Osteoporosis & Osteopenia
Osteoporosis is being treated as an epidemic in our country. Due to the side effects of the medications used to treat osteoporosis we are beginning to ask:
Should osteoporosis be treated?
What is osteopenia and should it be treated?
Who should we treat?
Are we over-treating women who should not be treated and causing known and unknown long-term side effects?
In this article I will discuss healthy bone function, define osteoporosis and osteopenia and how they are diagnosed. I will also discuss the FRAX tool, which is currently being used to determine your risk for the development of osteoporosis and hip fracture. I will then discuss medical treatments for osteoporosis and my concerns about the use of bisphosphonate medications. I will close with a discussion on a Bone Health Program.
Healthy bones are a function of two types of cells: osteoblasts and osteoclasts. Osteoblasts build bone, osteoclasts break down bone. In younger years there is a balance between building up and tearing down the bone, which leads to good bone health. The peak bone building years are between the ages of 9 to 18 years of age. Peak bone mass is reached between the ages of 25 to 30 years old. By the age of 35 to 40 years old we begin to lose bone. The osteoclasts continue with their activity, but the osteoblasts are not keeping up. As we age, osteoporosis may occur because of this.
Osteoporosis is thinning of the bone with reduction in bone mass. If it is not treated, osteoporosis may progress painlessly until a bone breaks. The primary symptoms of vertebral fractures are severe back pain and loss of height. A fracture of the wrist or hip may be the first sign of osteoporosis.
Osteopenia means small bone cells. It may lead to osteoporosis and it may not. Many experts think it is a variant of normal. Janet Schlechte MD, Professor of Medicine, Division of Endocrinology, Department of Internal Medicine University of Iowa Hospital and Clinics states osteopenia is not a disease, it is not a diagnosis. Therefore, it should not be treated.
There are a lot of risk factors for osteoporosis. The more risk factors you have, the more likely it is you could develop osteoporosis. Risk factors include:
- Age: the older you get the more likely you are to develop osteoporosis
- Estrogen deficiency: The younger you are when you go through menopause the higher your risk for developing osteoporosis. Estrogen deficiency also occurs in females who stop menstruating due to anorexia, bulimia and excessive physical exercise.
- White race
- Small-boned, thin females
- Personal history of non- traumatic fractures as an adult
- Lifestyle factors such as smoking, excessive alcohol intake (more than one drink per day for females), sedentary lifestyle, low calcium and Vitamin D intake
- Family history of osteoporosis and frailty fractures
- Medications: steroids, anti-convulsants and excessive thyroid hormones
- Depression
Osteoporosis and osteopenia are diagnosed by the Dual Energy Bone Densitometry (DEXA). The DEXA is the gold standard for measuring bone density. It measures the hip and spine. Osteopenia is a T score of -1 to -2.5 and osteoporosis is T score of – 2.5 or less.
Who should be tested? The recommendations from the Clinician’s Guide to Prevention and Treatment of Osteoporosis from The National Osteoporosis Foundation are to do a bone density on females at age 65 and males age 70 years of age. In postmenopausal women and men age 50 to 69, a bone density scan is recommended based on their risk factor profile.
Your risk factor profile can be determined by taking the Fracture Risk Assessment Tool (FRAX). The World Health Organization (WHO) has developed this tool. It can be found here.
Based on risk factors, T Score, age and using an individualized approach, some women and men will need medication to treat their osteoporosis.
Bisphosphonates are usually first line therapy. The most common are Fosamax©, Actonel© and Boniva©. Bisphosphonates work by decreasing bone breakdown and allowing increased bone growth. The question, which has been asked for years? Is it good bone or brittle bone? I am very concerned about the abundant use of these medications and the severe side-effects coming to light. Side-effects include muscle, joint and bone pain, stomach problems, irregular heart rate, jaw necrosis and, most recently, spontaneous fractures of the femur. We are not sure why this is happening. We are not really sure how prevalent this is, as there are so many women on bisphosphonates. The current recommendation by some experts is to be on the bisphosphonate for no more than 5 years, then take a drug holiday. A drug holiday is defined as no medication for two years to several years. DO NOT STOP YOUR MEDICATION UNTIL YOU TALK TO YOUR PRIMARY HEALTH CARE PROVIDER.
Estrogen is good for the bones. We do not use hormone replacement therapy for osteoporosis unless it is indicated for menopausal symptoms. Janet Schlechte MD, Professor of Medicine, Division of Endocrinology, Department of Internal Medicine, University of Iowa Hospital and Clinics states premenopausal women rarely should be considered for bisphosphonate therapy because they are still producing estrogen.
