Osteoporosis and Osteoporosis Treatment – ​​Integrative Practitioner

Written by Erin Yeh

Osteoporosis and osteoporosis are bone diseases that commonly affect women, especially if they are premenopausal or postmenopausal. Low estrogen levels are the main culprit behind bone loss, but Lara Pizzorno, LMT, MA, MS, senior medical editor for Integrative Medicine Advisors, and Joseph Pizzorno, ND, president of Bastyr University, believe there is more to it than just a lack of a particular hormone. At the Integrative Healthcare Symposium last month, the husband-and-wife team presented other reasons behind bone disease and loss, and why medications shouldn’t be the only treatment option.

Drugs are not the solution

In June 2024, the US Preventive Services Task Force reported that bisphosphonates provide subtle benefits for bone health. The absolute risk reduction is very small, at only 2.4% for all clinical fractures, 1.8% for nonvertebral fractures, and 1.8% for clinical vertebral fractures over three years. The absolute risk reduction for hip fractures is only 0.6%. The treatment benefits of drugs other than bisphosphonates are less certain.

“You cannot correct the problem by simply prescribing an orthopedic medication,” Lara emphasized. “Medications do not restore bone health.”

She urged shifting the focus toward chronic low-grade inflammation, which plays a major role in bone loss. Inflammatory processes increase the activity of osteoclasts, which are the cells responsible for bone breakdown, while inhibiting osteoblasts that build bone.

It’s way more than that…

There are many factors that contribute to inflammation, but there are “too many potential causes of bone loss to consider without any way to narrow it down,” Lara says. A list of basic laboratory tests is provided to identify the most relevant issues.

• Vitamin D It plays one of the most important roles in bone health. Ideal levels are between 60-80 ng/ml, not 30 ng/ml, for immune regulation. Not only is vitamin D important for calcium metabolism, it also regulates immune function by shifting T-cell activity toward anti-inflammatory pathways, thus reducing bone loss. Magnesium is also required for the enzymatic activation of vitamin D, and deficiency levels are a common barrier to effective supplementation.

• Cardiovascular diseases Lara explained that it has a strong relationship with osteoporosis, as both conditions share the same mechanisms and risk factors. High LDL cholesterol often causes high blood pressure, reduces nutrient delivery and waste removal, reduces calcium absorption in the intestine, and increases urinary excretion. High cholesterol and unhealthy fats may also promote calcium deposits in blood vessels rather than bones. Statin medications further complicate the picture, as higher doses (more than 10 mg per day) have been associated with an increased risk of bone loss and may interfere with the production of vitamin K2, which directs calcium to bones and prevents calcification of blood vessels.

• Eat balanced mineralsEspecially the ratio between calcium and magnesium, is crucial. Ideally, the ratio should be 2:1 with about 1200-1500 mg of calcium and 600-750 mg of magnesium per day from diet and supplements combined. In the United States, magnesium intake is usually inadequate, but calcium intake has increased, leading to bone problems. Furthermore, chronic stress can deplete magnesium.

• drought It is “a major unrecognized problem that greatly interferes with normal bone regeneration,” says Lara. She noted that dehydration can impair bone cell production and shift bone marrow stem cells toward forming fat cells instead of bone-forming cells.

• Homocysteine This is the molecular equivalent of an acid spray gun, Lara explained. High levels of homocysteine ​​increase inflammation and weaken bones by interfering with collagen formation. High homocysteine ​​often indicates problems with methylation pathways, which depend on adequate levels of vitamins B6, B12, and folate.

• Hyperparathyroidism It is when there are elevated levels of parathyroid hormone (PTH) and can indicate a vitamin D deficiency. Persistent high PTH also stimulates bone resorption and leads to progressive bone loss.

• Decreased kidney function Vitamin D activation and calcium homeostasis are impaired, leading to increased PTH secretion.

• Cadmium It is an environmental toxin strongly linked to osteoporosis and kidney damage. It also interferes with the activation of vitamin D. Smoking and contaminated foods are the main sources.

• Liver function Participates in vitamin D metabolism, thyroid hormone conversion, and detoxification. Elevated levels of aspartate aminotransferase and alanine aminotransferase (sensitive markers of liver damage) are associated with systemic inflammation, oxidative stress, and muscular dystrophy, all of which affect bone density. Impaired liver function (particularly metabolic dysfunction-associated fatty liver disease, or steatosis) promotes insulin resistance, another inflammatory factor.

• iron It is a “moderate nutrient.” Lara stressed the need to organize iron carefully. Iron deficiency and iron excess can contribute to bone loss. Low ferritin levels increase the risk of osteoporosis by impairing collagen synthesis and vitamin D metabolism. Excess iron promotes oxidative stress, insulin resistance, and increased bone cell activity.

Personal status report

Joseph discussed Lara’s case report. Several women from Lara’s family died from complications of osteoporosis. Although Lara lived a healthy lifestyle and took precautions to ensure healthy bones, she was eventually diagnosed with osteoporosis.

After running several tests, including the first genetic test, they discovered that Lara had a deficiency at the vitamin D receptor site. Her body wasn’t processing or absorbing vitamin D efficiently. Joseph reported that her vitamin D intake was dramatically increased to 14,000 IU daily for approximately 2 years to overcome decreased receptor activity and achieve adequate physiological effects. Eventually, Lara’s bone density stabilized and began to improve.

This case report is an example of how personalized medicine can make a difference for a patient. If the underlying genetic and metabolic conditions are not identified, Lara’s condition could progress from osteopenia to osteoporosis, as was the case for other members of her family.

“We live healthy. We only eat ecologically grown foods. We avoid environmental toxins as much as possible,” Joseph said. “But the reality is that by following these protocols, (the protocols) work.”