The 411 on Healthy Bones

By Julie T. Chen, MD

Many of my patients have autoimmune diseases that predispose them to steroid medication exposure, so bone issues are always a topic that comes up over and over again in my clinic. Many of these patients have had bone mineral density studies that show osteopenia or osteoporosis, which means varying levels of bone thinning are already in place.

However, when we focus on a diet that is anti-inflammatory and supplements that help to lessen inflammation, some of these patients show up in follow up bone mineral densities with improvement of bone density. So, while an anti-inflammatory diet and supplement regimen is frequently seen as helpful for diseases like lupus, heart disease, or cancers - let's not forget that it can also be helpful for arthritis and bone mineral density improvement as well.

When we talk about bone health, the first thing to think about is what of your medications might actually be worsening your bone health. There are some studies that suggest varying levels of concern about proton pump inhibitors we use for heartburn or gastritis might worsen our risks of bone fractures with prolonged use. Similarly, as I mentioned before, steroid therapy also is concerning for bone health with prolonged or repetitive therapy. So, if you are one of the patients taking these medications, what can you do to protect your bones?

First, ask your physician about options on how to potentially come off these medications…yes, please have that discussion first with your physician and don't just take yourself off the medication because that may be dangerous. Also, your original symptoms for why you are taking these medications might rebound back stronger than before with abrupt stopping of the medication.

Second, ask your physician to check your vitamin D and calcium levels and even vitamin K levels. If any of these are low, ask your physician about dosing for the vitamin based on your lab result and also about foods that help you to build your bones. Many food options may include nuts and wide variety of vegetables and fruits.

In regards to arthritis, if you have rheumatoid arthritis, a diet and supplement regimen for anti-inflammation is very important. Some potential supplements you can ask your physician about using to help decrease destruction to your joints include, but are not limited to, fish oil, curcumin, ginger, MSM, boswellia, Chinese skullcap, rosemary, and holy basil. You should speak to your physician before starting any of these to make sure you don't have health issues that would keep you from taking these.

If you have osteoarthritis, making sure that you eat an anti-inflammatory diet and speaking to your physician about glucosamine and MSM is a good way to start. You also should make sure that your levels of vitamin D and calcium are sufficient. As far as activities are concerned, you should speak to your physician about repetitive activities that put you at risk or worsens your condition. There are various durable medical equipment options to help protect your joints or help support them, as well, such as knee braces or back braces, just to name a few.

In summary, we all know that as we get older, there will be some wear and tear on our bones and joints simply from the number of years we've spent living and enjoying life. However, by keeping our diet and supplements as anti-inflammatory as possible and staying on top of which medications or lifestyle habits might be worsening our bone health with regular discussions with your physician, you can try to keep your joints and your bones as healthy as possible so that they can keep you moving and living life as healthily and as happily as possible.

Dr. Julie T. Chen is board-certified in internal medicine and fellowship-trained and board-certified in integrative medicine. She has her own medical practice in San Jose, Calif. She is the medical director of corporation wellness at several Silicon Valley-based corporations, is on several medical expert panels of Web sites and nonprofit organizations, is a recurring monthly columnist for several national magazines, and has been featured in radio, newspaper, and magazine interviews. She incorporates various healing modalities into her practice including, but is not limited to, medical acupuncture, Chinese scalp acupuncture, clinical hypnotherapy, strain-counterstrain osteopathic manipulations, and biofeedback. To learn more, visit www.makinghealthyez.com.