SERMs (Selective Estrogen Receptor Modulators) inhibit bone breakdown. Raloxifen and Tamoxifen fall in this category. They are effective. There is concern they may cause dementia as they block the estrogen receptors in the brain.
What is a woman to do?
- Number One: DO NOT STOP YOUR MEDICATION UNTIL YOU TALK TO YOUR PRIMARY HEALTH CARE PROVIDER!
- Number Two: Do the FRAX questionnaire to determine your risk factors.
- Number Three: If your fracture risk is high and you are less than 65 years old, get a bone density test.
- Number Four: If you are older than 65 you need a bone density test - male or female.
- Number Five: Start a Bone Health Program. Taking care of your health is like starting a full time job ~ Robert S. Ivker DO. In this day and age we have medications that are helpful. They do have side-effects but they are better than doing nothing at all. If you choose not to use medications then you must work on your health day after day after day. If you present to a medical office, and are not interested in doing the work it takes to remain in good health you will be put on medication. That is our job.
You are responsible for your health. Make an effort!
A good bone health program consists of regular exercise, eating healthy and supplementation.
The most important thing you can do to reduce your risk of developing osteoporosis is exercise: weight bearing and weight lifting. Experts are starting to look at flexibility exercise such as yoga and Tai Chi as being helpful for prevention of osteoporosis. We do know that Tai Chi is very helpful for balance, which can prevent an individual from falling. Also, the slow stretching with yoga and Tai Chi will stimulate the bones and help promote bone growth.
Diet: eat your protein at each meal and lots of veggies. Cut out pop, white flour and sugar products. Moderate consumption of dairy products is okay, preferably not milk. There is a lot of discussion in the literature stating there is either no benefit or an actual increase in fracture rate in those individuals who used the most dairy products compared to those who used the least.
There are a variety of supplements one can take to improve bone health. These include calcium, magnesium, vitamin D and strontium.
The recommended daily amount for calcium for teens is 1300 mg; females, age 19 to 50, 1000 mg; over age 50, 1200 to 1500 mg. Calcium citrate is better absorbed than calcium carbonate. Pro Bono©, a product I recommend as a multi vitamin/bone health supplement, contains two types of calcium. One is hydroxyapatite, recommended by Mayo Clinic; the other is D Calcium Malate. With Pro Bono you will be taking all of your calcium at one time, because there are two types of calcium. If you are taking one type of calcium split the dose, 500 mg two times per day with meals.
Magnesium is important for bone health. It helps with calcium metabolism. The recommended dose is 400-800 mg. It is also helpful for the heart and achy legs.
Vitamin D is imperative for bone health. Vitamin D can be obtained through sun exposure and with supplements. It is hard to get enough in our food intake. The recommended dose is exposing your face, arms, and legs to sunlight without sunscreen 15-20 minutes three to four times per week. The recommended supplement dose is 1000 to 2000 IU vitamin D 3 per day. See my article on Vitamin D for more information.
Strontium is thought to increase the formation of bone, and decrease the breakdown of bone. It binds to the same receptors as calcium so needs to be taken separately from calcium and with a meal. Dose ranges from 680 mg to 2000 mg per day.
Orthomolecular Products© makes a multi vitamin/bone health supplement called Pro Bono©. It is a full multi vitamin plus supplements for bone health including Strontium, Calcium, Vitamin D and Magnesium, all in adequate doses. I think everyone should be taking this, men included. The distributor I am working with is at Healthy Vitality.
An osteoporosis diagnosis does not mean you will fracture a hip, despite what commercials say. Take charge of your life. Start moving, eat a healthy diet with lots of vegetables, stay away from refined sugars, quit smoking, take your supplements, treat your depression and live life to the fullest.
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Bowel Health ~ Fiber
As any of you who have had bowel problems knows, when your bowels are not working well, nothing is working well! So, just how well are your bowels working?
Proper bowel health is a very important aspect of healthy living. When we look at healthy bowel function we want a large, soft, formed stool. Each bowel movement need not be perfect because everyone is different. However, if your stools are consistently loose, or if you are straining and constipated, your bowels are not functioning properly.
There are various bowel disorders that cause abnormal function. These disorders include Diverticulosis, Irritable Bowel Syndrome, Constipation and Diarrhea.
Diverticulosis involves having diverticulae, small pouches in the walls of the colon. These pouches are formed in weak spots that actually ‘bubble out’ from having to push too hard. They can trap matter and become inflamed and infected.
