How do ageing & menopause cause osteoporosis? Homeopathic management & prevention.

Osteoporosis is a condition that makes bones weak and brittle due to decreased bone mass and strength. Women, particularly after menopause is a high risk of osteoporosis due to declining estrogen hormone. Nutrition,physical activity and some homeopathic drugs have crucial role in the prevention of osteoporosis.

updated on:2023-12-21 07:17:50

How do ageing & menopause cause osteoporosis?
Homeopathic management & prevention.

Evidence based information

Osteoporosis is a condition that makes bones weak and brittle due to decreased bone mass and strength. It develops when bone mineral density and bone mass decreases, or when the structure and strength of bone changes.

This reduced strength and bone loss can increase the risk of bone fractures. There are multiple causes for osteoporosis to occur. Menopause related estrogen deficiency one of the major causes of osteoporosis and fracture [bone break down] in women.

Osteoporosis is like a silent disease with no apparent symptoms for long time. The only symptom that comes late is a sudden fracture of bone that happens from trivial injury. Normal stresses such as bending, lifting, or even coughing may cause a spontaneous fracture. Fractures may occur in any bone of the body but mostly bones of the hip, vertebrae of spine, wrists are broken.

Why are postmenopausal and old women at risk of osteoporosis or low bone density?

Bone mineral density decreases with ageing as well as with decline in estrogen hormone of menopause which can weaken bone strength.

· Women, particularly after menopause is a high risk of osteoporosis due to declining estrogen hormone.

After the onset of menopause, women are vulnerable to fracture as bone mineral density decreases and bone strength also weakens. The function of estrogen in the bone remodeling process is now clear after meticulous research which lasted many years. Estrogen plays a key role in both the formation of bone as well as the prevention of the resorption of bone.

Osteoporotic fracture is common in old age. Of the estimated 10 million people affected with osteoporosis, about eight million or 80% are women. Approximately one in two women over age 50 is at risk of osteoporotic bone fracture.

Woman can lose up to 20% of her bone density during the five – seven years following menopause. If the bone mass loss is in faster pace, there is greater chance of developing osteoporosis.

Fuller Albright observed 70 years ago that estrogen deficiency in women is associated with bone loss and osteoporosis. After that many research studies were conducted to elucidate the role of estrogen in bone formation and resorption.

What is bone remodeling process?

Bones can grow strong or weaker, and break when subjected to the application of excessive force. If any damage occurs bones can regenerate without any obvious scar. It is evident in bone fracture healing after a fall or injury. Similarly minor spontaneous cracks within bones also are repaired. These cracks develop with ageing, poor diet; hormonal imbalances etc. Genes also play a pivotal role in bone changes. To maintain structural integrity, the skeleton of human body needs to constantly remodel and repair these minor cracks that develop in the bones of vertebrae, pelvis, and of long bones. This remodeling process occurs in osteoclasts, osteoblasts, and osteocytes, cells within the bone remodeling cavity.

Bones are highly specialized connective tissue with a potential to remodel. The primary cell which helps for building bone is the osteoblast. Osteoblasts normally secrete a fluid osteoid, which is rich in a protein known as type I collagen. Another component of the osteoid is the ground substance, composed of osteocalcin and chondroitin sulfate. The osteoid will undergo the process of mineralization with inorganic components such as calcium and phosphate obtained from diet. This mineralization process is important for bone hardening or bone strength.

Vitamin D is crucial for bone mineralization. Therefore it is important to consume calcium, phosphorus, magnesium and vitamin D rich foods for bone strength. Include dairy products, green leafy vegetables, fish, cod liver oil, eggs and meat in your diet for maintaining bone health.

Osteocytes within the bones play a major role in controlling the process of remodeling. The osteocytes are typically found in lacunae arranged concentrically around a central opening known as a Haversian canal, which provides the blood supply for the bone cells.

Osteocytes can sense the mechanical strain and the developing micro cracks of bones, and also respond to hormonal changes, such as estrogen deficiency, triggering bone remodeling, in association with bone-lining cells [2].

The process of Bone remodeling begins by the initiation of bone resorption or loss of old or damaged bone by osteoclasts, cells with in the bone. The osteoclasts, multinucleated cells derived from macrophages found in Howship’s lacunae on the surface of the bones. They are under the control of the osteoblasts.

Role of estrogen in bone remodeling process

Osteoblasts are new bone forming cells. Estrogen hormone can inhibit the osteoblast death [apoptosis] and increase osteoblast lifespan, thereby increasing the functional capacity of each osteoblast which is important for bone formation. Estrogen decline of menopause reduces the lifespan and functional ability of bone forming osteoblasts [3].So bone strength and mass weakens.

Estrogen has numerous direct and indirect effects on osteoclast formation, activity, and lifespan. Osteoclasts are bone destroying cells.

Estrogen hormone has great role in bone health maintenance as they have impacts on

· Decreasing the cell death rate of bone forming cells [osteoblast apoptosis].

· Activating bone remodeling process of new bone formation or repair.

· Reducing oxidative stress associated with ageing.

· Decreasing osteoblastic NF-κB activity.

