Holladay Physical Medicine


Facilities Related Services Products Doctors Contact us DTS Spinal Decompression Newsletters All about Chiropractic 7 Keys to Absolute Health Conditions We Manage Accidents and Injuries Ask the Doctor Account Status Review fee Schedule View Driving	WHAT NO ONE IS TELLING YOU ABOUT OSTEOPOROSIS Osteoporosis has become a 21st Century epidemic. Between 25 and 30 percent of all people in nursing homes are there because of hip fractures, and fractures from osteoporosis result in more deaths among women than ovarian and breast cancer combined. One study revealed that osteoporosis in women as young as 40 can cause intense bone pain, muscle weakness, and difficulty in walking. (Br Med J 96;312:570-572) Conventional medicine's approach to treating osteoporosis has been calcium and estrogen replacement therapy (ERT). But if you're taking estrogen in an effort to treat osteoporosis, it may be the equivalent of burning down the barn to get rid of the mice. Let me explain. I've written many times in the past on how a greater lifetime exposure to estrogen increases the risk of cancer, particularly breast cancer; but this information has been largely overshadowed by the fact that estrogen increases the absorption of calcium, which increases bone mass. Estrogen levels are so closely linked to bone mass that researchers now tell us that they can predict a woman's cumulative lifetime exposure to estrogen simply by measuring her bone mass. The higher the bone mass, the more exposure to estrogen--and the greater the estrogen exposure, the greater the risk of developing breast cancer. NEW HOPE FOR OSTEOPOROSIS SUFFERERS Surprisingly, with hormones like estrogen constantly in the headlines these days, one very important hormone, progesterone, doesn't receive much publicity. It should. Balancing progesterone levels is often the key to correcting a wide variety of common complaints. I need to make it very clear that I'm talking about natural progesterone, not progestins. Progestins are chemically altered or synthetic forms of progesterone linked to a long list of side effects. Used during pregnancy, they can cause abnormal formation of sexual organs in the fetus. In addition, progestins can cause abnormal menstrual flow or cessation, fluid retention, nausea, insomnia, jaundice, mental depression, fever, masculine characteristics in females, weight fluctuations, and allergic reactions. With natural progesterone, however, side effects are extremely rare. In fact, we've only been able to find two minor problems related to its use: a feeling of euphoria (at higher dosages) or a slight altering in the timing of menstrual cycles. AN IMPORTANT FINDING: BENEFITS FROM NATURAL PROGESTERONE CREAM Dr. John Lee of Sebastapol, California has found that by adding natural progesterone cream to an established osteoporosis program, bone density can be increased up to ten percent within the first six months, then increased annually at the rate of three to five percent, until stabilizing at levels common to a healthy 35-year old. (Lancet 90;336 [8726]:1327) (Inter Clin Nutr Rev 90;10 [3]:385-91) Dr. Lee's study lasted three years and involved 100 postmenopausal patients ages 38 to 83. The majority had already lost height from the disease, some as much as five inches. Patients on estrogen took 0.3 to 0.625 mg of conjugated estrogen daily for three weeks each month and applied a cream containing three percent natural progesterone at bedtime for 12 days a month. (Those using estrogen were asked to apply the cream during the last two weeks of the month.) All were told to use 1/2 to 1/3 of a one-ounce jar each month. Bone density tests were performed and the results were nothing short of spectacular. Two of the findings were that neither age nor time from menopause seemed to influence the restoration of bone. In fact, those patients that began the study with the lowest bone densities had the fastest increases. All except three began to show improvement in the first six months. Of these three, one needed hydrochloric acid digestive supplements, another had been taking three times the amount of thyroid supplement she should have, and the third had recently lost her husband to cancer and had not been following the program as prescribed. After each of these conditions were corrected, all three showed immediate improvement. What's more, the incidence of pathological fractures dropped to zero among these women. Theft height stabilized, they experienced more energy, more joint mobility, and less aches and pains. Many reported that their sex drive returned to normal. Best of all, no side effects were reported. Some of the women in Dr. Lee's study were taking estrogen hormones. The only positive effects from estrogen seemed to be relieving hot flashes and stimulating lubrication of the vagina. (They were not using additional progesterone to correct hot flashes. It has also been suggested that these women could apply progesterone cream to the vaginal area to increase lubrication there. If both these techniques worked, it's possible estrogen wouldn't be needed at all.) There are a number of progesterone creams on the market, under a variety of names. Make sure that the one you use contains three-percent natural progesterone---the dosage used in Dr. Lee's Studies. THE REST OF THE PROGRAM Diet: A diet rich in green vegetables and low-fat cheese was emphasized. Red meat was limited to three times a week. All sodas were eliminated (their high phosphorus content interferes with calcium absorption). Alcohol consumption was minimized and smoking was forbidden. Exercise: 20 minutes daily or 1/2 hour three times a week. Bone grows in relation to the stress (exercise) that is placed upon it. Proper bone growth requires exercise. Supplementation: Calcium: 800-1,000 mg, Vitamin D: 350-400 IU (I recommend 800 IU), Vitamin C: 2,000 mg in divided dosages, Beta-carotene: 15 mg HOW ACID/ALKALINE BALANCE FITS INTO THE PICTURE Proper pH balance (pH measures the acidity or alkalinity of a substance) is essential for good health. Many people don't know that pH is a subtle measurement of the body's electrical balance, which regulates many bodily functions. The pH scale runs from 0 to 14, with 0 being the most acidic, 14 being the most alkaline, and 7 being neutral. To survive, our bodies must maintain pH very close to 7.4, which is just on the alkaline side of neutral. If the pH varies too much from the ideal, it becomes difficult for various enzymes to function properly. Maintaining this slightly alkaline state is a constant challenge, primarily because of the acid forming functions that take place within the body and the over-abundance of acid-producing foods we consume. The idea that various foods influence the pH of the body isn't new. In fact, as far back as the early 1900s, doctors began studying the pH-altering effects of different foods. They found that while a few foods were "neutral" in their effects, most were either alkaline- or acid-producing. They also found that simply changing the diet could change body pH. Bringing body pH closer to the normal range rid patients of many of their health complaints. For some reason, however, the idea of adjusting the diet to influence the body's pH fell out of favor rather quickly. I don't think most people understood just how critical proper pH is to health. When you look at most of the studies