Graceful Women: Wait! I’m Too Young to Have Osteoporosis!

On another Graceful Women post, The gluten-free diet and osteoporosis, Betsy Wuebker mentioned that she was diagnosed with osteoporosis. In her comment, she talked about some of the contributing factors to this disease. Osteoporosis is an important concern for menopausal women, so I asked Betsy if she would elaborate on its causes and treatments.

Betsy is author of the blog Passing Thru, and here is her story:

Every Sunday morning I swallow a miracle.It’s a pill that may save my life, and definitely will restore my youth. The name of this wonder is alendronate sodium. I take it because, at age 55, I have the bone density of an 80-year-old. I’ve got full-blown osteoporosis.

While serious in someone my age, this diagnosis didn’t exactly come as a shock. My mother and her mother both had it. Their stooped, painful posture was what is still commonly referred to as “dowager’s hump.” They were literally incapable of standing up straight. With this family history, I always suspected I’d wind up with osteoporosis in my dotage, too. What I didn’t expect was that it would show up this early. I’m way too young, after all!

Six months ago, a series of somewhat alarming symptoms led me to consult with my OB-GYN. She ordered what seemed like an inordinate amount of blood work, did some exams, accelerated a colonoscopy appointment (did I have cancer?), and sent me in for scans. Within the space of a few weeks, I went from taking no medications other than an occasional aspirin and over the counter heartburn relief, to several daily prescriptions. I had high cholesterol, Gastroesophageal Reflux Disease , and a significant Vitamin D deficiency.

All of these conditions are fairly common, but I found the Vitamin D deficiency surprising. Anyone who looks at me will conclude I am hardly undernourished. How was I vitamin D deficient?It was explained: With all the concern about skin cancer, more folks are staying out of the sun. In colder climates, there is less sunlight during short days in winter. I’m a pale, pink person who always burns. I use a lot of sunscreen, and since pre-menopause, don’t tolerate excessive heat well, keeping me out of the sun even more. Add that to decreased milk intake from my inability to tolerate lactose, and bingo. I was prescribed a mega-dose of Vitamin D for six weeks.

In the meantime, my bone scan results came in, and I received a letter summoning me for a consult. “You have osteoporosis,” the letter said. “Please come in as soon as possible to begin a treatment plan.” Great.

My OB-GYN referred me to a rheumatologist when it was revealed most osteo drugs have the unfortunate side effect of increased heartburn. We both knew I needed no more of that. I was pleased to note the new doctor was on several “Best” lists, and his manner was kind and knowledgeable. “What we call the ‘neck of your hip’ and your lower back bones are so porous, you’re at extreme risk. We generally see this deterioration in someone in their 80’s, not their 50’s.” Swell.

Acting as though he had no other patients in the world besides me, he took the time to explain my options. “If you’re heartburn prone, your insurance still requires you to tough it out for a month before changing you to the more expensive annual injection. Plus you’re going to want a combination supplement – always take calcium with vitamin D. The vitamin D is the assist in absorption.” My circumstances – lactose intolerance, no milk, no sun, and no supplementation until now – had created the perfect storm for accelerated bone density loss.

“The good news is, with this drug your bone loss will rapidly arrest and then start to correct itself. Within two years, your bone density will be age appropriate, and you can go on a maintenance plan. Plus, with exercise, you can strengthen even further.” Awesome, a dispensation!

“Until then, whatever you do, do NOT fall. You’ll break a hip or fracture your back.” Jeez, okay. I’m already fearful carrying laundry down our scary basement stairs or walking on icy sidewalks. I’ll probably forego the bicycling I looked forward to this year, as I took a spill a couple of years ago which impacted my mobility for several weeks. It could have been much, much worse.

So . . . every week, I take my miracle pill that is going to restore my bones back to relative youth. Every day, I take my calcium + vitamin D to give these nutrients their best, life-saving shot. And every day, I get my hour’s exercise on a treadmill that’s only an inch or so above the ground, so there’s not far to fall. This is all easily achieved. What a simple fix to ensure I’m around for the next thirty years, when I’ll really be old!

