Osteoporosis during menopause

About the Disorder

The skeleton is a living tissue, formed by a protein parte (collagen) and by a mineral part (mainly calcium, magnesium, phosphorus and fluoride salts). Its efficiency depends on a multitude of factors, among which nutrional lifestyle and physical movement play a key role.

Diets that are poor in nutrients,together with oxidative stress and a sedentary lifestyle are mainly responsible for the increase in the incidence of osteoporosis typical of modern society. Women are more exposed to such risk: female hormones exert a protective role on bones, both in terms of the vitality of collagen and as regards the deposition of calcium in the mineral structure.

Conditions of unbalance and hormonal decline typical of menopause can worsen the situation of a skeleton already compromised by an unhealthy lifestyle. Menopause as such does not trigger osteoporosis; it can, however, aggravate it. An adequate, balanced supply of nutrients involved in bone metabolism is a factor that can indeed be influenced; therefore, resorting to a correct integration of necessary elements has an important role to play in maintaining bone mass, both as a preventive measure as well as in treatment of osteoporosis.

Conventional medicine and osteoporosis   

Main medicines prescribed in conventional medical practice to prevent and counter osteoporosis are:

HRT: Hormonal Replacement Therapy, no longer representing first choice therapy for the prevention of osteroporosis. Risks are considered higher than benefits.

RALOXIFENE: during the past few years, a line of research has developed, aimed at evaluating how certain medicines used for anticancer therapies, called SERMS (i.e. Selective Estrogenic Receptor Modulators), act on bone tissue. Raloxifene belongs to this category and is a synthetic substance with an estrogenic effect on bones, while being antiestrogenic on uterus and breast at the same time. For this reason it is amply advertised as the primary medicine in the treatment of osteoporosis.

Studies have shown that it prevents loss of bone mass and diminishes the risk of fractures at spine level in post menopausal women. However, it doesn’t have the ability to reduce the risk of much more common hip fractures. Underlying reasons for this are not yet clear. Side effects include hot flashes and more concerning consequences such as the increased risk of thromboembolus particular at lung level, depression and dementia. In fact, unfortunately this substance blocks captation of estrogens not only at uterus and breast level, but also at the level of the brain!

ALENDRONATE: it belongs the family of bisphosphonates. Some of these, including alendronate, have proven effective in preventing bone mass loss and contributing to reconstruct it. Side effects include nausea, constipation, ulcer. It is important to take the medicine on an empty stomach as a first thing in the morning, only with a full glass of water; no other food or drinks should be taken during the first 30 minutes after intake and, in order to minimize disorders of the upper digestive tract. The patient must not lie down at least for 30 minutes after ingesting the medicine.

CALCITONIN:  a hormone naturally present in our organism. It mainly acts by stimulating the activity of osteoblasts. Side effects include nausea and hot flashes. A different approach is therefore necessary, that takes into account the physiological evolution of bones in the female body, protecting them from bone density loss. Nature can therefore once more be of valuable help, offering ingredients of proven efficacy.

Nature can help you in case of osteoporosis.    

Our Approach

A natural and effective approach

It is possible to help women handle the problem of bone fragility, a phenomen that may appear during menopause. The approach provides for different aspects, all of which equally important and to be followed simultaneously, to allow synergic action of the different constituents:

  1. rebalancing hormonal rhythms, modulating the irregular trends generally occurring during menopause;
  2. compensating for a widespread nutritional shortage in the Western world (namely, the lack of magnesium) and effectively contrast oxidative stress, responsible for aggravating menopausal disorders;

3.safeguarding the bones in a more specific way, protecting collagen and providing essential nutrients for the mineralization of the skeleton and for the absorption of calcium.

This approach, combined with a healthy lifestyle (in terms of diet, but not only), includes the use of natural remedies that are well known in folk tradition and the efficacy of which in providing a valuable and effective way to handle this specific problem has been confirmed by recent studies.

  1. To rebalance hormonal rhythms, modulating the irregular trends generally occurring during menopause…

Nature can help you with…

Soy isoflavones: these substances, belonging to the category of phytoestrogens, are capable of binding with receptors for estrogens (even though less similar), exerting a mild hormone-like action (in fact, they are less powerful, exactly 1000 to 10.000 weaker compared to estradiol). Scientists became interested in studying soy isoflavones after noticing that typical menopausal symptoms were absent in Asian woman, whose diet instead is rich in soy. Epidemiological studies have moreover pointed out that the incidence of degenerative pathologies, of arteriosclerosis and osteoporosis, as well as of certain tumours – affecting breast and uterus, is definitely lower in Eastern countries compared to the West.

