks, just say NO! Also, a diet high in protein, especially animal protein can leach calcium from bone.

• People with low vitamin D in their blood – vitamin D increases calcium absorption by as much as 50%.
• Malabsorption – gastrointestinal problems that impact absorption such as celiac disease and Crohn’s disease.
• Those who lack stomach acid either from medications or because their body does not produce adequate amounts of stomach acid.
• Dairy-free diet – while it is true that greens contain abundant calcium it still may be difficult for some to get enough calcium from their diet.
• Excessive intake of any of the following can inhibit calcium absorption or utilization: protein, caffeine, alcohol and sugar.
• Phytic acid and oxalic acid are found naturally in some plants; both bind with calcium and inhibit calcium absorption. High levels of oxalic acid can be found in spinach, collard greens, sweet potatoes, rhubarb, and beans. Foods high in phytic acid are fiber-containing whole-grain products such as wheat bran, beans, seeds, nuts, and soy isolates. These are healthy foods and should not be totally avoided. This is why eating a diet with a wide variety of foods is so important, making sure you eat plenty of greens daily.

If you have any questions regarding calcium please leave it in the comments section – I actually read my comments.
The National Institute of Health recommends the following RDA for Calcium intake:

Table 1: Recommended Dietary Allowances (RDAs) for Calcium [1]
Age	Male	Female	Pregnant	Lactating
0–6 months*	200 mg	200 mg
7–12 months*	260 mg	260 mg
1–3 years	700 mg	700 mg
4–8 years	1,000 mg	1,000 mg
9–13 years	1,300 mg	1,300 mg
14–18 years	1,300 mg	1,300 mg	1,300 mg	1,300 mg
19–50 years	1,000 mg	1,000 mg	1,000 mg	1,000 mg
51–70 years	1,000 mg	1,200 mg
71+ years	1,200 mg	1,200 mg

• Adequate Intake (AI)

Resources and references
Office of Dietary Supplements
Heaney RP, Recker RR, Stegman MR, Moy AJ. Calcium absorption in women: relationships to calcium intake, estrogen status, and age. J Bone Miner Res 1989;4:469-75. [PubMed abstract]
•  Massey LK, Whiting SJ. Caffeine, urinary calcium, calcium metabolism, and bone. J Nutr 1993;123:1611-4. [PubMed abstract]
•  Hirsch PE, Peng TC. Effects of alcohol on calcium homeostasis and bone. In: Anderson J, Garner S, eds. Calcium and Phosphorus in Health and Disease. Boca Raton, FL: CRC Press, 1996:289-300.

Osteoporosis Miracles? + The Produce Dirty Dozen revised

In the last newsletter I wrote about the Bemer 3000 device and claims that it can improve bone density. Many of you who have Bemer machines wrote me to let me know you love your Bemer. That is great, what I have a problem with is the claims specifically about bone. There are simply NO studies to support the claim that the Bemer will increase bone density in a patient who has osteoporosis. The piezoelectric effect (see definition below) has been well studied and can increase the ability for fractures to heal. However, this does not mean that every electrical current or vibration will actually result in bone growth especially in osteoporosis cases.  Until the Bemer undergoes studies with before and after bone density testing of the hip and lumbar spine we simply cannot extrapolate from the current science data that we have.

Piezoelectric effect (PEE) is the property of some materials to convert mechanical energy to electrical current. “Piezo” is a Greek word that means, “to squeeze.” Pierre Curie and Jacques Curie first discovered the effect in 1880. Dr. I. Yasuda in 1957 discovered the existence of piezoelectric effect in bones. What is the significance of the PEE? An external electrical stimulation may lead to healing and repair in bone. In addition, the piezoelectric effect in bone may be used for bone remodeling. Dr. Julius Wolff in 1892 observed that bone is reshaped in response to the forces acting on it. This is also known as Wolff’s law. While this effect is known in bone it does not mean that any one product will produce a total body response to improve bone density.

