Osteoporosis: The bones of contention

By Sherrill Sellman, ND

Osteoporosis is big news—and big business—these days. As a disease, it emerged out of obscurity only two decades ago to become a concern for women throughout the industrialized world. Advertising campaigns in the media and fact sheets in doctors’ waiting rooms and pharmacies continually warn women of the dangers of disappearing bone mass.

The marketing hype announces that one woman in two over the age of 60 is likely to crumble from an osteoporotic fracture (yet one man in three will also get osteoporosis); that the incidence of hip fracture exceeds that of cancer of the breast, cervix and uterus combined; and that 16 percent of patients suffering hip fractures will die within six months while 50 percent will require long-term nursing care.

The statistics also say that in the United States more than 20 million people have osteoporosis and approximately 1.3 million people each year will suffer a bone fracture as a result of osteoporosis. In 1993, the US incurred an estimated loss of $10 billion due to lost productivity and health-care costs related to osteoporosis.

It’s important to put these statistics into perspective. While it is true that death occurs in men and women who have hip fractures, these people are usually very elderly and frail. People who die from hip fractures are not only the most frail, but are also ailing from other causes.

Women are constantly bombarded with the message that the war on bone loss must include calcium supplements and a daily consumption of calcium-rich foods, primarily dairy products. In spite of increased breast-cancer risk, doctors continue to recommend long-term use of synthetic estrogen to the postmenopausal woman, and, if additional help is required, suggest use of bone-building drugs like Fosamax. So, armed with this powerful arsenal, a woman is assured that she will walk tall and fracture-free through the latter part of her life. Unfortunately, this is far from the truth.

The most popular treatments for osteoporosis are in fact dangerous to women’s health. Synthetic estrogen is a known carcinogenic drug. Most calcium supplements are not only ineffectual in rebuilding bone, but they can actually lead to mineral deficiencies, calcification and kidney stones. And contrary to popular belief, dairy products have been proven to be a cause of bone loss.

The osteoporosis industry: an unholy alliance

Osteoporosis has spawned a phenomenal growth industry. The sale of just one estrogen drug, Premarin, grossed $945 million worldwide in 1996. The US dairy industry is thriving with its annual $20 billion of revenue. And sales of calcium supplements have spiraled upwards into the hundreds of millions of dollars.

The osteoporosis industry has not only created a huge market for its wares, it has also been specifically designed to target women. Obviously, the fear-mongering advertising campaign about osteoporosis as a ‘silent thief’ stalking women’s bones has paid off. Unfortunately, unsuspecting women are unaware they are really being stalked by an unholy alliance of the pharmaceutical companies, the medical profession and dairy industry who have orchestrated one of the most successful and well-planned marketing maneuvers in history.

By distorting the facts, by manipulating the statistics and by withholding scientific research in the pursuit of profits, this powerful alliance has once again jeopardized lives by exposing women to an increased incidence of such illnesses as breast and ovarian cancer, strokes, liver and gall bladder disease, diabetes, heart disease, allergies, kidney stones and arthritis.

The bare bones about bones

To understand the many myths about osteoporosis and its prescribed treatments, it is vital to understand the nature of bones. Bone is living tissue that undergoes constant transformation. Bone might appear to be static, but its basic components are continually 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 constant 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. This self-repair capability is extremely important. Imbalances in bone remodeling contribute to osteoporosis. When more old bone is eaten up than new bone is laid down, bone loss occurs.

Bone turnover never stops completely. In fact, after about the age of 50 the rate increases, though it’s not quite co-coordinated. The bone-building cells, the osteoblasts, become less and less capable of completely refilling the spaces made by the osteoclasts. The peak amount of bone you started with and the rate of this loss determines the density of your bones. Density varies greatly in different individuals, cultures, races and sexes.

As Dr. Susan Love, author of Dr. Susan Love’s Hormone Book, explains: “...the correct term for low bone density is ‘osteopenia.’ It is only one factor in osteoporosis and the fractures that result from it. Another factor is the micro-architecture of the bone. As osteoclasts absorb more bone than is rebuilt, the micro-architecture becomes fragile. As it weakens, the wrist and hip become more vulnerable to fracture. Your vertebra doesn’t really fracture or crack but collapses on itself causing loss of height and, if enough vertebra are crushed, a dowager hump is created.”