Irritable Bowel Syndrome comes in three types – diarrhea, constipation or a combination of both. Other forms of constipation and diarrhea exist that are not related to Irritable Bowel Syndrome. Regular fiber intake can reduce the symptoms of these bowel disorders.
In the case of Diverticulosis, it prevents matter from becoming lodged in the diverticulae. With diarrhea, the fiber ‘bulks up’ and helps form the stool. When constipated, the fiber ‘bulks up’ and softens the stool. Adding fiber returns the bowels to normal, proper movement and function.
The bowel is very sensitive to change. It likes a regular routine. Many factors can cause an unhappy bowel; some are stress, change in diet, medications and a decrease in activity. As you may have experienced, it is common to see an increase in bowel problems when traveling or even hospitalized due to the changes in your daily routine.
Having a regular bowel health plan is important if you have bowel problems. As you get older, bowel function can change. The daily routine becomes even more important for maintaining your good health and ultimately, making you feel good.
What is fiber and how to get it?
Fiber is the part of a carbohydrate food that cannot be digested. Carbohydrate foods include fruits, vegetables, grains, seeds and legumes. There are two types of fiber, Soluble and Insoluble. Soluble fiber partially dissolves in water while Insoluble fiber does not. Increasing fiber in your diet can lead to a number of other health benefits as well. It can lower your cholesterol; reduce your risk of heart disease, diabetes and even some types of cancer
Soluble Fiber dissolves into a gel-like substance. Any of you who have used Metamucil™ know if you don’t stir and drink it quickly, it will become gel like. Soluble Fiber is found in oats, beans, peas, soybeans, apple pulp, barley, strawberries and psyllium, which is used in Metamucil™.
Insoluble Fiber does not change form. It adds bulk to the stool to develop a large soft, formed stool. Insoluble fiber is found in whole wheat foods, bran, nuts, seeds, cabbage, cauliflower, brussel sprouts and apple skins.
Because fiber comes from carbohydrates, I struggle with how to advise people to increase fiber without overloading their diet with ‘carbs’.
Some carbohydrates including wheat, rye, barley and oatmeal contain gluten. Recently, there has been a dramatic increase in gluten sensitivity in the United States. This sensitivity can cause a whole host of problems in the body. Celiac disease, which is a gluten allergy, affects adults and children. If not treated, it can be devastating to the body. Symptoms of Celiac Disease include diarrhea, abdominal cramps, gas and bloating, anemia, osteoporosis, muscle weakness, depression, skin rash, tingling in legs and feet and weight loss.
We’ve all heard and seen the claims on TV regarding the benefits of oatmeal for reduction of heart disease and cholesterol. It is in fact true; Studies have shown that oatmeal lowered total cholesterol about 7.8 mg/dl and LDL cholesterol 7 mg/dl. However, in these studies slow-cooked oatmeal with nothing in it or on it was used.
I have found most people are using the instant type, not slow-cooked oatmeal. The instant type oatmeal’s are loaded with carbohydrates. To make matters worse many people then add all sorts of high carbohydrate items like brown sugar, maple syrup, dried cherries and raisins. This defeats the purpose and will actually cause your cholesterol, weight and blood sugar to increase. I strongly recommend if it is advertised on TV as good for you, it likely is not!
Where to get fiber and how much fiber?
The recommended daily amount of fiber intake is 35 gm for men and 25 gm for women. The average American consumes about 14 gm of fiber per day.
There are two ways to add fiber to your diet: Food or supplements. I suggest one to two servings of carbohydrates in addition to your daily vegetables. Also, carbohydrates need to be eaten with protein to keep your blood sugar in balance. Foods known for high fiber will contain 5 grams or more per serving. Go to Fiber Content Chart for fiber in content in a variety of foods. Remember to measure portion size.
There are several methods to increase daily fiber intake by using either food or dietary supplements. I caution you to slowly increase your fiber. It is also important to increase your water intake when increasing fiber. This will aid the work of the soluble fibers.
The first method is a home treatment I call the ‘Laxative Remedy’. It has been used for years with great success for nursing homes patients. Anything that can help them is pretty powerful stuff. To make this remedy, mix equal parts of prune juice, applesauce and oat bran. I have patients begin with one or two tablespoons with at least 8 ounces of water per day. You can increase the dose weekly as needed. This is a wonderful blend of soluble and insoluble fiber.
