Nexus - 0506 - New Times Magazine-pages

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cure, HRT has been imbued with a kind of saintliness. HRT bone is eaten up than new bone is laid down, bone loss occurs. offers salvation where otherwise there would be none, rescuing Bone turnover never stops completely. In fact, after about the women from an unthinkable fate as deformed old crones. In face age of 50 the rate increases, though it's not quite co-ordinated. of this, how could anyone be so ungrateful as to raise the question The bone-building cells, the osteoblasts, become less and less of risk?" capable of completely refilling the spaces made by the Common sense was thrown out the window when it came to osteoclasts.'* The peak amount of bone you started with and the hormone therapy. There was no discussion of the wisdom or rate of this loss determines the density of your bones. Density ethics of medicating huge numbers of asymptomatic healthy varies greatly in different individuals, cultures, races and sexes. women with oestrogen drugs which are acknowledged as among As Dr Susan Love, author of Dr Susan Love's Hormone Book, the "most potent drugs in the pharmacopoeia". The fact that this explains: "...the correct term for low bone density is ‘osteopenia’. approach has never been recommended for any other drug or for _It is only one factor in osteoporosis and the fractures that result the prevention of any other condition was immaterial. The switch from it. Another factor is the micro-architecture of the bone. As from HRT as a treatment to HRT as a long-term preventive thera- osteoclasts absorb more bone than is rebuilt, the micro-architec- py occurred without debate or justification. ture becomes fragile. As it weakens, the wrist and hip become Osteoporosis became a high-profile issue because it sells things. more vulnerable to fracture. Your vertebra doesn't really fracture Besides resurrecting HRT and securing its front-line position in or crack but collapses on itself, causing loss of height, and if the treatment protocol, the dairy industry and the pharmaceutical enough vertebra are crushed, a dowager hump is created.""” companies that make calcium supplements hitched a ride on the How real is this "dowager hump" syndrome? According to Dr osteoporosis bandwagon. Osteoporosis suited a number of vested Bruce Ettinger, Associate Clinical Professor of Medicine at the interests. It came to the rescue of the dairy food industry atatime | University of California and an endocrinologist: "...women when sales were plummeting because of people's anxieties about shouldn't worry about osteoporosis. The osteoporosis that causes eating foods containing saturated pain and disability is a very rare dis- fats. Calcium was added to skim ease. Only 5% to 7% of 70- year-olds milk, thus transforming milk into a Osteoporosis suited a number of will show vertebral collapse; only product that could be marketed as alf of these will have two involved healthy—a prevention against osteo- vested interests. It came to the vertebrae; and perhaps one-fifth or porosis. Women were warned that one-sixth will have symptoms. I have their bones would become brittle if rescue of the dairy food industry a very big referral practice and I have they didnt take extra calcu by way ata time when sales were very few Dent Over pawents heres of the new calcium-fortified dairy . een a tremendous hullabaloo lately, products.'° plummeting because of people's and there are a lot of worried The makers of calcium supple- anxieties about eating foods women—and excessive testing and ments also claimed that their prod- a administration of medications."” ucts could prevent bone loss, despite containing saturated fats. The medical definition of osteo- the fact that there is no absolute evi- orosis used to be "fractures caused dence that this is true. By 1986 y thin bones". It has since been American consumers were spending redefined to "a disease characterised US$166 million on calcium supplements. Prior to the calcium by low bone mass and micro-architectural deterioration of bone craze, and contributing to it, the US National Institutes of Health tissue which lead to increased bone fragility and a consequent (NIH) had recommended in 1985 that women should increase increase in fracture risk"."" However, there is a problem with their daily calcium allowance. By 1989 the NIH was warning that defining osteoporosis as a disease, not a fracture. Low bone mass the promoters of calcium "promise more than calcium is going to is only one risk-factor for osteoporosis, not osteoporosis itself. deliver".'° It's a warning sign that might be useful, so you can begin to con- sider ways to keep the disease itself from occurring. Dr Love THE BARE BONES ABOUT BONES offers a striking analogy: "This is like defining heart disease as To understand the many myths about osteoporosis and its pre- having high cholesterol rather than having a heart attack. scribed treatments, it is vital to understand the nature of bones. Needless to say, this new definition has increased the number of Bone is living tissue which undergoes constant transformation. women and men who have osteoporosis." Bone might appear to be static, but its basic components are con- Although this new disease has two components—bone mass tinually renewed. At any given moment in each of us, there are and micro-architecture—micro-architecture is virtually ignored. from 1 to 10 million sites where small segments of old bone are The problem is that, presently, only bone density can be mea- being dissolved and new bone is being laid down to replace it. sured. Also, not everyone with low bone density will get frac- Bone tissue is nourished and detoxified by blood vessels in con- tures. For instance, Asian women have low bone density yet have stant exchange with the whole body.'” A healthy body will ensure very low rates of bone fractures. healthy bones. The general assumption has been that once bone reaches a cer- Bone-forming cells are of two different kinds: osteoclasts and __ tain level of thinness, it becomes subject to fractures more easily. osteoblasts. The job of osteoclasts is to travel through the bone in Now that more is known about bone physiology, it is clear that search of old bone that is in need of renewal. Osteoclasts dissolve __ this is not the full story. Bone does not fracture due to thinness bone and leave behind tiny unfilled spaces. Osteoblast cells then alone. Leading bone expert, and author of Better Bones, Better move into these spaces in order to build new bone. In this way, Body, Susan E. Brown, PhD, states: "Osteoporosis by itself does bone heals and renews itself in a process called "remodelling". not cause bone fractures. This is documented simply by the fact This self-repair capability is extremely important. Imbalances in __ that half of the population with thin osteoporotic bones in fact bone-remodelling contribute to osteoporosis. When more old never fracture."* plummeting because of people's anxieties about eating foods containing saturated fats. THE BARE BONES ABOUT BONES To understand the many myths about osteoporosis and its pre- scribed treatments, it is vital to understand the nature of bones. Bone is living tissue which undergoes constant transformation. Bone might appear to be static, but its basic components are con- tinually renewed. At any given moment in each of us, there are from 1 to 10 million sites where small segments of old bone are being dissolved and new bone is being laid down to replace it. Bone tissue is nourished and detoxified by blood vessels in con- stant exchange with the whole body.'” A healthy body will ensure healthy bones. Bone-forming cells are of two different kinds: osteoclasts and osteoblasts. The job of osteoclasts is to travel through the bone in search of old bone that is in need of renewal. Osteoclasts dissolve bone and leave behind tiny unfilled spaces. Osteoblast cells then move into these spaces in order to build new bone. In this way, bone heals and renews itself in a process called "remodelling". This self-repair capability is extremely important. Imbalances in bone-remodelling contribute to osteoporosis. When more old NEXUS - 23 at a time when sales were OCTOBER - NOVEMBER 1998