Suggested Reading:

http://www.nof.org/osteoporosis/”>Osteoporosis: A debilitating disease that can be prevented and treatedhas a downloadable questionnaire

Osteoporosis Symptoms, Treatment, Causes, Prevention, Risk Factors and Diagnosis

Hormone Replacement Therapy now Contraindicated in Osteoporosis Treatment due to increased risks for breast cancer, heart attack, stroke and blood clots

The Mayo Clinic – Osteoporosis

Your turn

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Graceful Women: The gluten-free diet and osteoporosis

As we age, it becomes more important than ever to take responsibility for our own health and welfare. And sometimes this means a long and frustrating search to find out what is going on in our body.

Davina Haisell suffered for years with a misdiagnosis of Irritable Bowel Syndrome. Still not feeling any healthier, she kept searching until she discovered she had non-celiac gluten-intolerance. The first sentence in her story says it all about how she felt at the end of this health journey.

Davina can be found at Shades of Crimson, and this is her story:

Gluten-free me

I hung up the phone and danced into the hallway grinning. “The test result was positive. I’m gluten-intolerant.” I said.

My coworker looked puzzled, until I explained my strange response to the phone call.

For years I’d suffered from digestive problems that doctors labeled as Irritable Bowel Syndrome (IBS). I’d tried everything; digestive enzymes, probiotics, food combining, colonics, juice cleanses, dairy-free, sugar-free and wheat-free. Nothing helped.

My tummy looked swollen most of the time and I had other intestinal symptoms that I won’t discuss. I’d accepted that this was normal and tried to make the best of it.

Non-celiac gluten-intolerance

In my late 30s my dentist suggested I be tested for thyroid problems as my teeth were shrinking! This led me to have the blood test done for celiac disease; the result was negative.

Two years later I went to a seminar on the topic of non-celiac gluten-intolerance. The naturopath explained that a person can be sensitive to gluten, but not have the full-blown symptoms of celiac disease.

When a person who has celiac disease eats wheat or gluten-containing grains such as barley, rye, kamut and spelt, the continued immune response leads to a flattening of the intestinal villi.

Absorption of vitamins and minerals is reduced and a myriad of possible conditions can result: arthritis, crohn’s disease, diabetes mellitus, depression, asthma, thyroid disorders, eczema, infertility, anemia and osteoporosis, to name a few.

It is possible for a person to have an allergy to gluten but not have intestinal damage. It is also possible that antibodies are not prevalent in blood tests of people who have not yet developed full-blown celiac disease. There is still however, an immune response that occurs when gluten is ingested.

Saliva testing diagnosis

This naturopath was testing for gluten-intolerance using a saliva test. Apparently the antibodies can show up in the saliva and not the blood. I was hopeful that this might be the answer and I was right. The test was positive. Though I was not pleased to start the gluten-free diet, I was relieved to finally know what the problem was and what I could do about it.

My doctor ordered a bone density scan. The results showed that at the age of 40 I had the bone density of a 60-year-old (osteopenia), and was in the early stages of developing osteoporosis.

Two years after being on the gluten-free diet, a follow-up bone density scan showed an increase in bone density of 11%. I was thrilled, knowing I was on the right track.

The gluten-free diet

The gluten-free diet is not easy, but has become second nature after more than six years. There are a lot of gluten-free products on the shelves these days, including beer. Most are quite expensive and lacking in nutrition; but they’ll do in a pinch.

My recommendation is to stick with fresh fruits, vegetables, nuts, yogurt, meat, and grains such as quinoa, millet and rice. Staying away from packaged food is the safest bet, but reading food labels has also become second nature.

Wheat-free doesn’t mean gluten-free; rye, barley, spelt, kamut and oats (depending on processing) all contain gluten. Gluten is also found in soy sauce, barley malt that is in many chocolates, some corn chips, and licorice. These are just a few of the hidden sources of gluten.

Eating out means asking a lot of questions, though I continue to be surprised at how many restaurants have knowledge of the gluten-free diet these days.