The other food treatment I recommend is Flaxseed. The seeds must be ground to be effective. Flaxseed can turn rancid quickly so I suggest grinding it yourself versus buying the preground Flaxseed. Use a coffee grinder to grind a 2 or 3 day supply in advance. Always refrigerate Flaxseed. To start, I suggest one teaspoon in 6 oz of water. You can gradually increase to ¼ cup per day in 8 oz of water. Caution: If you have Diverticulosis do not use Flaxseed, as those small seed particles can get caught in the diverticulae.
My favorite fiber supplement is Orthomolecular Products©, Fiber Plus™. When I first read the ingredients, I chuckled. They have taken the ‘Nursing Home’ blend of apple pectin, prune, and fig and put it in a pill. It is much easier to take and contains a whopping 6.5 gm of fiber per pill. It also contains rice bran instead of oat bran. This eliminates gluten sensitivity concerns.
Fiber Plus™ also contains Psyllium seed and husk, the ingredients in Metamucil™. Acidophilus is included, which is a probiotic. Probiotics are not fiber but play a very important role in the digestive tract. I suggest beginning with one capsule per day with food and eight ounces of water. Increase to two capsules per day in one week if needed. You can find Fiber Plus™ at Healthy Vitality.
Other over the counter fiber supplements include Metamucil™, Konsyl™, Citrucel™, Perdiem Fiber Therapy™, Fibercon™ and Benefiber™. Metamucil and Konsyl are psyllium seed and husk. Citrucel is methylcellulose and Perdiem Fiber Therapy and Fibercon are calcium polycarbophil. Benefiber is wheat dextran, which is gluten free.
Psyllium seed and husk comes form the plants plantago psyllium or plantago ovata. It is mostly soluble fiber, 71 percent by weight, and is very effective as a bulk laxative. Methylcellulose comes from the methylation of cellulose. Cellulose is the main material that makes up the cell walls in plants. Calcium polycarbophil is a calcium salt of a hydrophilic resin of the polycarboxylic type. Wheat dextran is a soluble fiber. These are all bulk laxatives, which increase the amount of water in the stool to form a large soft-formed stool.
There you have it. Healthy, happy bowels make for a happy you! It is important to get fiber from your foods. However, too many grains in the diet can lead to a whole host of additional conditions. For years I have recommended the ‘laxative remedy’ and patients have had great results.
I now recommend the use fiber supplements to increase fiber because of their ease of use. Fiber Plus™ is my new favorite because of its very potent formula.
When starting with fiber, start low and go slow, and be sure to increase your water intake.
Remember, a healthy bowel plan includes a nutritious diet, regular exercise, fiber and probiotics. When your bowels aren’t working, nothing is working!
Also see The Five E’s to Weight Release
There is a lot of controversy regarding what defines a healthy diet. I believe a low carbohydrate, high protein diet is the one most should follow. You will feel great and it also treats a variety of diseases. See The Five E’s to Weight Release section on my website for more information.
I urge you to try it; I think you will be amazed at how good you will really feel. When you first begin this program, you may become constipated. Fiber, probiotics, increased water intake and exercise can all be beneficial as your body adjusts to the dietary changes.
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Vitamin D
I have been hearing a lot about Vitamin D. Should I start taking it?
I am very excited about Vitamin D and the health benefits it can provide. I have been researching Vitamin D and testing my patient’s blood levels since last fall. Let me tell you what I have discovered.
Our body makes Vitamin D when our skin is exposed to sunlight. Sunscreen as low as number eight prevents our body from making any Vitamin D. Michael F. Holick PhD MD, author of The UV Advantage, reports that 40-50% of the adults in the United States are deficient in Vitamin D. I am finding more than that in my practice. In fact, I have only found two people who were not deficient. Individuals who are prone to low Vitamin D include the elderly, dark skinned people, and individuals who are obese. As we age our body is less able to manufacture Vitamin D. Dark skinned people produce less Vitamin D in response to sunlight. Vitamin D is stored in our fat tissue, making it less available to other tissues when one is obese.
We have always known that Vitamin D works by helping calcium into the bone to make strong bones. We are now finding that there are Vitamin D receptors in the brain, heart, breast, prostate, immune cells, hair follicles, kidney, liver, muscle, skin, stomach and thyroid, which is why low Vitamin D can cause a variety of health problems and diseases. I will discuss some of the effects that low Vitamin D has on our body and what you can do.