on osteoporosis, it appears that most scientists and medical professionals can't explain what's going on. While they realize that risk factors such as calcium deficiency, too much meat protein, smoking, menopause, and a lack of exercise play a role, they also realize that all of these factors account for less than half of all hip fractures. Only a handful of researchers realize the true role an acidic pH can have on living bone. BONES--THE ALKALINE STOREHOUSE Earlier I mentioned that the ideal pH is close to 7.4. Your body has to constantly work to neutralize or rid itself of acid byproducts to maintain this level. Organs such as the liver and pancreas produce and release alkaline enzymes to reduce excess acidity. Patches of lymphatic tissue in your small intestines called Peyer's patches produce large amounts of the alkalizing enzyme called chyle. But even with all the alkalizing compounds your body produces, it is impossible to neutralize every bit of the acid it ingests or produces. To help maintain the proper pH, acids need to be eliminated from your body. Your blood is one of the primary means for the removal of acidic waste products. It carries carbonic acid from metabolized food to your lungs where it is eliminated as carbon dioxide and water. Blood also is constantly circulated through the kidneys, where acids are removed and excreted in the urine. Acidic wastes are also released by sweat glands and through feces from the large intestine. Even with these mechanisms at work, there are times when the body becomes too acidic and pH drops below the required 7.4. This is crucial because when pH drops to just 7.38, the body begins to break down bone and muscle tissues to use their alkalizing ammonia, carbonates, and phosphates. From man's beginning, in addition to supporting the body, bones have served as the storage facility for acid-neutralizing minerals. Earlier in history, our ancestors might have become over-acidic for temporary periods when meat was available, during periods of starvation, or when vegetables were in short supply. At such times, alkalizing minerals from their bones would be removed, but within a short period of time they would return to a more vegetable/fruit-based diet and the bone minerals would be replaced. Today this doesn't occur. Anthony Sebastian and Deborah Sellmeyer with the University of California in San Francisco reviewed more than 85 different studies and evaluated typical diets in 33 countries. They discovered a direct relationship between diets high in animal protein, such as fish, meat, and cheese, and the incidence of hip fractures. Germany and Sweden, with the highest consumption of these foods, had 40 times the rate of hip fractures than Thailand did. While Thais consume enormous amounts of acid-producing rice dishes, they also eat far more fruits and vegetables, one-third as much meat, and practically no cheese. (J Gerontol A Biol Sci Med Sci 00;55(10):M585o92) A follow-up study by the same researchers found that women eating a high acid-producing diet had more rapid bone loss and a 3.7.times greater risk of hip fracture than women eating fewer acid-producing foods. (Am J Clin Nutr 01;74(3):411-2) WHY BONES HATE CHEESEBURGERS A top researcher in this area, Thomas Remer of the Research Institute of Child Nutrition in Dortmund, Germany, has been analyzing foods to see the amount of acid each produces in the body. While many acid/ alkaline charts from the early 1900s are fairly accurate, we've learned a great deal more from Remer's work. For example, we now know why milk is pretty much neutral as far as acid or alkaline production is concerned, but cheese is strongly acid-forming. Milk contains roughly equal parts acid- and alkaline-producing compounds. In the production of cheese, however, the liquid, alkaline-producing portion is removed. (The protein-rich liquid, whey, is healthy and pretty much neutral). It appears that the more sharp or crumbly the cheese, the more acid-producing it is. Parmesan cheese is the most acid-forming of the cheeses tested. Another interesting finding from the folks in California was that not all proteins have the same acid forming effect. Animal proteins seem to be strongly acid-forming, whereas vegetable proteins seem to contain alkaline compounds that neutralize any acidic effects. (Am J Clin Nutr 01;73(1):118-22) This also helps explain why some studies have shown that high protein diets cause bone loss, while other studies show just the opposite. Bodybuilders routinely follow high protein diets in an effort to build lean muscle. To increase their protein intake, they often resort to protein powders, which are increasingly being produced from whey, a byproduct of cheese production, as I mentioned earlier. When Remer compared the protein intake to the acid production in bodybuilders, he found little, if any, increased acid load. (Z Ernahrungswiss 95;34(1):10-5) This is probably due to the source of the protein and the fact that serious bodybuilders include lots of fruits and vegetables in their diet. It would be interesting to see a study of acid-formation and subsequent bone loss among individuals who follow a high-Protein diet such as that advocated by Dr. Richard Atkins. Based on the research I've seen, following such a program would probably result in major bone loss. For various reasons, I've never been a supporter of high-protein diets, and after reviewing the above research, I'm even less of a fan. This research isn't widely known in conventional circles, and I suspect it will be years before you hear much, if anything, about it. There's a major effort underway by pharmaceutical companies to promote a generation of drugs to treat osteoporosis (such as bisphosphonates) or to promote hormone replacement therapy, estrogen, and the hormone calcitonin. Keep in mind that these drugs have adverse side effects and have been shown to be only marginally effective. The real problem is that they interfere with a normal physiological process. A certain amount of resorption (dissolving of old bone by the body) is normal, and is followed by the growth of new bone. Long-term use of these drugs prevents the loss of old bone, but prevents the building of new, and the bones eventually become brittle. Obviously, such drugs aren't the answer. I can assure you that the new epidemic of osteoporosis we're now experiencing isn't from a drug deficiency. In addition to factors such as vitamin D deficiencies and lack of exercise, our acid-forming diet is to blame. DIETARY WAYS TO ACHIEVE BALANCE Through the years, there have been diet plans, formulas, charts, etc. that have attempted to outline exactly what foods in what amounts need to be eaten to achieve this balance. Unfortunately, most are so confusing they only make the problem seem too difficult to overcome. In reality, the solution is quite simple. If you were to look at history or at societies where osteoporosis is not such a big problem, you would find that 75 to 80 percent of the diet consists of alkaline-producing foods. These findings translate to some pretty straightforward dietary advice: Breakfast, lunch, or dinner should consist of 75 to 80 percent alkalizing foods and a maximum 20 to 25 percent acidic foods. Most people will need to eat a few vegetable-only meals each week to make up for excess acid-forming foods. And some might prefer to eat vegetables, fruits, or other