Over 55% of all adults over the age of 50 suffer with osteoporosis or low bone density. That is over 44 million people living with an increased risk of bone fracture and overall bone weakness on a daily basis. Osteoporosis is a systemic bone condition which can also reduce the average life expectancy, more in men than in women, creating an increased state of frailty and susceptibility to injury. Current therapy options offer hope and benefits for many, but what about herbs, specifically curcumin? Could curcumin impact the progression of osteoporosis? Are there benefits to adding curcumin or turmeric to your daily regimen?
Osteoporosis is a health condition which impacts both men and women, generally as they age, resulting in reduced bone mass or density, which then predisposes to an increased risk of bone fractures. The bones become more fragile and brittle, easily breaking with simple movements or light exposure to stress such as lifting an object.
The precise cause of osteoporosis is unknown, and likely there is no one specific cause. More so, osteoporosis is a malfunction of normal bone metabolism. For a bone to remain healthy, there is a balance between bone production and bone loss or resorption. Bone is a living tissue and regenerates over time, losing some and creating new bone to replace that which is lost. Osteoporosis develops when there is an upset in this balance between creation and loss. In osteoporosis, there is an increased state of bone loss with a marked reduction in new bone formation. This results in the decreased bone mass or density and increased bone brittleness.
This process of bone remodeling is a cellular event, triggered and impacted by cellular signaling chemicals. Research indicates that many chronic inflammatory conditions can impact bone remodeling, and alter the normal function of bone loss and creation. Bone is removed by cells termed osteoclasts and created by cells termed osteoblasts. The imbalance between the two cell types can be influenced by chronic inflammation. Thus, osteoporosis could be considered a disease of chronic inflammation.
It is not a coincidence that osteoporosis is found in the older population. This is the same population of people that are also suffering the increased health ailments associated with the aging process, which is also directly linked to chronic inflammation and free radicals. In that regard, osteoporosis could be seen as a symptom of aging, more so than an isolated disease.
Symptoms of Osteoporosis Include:
- Back pain associated with a fracture or vertebral weakness/collapse
- Reduction or loss of height over time
- A stooped over body posture
- Bone fracture not associated with severe trauma
Risk Factors Associated with Osteoporosis Include:
- Gender (women at higher risk than men)
- Increasing age
- Race (White and Asian at higher risk)
- Genetic history
- Smaller frame size (reduced original bone mass)
- Sex hormone reduction (estrogen, progesterone, testosterone)
- Thyroid hormone (overactive)
- Adrenal gland (overactive) – – possible stress association
- Dietary Factors (poor nutrition, low calcium intake)
- Reduced Vitamin D levels
- Eating disorders or poor absorption conditions (IBS, IBD, Crohn’s disease)
- Medications (seizure medications, ulcer medications, steroids)
- Concurrent health problems (kidney and liver disease, cancer, autoimmune conditions)
- Sedentary lifestyle
- Moderate alcohol consumption
Osteoporosis Management and Therapy Options Include:
- Maintain a healthy body weight and body mass index (BMI)
- Proper nutrition (calcium and protein intake)
- Vitamin D supplementation
Along with the above mentioned preventative measures for osteoporosis, it can be common to implement certain medications termed bisphosphonates, to help combat the condition. Bisphosphonates are a debatable group of medications, of which there are several brand names that are currently being prescribed, while others have been discontinued due to side effects. Bisphosphonates work by helping to balance the bone remodeling process, by reducing the action of osteoclasts. One major side effect that has been noted in research is osteonecrosis of the jaw, which can be a serious problem. In reality, these medications are reducing the removal of bone or bone resorption, while new bone is still being formed. This can create overly dense bone and contribute not just to bone pain, but vomiting, nausea, and potentially kidney problems.
Hormone replacement therapy is another option that has shown promise and benefit in some patients. In women, the supplementation with estrogen has shown some benefits in regards to bone health and osteoporosis, however, there has been some increased concern over the development of other health conditions as a result. So, hormone replacement therapy may not be as beneficial in the long-term as we would like it to be.
Chronic Inflammation, Curcumin, and Osteoporosis
One of the main preventative and therapy actions that you can take to reduce the risk of and provide better management of osteoporosis is nutritional therapy. This means that a better, healthier diet is pursued and implemented, moving away from processed foods and refined sugars, towards more fruits and vegetables. This dietary approach has several potential benefits and not all are related to pure nutrient provision. Many of these whole-foods provide clinical and research supported benefits towards the inflammatory process that is occurring in all of our bodies.
One food, or more specifically an herb, is Turmeric or one of the active ingredients, Curcumin. Curcumin is one of many active ingredients demonstrating medicinal benefit in research that is found in the plant root, Turmeric, or Curcuma longa. Curcumin has been demonstrated in research for many years to have potential health benefiting properties including antioxidant benefits, anti-inflammatory properties, and even anti-cancer ability. It is one of the most heavily researched herbs for these vary reasons, but what about osteoporosis? Considering the connections between curcumin and management of chronic inflammatory pathways, the benefits towards osteoporosis are very possible!
In one clinical study comparing the administration of a bisphosphonate (alendronate) alone or the bisphosphonate in combination with curcumin, it was noted that both groups demonstrated an increase in bone mass density and reduction of bone associated enzymes, BUT the curcumin combination group had a greater increase in bone density and reduction of enzymes. So, the combination actually provided more benefits than the medication alone. (Khanizadeh, 2018)
Another group of 51 patients with asymptomatic low bone density also responded well to curcumin therapy along with lifestyle changes. In the 24-week research trial, the patients demonstrated increased bone density in all areas measured with no noted side effects, including jaw pain, with no medications utilized. (Riva, 2017)
The precise mechanism as to how curcumin provides benefits in cases of osteoporosis is unclear, but in some studies using excess glucocorticoids (steroids), which are known to induce osteoporosis, curcumin appears to impact cellular signaling pathways. These pathways are involved with the inhibition or reduction of osteoblasts and new bone formation. So, it appears that curcumin helps to reactivate, to an extent, formation of new bone via osteoblasts. This is likely through modification of the ever complex pathway of chronic inflammation. (Chen, 2016)
Bone Health, Intervention, and Choice
Aging is a process that you and I cannot avoid, but through proper lifestyle choices we may be able to slow the inevitable. Osteoporosis is essentially a disease of aging, and therefore a disease associated strongly with chronic inflammation.
Lifestyle choices, including a healthy diet, herbal usage, and exercise can go a long way potentially in helping us to not only manage these age related conditions, such as osteoporosis, but they may help us to reduce the risk additionally. Curcumin, being one of many potentially beneficial herbs, could provide real clinical benefits, when combined with proper lifestyle choices.
Aging and the associated deterioration of our health is inevitable, but in the end, there is a choice involved as to the degree that you are impacted.
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Author: Tom Schell, D.V.M, CVCH, CHN