The extraordinary nature of phytoestrogens, and isoflavones in particular, lies in their capacity to modulate the action carried out by physiological estrogens, rebalancing their effects. Recent studies have shown that isoflavones exert both an antagonist and agonist action on estrogen receptors.  This implies that, with excess endogenous estrogens (a typical situation in the transitional phase in which estrogens dominate over progesterone), isoflavones carry out an anti-estrogenic activity, i.e. they bind receptors, exerting a weaker hormone-like action compared to endogenous estrogens, therefore lowering the general effect. Instead, in the presence of lower hormonal levels (a typical postmenopausal condition), isoflavones exert a weak pro-estrogenic activity, since they occupy receptor sites that would otherwise remain inactivated. This action not only influences the reproductive system but all organs and tissues (bones, nervous system, skin, mucosae, cardiovascular system, etc.): in fact, isoflavones positively influence all menopausal symptoms.

Vitex agnus-castus (also called chaste tree): its berries have a rebalancing effect on the progestogen hormonal component. Their use for menopausal symptoms is explained by their action at the level of the hypophysis where, acting on gondadotropins (FSH and LH), they promote the production of progesterone and contribute to alleviating typical transitional phase symptoms. Moreover, it has recently been discovered that intake of chaste tree stimulates the production of melatonin by the brain, improving depressive symptoms as well as the quality and quantity of nightly rest.

Dioscorea villosa: of Mexican origin, it has been used since Aztec times to treat many female disturbances, from premenstrual syndrome to menopausal symptoms. Among its active ingredients there is diosgenin, a substance with a structure similar to progesterone. Evidence of the drug’s use (dry root extract) shows hormone-like effects towards the progestogen component. Its mechanism of action is not yet known: it can act as a phyto-progestin, interacting with progesterone receptors; it can rebalance the hypophysial secretion of FSH and LH or stimulate the hormonal production of the adrenal gland.

The most convenient form of intake of these ingredients comes in swallowable tablets.

  1. To compensate for a widespread nutritional shortage in the Western world (namely, the lack of magnesium) and effectively contrast oxidative stress, responsible for aggravating menopausal disorders…

Nature can help you with…

Magnesium: the widespread deficiency of this mineral, mainly due to soil depletion and refined foods, bears implications for many aspects related to health, ranging from the psychic and neuro-muscular spheres, to the cardiovascular, osteoarticular and gynaecological domains. Due to hormonal trends which are typical of fertile life (menstrual cycle, pregnancies, breast-feeding, menopause), women are affected by a lack of magnesium with a frequency that is four times higher compared to men.

In the general, current worsening of menopausal symptoms related to the neurovegetative sphere and mood levels, magnesium plays a vital role , just as in the increase of degenerative, chronic pathologies such as osteoporosis, insulin resistance, hypertension and vascular damage. Whenever there is a lack of magnesium, the action of calcium at the level of muscles and nerve endings tends to prevail. Anxiety, irritability, stress, insomnia, headache, muscle tension and cramps are a direct consequence. Effects at cardiovascular level are even more dramatic (arrhythmias, fibrillation, heart attack, hypertension).

Another consequence ensuing from the lack of magnesium regards bone structure: magnesium is vital to “keep us on our feet an entire lifetime”, in other words, it “saves our bones”. To contrast vasomotor and neurovegetative symptoms, to safeguard the cardiovascular apparatus and protect the bone structure, an intake of at least 400 – 500 mg of magnesium a day is recommended during menopause, to be taken as salts with high bioavailability, of which magnesium citrate represents the best.

Alpha lipoic acid: this is naturally produced at hepatic level (synthesis, however, decreases with age) and it carries out a fundamental role in cellular metabolism of energy; it also protects from the attack of free radicals and reactive oxygen species that damage and wear out organs and tissues. Solubile in both  aqueous and lipid cellular fractions, it is active in every body district.

Its extraordinary nature lies in the fact that, while fulfilling its antioxidant function, it passes from a reduced to an oxidized form. Meanwhile, the alpha lipoic acid regenerates C and E vitamins, according to an “antioxidant recycling” process. It is capable of chelating dangerous metals, helping the organism to eliminate them. For these reasons it is considered “king of antioxidants” and is particularly useful for the general protection of the female organism, especially during menopause.

Intake via practical sachets to be dissolved in water is recommended.