alkaline-producing foods exclusively for three-quarters of their meals. A good protein powder shake for breakfast is also a great ides. IS YOUR BODY TOO ACIDIC? Another complaint associated with acidosis stems from poor oxygen utilization. One of the primary waste products produced by all the living cells in your body is carbon dioxide. Bicarbonates, or alkaline compounds, are required in the cellular exchange of oxygen and carbon dioxide. Without adequate supplies of bicarbonates, carbon dioxide accumulates within the tissues. In simple terms, you suffocate. Due to the excess carbon dioxide and lack of oxygen, overly acidic individuals tend to sigh a lot and experience breathlessness. The slightest amount of exertion leaves them panting and can lead to muscle pain and cramping. Frequently, they suffer from insomnia. Many complain of a constant "lump" in the throat (which comes from dehydration and the associated loss of sodium). I've also found that when people are very acidic, their tissue levels of oxygen are so low that they have difficulty holding their breath for more than 20 seconds. These symptoms are a fairly good indication that you're too acidic. If you can't tell if you're too acidic by what I've written so far, there's a simple and fairly accurate way to test yourself. Saliva closely parallels the blood when it comes to pH. Blood pH is normally 7.4 and the normal saliva pH should be between 6.5 and 7.0. You can check your saliva pH using pH Hydrion test strips of paper (available from Simply Hydroponics at 727-531-5355 or www.simplyhydroponics.com/hydrion_strips.htm). If your saliva pH consistently falls below 6.5, you have an acidosis problem. If it consistently reads above 7.0, you could be too alkaline. In the past, some have recommended testing urine to evaluate the body's overall pH. I think there are too many variables that influence the pH of the urine, which makes it unreliable for this purpose. TO FIND THE SOLUTION, YOU NEED TO UNDERSTAND THE PROBLEM Thomas Remer (mentioned earlier) has found that even though individuals living in countries like South Africa and Singapore consume less than one-third the recommended amount of calcium, they have fewer hip fractures than their Western counterparts. The reason is that they eat a low-acid-producing diet. All the calcium in the world won't rebuild bones ff it's accompanied by an acid-producing diet. Besides diet, other recent lifestyle changes have contributed to this problem of widespread acidosis, including the selection and improper digestion of fat. When fats aren't oxidized and metabolized, you lose their alkalizing properties. HOW BILE AFFECTS DIGESTION Fats are one of the more difficult things for your body to digest, and fat digestion is a fairly complex event. At the risk of oversimplifying the matter, I'll say that one of the primary components necessary to digest fats is bile. Bile consists of alkaline bile salts, bilirubin, cholesterol, fatty acids, lecithin, vitamins, and minerals. It is produced in the liver and passes into the gallbladder where water and minerals are reabsorbed into the body, making the bile more concentrated. The gallbladder releases this concentrated bile when fat moves into your small intestine. Bile salts act much like soap, helping emulsify or break down fats into smaller particles for absorption into the bloodstream. After the liver removes poisons, drugs, excess sex hormones, toxins, heavy metals, etc., from the body, it gets rid of them by dumping them in bile. After aiding in the digestion of fats, the bile is reabsorbed from the small intestine, while toxins and other poisons continue through the intestinal tract, exiting the body in the stool. For years I've equated the removal of gallbladders without informing the patients about the need for digestive bile salts with malpractice. If you've had your gallbladder removed, you should be taking bile salts with every meal for the rest of your life. Without your gallbladder, your body's ability to store and concentrate bile becomes impaired. This interferes with fat digestion and the proper maintenance of cholesterol. Gallbladder patients who fail to use bile-salt supplements will progressively begin to experience all the symptoms of essential fatty acid deficiencies (skin problems, cataracts, heart disease, etc.). Also keep in mind that hormones from your thyroid gland are associated with fat metabolism. An underactive thyroid gland increases cholesterol and fat levels in the blood. Anyone who benefits from the use of bile salts should also be tested for an underactire thyroid. HOW TO GET SUPPLEMENTAL BILE SALTS There are several bile salt products on the market. I personally take and recommend the product called Cholacol from Standard Process. It contains a proprietary blend of collinsonia (root) and purified bovine bile salts. I've had consistent and excellent results using this product for the last 20 or so years. I generally recommend taking two tablets immediately before a meal. (Unfortunately, only health care professionals can purchase Cholacol from Standard Process, Inc. PHOSPHORUS When it comes to your health, there's one mineral you hear very little about, even though it is the second-most abundant mineral in your body and is necessary for practically every chemical reaction that takes place. That mineral is phosphorus. As important as phosphorus is to good health, however, an excess of it in your system can lead to serious problems. It has only been in the last few years that Department of Agriculture food surveys have shown our phosphorus intake to be above normal. From 1989 through 1991, the Department performed a survey to determine dietary calcium and phosphorus levels in the U.S. population. The survey involved over 12,000 people from 48 states and Washington, DC. Results: Only children under 11 years of age were found to be getting the 1989 Recommended Dietary Allowances (RDAs) set for calcium. Adolescent girls were getting only 56 percent of the RDA for calcium, and young women only 48 percent. Adults over the age of 60 were often getting less than haft the RDA for calcium. Phosphorus levels, on the other hand, were at or above the RDA for all age and sex groups except for girls and young women under the age of 25. More than 45 different phosphorus-containing food additives, which are not accounted for in these surveys, are now added to foods as preservatives of color and moisture, and as emulsifiers and sequestrates. Five different phosphate-containing food starches have been approved for use in ready-to-eat frozen foods and desserts. Phosphorus additives are widely used in frozen pizzas, chicken, and fish. Additionally, over 70 phosphorus compounds are in use as indirect additives in packaging materials, sanitizers, and production acids. Additional phosphorus comes from hard water sources and soft drinks, neither of which is accounted for in these food surveys. A 12-ounce soft drink contains around 50 mg of phosphorus, and the average annual consumption of soft drinks in this country now exceeds 50 gal. per person. Soft drink consumption surpassed water consumption in the early 1980s. As strange as it may sound, the average person in this country consumes over 50 gallons of soft drinks a year, but only 40 gallons of water. Unlike calcium, which is difficult to absorb, roughly 70 percent of all dietary phosphorus is readily