For more information visit the Canadian Celiac Association at www.celiac.ca or Celiac Spru Association www.csaceliacs.org

Suggested reading:
Dangerous Grains by James Braly and Ron Hoggan
Wheat-Free, Worry-Free by Danna Korn

Both books are available for purchase through Amazon by clicking the Silver & Grace book recommendations.

Keeping osteopororis at bay

One of the downfalls of researching health problems associated with aging, is discovering your best prevention opportunity occurred almost 20 years ago!

Such is the case with osteoporosis. Seems my bones reached their maximum density by age 30. Fortunately, I think I did a pretty good job living ‘bone healthy’, but I sure will be now to keep my risk at a minimum.

Who is affected by osteoporosis?

Osteoporosis is most common in post-menopausal women. However, men are not immune. 1 in 8 men over the age of 50 are also affected.

What is osteoporosis?

Osteoporosis is a condition in which the bones become porous and spongy. This leads to the skeleton unable to support the body’s weight, causing bone fractures and breaks.

How does this porous condition come about?

Throughout our lifetime, our bones are constantly being broken down and rebuilt. Little miners, called osteoclasts, come along and extract calcium from the bones to release into the bloodstream. Then a repair crew, called osteoblasts, come along and fill up the holes again.

The problem occurs when osteoclasts continue their digging, or even escalate their digging, but the osteoblasts start to go into retirement mode.

Generally, decreased osteoblast activity is caused by the drop in estrogen associated with menopause. Primary osteoporosis can be the result. However, there is also secondary osteoporosis caused by:

• diseases of the endorine system;
• eating disorders;
• chronic alcoholism;
• poor nutrition;
• liver disease;
• vitamin D deficiency;
• being bed ridden for an extended period of time.

What are the risk factors associated with osteoporosis?

Some risk factors are out of our control. They are:

• female;
• age 50 or older;
• post-menopausal, particularly if the onset of menopause is early;
• prolonged hormonal imbalances;
• thin, small-boned frame;
• Caucasian or Asian;
• family history of osteoporosis.

However, the following risk factors are within our control:

• excessive use of certain medications, such as steroids;
• not enough calcium or vitamin D in our diet;
• lack of exercise;
• smoking;
• caffeine;
• excessive alcohol consumption;
• excessive exercise leading to cessation of menstruation.

So, you are definitely past the age of 30, now what?

Your bone density is what it is by the age of 30; however, there are ways to maintain that density:

• get enough calcium – which means less mining for calcium in your bones. Over the age of 50, you need 1200 mg per day. You can get this from calcium supplements, and a variety of food sources;
• get enough vitamin D – this helps the body absorb calcium efficiently. We produce vitamin D through exposure to the sun, but often this is not enough. Over age 50 we need 800 – 1000 IU per day. Again, this can be through supplements and food sources;
• engage in proper exercise – you need a combination of weight bearing exercises (e.g. running), to strengthen your bones, and resistance exercises (e.g. weight training);
• enhance your balance – as we get older, we get more teetery and prone to falls. Doing exercises, such as yoga, increases our sense of balance, making us less likely to fall down and break something.

How do you know if you have osteoporosis?

Generally you don’t until you break something. However, there are tests for bone density that can be performed. They are:

• dual energy x-ray absorptiometry (DEXA) – most common procedure which is a low radiation x-ray;
• dual photon absorptiometry (DPA) – a bit less concise than the DEXA;
• quantitative computed tomography (QTC) – as known as CAT scans, can accurately measure each vertebrae;
• ultrasound – limited to peripheral sites like heel or kneecap;
• urine tests – to determine if bone loss is increasing or decreasing.

Is there a cure for osteoporosis?

No, there is no cure, although there are medications available to help repair damage to the bone. For osteoporosis, prevention truly is the best medicine.

My bones are what they are at this point in my life, but I will be doing everything I can to keep them strong and healthy. I will also be sure to educate my young adult daughters on the importance of building bone density before they enter their thirties.

Suggested Reading:

All about osteoporosis
Prevention of Osteoporosis
The Facts on Osteoporosis

Your turn:

• What foods do you eat to ensure you get enough calcium each day?
• Do you have a story to share about someone in your life who has osteoporosis?