  1. To safeguard the bones in a more specific way, protecting collagen and providing essential nutrients for the mineralization of the skeleton and for the absorption of calcium…

Nature can help you with…

Calcium: the human body contains between 1000 and 1500 g of calcium, of which 99% is located in the bones, together with phosphorus, in the form of hydroxyapatite, a crystalline structure conferring solidity and resistance. The introduction of calcium through nutrition is of primary importance for the formation and maintenance of the bone structure; however, intake of calcium not always automatically means it will be incorporated into the skeleton.

There are other mechanisms contributing, as well: calcium must be absorbed at intestinal level and fixed in the bones. In order to do this, the organism uses certain vitamins: in particular, vitamin D, and minerals such as magnesium, zinc, copper, manganese, essential for bone metabolism.

Another fundamental element for the mineralisation process of the skeleton is phosphorus, particularly abundant in today’s diet and which therefore does not require further integrations. Menopausal women should make sure they have a highy daily intake of calcium to safeguard their skeleton.

Such daily supply is essential, but it needs to be supported by the intake of other nutrients, often lacking from common diets, in order to promote the absorption of calcium, ensure its incorporation in the bones and prevent it from being deposited in other areas, causing side effects such as stiffening of the joints or formation of kidney stones.

Magnesium: magnesium is also essential to mantain the bone structure, both because it is one of the constituents of the mineral part, as well as because it regulates the metabolism of calcium, intervening in its use by the skeletal tissue.

 A deficiency of magnesium is associated with the diminution of bone mass density and with an increase in the risk of fractures. Magnesium is involved in the metabolism of vitamin D, it stimulates the secretion of calcitonin (a hormone promoting the activity of osteoblasts, cells in charge of bone formations) and inhibits parathyroid hormone (a hormone stimulating osteoclasts, cells in charge of demolishing bones).

Numerous studies have confirmed magnesium’s capacity to effectively improve the conditions of bones in women affected by osteoporosis. The chosen form of magnesium, easily to break down at intestinal level, ensures good absorption of this mineral, ensuring beneficial effects.

 Vitamin D: Vitamin D is essential to regulate bone metabolism. In fact, if favours intestinal absorption and renal re-absorption of calcium, as well as enhancing mineralization processes of the skeleton. Most of vitamin D is synthesized by the organism starting from cholesterol derivatives present in the skin, thanks to a number of cascading reactions triggered by sunlight and involving liver and kidneys.

Blood levels of vitamin D tend to decline with age for several reasons: lower exposure to sunlight, reduced activation of cutaneous precursors, poor ability of liver and kidneys to complete the conversion. An integration is therefore necessary.

Zinc: a vital element in the metabolism of the skeletal tissue since it acts as a cofactor in several enzymatic reactions, among which alkaline phosphatase, necessary for the mineralization of the skeleton, and collagenase, essential for the development of the protein structure of the bones. It is moreover involved in the biochemical activity of vitamin D and is a constituent of the copper –zinc superoxide dismutase enzyme, thereby contributing to protect connective tissue from the damage caused by free radicals.

Copper: an important element for the formation of the protein matrix of bones. In fact, it is part of an enzyme called lysyl-oxidase, through which lysine and hydroxylysine of collagen are transformed so as to produce crosslinkings necessary for the development of the connective tissue of bones, making them resistant. Copper competes against zinc for intestinal absorption and an excess of zinc can cause lack of copper. Zinc and copper should therefore be taken together, in the physiological 10 to 1 relationship.

Manganese: it participates in the bone metabolism, for both mineralisation and formation of collagen, contributing to preserve the skeletal system’s density. It moreover contributes to protect from oxidative damage, thanks to a marked anti-free radicals action.

Folic acid: recent studies have highlighted folic acid’s preventive action against the risk of hip fractures. It is capable of lowering the levels of homocysteine, an aminoacid that, when present at high concentrations, is related to a doubled risk of fractures. Folic acid therefore indirectly contributes to the health and robustness of the skeleton. Given the variability of symptoms (both in terms of timing and of intensity) signalling the onset of menopause, the above described ingredients should be taken according to personalized requirements, and in any case for periods lasting 3 – 6 months at least.

Polygonum cuspidatum: this plant, native to Asia and present throughout North America, is an extremely rich source of resveratrol, a polyphenolic substance, the activity of which as recently been studied in relation to its protective action towards the bone tissue. The principal reasons explaining its use are as follows:

1) it protects collagen from oxidative stress, both by blocking the spreading of free radicals as well as chelating metal ions responsible for the formation of reactive species;

2) it is a phytoestrogen, and as such it exerts a protective role towards the bone tissue, binding to estrogen receptors and exerting an estrogen-like action, albeit in a weaker way.

Swallowable tablets are undoubtedly the best means of intake for these elements, to be taken for periods between 6 months and 1 year at least.