absorbed and directly transported into the bloodstream. Also, unlike calcium, your body has very little control over how much phosphorus is absorbed. Certain minerals such as iron and magnesium can interfere with phosphorus absorption, but only when large amounts are token. High fat diets increase the absorption of phosphorus. High phosphorus diets, especially when you're low in calcium, will lead to osteoporosis. When you consider how the phosphorus content in our diet has increased during the last couple of decades, it shouldn't be much of a surprise to learn that this disease is becoming more and more common. The surprise comes when you look a little deeper. Less obvious problems that are linked to high phosphorus/low calcium diets are: muscle cramps, mini-strokes, periodontal disease and tooth loss, high blood pressure, and osteomalacia, a softening of the bones. It is usually accompanied by aching bone pains (often referred to as rheumatism), chronic hoarseness, Parkinson's Disease, and soft tissue calcification (kidney stones and atherosclerosis). These problems can be easily treated by readjusting your phosphorus/calcium levels and improving parathyroid function. The long-term benefits of improving your phosphorus/calcium levels, such as arthritis and osteoporosis prevention, can be enormous. However, it may be the short-term effects, like preventing a stroke, that actually save your life. LOWER YOUR PHOSPHORUS INTAKE Increasing your calcium intake, (see below) is probably the easiest thing you can do. Unfortunately, increasing calcium will not eliminate all of the undesirable effects of too much phosphorus, and decreasing the amount of phosphorus in your food may be one of the more difficult tasks. Phosphorus is plentiful in food. The first order of business is to cut back or eliminate soft drinks from your diet. Next, you should try to integrate a wider variety of fresh foods into your diet. The typical meat and potato diet is high in phosphorus. In addition, eat fewer prepared foods. Processed and frozen food dishes are loaded with phosphorus and phosphate additives; but currently, phosphorus and phosphate levels are not listed on food labels, so it's hard to know exactly what and how much of these additives are actually used in a given product. CALCIUM With all the hoopla and media attention, you may think enough has been said about calcium. Unfortunately, what you've heard or read may be misleading or even incorrect. Certain nutrients like calcium, iron, and protein require high hydrochloric acid (HCI) levels in the stomach to be properly digested. Sadly, with age HCI production in the body declines dramatically. In fact, by age 50, the stomach releases only 15 percent of that amount of acid it released at age 25. Even more alarming, 35 percent of all people over 65 don't produce any hydrochloric acid at all! This one fact alone explains why calcium deficiencies are commonly linked with' health problems in older patients, such as high blood pressure, arthritis, heart palpitations, tremors, osteoporosis, insomnia, leg cramps, osteomalacia, excessive nervousness and irritability. Unfortunately, many well-meaning doctors are still recommending calcium supplements that even further reduce stomach acids. And antacids for calcium may decrease your ability to absorb iron (leading to anemia) and protein, and trigger an acid-rebound effect that can lead to indigestion and even ulcers. PHOSPHORUS LEACHES CALCIUM FROM YOUR BONES I've discussed some of the dangers of ingesting excessive phosphorus. Another danger affects calcium levels. Phosphorus acts on the parathyroid glands. These glands secrete the parathyroid hormone (PTH), which regulates calcium levels in blood and tissues. When calcium levels are low, the parathyroid glands produce PTH, which raises calcium levels by leaching it from bones. (As a side note, estrogen makes bone less sensitive to the parathyroid hormone and can help stop the removal of calcium. This helps explain why osteoporosis occurs less in premenopausal women and those taking estrogen.) New research indicates that simply adjusting the time of calcium intake may be a key to preventing osteoporosis. The production and release of PTH is linked to your circadian rhythm (your 24hour biological clock). PTH levels, and subsequently the amount of calcium being taken from your bones, increases during the night. Researchers at Northern General Hospital in Sheffield, England evaluated the effect of taking calcium supplements at different times of the day. They've now informed me that when premenopansal women took 1,000 mg of calcium at 11 p.m., the calcium reversed the nighttime increase in PTH activity and eliminated the increase in bone loss that normally would occur. WHY YOU NEED TO SUPPLEMENT CALCIUM Your body's storage of calcium is in a constant state of transformation, or "bone remodeling." Bones act as a storehouse for calcium reserves. Roughly 99 percent of the total calcium in your body is in your bones and teeth; the other one percent is in body fluids and soft tissue. As you've seen, calcium is drawn from the bones when it's needed to maintain blood and tissue levels. When there is an excess of calcium, it is redeposited in the bones. Research has shown that under normal circumstances the calcium in your bones is completely removed and replaced about every ten years. Dietary surveys have now revealed that calcium bone levels are being depleted because calcium levels in food are not sufficient to reverse the trend and phosphorus levels in foods are increasing. Currently, only children below the age of 11 are getting enough calcium in their diets to replace what is lost during bone remodeling. As we reach adolescence and early adulthood, we begin to lose more calcium than we can replace from diet alone. And the problem gets worse with age. Calcium becomes harder to assimilate due to a lack of digestive acids. Less exposure to the sun results in lower body levels of vitamin D, which is essential for strong bones and proper calcium use. Women in their 30s and 40s and those on estrogen replacement therapy should get at least 1,000 mg of calcium a day. Postmenopausal women not on estrogen should get 1,500 mg daily. Most men should get 1,000-1,200 mg daily. Note: While too much calcium generally isn't a problem, dally intakes of 2,000 mg or more may cause the parathyroid glands to increase hormone secretion in an effort to lower calcium levels. HOW TO GET ADEQUATE CALCIUM INTAKE While you most likely need a supplement to meet your overall calcium needs, there are certain calcium-rich foods I highly recommend. Fermented milk products provide calcium along with lactic acid to enhance the digestive process. They also provide beneficial bacterial flora for the lower bowel. Include yogurt, kefir, buttermilk, acidophilus milk and cheeses to your diet. If you suffer from lactose intolerance, most of these items are now available with the enzyme lactase. There are hundreds of calcium products on the market. In selecting a calcium supplement, look for one that contains the digestive acid betaine hydrochloride, additional magnesium, and vitamin D. Each of these will help increase the amount of calcium you assimilate into your system. I personally like the product Pinna-Cal. You may find it at your local health food store, or it can be ordered online from a variety of sources.