· Increasing apoptosis or death of bone destroying cells or osteoclasts.

· Decreases bone resorption or loss.

How does ageing impact on bone health?

Aging is a process characterized by the progressive loss of tissue and organ function due to the accumulation of free radicals or reactive oxygen and nitrogen species [RONS] induced damages. That is , oxidative stress. This may affect almost all organs and cells of ageing body producing various diseases such as cardiovascular ailments, cancers, lung diseases, diabetes etc. Bones also are affected by oxidative stress in old people and it can impair bone formation [4].

Oxidative stress occurs when there is an imbalance between the formation and the removal of RONS free radicals because of an overproduction and/or an impaired ability to neutralize them or to repair the resulting damage.

Ageing is associated with oxidative stress to bones. Therefore regular consumption of antioxidant rich foods such as fruits, nuts, seeds and green leafy vegetables in adequate amount is crucial for bone health in ageing people.

Oxidative stress related to ageing affects bone health of both sexes; however women are more vulnerable to reduced bone strength due to the added effects of estrogen decline after menopause.

Osteoporotic fracture is common in old age. Of the estimated 10 million people affected with osteoporosis, about eight million or 80% are women. Approximately one in two women over age 50 is at risk of osteoporotic bone fracture.

Woman can lose up to 20% of her bone density during the five – seven years following menopause. If the bone mass loss is in quicker pace, there is greater chance of developing osteoporosis.

How to prevent & manage osteoporotic fracture?

· Nutritional intervention

Include foods rich in vitamin C, D and minerals such as calcium, magnesium, phosphorus, selenium etc.

A well balanced diet is recommended for women of all age groups, particularly after menopause with supplementation of calcium and vitamin D in risk groups for osteoporosis.

Recommended dietary allowance of calcium

For adults ages 19 to 50 and men ages 51 to 70, the Recommended Dietary Allowance (RDA) is 1,000 milligrams (mg) of calcium a day.

The recommendation increases to 1,200 mg a day for women age 51 and older and for men age 71 and older.

Good sources of calcium include dairy products, almonds, broccoli, kale, fishes such as salmon, sardines and soy products, such as tofu.

Your body needs vitamin D also to absorb calcium. Vitamin D is crucial for bone mineralization. Therefore it is important to consume calcium, phosphorus, magnesium and vitamin D rich foods for bone strength. Include dairy products, green leafy vegetables, fish, cod liver oil, eggs and meat in your diet for maintaining bone health.

Recommended dietary allowance of vitamin D

For adults ages 19 to 70, the RDA or recommended dietary allowance of vitamin D is 600 international units (IUs) a day. The recommendation increases to 800 IUs a day for adults age 71 and older.

Good sources of vitamin D include oily fish, such as salmon, trout, tuna and mushrooms, eggs etc.

Vitamin D fortified milk and cereals, are good sources of vitamin D. Sunlight exposure also helps to produce vitamin D by the skin. Vitamin D supplements also help to maintain your vitamin D level adequate.

Include green leafy vegetables, fruits milk and seafood for ensuring the adequate supply of minerals such as magnesium, potassium, selenium etc. which also help bone remodeling.

· Physical exercise

Women who are physically inactive have a higher risk of osteoporosis than do their more-active counterparts. Include physical exercise in your daily routine. Exercises such as brisk walking, jogging and climbing stairs, can help to strengthen your bones and slow bone loss. Moderate intensity strength trainings like exercise with dumbbells, Pushups, aerobic exercises are recommended.

Weight-bearing physical activity may reduce the risk of osteoporosis in women by increasing bone mineralization during the early adult years producing peak bone mass and reducing the loss of bone after menopause.

High-intensity activities, such as resistance training, seem to provide the best stimulus for improving bone mineralization process.

Repetitive activities, such as walking, may have a positive impact on bone mineral when performed at higher intensities. In addition, physical activity improves muscular strength, endurance, and balance can reduce fracture risk, preventing falls.

· Avoid substance abuse, smoking and limit alcohol consumption.

· Phytoestrogens

Estrogen deficiency is a major risk factor for osteoporosis in postmenopausal women. Although hormone replacement therapy (HRT) has been used to recompense for the bone loss, it is associated with severe adverse effects. Perhaps, due to this toxicity and adverse effect a large number of the postmenopausal women are attracted to natural products such as phytoestrogens from soy products.

Phytoestrogens are plant-derived polyphenol compounds that show a structural similarity to steroid hormone (17-beta-estradiol).

The classical phytoestrogens constitute a group of compounds (isoflavones, lignans, coumestanes, stilbenes, flavonoids quercetin and kaempherol) of plant origin.

Soy foods and soy protein contains isoflavones.

Soy isoflavones are structurally and functionally related to 17-beta-estradiol and are known to act on both osteoblasts and osteoclasts and have beneficial effects on BMD, bone turnover markers, and bone mechanical strength in postmenopausal women [7,8].

In addition to soy, clover, licorice, hops, and fo-ti to have high estrogen activity.