We have always known that low Vitamin D can cause rickets, osteomalacia and osteoporosis. The first study on Vitamin D and osteoporosis I heard about was in a nursing home. They were giving the residents the proper amount of calcium but they were still fracturing their hips. What they discovered was that because the residents were never in the sunlight, they were not producing any Vitamin D, thus the calcium could not get into the bones and fractures occurred. Rickets is a form of osteomalacia found in children and is on the rise. Osteomalacia is a softening of the bones causing bone and muscle pain. Michael F. Holick PhD MD wonders if fibromyalgia is actually osteomalacia secondary to low Vitamin D. If you have osteoporosis or osteopenia it is important to take Vitamin D with your calcium. If you have fibromyalgia you may want to get your Vitamin D levels checked to see if your level is low.
High blood pressure can also be caused by low Vitamin D. We see more hypertension in the winter when our sun exposure is very low. It was found that low Vitamin D caused a three-fold increase in high blood pressure in men and women with men being more sensitive to this effect.
Studies have shown that low levels of Vitamin D increase the risk of stroke in the elderly and may contribute to congestive heart failure. There is also a reduction of risk for developing gum disease with adequate levels of Vitamin D. We are finding that gum disease is directly related to heart disease.
Adequate levels of Vitamin D reduce insulin resistance. Insulin resistance causes the metabolic syndrome, which is a huge risk factor for heart disease. The metabolic syndrome is a combination of weight gain in the abdomen, high blood pressure, diabetes or pre- diabetes, high triglycerides and low HDL (good cholesterol). We also have found that Polycystic Ovarian Syndrome is related to insulin resistance and obesity. In a study looking at women with Polycystic Ovarian Syndrome, those with the lowest levels of Vitamin D had the highest levels of insulin resistance and obesity.
We are seeing many cancers related to low Vitamin D. Women with a Vitamin D level of 50 or greater had the least chance of developing breast cancer. Another study showed a 46% decrease in reoccurrence of melanoma in those with adequate Vitamin D levels. Non-Hodgkin’s Lymphoma development was reduced by 40% with adequate Vitamin D levels. Other cancers that were reduced with adequate Vitamin D in the body include colon, prostate and ovarian.
We have known for a long time that Autoimmune Diseases such as multiple sclerosis, rheumatoid arthritis, and irritable bowel disease are less common in countries near the equator where they get more sunlight. We are now discovering direct links to these diseases with low Vitamin D levels.
In the elderly we see individuals more prone to muscle weakness, falls and decreased brain function when their Vitamin D levels are low. It was also shown that high levels of Vitamin D helped decrease the symptoms of Alzheimer’s disease. Age related macular degeneration risk can be reduced with adequate Vitamin D.
Psoriasis gets better in the summer when the individual is exposed to the sun. An effective treatment for psoriasis is to go to the tanning salon during the winter months.
There is a theory that low Vitamin D levels may be one cause of major depression. We do know that minimal sunlight in the winter leads to SAD (seasonal affective disorder), a form of depression that resolves during the summer. Studies are showing that low Vitamin D can cause depression and supplementing with Vitamin D can improve mood and well-being.
Is Vitamin D the new miracle vitamin? I always get a little suspicious when anything claims it can cure everything. However, being the sun worshiper that I am I know how good it feels to sunbathe. I also see a lot of seasonal affective disorder in my practice. Gaylord gets very little sunlight for what feels like 6 months of the year. The medical studies that are being done and the fact that we have receptors for Vitamin D through out our body have certainly intrigued me enough to begin testing and treating low Vitamin D. I believe it can certainly play a factor in disease prevention and management.
You can get Vitamin D from food. Oily fish such as salmon and sardines are good examples. To get an adequate amount you would need to eat two servings of salmon per day. Milk, orange juice and some cereals have been fortified with Vitamin D. You would have to drink 10-40 glasses of milk per day to get an adequate amount. Orange Juice is just liquid sugar so I would advice against getting your Vitamin D from orange juice.
Cod Liver Oil is high in Vitamin D and also high in Vitamin A. We are seeing some serious problems supplementing with high levels of Vitamin A. I would advice against using cod liver oil.
The best place to get your Vitamin D is from the sun and from supplements. The sun is not a bad thing. It has been around for a very long time. When used in moderation it can have a powerful effect on our health. We can get a large amount of Vitamin D in our system if we sunbathe without sunscreen 20 minutes 4 times per week. Do not do this at high noon, and do not burn. Once your get your sunbathing in you can apply sunscreen. This will cover your Vitamin D requirements through October. What do you do the rest of the year? You can go to the tanning salon 3 times per week or you can supplement.