WHAT NO ONE IS TELLING YOU ABOUT OSTEOPOROSIS

Osteoporosis has become a 21st Century epidemic. Between 25 and 30 percent of all people in nursing homes are there because of hip fractures, and fractures from osteoporosis result in more deaths among women than ovarian and breast cancer combined. One study revealed that osteoporosis in women as young as 40 can cause intense bone pain, muscle weakness, and difficulty in walking. (Br Med J 96;312:570-572)

Conventional medicine's approach to treating osteoporosis has been calcium and estrogen replacement therapy (ERT). But if you're taking estrogen in an effort to treat osteoporosis, it may be the equivalent of burning down the barn to get rid of the mice. Let me explain.

I've written many times in the past on how a greater lifetime exposure to estrogen increases the risk of cancer, particularly breast cancer; but this information has been largely overshadowed by the fact that estrogen increases the absorption of calcium, which increases bone mass. Estrogen levels are so closely linked to bone mass that researchers now tell us that they can predict a woman's cumulative lifetime exposure to estrogen simply by measuring her bone mass. The higher the bone mass, the more exposure to estrogen--and the greater the estrogen exposure, the greater the risk of developing breast cancer.

NEW HOPE FOR OSTEOPOROSIS SUFFERERS

Surprisingly, with hormones like estrogen constantly in the headlines these days, one very important hormone, progesterone, doesn't receive much publicity. It should. Balancing progesterone levels is often the key to correcting a wide variety of common complaints.

I need to make it very clear that I'm talking about natural progesterone, not progestins. Progestins are chemically altered or synthetic forms of progesterone linked to a long list of side effects. Used during pregnancy, they can cause abnormal formation of sexual organs in the fetus. In addition, progestins can cause abnormal menstrual flow or cessation, fluid retention, nausea, insomnia, jaundice, mental depression, fever, masculine characteristics in females, weight fluctuations, and allergic reactions. With natural progesterone, however, side effects are extremely rare. In fact, we've only been able to find two minor problems related to its use: a feeling of euphoria (at higher dosages) or a slight altering in the timing of menstrual cycles.

AN IMPORTANT FINDING: BENEFITS FROM NATURAL PROGESTERONE CREAM

Dr. John Lee of Sebastapol, California has found that by adding natural progesterone cream to an established osteoporosis program, bone density can be increased up to ten percent within the first six months, then increased annually at the rate of three to five percent, until stabilizing at levels common to a healthy 35-year old. (Lancet 90;336 [8726]:1327) (Inter Clin Nutr Rev 90;10 [3]:385-91) Dr. Lee's study lasted three years and involved 100 postmenopausal patients ages 38 to 83. The majority had already lost height from the disease, some as much as five inches. Patients on estrogen took 0.3 to 0.625 mg of conjugated estrogen daily for three weeks each month and applied a cream containing three percent natural progesterone at bedtime for 12 days a month. (Those using estrogen were asked to apply the cream during the last two weeks of the month.) All were told to use 1/2 to 1/3 of a one-ounce jar each month.

Bone density tests were performed and the results were nothing short of spectacular. Two of the findings were that neither age nor time from menopause seemed to influence the restoration of bone. In fact, those patients that began the study with the lowest bone densities had the fastest increases. All except three began to show improvement in the first six months. Of these three, one needed hydrochloric acid digestive supplements, another had been taking three times the amount of thyroid supplement she should have, and the third had recently lost her husband to cancer and had not been following the program as prescribed. After each of these conditions were corrected, all three showed immediate improvement. What's more, the incidence of pathological fractures dropped to zero among these women. Theft height stabilized, they experienced more energy, more joint mobility, and less aches and pains. Many reported that their sex drive returned to normal. Best of all, no side effects were reported.

Some of the women in Dr. Lee's study were taking estrogen hormones. The only positive effects from estrogen seemed to be relieving hot flashes and stimulating lubrication of the vagina. (They were not using additional progesterone to correct hot flashes. It has also been suggested that these women could apply progesterone cream to the vaginal area to increase lubrication there. If both these techniques worked, it's possible estrogen wouldn't be needed at all.)

There are a number of progesterone creams on the market, under a variety of names. Make sure that the one you use contains three-percent natural progesterone---the dosage used in Dr. Lee's Studies.

THE REST OF THE PROGRAM

Diet: A diet rich in green vegetables and low-fat cheese was emphasized. Red meat was limited to three times a week. All sodas were eliminated (their high phosphorus content interferes with calcium absorption). Alcohol consumption was minimized and smoking was forbidden.
Exercise: 20 minutes daily or 1/2 hour three times a week. Bone grows in relation to the stress (exercise) that is placed upon it. Proper bone growth requires exercise.
Supplementation: Calcium: 800-1,000 mg, Vitamin D: 350-400 IU (I recommend 800 IU), Vitamin C: 2,000 mg in divided dosages, Beta-carotene: 15 mg

HOW ACID/ALKALINE BALANCE FITS INTO THE PICTURE

Proper pH balance (pH measures the acidity or alkalinity of a substance) is essential for good health. Many people don't know that pH is a subtle measurement of the body's electrical balance, which regulates many bodily functions. The pH scale runs from 0 to 14, with 0 being the most acidic, 14 being the most alkaline, and 7 being neutral. To survive, our bodies must maintain pH very close to 7.4, which is just on the alkaline side of neutral. If the pH varies too much from the ideal, it becomes difficult for various enzymes to function properly.

Maintaining this slightly alkaline state is a constant challenge, primarily because of the acid forming functions that take place within the body and the over-abundance of acid-producing foods we consume. The idea that various foods influence the pH of the body isn't new. In fact, as far back as the early 1900s, doctors began studying the pH-altering effects of different foods. They found that while a few foods were "neutral" in their effects, most were either alkaline- or acid-producing. They also found that simply changing the diet could change body pH. Bringing body pH closer to the normal range rid patients of many of their health complaints. For some reason, however, the idea of adjusting the diet to influence the body's pH fell out of favor rather quickly. I don't think most people understood just how critical proper pH is to health.

When you look at most of the studies on osteoporosis, it appears that most scientists and medical professionals can't explain what's going on. While they realize that risk factors such as calcium deficiency, too much meat protein, smoking, menopause, and a lack of exercise play a role, they also realize that all of these factors account for less than half of all hip fractures. Only a handful of researchers realize the true role an acidic pH can have on living bone.