Osteodenx – formula for bone

This is a product that the Nikken Corporation produces. It’s main ingredient that is supposed to increase bone density is lactoferrin. I have looked at the studies and remain unimpressed. There are multiple studies looking at animal models where bone markers are used. In the small studies lactoferrin shows changes in the bone markers. This does not mean that this will translate to an increase in bone in humans. There are NO credible before and after bone density exams. When I asked to be furnished with bone density exams of the hip and lumbar spine I was sent ultrasound exams of the heel on several people. The exam appeared to show an increase of 30% in less than 6 months. Either the exams were an artifact or worse. Increasing bone density of 30% would indeed be a huge miracle and painful for the patient – the periostial response of bone building at that level would be very painful.

Lactoferrin definition – an iron-binding protein found in the granules of neutrophils where it apparently exerts an antimicrobial activity by withholding iron from ingested bacteria and fungi; it also occurs in many secretions and exudates, such as milk, tears, mucus, saliva, and bile.

What we can learn

I am on the hunt for products that will truly build bone. One thing to keep in mind is that every person who has osteoporosis is different. For example, perhaps one person with osteoporosis never built up a good bank account of bone to begin with while another person with the exact diagnosis is actively losing bone. To think that any one product will, across the board increase bone density with quality bone is a mistake.

Wednesday night’s webinar – I will share additional thoughts

Build our Bones support group with Dr. Lani  - Starting January

We can build bone with quality nutrition, healthy digestion and exercise. This group will aim to support and guide participants with sound nutritional and exercise information that will help stop bone loss and increase bone. The group will meet one time each week. If you miss one of the meetings it will be recorded so that you can listen at your convenience. I will utilize slides that you will be able to view as we go along and question and answer sessions each class. We will also have special guests that will encourage you and help with the mindfulness and positive mind set needed to deal with osteoporosis.

Meeting time Tuesdays at noon PST

6 weeks – every Tuesday at noon

The Dirty Dozen Fruits and Vegetables revised

The Environmental Working Group has updated their worst of the Dirty Dozen vegetables and fruits that have the most chemical residues when tested. They also include produce that is lowest in pesticides.

In descending order the following fruits and vegetables have the most chemical residues. Spinach crops use over 50 pesticides. Why does this matter? Isn’t it only a tiny amount? First, it is important to understand that many pesticides exhibit hormonal activity. Children are most affected by minute amounts of hormones. It is not the one apple, but rather the cumulative effect over time.

Buy these organic

1. Apples
2. Celery
3. Strawberries
4. Peaches
5. Spinach
6. Nectarines – imported
7. Grapes – imported
8. Sweet bell peppers
9. Potatoes
10. Blueberries – domestic
11. Lettuce
12. Kale/collard greens
13. Cilantro
14. Cucumbers
15. Grapes – domestic

Lowest in pesticides

1. Onions
2. Sweet Corn
3. Pineapples
4. Avocado
5. Asparagus
6. Sweet peas
7. Mangoes
8. Eggplant
9. Cantaloupe – domestic
10. Kiwi
11. Cabbage
12. Watermelon
13. Sweet Potatoes
14. Grapefruit
15. Mushrooms

Support your local farmer’s – buy local.

Bemer 3000 or Nikken Products improve bone density? Is this hype?

It happened again today. One of my patients with osteoporosis called me about a machine that someone told her would potentially help her to improve her bone density.

I am constantly bombarded with information from companies or individuals who claim that they have a machine or supplement that will reverse osteoporosis. I have investigated many such claims and found them to be baseless. The so-called science usually refers to in-vitro studies. This means it has shown some promise in the lab working with cells in a Petri dish or perhaps 6 or so rats. This does not mean in that it will translate to human beings. We all love magical thinking.

Why do people believe the company hype? Because they make it look good. Often they will have top universities or a Harvard educated doctor who performed the in-vitro lab work. It looks scientific to people who do not understand how to evaluate the usefulness of the study.

