Summary of Recommendations for Osteoporosis Analysis

A Review of Blood Testing and Nutritional and Lifestyle Considerations for Osteoporosis by  Dr. Frank Driano, D.C.

Summary of Recommendations for Osteoporosis Analysis:

Basic blood chemistry testing can provide a wealth of information with several metabolic conditions, including osteopenia and osteoporosis. More importantly, it can help to direct the clinician’s next step in the investigation process. Discovering biomarkers that may indicate an active or chronic infection, a variety of anemia types, liver and kidney disorders, electrolyte/mineral imbalances, acid-base disruption, inflammatory responses, thyroid disease, vitamin D discrepancies, and glucose dysfunction, can all be determined from routine blood panels that are made easily available.

The following list includes a combination of diagnostic imaging tests, as well as some of the more specific urine and blood chemistry biomarkers used in the diagnosis and assessment of osteoporosis.

1. DEXA Scan (Dual-Energy X-ray Absorptiometry) - aka Bone Mineral Testing (BMT): Results are calculated in the form of a “T- Score and Z- Score” as compared to specific ages in the population.

2. TBS (Trabecular Bone Score) – With the combined results of the DEXA score, this test measures the resiliency of trabecular bone microarchitecture.

3. P1NP (Intact N-Terminal Propeptide of Type I Procollagen) – A serum test used as a strong indicator of bone and collagen matrix formation and proliferation.

4. CTX (C-Telopeptide) - A serum test indicating bone matrix and collagen breakdown. Results appear to be more consistent due to molecular stability, making this test a reliable source.

5. NTX (N-Telopeptide) – A test which may be used to determine bone matrix and collagen breakdown. This test can be in the form of both serum and urine. However, due to sensitivity issues, results can vary unless regular repeated testing is implemented.

6. DPD (Deoxypyridinoline) – A urine test that measures the breakdown of type 1 collagen fibers. It is unaffected by diet or exercise, and it is also directly delivered into the urinary system in its unmetabolized form.

7. Calcitonin – A hormone produced by the thyroid gland. It directly inhibits osteoclastic activity by activating when serum levels of the mineral calcium are elevated. It inhibits bone resorption leading to an increase in bone mass.

8. Cortisol – A hormone released by the adrenal cortex. In elevated amounts, cortisol has the potential to increase bone loss by reducing intestinal absorption and renal reabsorption of the mineral calcium.

9. Estradiol – A reproductive hormone produced in the granulosa cells of the ovaries mainly during a female’s child bearing years. It has the properties to stimulate osteoblastic cells while also inhibiting osteoclastic activity.

10. Progesterone – A reproductive hormone produced by the ovarian corpus luteum. It decreases during menopause and is produced in small amounts by the adrenal glands. It has a stimulating effect on osteoblastic function.

11. PTH (Parathyroid Hormone) – This hormone will be produced by the parathyroid gland when the mineral calcium is required to be released by the bone structure during times of inflammation and/or to help neutralize the effect of the blood pH becoming more acidic.

12. Testosterone – A masculinizing reproductive hormone that has been shown to stimulate osteoblastic activity in both men and women.

Nutritional and Lifestyle Considerations for Osteoporosis:

1. Low Dose Bone Minerals (magnesium, calcium, manganese, zinc, iron, & phosphorus)

2. Vitamin D3 (3,000 – 5,000 IU daily)

3. Vitamin K2 MK4/MK7 (150 – 200 mcg. daily)

4. Omega 3 Fatty Acids Fatty Fish Sources (2 – 3 grams daily)

5. Hyaluronic Acid (low molecular weight 100 – 200 mg daily)

6. Natural Anti-Inflammatories (Curcumin &Turmeric lipid soluble forms 500 mg./daily)

7. Alkaline Diet to avoid excess acid build up in blood stream

8. Anti-inflammatory diet (low glycemic with increased Omega 3 fatty acids)

9. Balance hormones with nutrition and diet

10. Add weight bearing exercise to daily routine

11. Eliminate smoking.

12. Reduce alcohol intake.

By: Dr. Frank Driano, DC, DCBCN

Companion Video Available