BONES--THE ALKALINE STOREHOUSE

Earlier I mentioned that the ideal pH is close to 7.4. Your body has to constantly work to neutralize or rid itself of acid byproducts to maintain this level. Organs such as the liver and pancreas produce and release alkaline enzymes to reduce excess acidity. Patches of lymphatic tissue in your small intestines called Peyer's patches produce large amounts of the alkalizing enzyme called chyle. But even with all the alkalizing compounds your body produces, it is impossible to neutralize every bit of the acid it ingests or produces. To help maintain the proper pH, acids need to be eliminated from your body.

Your blood is one of the primary means for the removal of acidic waste products. It carries carbonic acid from metabolized food to your lungs where it is eliminated as carbon dioxide and water. Blood also is constantly circulated through the kidneys, where acids are removed and excreted in the urine. Acidic wastes are also released by sweat glands and through feces from the large intestine.

Even with these mechanisms at work, there are times when the body becomes too acidic and pH drops below the required 7.4. This is crucial because when pH drops to just 7.38, the body begins to break down bone and muscle tissues to use their alkalizing ammonia, carbonates, and phosphates.

From man's beginning, in addition to supporting the body, bones have served as the storage facility for acid-neutralizing minerals. Earlier in history, our ancestors might have become over-acidic for temporary periods when meat was available, during periods of starvation, or when vegetables were in short supply. At such times, alkalizing minerals from their bones would be removed, but within a short period of time they would return to a more vegetable/fruit-based diet and the bone minerals would be replaced. Today this doesn't occur.

Anthony Sebastian and Deborah Sellmeyer with the University of California in San Francisco reviewed more than 85 different studies and evaluated typical diets in 33 countries. They discovered a direct relationship between diets high in animal protein, such as fish, meat, and cheese, and the incidence of hip fractures. Germany and Sweden, with the highest consumption of these foods, had 40 times the rate of hip fractures than Thailand did. While Thais consume enormous amounts of acid-producing rice dishes, they also eat far more fruits and vegetables, one-third as much meat, and practically no cheese. (J Gerontol A Biol Sci Med Sci 00;55(10):M585o92)

A follow-up study by the same researchers found that women eating a high acid-producing diet had more rapid bone loss and a 3.7.times greater risk of hip fracture than women eating fewer acid-producing foods. (Am J Clin Nutr 01;74(3):411-2)

WHY BONES HATE CHEESEBURGERS

A top researcher in this area, Thomas Remer of the Research Institute of Child Nutrition in Dortmund, Germany, has been analyzing foods to see the amount of acid each produces in the body. While many acid/ alkaline charts from the early 1900s are fairly accurate, we've learned a great deal more from Remer's work. For example, we now know why milk is pretty much neutral as far as acid or alkaline production is concerned, but cheese is strongly acid-forming.

Milk contains roughly equal parts acid- and alkaline-producing compounds. In the production of cheese, however, the liquid, alkaline-producing portion is removed. (The protein-rich liquid, whey, is healthy and pretty much neutral). It appears that the more sharp or crumbly the cheese, the more acid-producing it is. Parmesan cheese is the most acid-forming of the cheeses tested.

Another interesting finding from the folks in California was that not all proteins have the same acid forming effect. Animal proteins seem to be strongly acid-forming, whereas vegetable proteins seem to contain alkaline compounds that neutralize any acidic effects. (Am J Clin Nutr 01;73(1):118-22) This also helps explain why some studies have shown that high protein diets cause bone loss, while other studies show just the opposite.

Bodybuilders routinely follow high protein diets in an effort to build lean muscle. To increase their protein intake, they often resort to protein powders, which are increasingly being produced from whey, a byproduct of cheese production, as I mentioned earlier. When Remer compared the protein intake to the acid production in bodybuilders, he found little, if any, increased acid load. (Z Ernahrungswiss 95;34(1):10-5) This is probably due to the source of the protein and the fact that serious bodybuilders include lots of fruits and vegetables in their diet.

It would be interesting to see a study of acid-formation and subsequent bone loss among individuals who follow a high-Protein diet such as that advocated by Dr. Richard Atkins. Based on the research I've seen, following such a program would probably result in major bone loss. For various reasons, I've never been a supporter of high-protein diets, and after reviewing the above research, I'm even less of a fan.

This research isn't widely known in conventional circles, and I suspect it will be years before you hear much, if anything, about it. There's a major effort underway by pharmaceutical companies to promote a generation of drugs to treat osteoporosis (such as bisphosphonates) or to promote hormone replacement therapy, estrogen, and the hormone calcitonin. Keep in mind that these drugs have adverse side effects and have been shown to be only marginally effective. The real problem is that they interfere with a normal physiological process. A certain amount of resorption (dissolving of old bone by the body) is normal, and is followed by the growth of new bone. Long-term use of these drugs prevents the loss of old bone, but prevents the building of new, and the bones eventually become brittle.

Obviously, such drugs aren't the answer. I can assure you that the new epidemic of osteoporosis we're now experiencing isn't from a drug deficiency. In addition to factors such as vitamin D deficiencies and lack of exercise, our acid-forming diet is to blame.

DIETARY WAYS TO ACHIEVE BALANCE

Through the years, there have been diet plans, formulas, charts, etc. that have attempted to outline exactly what foods in what amounts need to be eaten to achieve this balance. Unfortunately, most are so confusing they only make the problem seem too difficult to overcome. In reality, the solution is quite simple. If you were to look at history or at societies where osteoporosis is not such a big problem, you would find that 75 to 80 percent of the diet consists of alkaline-producing foods. These findings translate to some pretty straightforward dietary advice: Breakfast, lunch, or dinner should consist of 75 to 80 percent alkalizing foods and a maximum 20 to 25 percent acidic foods. Most people will need to eat a few vegetable-only meals each week to make up for excess acid-forming foods. And some might prefer to eat vegetables, fruits, or other alkaline-producing foods exclusively for three-quarters of their meals. A good protein powder shake for breakfast is also a great ides.

IS YOUR BODY TOO ACIDIC?