How real is this “dowager hump” syndrome? According to Dr. Bruce Ettinger, Associate Clinical Professor of Medicine at the University of California and an endocrinologist: “...women shouldn’t worry about osteoporosis. The osteoporosis that causes pain and disability is a very rare disease. Only 5 to 7 percent of 70-year-olds will show vertebral collapse; only half of these will have two involved vertebrae; and perhaps one-fifth or one-sixth will have symptoms. I have a very big referral practice and I have very few bent-over patients. There’s been a tremendous hullabaloo lately, and there are a lot of worried women, and excessive testing and administration of medications.”

The medical definition of osteoporosis used to be “fractures caused by thin bones.” It has been redefined to “a disease characterized by low bone mass and micro-architectural deterioration of bone tissue which leads to increased bone fragility and a consequent increase in fracture risk.” There is a problem with defining osteoporosis as a disease, not a fracture. Low bone mass is only one risk-factor for osteoporosis, not osteoporosis itself. It’s a warning sign that might be useful, so you can begin to consider ways to keep the disease itself from occurring. Dr. Love offers a striking analogy: “This is like defining heart disease as having high cholesterol rather than having a heart attack. Needless to say, this new definition has increased the number of women and men who have osteoporosis.”

Although this new disease has two components—bone mass and micro-architecture—micro-architecture is virtually ignored. The problem is that only bone density can be measured. And not everyone with low bone density will get fractures. For instance, Asian women have low bone density yet have very low rates of bone fractures.

The general assumption has been that once bone reaches a certain level of thinness, it becomes subject to fractures more easily. Now that more is known about bone physiology, it is clear that this is not the full story. Bone does not fracture due to thinness alone. Leading bone expert and author of Better Bones, Better Body, Susan E. Brown, PhD, states: “Osteoporosis by itself does not cause bone fractures. This is documented simply by the fact that half of the population with thin osteoporotic bones in fact never fracture.”

Lawrence Melton of the Mayo Clinic noted as early as 1988: “Osteoporosis alone may not be sufficient to produce such osteoporotic fracture, since many individuals remain fracture-free even within the sub-groups of lowest bone density. Most women aged 65 and over and men 75 and over have lost enough bone to place them at significant risk of osteoporosis, yet many never fracture any bones at all. By age 80, virtually all women in the United States are osteoporotic with regard to their hip bone density, yet only a small percentage of them suffer hip fractures.”

Why does there seem to be many more women now with osteoporosis than in the past? As Dr. Love explains: “...part of that increase is nothing but a change in definition... Needless to say, the broader the criteria used to define osteoporosis, the more women will fall into that category. The level of bone density that defines osteoporosis has been set rather high, with the result that most older women will fall into the ‘disease’ category—which is very nice for the people in the business of treating disease.”

The bone-building drugs scam

The drug companies boast one other weapon in their anti-osteoporosis arsenal: medication that promises to halt bone loss. One of the drugs in favor is Fosamax. Studies of this drug were cleverly stopped after four to six years. This is just the point at which the fracture rate for women taking similar drugs began to rise. So, although Fosamax will superficially appear to increase bone density, in reality it decreases bone strength. Fosamax is a metabolic poison and will actually kill osteoclast cells that are required to maintain dynamic bone equilibrium. In addition, Fosamax can cause severe and permanent damage to the jaw bone, esophagus and stomach. It is also hard on the kidneys and can cause diarrhea, flatulence, rashes, headaches and muscular pain. Rats given high doses developed thyroid and adrenal tumors. Fosamax also causes deficiencies of calcium, magnesium and vitamin D, all essential for the bone-building process.

Dr. Sherrill Sellman’s career has taken her around the world with a strong message for women. Through her own personal journey of reclaiming her health, she has been inspired to share with other women ways they, too, can reclaim their own health by gaining a deeper appreciation of their bodies natural cycles and their innate wisdom. After twelve years of in-depth research, Sherrill is bravely bringing into the open facts and figures that have been ignored, suppressed and buried for years. Over the past ten years, Sherrill has been lecturing worldwide about the seriousness of using synthetic hormones as well as the many myths and abuses regarding women’s hormonal health. Her many prophetic warnings have now been proven true.