Potential adverse effects of phytoestrogens:

However, some studies show that the extensive use of supplemental phytoestrogens is shown to cause grade 1 endometrioid adenocarcinoma of the endometrium, affects breast growth and lactation and has a role in uterine diseases such as fibroids and endometriosis [10, 11].

Therefore further extensive studies are warranted for using phytoestrogen as supplements.

Homeopathic remedies for prevention of osteoporosis

Remedies for decalcification of bones or osteoporosis:

· Calcarea carbonica

It is one of the polychrest remedies adapted to leucophlegmatic constitution with fatness, sluggishness and a lot of fears. Scroffulous diathesis. Glandular enlargement in general. Chilliness of body with cold clammy feet. Apprehension and fear of diseases.Aversion to darkness.Dread of open air.Great weakness on exertion, ascending.

Melancholy with lachrymose disposition; Anguish and palpitations of the heart. Aversion to work and labour.

Calcarea carb is indicated for degeneration of bones or osteoporosis [ murphy]. Research studies also substantiate for the effects of calcarea compounds in improving bone mineral density in animals.

· Calcarea fluoricum

I t has profound action on bones. It is used for preventing bone degeneration.

It is also used in osteomyelitis and giant –cell sarcoma of maxillary bone [according to JH Clarke].Induration threatening suppuration of bones is the indication in these cases of bone inflammations.it is also used in induration of glands, synovial swellings, exostosis etc.

Calc fluor has fear of poverty, indecisive mind with sadness. frightul dreams of death of relatives.

It is an anti-syphilitic remedy which can address the degeneration of bones. Caries of bones. Exostoses of fingers. Osteoarthritis with nodosities of finger joints.

Curvature of spine. Caries of teeth, deficient enamel.

· Calcarea phosphoricum

This is also an indicated remedy for osteoporosis .

This drug is more adapted to emaciated people, with large abdomen, weak memory. Anger and irascibility, and vexation cause ailments. Also, ailments from grief, disappointed love and defective nutrition.

Aversion to company. Reproaches himself and others. Anxiety, fear of bad news. Censorious or faultfinding in nature. Discontented. Mental restlessness. Melancholy.

Mental confusion from mental exertion. Sluggishness of mind. Thinking and comprehension difficult. Forgetfulness.

Makes mistakes in writing in.Prostration of mind from talking.

Consolation <.

Sighing frequently.

Suspicious

In mental sphere and in etiology of ailments calcarea phos resembles natrum muriaticum.

Calcarea phos has a desire to travel like tuberculinum due to mental restlessness.decayed teeth,caries,crumbling teeth.

Craves for smoked meat, salt, indigestible things.

Cervical backpain. Pain in scapulae, lumbar and dorsal region. Crampy and cutting pains, stiffness to shoulder and arms, Cervical radiculopathy,

Arthritic nodosities of finger joints, osteo arthritis. Numbness of extremities. Gout.

Pains < cold weather.

Weather changes and slight draught of air aggravates bone and joint pains.

· Symphytum

A drug indicated for injured bone or periosteum[ according to Lippe].

Pricking pains in the affected area. Inflammation of bones.

Symphytum facilitates union of fractured bones. It favors callous formation. Research studies [listed below]substantiate the role of symphytum in bone mineralization.

· Hecla lava

It is an indicated remedy for various ailments of bones.

Tumors of bones.Exostoses. Osteitis deformans. Osteosarcoma, Osteomalacia. Rickets.

Exostosis of the jaws.

Hecla is an effective remedy in osteosarcoma.

Exostoses of tibia.

Hecla is also indicated for degeneration of bones [complete repertory-Murphy]

· Silicea

Silicea is indicated in people with osteoporosis as a constitutional remedy: this drug is adapted to constitutions with want of grit and self-confidence; nervous, irritable sanguine temperament; Light complexion and lax muscles defines silicea; scrofulous& psoric diathesis.

Oversensitive senses. Yielding disposition. Melancholy. Anxiety, lachrymose mood.

Restless and fidgety.

Obstinacy.

Weak memory. Inability to think. Fixed ideas.

Bad effects of defective nutrition &vaccination; suppressed foot sweat.

Constitutional impact from imperfect assimilation of nutrients in the body.

Constipation is usually common problem in silicea. Inactivity of rectum.

Silicea is indicated for a variety of ailments and it is a deep acting polychrest.

Numbness of extremities.

Research evidence about the efficacy of homeopathic remedies in improving bone mineral density:

Homeopathic drugs symphytum and calcarea group of remedies help bone mineralization. A few animal studies conclude that homeopathic dilutions, caused a significant increase of calcium-hydroxyapatite concentration in bones of experimental animals. Further human clinical trials and studies are required to confirm the role of these drugs in humans with irrefutable evidence although these drugs are clinically used effectively for healing of bone fractures

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How do ageing & menopause cause osteoporosis? Homeopathic management & prevention.

Osteoporosis is a condition that makes bones weak and brittle due to decreased bone mass and strength. Women, particularly after menopause is a high risk of osteoporosis due to declining estrogen hormone. Nutrition,physical activity and some homeopathic drugs have crucial role in the prevention of osteoporosis.

How do ageing & menopause cause osteoporosis? Homeopathic management & prevention.