Another complaint associated with acidosis stems from poor oxygen utilization. One of the primary waste products produced by all the living cells in your body is carbon dioxide. Bicarbonates, or alkaline compounds, are required in the cellular exchange of oxygen and carbon dioxide. Without adequate supplies of bicarbonates, carbon dioxide accumulates within the tissues. In simple terms, you suffocate.

Due to the excess carbon dioxide and lack of oxygen, overly acidic individuals tend to sigh a lot and experience breathlessness. The slightest amount of exertion leaves them panting and can lead to muscle pain and cramping. Frequently, they suffer from insomnia. Many complain of a constant "lump" in the throat (which comes from dehydration and the associated loss of sodium). I've also found that when people are very acidic, their tissue levels of oxygen are so low that they have difficulty holding their breath for more than 20 seconds. These symptoms are a fairly good indication that you're too acidic.

If you can't tell if you're too acidic by what I've written so far, there's a simple and fairly accurate way to test yourself. Saliva closely parallels the blood when it comes to pH. Blood pH is normally 7.4 and the normal saliva pH should be between 6.5 and 7.0. You can check your saliva pH using pH Hydrion test strips of paper (available from Simply Hydroponics at 727-531-5355 or www.simplyhydroponics.com/hydrion_strips.htm).

If your saliva pH consistently falls below 6.5, you have an acidosis problem. If it consistently reads above 7.0, you could be too alkaline. In the past, some have recommended testing urine to evaluate the body's overall pH. I think there are too many variables that influence the pH of the urine, which makes it unreliable for this purpose.

TO FIND THE SOLUTION, YOU NEED TO UNDERSTAND THE PROBLEM

Thomas Remer (mentioned earlier) has found that even though individuals living in countries like South Africa and Singapore consume less than one-third the recommended amount of calcium, they have fewer hip fractures than their Western counterparts. The reason is that they eat a low-acid-producing diet. All the calcium in the world won't rebuild bones ff it's accompanied by an acid-producing diet.

Besides diet, other recent lifestyle changes have contributed to this problem of widespread acidosis, including the selection and improper digestion of fat. When fats aren't oxidized and metabolized, you lose their alkalizing properties.

HOW BILE AFFECTS DIGESTION

Fats are one of the more difficult things for your body to digest, and fat digestion is a fairly complex event. At the risk of oversimplifying the matter, I'll say that one of the primary components necessary to digest fats is bile. Bile consists of alkaline bile salts, bilirubin, cholesterol, fatty acids, lecithin, vitamins, and minerals. It is produced in the liver and passes into the gallbladder where water and minerals are reabsorbed into the body, making the bile more concentrated. The gallbladder releases this concentrated bile when fat moves into your small intestine. Bile salts act much like soap, helping emulsify or break down fats into smaller particles for absorption into the bloodstream.

After the liver removes poisons, drugs, excess sex hormones, toxins, heavy metals, etc., from the body, it gets rid of them by dumping them in bile. After aiding in the digestion of fats, the bile is reabsorbed from the small intestine, while toxins and other poisons continue through the intestinal tract, exiting the body in the stool.

For years I've equated the removal of gallbladders without informing the patients about the need for digestive bile salts with malpractice. If you've had your gallbladder removed, you should be taking bile salts with every meal for the rest of your life. Without your gallbladder, your body's ability to store and concentrate bile becomes impaired. This interferes with fat digestion and the proper maintenance of cholesterol. Gallbladder patients who fail to use bile-salt supplements will progressively begin to experience all the symptoms of essential fatty acid deficiencies (skin problems, cataracts, heart disease, etc.).

Also keep in mind that hormones from your thyroid gland are associated with fat metabolism. An underactive thyroid gland increases cholesterol and fat levels in the blood. Anyone who benefits from the use of bile salts should also be tested for an underactire thyroid.

HOW TO GET SUPPLEMENTAL BILE SALTS

There are several bile salt products on the market. I personally take and recommend the product called Cholacol from Standard Process. It contains a proprietary blend of collinsonia (root) and purified bovine bile salts. I've had consistent and excellent results using this product for the last 20 or so years. I generally recommend taking two tablets immediately before a meal. (Unfortunately, only health care professionals can purchase Cholacol from Standard Process, Inc.

PHOSPHORUS

When it comes to your health, there's one mineral you hear very little about, even though it is the second-most abundant mineral in your body and is necessary for practically every chemical reaction that takes place. That mineral is phosphorus. As important as phosphorus is to good health, however, an excess of it in your system can lead to serious problems.

It has only been in the last few years that Department of Agriculture food surveys have shown our phosphorus intake to be above normal. From 1989 through 1991, the Department performed a survey to determine dietary calcium and phosphorus levels in the U.S. population. The survey involved over 12,000 people from 48 states and Washington, DC. Results: Only children under 11 years of age were found to be getting the 1989 Recommended Dietary Allowances (RDAs) set for calcium. Adolescent girls were getting only 56 percent of the RDA for calcium, and young women only 48 percent. Adults over the age of 60 were often getting less than haft the RDA for calcium. Phosphorus levels, on the other hand, were at or above the RDA for all age and sex groups except for girls and young women under the age of 25.

More than 45 different phosphorus-containing food additives, which are not accounted for in these surveys, are now added to foods as preservatives of color and moisture, and as emulsifiers and sequestrates. Five different phosphate-containing food starches have been approved for use in ready-to-eat frozen foods and desserts. Phosphorus additives are widely used in frozen pizzas, chicken, and fish. Additionally, over 70 phosphorus compounds are in use as indirect additives in packaging materials, sanitizers, and production acids.

Additional phosphorus comes from hard water sources and soft drinks, neither of which is accounted for in these food surveys. A 12-ounce soft drink contains around 50 mg of phosphorus, and the average annual consumption of soft drinks in this country now exceeds 50 gal. per person. Soft drink consumption surpassed water consumption in the early 1980s. As strange as it may sound, the average person in this country consumes over 50 gallons of soft drinks a year, but only 40 gallons of water.

Unlike calcium, which is difficult to absorb, roughly 70 percent of all dietary phosphorus is readily absorbed and directly transported into the bloodstream. Also, unlike calcium, your body has very little control over how much phosphorus is absorbed. Certain minerals such as iron and magnesium can interfere with phosphorus absorption, but only when large amounts are token. High fat diets increase the absorption of phosphorus.