Sometimes there may be multiple studies, but again a close look at even 10 studies on lab animals does not necessarily translate to human beings.

However, if any of you have increased bone density using a supplement or devise please share your story and your bone density tests with me.

Some of the devices come at a high cost. One such machine, the Bemer 3000 is quite expensive. A patient asked me whether or not this machine would help her gain bone. I went to their website and there are zero studies regarding bone density. If any of you think you have gained bone mass using this machine please contact me. I am open to the possibility, but I remain highly skeptical. Osteoporosis is a serious disease with multiple causes and each case is different – there is no one-size-fits-all approach.

Another company boasting a product that will increase bone density is, Nikken’s  Osteodenx product – will this work? This is another very hyped product. In the next newsletter I will review what the company claims and if there is real data to back up their claims.

If you have bone density tests from a DXA (hip and lumbar spine) and you think you have gained bone with any program I would like to hear from you. We need to gather success stories. In the end most success stories will likely include significant exercise along with a healthy bone building diet. If you do plan on sending me your case I will need the computer printout of the bone density as well as the radiologist report. Keep in mind that there can be up to 5% error (or more) depending on how well the machine is maintained and how well the technologist positions a patient on the table.

My healthy skepticism started in 1994 when Dr. John Lee made claims that bio-identical progesterone would reverse osteoporosis. Many of my patients used the cream, including myself.  I was the owner and director of the Osteoporosis Diagnostic Center and wrote all reports for the bone density tests of the low back and hip (performed on a Hologic 4500). I was excitedly waiting to see the increase in bone density using his program, which included basic nutritional and exercise advice. Unfortunately none of the patients showed a statistically relevant increase in bone density.  Still, to this day I have not seen any evidence that bio-identical progesterone will appreciably increase bone density.

Do I want a magic bullet? You bet I do and there are some that come close. Correcting a digestive disorder such as Celiac disease or a vitamin D deficiency comes close. I will be offering a webinar in the near future outlining a sound bone-building program. Keep in mind that it is much easier to lose bone than to gain bone.

Send in your success stories – we all want to know about them and have them verified. I am qualified to verify such claims as I am a Certified Clinical (bone) Densitometrist – I read bone density exams and understand the nuances of testing.

Below is the evidence regarding treating osteoporosis with the Bemer device – from the website International Teaching and Research Facility (http://www.afb-us.com/cms/info-en0.html). The Bemer and many other devices utilize PEMF, Pulsing Electromagnetic Field therapy. While it may be useful for some ailments I am focusing on osteoporosis. In theory maybe there is something to it, but there is no evidence that it does anything to increase bone density.

A European physician’s user study under the direction of the AFB documented the effects of the electromagnetic field of the BEMER 3000 therapy system. A total of 1116 patient protocols were captured. Since several patients presented with more than one clinical condition, 2031 cases of illness were documented. A therapy span of 6 weeks and observation of 52 subjects (see excerpt below) showed the following results:

Excerpt from the physician’s user study with the BEMER 3000 therapy system

Dr. Lani’s interpretation of the value of this “study”.

This is a perfect example of graphs being used to illustrate virtually no useful information. Healing of fractures? How was this measured to make sure the Bemer had anything to do with it. The study involved 52 people for 6 weeks. Improvement of what? Can’t check bone density in 6 weeks. Would you purchase this machine to improve your bone density based on this information? I would not.

Is it possible that the Bemer might impact bone density? Very hard to know until actual studies that include before and after bone density testing, over a period of at least one year are compared.

Will the Bemer improve bone quality? Maybe but again, no studies.

The following is an excerpt from the Bemer company website: BEMER research has over many years achieved leading-edge results in terms of the biorhythm of local and external regulation flows in microcirculation. The core of BEMER technology is a multi-dimensional signal structure, which effectively stimulates restricted or defective microcirculation. Consequently, it supports one of the most important regulation mechanisms in the human body for prevention, healing, recovery and regenerative processes.