In regards to supplementation there are a variety of recommendations. Many experts recommend 1000 to 2000 IU of Vitamin D 3 (cholecalciferol) every day except during the summer. General Guidelines for Vitamin D intake from the University of Michigan's Impact of Integrative Medicine in Primary Care - A Practical Update Conference: "Adults 2000-30000 IU Vitamin D 3 in the winter, 1000 IU in the summer. Take with food." Child dose is 1000 IU in the winter; 400 IU in the summer, taken with food. Without a lab test I agree with that recommendation. The correct lab test is 25(OH) Vitamin D. I like the levels to be 60-80 ng/ml. You should also get your calcium checked as high levels of Vitamin D can cause high levels of calcium, which can cause all sorts of health problems. I have been using doses up to 5000 IU two times per day in individuals with low Vitamin D. Using this dose is based on lab values with follow-up labs to monitor levels. It will take 3-4 months to get the levels up. It is important that you take calcium with Vitamin D, 500 mg two times per day or 1000 mg one time per day with meals. REMEMBER THAT VITAMIN D IS FAT SOLUABLE, IS STORED IN YOUR FAT CELLS AND CAN BE TOXIC. One of my patients is very healthy but has had several hairline fractures of her bones. I was sure she was low in Vitamin D so checked her level. Her level was 96. Just because you have symptoms of low Vitamin D does not necessarily mean you are low.
Summer is here. Get out in the sun and sunbathe and fill your body up with the healing properties of Vitamin D and the sun. I will be starting to test individuals at the end of October as the sun heads south.
For more information see Michael Holick PhD MD The UV Advantage or visit his website at UV Advantage. Another great website is Vitamin D Council. Happy Sunning!
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Omega 3s
All diseases have an inflammatory component and Omega 3s are a powerful anti-inflammatory supplement. Everyone should take Omega 3s on a daily basis.
I made the above statement at a conference recently. One of the participants asked if Omega 3s were contraindicated in anyone. I thought for a moment. I said, “An individual who eats a healthy diet with lots of fish and vegetables, exercises on a regular basis and lives a joyful, stress-free life would probably not benefit from Omega 3s; everyone else will benefit from Omega 3s.” I added, “If you know that person, I would like to meet her!”
There is evidence Omega 3s may thin the blood. If you are on Coumadin, you should have your INR and PT checked after two weeks of taking Omega 3s. If you begin bruising easily after starting Omega 3s, reduce your dose.
The primary side-effect of fish oil is eructation or burping. If there is more fish oil than Omega 3 in the supplement, you may burp a fishy taste. This can be reduced by keeping the supplements in the refrigerator or by getting pharmaceutical blends of Omega 3s.
We are not sure of the exact mechanism of action of Omega 3s, but it appears to be anti-inflammatory. I will be discussing the Omega 3 fatty acids called Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA). I will not be discussing ALA, which is in flaxseed. ALA must be converted to EPA and DHA to obtain the Omega 3 effect. In the human body, ALA is not readily converted to EPA and DHA due to lifestyle, age and other influences. You will not get the Omega 3 effect by using ALA. I will discuss the benefits of flaxseed and ALA in another article.
Experts in Vitamin D research are making strong recommendations against the use of cod liver oil. Cod liver oil contains high levels of Vitamin A with little Vitamin D. Studies have shown Vitamin A antagonizes or stops the effects of Vitamin D. In one study, Vitamin A was shown to stop the protective effect Vitamin D has on the prevention of colon cancer. High levels of Vitamin A may increase the risk of hip fracture due to the antagonizing effect on Vitamin D.
EPA and DHA are found in the oil of cold-water fish such as salmon, tuna, trout, mackerel and sardines. Increasing fish in your diet can have a profound effect on your health. Likewise, adding the Omega 3 supplement can be very beneficial to your health.
There are numerous studies showing the benefits of Omega 3’s in a wide variety of disease states.
- Heart Health – We see benefits in lowering high blood pressure and triglycerides. Omega 3s improve heart health, reduce the risk of a heart attack and can stabilize an irregular heart rhythm. Studies are mixed on whether it can reduce stroke. Omega 3s work so well at lowering triglycerides, we actually have a prescription Omega 3 that can be taken to lower triglycerides. The medication used to be called “Omacor”, and is now labeled “Lovaza”.
- Musculoskeletal Heath – The use of Omega 3s show benefit in reducing the symptoms of osteoarthritis, Rheumatoid arthritis, lupus and fibromyalgia.
- Cancer Prevention – Some studies report Omega 3s can reduce the risk of developing breast, colon or prostate cancer. Other studies have shown Omega 3s can reduce the growth of colon cancer and colon polyps. Studies indicate an inflammatory component in the development of cancer; thus, it is believed the Omega 3s are of great benefit in reducing the risk of developing cancer.