High phosphorus diets, especially when you're low in calcium, will lead to osteoporosis. When you consider how the phosphorus content in our diet has increased during the last couple of decades, it shouldn't be much of a surprise to learn that this disease is becoming more and more common. The surprise comes when you look a little deeper. Less obvious problems that are linked to high phosphorus/low calcium diets are: muscle cramps, mini-strokes, periodontal disease and tooth loss, high blood pressure, and osteomalacia, a softening of the bones. It is usually accompanied by aching bone pains (often referred to as rheumatism), chronic hoarseness, Parkinson's Disease, and soft tissue calcification (kidney stones and atherosclerosis).

These problems can be easily treated by readjusting your phosphorus/calcium levels and improving parathyroid function. The long-term benefits of improving your phosphorus/calcium levels, such as arthritis and osteoporosis prevention, can be enormous. However, it may be the short-term effects, like preventing a stroke, that actually save your life.

LOWER YOUR PHOSPHORUS INTAKE

Increasing your calcium intake, (see below) is probably the easiest thing you can do. Unfortunately, increasing calcium will not eliminate all of the undesirable effects of too much phosphorus, and decreasing the amount of phosphorus in your food may be one of the more difficult tasks. Phosphorus is plentiful in food.

The first order of business is to cut back or eliminate soft drinks from your diet. Next, you should try to integrate a wider variety of fresh foods into your diet. The typical meat and potato diet is high in phosphorus. In addition, eat fewer prepared foods. Processed and frozen food dishes are loaded with phosphorus and phosphate additives; but currently, phosphorus and phosphate levels are not listed on food labels, so it's hard to know exactly what and how much of these additives are actually used in a given product.

CALCIUM

With all the hoopla and media attention, you may think enough has been said about calcium. Unfortunately, what you've heard or read may be misleading or even incorrect.

Certain nutrients like calcium, iron, and protein require high hydrochloric acid (HCI) levels in the stomach to be properly digested. Sadly, with age HCI production in the body declines dramatically. In fact, by age 50, the stomach releases only 15 percent of that amount of acid it released at age 25. Even more alarming, 35 percent of all people over 65 don't produce any hydrochloric acid at all! This one fact alone explains why calcium deficiencies are commonly linked with' health problems in older patients, such as high blood pressure, arthritis, heart palpitations, tremors, osteoporosis, insomnia, leg cramps, osteomalacia, excessive nervousness and irritability.

Unfortunately, many well-meaning doctors are still recommending calcium supplements that even further reduce stomach acids. And antacids for calcium may decrease your ability to absorb iron (leading to anemia) and protein, and trigger an acid-rebound effect that can lead to indigestion and even ulcers.

PHOSPHORUS LEACHES CALCIUM FROM YOUR BONES

I've discussed some of the dangers of ingesting excessive phosphorus. Another danger affects calcium levels. Phosphorus acts on the parathyroid glands. These glands secrete the parathyroid hormone (PTH), which regulates calcium levels in blood and tissues. When calcium levels are low, the parathyroid glands produce PTH, which raises calcium levels by leaching it from bones.

(As a side note, estrogen makes bone less sensitive to the parathyroid hormone and can help stop the removal of calcium. This helps explain why osteoporosis occurs less in premenopausal women and those taking estrogen.)

New research indicates that simply adjusting the time of calcium intake may be a key to preventing osteoporosis. The production and release of PTH is linked to your circadian rhythm (your 24hour biological clock). PTH levels, and subsequently the amount of calcium being taken from your bones, increases during the night. Researchers at Northern General Hospital in Sheffield, England evaluated the effect of taking calcium supplements at different times of the day. They've now informed me that when premenopansal women took 1,000 mg of calcium at 11 p.m., the calcium reversed the nighttime increase in PTH activity and eliminated the increase in bone loss that normally would occur.

WHY YOU NEED TO SUPPLEMENT CALCIUM

Your body's storage of calcium is in a constant state of transformation, or "bone remodeling." Bones act as a storehouse for calcium reserves. Roughly 99 percent of the total calcium in your body is in your bones and teeth; the other one percent is in body fluids and soft tissue. As you've seen, calcium is drawn from the bones when it's needed to maintain blood and tissue levels. When there is an excess of calcium, it is redeposited in the bones. Research has shown that under normal circumstances the calcium in your bones is completely removed and replaced about every ten years.

Dietary surveys have now revealed that calcium bone levels are being depleted because calcium levels in food are not sufficient to reverse the trend and phosphorus levels in foods are increasing. Currently, only children below the age of 11 are getting enough calcium in their diets to replace what is lost during bone remodeling. As we reach adolescence and early adulthood, we begin to lose more calcium than we can replace from diet alone. And the problem gets worse with age. Calcium becomes harder to assimilate due to a lack of digestive acids. Less exposure to the sun results in lower body levels of vitamin D, which is essential for strong bones and proper calcium use.

Women in their 30s and 40s and those on estrogen replacement therapy should get at least 1,000 mg of calcium a day. Postmenopausal women not on estrogen should get 1,500 mg daily. Most men should get 1,000-1,200 mg daily. Note: While too much calcium generally isn't a problem, dally intakes of 2,000 mg or more may cause the parathyroid glands to increase hormone secretion in an effort to lower calcium levels.

HOW TO GET ADEQUATE CALCIUM INTAKE

While you most likely need a supplement to meet your overall calcium needs, there are certain calcium-rich foods I highly recommend. Fermented milk products provide calcium along with lactic acid to enhance the digestive process. They also provide beneficial bacterial flora for the lower bowel. Include yogurt, kefir, buttermilk, acidophilus milk and cheeses to your diet. If you suffer from lactose intolerance, most of these items are now available with the enzyme lactase.

There are hundreds of calcium products on the market. In selecting a calcium supplement, look for one that contains the digestive acid betaine hydrochloride, additional magnesium, and vitamin D. Each of these will help increase the amount of calcium you assimilate into your system. I personally like the product Pinna-Cal. You may find it at your local health food store, or it can be ordered online from a variety of sources.

Holladay Physical Medicine - 4211 Holladay Blvd. Salt Lake City, UT - 801-272-8471

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