It's Time to Change the Discussion About Osteoporosis

May marks Osteoporosis Awareness Month, and this year, let's shift the focus from increasing bone density to reducing fracture risk.
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We're bombarded with messages about building bone all the time. How many times have you heard Sally Field talk about how her bone density increased after taking Boniva? May marks Osteoporosis Awareness Month, and this year, let's shift the focus from increasing bone density to reducing fracture risk.

After all, fractures are the most dangerous part of osteoporosis. Up to 40 percent of osteoporosis patients who suffer a hip fracture die within six months, and the increased risk of dying stays elevated for ten years. And 20 percent of people who survive the first year end up in nursing homes. Those with osteoporosis aren't the only ones who should heed this warning. Research shows that most fractures occur within one year of diagnosis in people with osteopenia (pre-osteoporosis). So the time to be proactive about bone health is long before you're diagnosed with osteoporosis.

The National Osteoporosis Foundation (NOF), the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) all now recognize the primary focus of osteoporosis treatment should be on reducing fracture risk, instead of just increasing bone density. The WHO has even launched a free online tool, called the Fracture-Risk Assessment Tool or FRAX. This easy-to-use application provides a 10-year risk of fractures given a person's ethnicity, body mass index, medical history and age.

The best way to prevent fractures is to take a proactive approach. Appropriate, weight-bearing and balance exercises are important, as is ensuring proper nutrition. In one study, muscle strengthening and balance exercises (e.g., Qi Gong, Tai Chi) decreased the risk for falls and fall-related injuries (e.g., fractures) by 75 percent. Additionally, one year of weight-bearing exercise training improved bone mineral density (BMD) by 8.4 percent.

Just as important is taking a dietary supplement that contains the forms and amounts of nutrients shown in clinical trials to reduce fractures. Most people have heard that they should take calcium and vitamin D to protect their bones. What is lesser known, but equally essential is 45 mg daily of MK4, a form of vitamin K2. MK4 is so effective that a study published in 2006 in the prestigious medical journal, Archives of Internal Medicine concluded that this amount of MK4 may decrease vertebral fractures by 60 percent, hip fractures by 71 percent and all nonvertebral fractures by 81 percent, which is better than all leading osteoporosis medications. MK4 exerts such a powerful influence on bone building that in Japan it's been an accepted osteoporosis treatment since 1995.

Fortunately, MK4 is available as a dietary supplement in the United States, which makes this option for bone health accessible to everyone. Unlike osteoporosis medications, which just add minerals to the bone to increase their density, MK4 stimulates the formation of connective tissue in bone. With more connective tissue, bone is more elastic and can absorb an impact--like a fall--and not break. Without the bone collagen, bone minerals are just like a column of chalk that crumbles.

In contrast, Fosamax only decreases vertebral fracture risk by about 45 percent, Actonel by about 50 percent and Boniva by 52 percent. They are even less effective at reducing other types of fractures. Plus, many people are concerned about taking these medications because of their dangerous side effects. Fosamax, Boniva and Actonel can cause bleeding ulcers in the esophagus, bone and muscle pain and osteonecrosis of the jaw (bone death in the jaw).

The risk of osteonecrosis of the jaw is such a concern, that dentists are now starting to recommend their patients stop Fosamax, Actonel and other related medications before they perform any tooth extractions or implants. Additionally, research published in the Journal of Orthopaedic Trauma and The Journal of Bone and Joint Surgery Br concluded that Fosamax may actually increase fracture risk in people taking it for more than five years.

Studies show that taking 45 mg of MK4 daily is completely safe and can be used in concert with an osteoporosis drug. There is even a study showing that MK4 increases the effectiveness of the Fosamax. The only people who shouldn't take dietary supplements with vitamin K are those on prescription anticoagulant medications such as warfarin (Coumadin).

Osteoporosis and osteopenia are major public health threats for an estimated 44 million Americans. In order to save lives, we can't waste any more time just focusing on increasing bone density and taking drugs. It will take a lot of voices to drown out the pharmaceutical companies' myopic message. So this month start talking--to your mothers, daughters, sisters, and yes, the men in your life and your healthcare providers. Discuss risk factors and make sure you all are doing everything possible to keep your bones healthy and strong. It's a conversation that will save lives.

John Neustadt, ND is medical director of Montana Integrative Medicine and the co-founder, with Steve Pieczenik, MD, PhD, of Nutritional Biochemistry, Incorporated (NBI) and NBI Testing and Consulting Corp (NBITC). The doctors created Osteo-K, a dietary osteoporosis supplement formulated by physicians from Harvard, Cornell, MIT and Bastyr. Osteo-K is the only nutraceutical to contain both the form and dose of Vitamin K2 (45 mg of MK4) shown in clinical trials to decrease fracture risk, plus calcium and vitamin D. For more information on building bone, calcium supplements, and decreasing your risk for osteoporosis and fractures, visit

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