- Mental Health – It is intriguing to me that depression is caused by an inflammatory effect. There are some good studies, which show depression, post-partum depression and attention deficit hyperactivity disorder symptoms can be reduced with Omega 3s. There are mixed studies on bipolar disease and high doses of Omega 3s. Do not stop your medications and begin Omega 3s. Omega 3s can be used in conjunction with your medications and your symptoms monitored by your healthcare provider.
- Skin Health – Studies are mixed regarding dermatitis and psoriasis. Personally, I have found the extremely painful skin cracks which can occur on your fingers and thumb in the winter can be reduced and prevented by Omega 3s. Nicholas Perricone, MD, a dermatologist, has achieved incredible results in face rejuvenation with his diet high in Omega 3s. Oprah had a show on plastic surgery options. The most dramatic effect was on a woman who followed The Perricone Prescription for four weeks. She looked at least 10 years younger after only 4 weeks! Dr Perricone’s diet is low in carbohydrates and high in Omega 3 foods. I see this all the time in my practice. As people reduce their intake of inflammatory carbohydrates, they look years younger and feel great. I am not sure supplements will work for face rejuvenation, but they are effective for the skin cracks on your fingers.
The basic dose of Omega 3s is 1000 to 2000 mg per day for good health. For many diseases you can take as high as 4000 mg per day. The dose is for the combined mg of EPA and DHA, not the fish oil. Some fish oils will say, “1000 mg of fish oil”. When you look on the back of the bottle, you may only see a combined dose of 500 mg of EPA and DHA. The pharmaceutical blends of fish oil/Omega 3s have high levels of EPA and DHA and reduced amounts of the saturated fats and fatty acids found in fish oil. This reduces the side effect of eructation or burping up fishy taste.
One question that remains unanswered in the literature is what should the ratio of EPA to DHA be? Most of the quality brands range from 1.3-2 : 1 EPA:DHA. Lovaza, the prescription Omega 3 is 1.2 : 1 EPA:DHA.
Consumerlab.com is a website with information on herbs and supplements. There is a cost to join ConsumerLab.com but I have found it to contain a wealth of knowledge. Periodically, Consumer Lab will evaluate a particular herb or supplement made by a variety of manufacturers. They evaluated 51 supplements, foods and beverages that contained Omega 3s. They did not find any dioxin, PCB or lead in any of the products. This is because mercury is found in the fish meat not the fish oil.
In Yoplait Kids Strawberry Vanilla Yogurt™, there are 16 mg DHA. In Tropicana Pure Orange Juice™, there are 50 mg of combined EPA and DHA in eight ounces of orange juice. This, once again, proves my point: If something is advertised as “good for you”, don’t eat it! To get the recommended daily dose of 1000 mg of EPA and DHA you would need to drink 20 cups of orange juice.
There is not a recommended dose of DHA/EPA for children. We do know that DHA is imperative for brain development in the first two years of life. DHA is now being added to formula.
Dr. Thomas Young was a physician who practiced medicine in London in the early 1800’s. He developed a rule of thumb to determine the dose of medication for children. The formula is adult dosage multiplied by the child’s age divided by the sum of the child’s age plus twelve. For example, the adult dosage for Omega 3s is at least 1000 mg per day. To determine the dose of a four-year-old child you would add four to twelve, which equals 16. Then divide 4 (the child’s age) by 16 (the child’s age plus twelve) which would equal 0.25. Next, take the adult dose of 1000 mg and multiply it by 0.25, which would equal 250 mg. Therefore, according to Young’s Rule, the Omega 3 dose for a four-year-old child would be 250 mg per day. A four-year-old would have to eat almost 16 servings of yogurt per day to get the recommend amount of Omega 3s!
Omega 3s are powerful anti-inflammatory supplements. They can be beneficial in preventing and reducing many diseases. Even more powerful is eating Omega 3s in food and moving away from the inflammatory effect of simple carbohydrates. Eat fish, take your supplements, move away from the inflammatory white flour and sugar products and feel great!
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*These articles are not, nor do they replace, medical advice. You should consult your healthcare provider before beginning any diet, exercise, herb, supplement or other treatment program.
Something to Contemplate
Something to Contemplate is a bimonthly eLetter of "Mary's Musings" on life. It may be a quote, a question, an idea or something happening in our world. Enjoy a moment to yourself and contemplate the thoughts: How do they make you feel? Where do they take you? Click here to receive the bimonthly STC.
Learning to Walk
Continuous effort - not strength or intelligence -
is the key to unlocking our potential.
~Winston Churchill
How are you doing so far in this New Year? Have you started to make those positive changes in your life? Are things going smoothly or have you become frustrated or overwhelmed? Remember, the key to change is baby steps!
Let me tell you a story about a baby learning to walk. Remember: Take baby steps!
Have you ever watched a baby learn to walk? There are three components necessary for the child to do so. They are belief, role models and support.
These are the attributes I want you to embrace as you begin to make changes in your life that will bring you joy.
Belief
There comes a time when each baby decides it is time to stop crawling and learn to walk. No one knows what triggers this decision; it is their own unique individual timing.
It is such a trying process. When a baby begins, she is very unsteady on her feet. She will repeatedly stand up, fall down, stand up, and fall down. I always thought it was a good timing that my daughter was in diapers at that stage. The extra cushioning had to help! The key is that she kept on trying, day after day after day.
A baby may take a day off, but she is right back at it the next day. Trying again and again and again. She has a belief and determination within herself that she will walk and she will keep on trying until she does.
After she has fallen for the hundredth time, a little one doesn’t think, “This is too hard. I give up!” Instead, she tries it one more time! Why does she keep trying? The answer is: Role Models.
Role Models
A baby has the perfect role models when learning to walk . . . everyone else does and so shall I! Either instinctually or intellectually, the baby knows it should be walking. And isn’t it like that for you and me? We all know that we as individuals should be walking, or should I say, what we should be doing. But are we?
This is where role models come into play in our lives. Just like that baby who is progressing, trying to walk like the loved ones around her, we too need role models. Choose your role models wisely. Choose a person who inspires you, who represents the ideals and behaviors you wish to achieve. Think of that person often. In trying to emulate that role model you will begin to achieve the changes in your life that you seek. And as mentioned before, believe in yourself and the changes you are going to make!
Support, A Helping Hand
Have you noticed how excited people get when that baby is learning to walk? If she falls down you say “oopsy daisy” and help her up. Sometimes she accepts your offer and other times she doesn’t. It is that inner belief in one’s self that motivates her.
At times you hold her hand as she toddles along. And at times you stand at a distance, cheering her on every step of the way! When she successfully walks to you, you cheer her on with the same enthusiasm as when she doesn’t.
What an incredible process it is: The determination, belief in one’s self and the role models and support of so many. What a human process it is!
It is said that one of the biggest killers of a person’s dreams is other people. That may be true, but I believe that we can kill our own dreams by giving up on them.
In your life, do you receive positive support from others? Do you receive unconditional love? More importantly, do you support and love yourself? This is something I want you to really examine. This is where we all seem to fail ourselves. Do you truly believe in who you are and where it is you want to be? Wouldn’t it be so much easier to quit right now? Taking the easy way out by blaming failure on others? Look deep inside, are you willing to give up or do you believe in yourself?
I remember when I was trying to set up my integrative medicine practice; the roadblocks and obstacles seemed insurmountable. At one point I was literally lying on the floor and had called a friend. I was sure that my attempts had failed . . . I was questioning what I was doing… in other words, having a great whine session! She thankfully listened like a good friend should, but didn’t buy any of it. She simply said, “You have two choices: quit or try again.” After whining a few minutes longer, I realized I wasn’t ready to quit, so having no other options, I tried again. I took a deep breath, stood up and began again. Finally, it happened and it has been better than I could have ever imagined.
It’s Your Turn
It’s time for you to look at your life, to determine what you want to bring in to it. Something from your childhood? Or perhaps a new skill that you’d like to learn? Take some time to contemplate what you really want. Begin to believe that you can do it. Find your role models, talk to them, or read about them. Find those who already posses the skills or traits you are seeking.
Take Action
There is no time like the present to take the action! And remember to fully expect that you will fall down. When you do, support yourself or seek support from another. Stay away from those joy snatchers, the people who you know will say, “Told you so!” or “That’s a stupid idea. Why would you want to do that?”
When you fall, you may need to stay down for a while, determine what happened, then say “oopsie daisy” and help yourself up. Rest is okay. It gives you time to establish why that attempt didn’t work. Is it an action that you need to keep practicing or do you need to go in another direction? Whatever the case, pick yourself up, dust yourself off and say “I can do this” and begin again.
What will you do this year with the same focused intensity and support that you had as you learned to walk?
The greatest crime in the world is not developing
your potential. When you do what you do best,
you are helping not only yourself, but the world.
~ Roger Williams
Just do It!
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