Bone and Joint Ask Me Archives


Question:
I have questions for my friend. She is at her late forties, has menopause, and is thin. What can she do to avoid osteoporosis? She is not a very strong individual, so can you recommend what are some good calcium supplements to take among other things. She only exercises twice a week. Any thing can you suggest to help her sleep easier is good. It takes her one to two hour before she can fall asleep. In addition, she is taking synthroid for her tyroid.

Answer:
The best way to avoid osteoporosis is:
a. take calcium and magnesium at the ratio of 1 to 1.5 , with about 300-400 mg being sufficient
b. weight training exercises and not only aerobics
c. natural progesterone cream which helps to osteoblast to built bones. Progesterone will also help with menopause.

If she is taking thyroid medicine, do watch her cholesterol as many hypothyroid people have high cholesterol. For sleep you can try melatonin 0.5 to 3 mg. Please note that the effectiveness is not dose dependent. If 3 mg does not work, it does not mean that 5 mg will. For many, a lower dose actually works better.


Question:
Your article suggests that most of us are low in magnesium and have an abundance of calcium. What are your suggestions to women whose bone density tests show bone thinning, and have been told by their doctors to increase calcium to more than 1200 mg daily? Most supplements I’ve seen show a calcium/magnesium ratio of 2 to 1. Do you agree, or do you think it should be 1 to 1?

Answer:
The recommendation of 1200 mg a day is based on data that is now some 30 years old. The latest research does not point to that high a calcium load for adult over 35 years old unless it is balanced with magnesium.

A 1:1 ratio is good. The more magnesium you take, the better it is. You know when it is too much as excessive magnesium will cause you to have diarrhea at which point you can back off.

I often recommend my patients to take only 300-500 mg of calcium with same of magnesium. Then add another 300-500 mg of magnesium as tolerated. Magnesium is highly deficient in our diet, and 80% of Americans are deficient in getting the 350 mg recommended RDA per day. That is not true of calcium which is present in lots of diary products such as cheese, pizza etc.

If you want to avoid osteoporosis, the key are:
a. take plenty of magnesium balanced with calcium in ratio of 1:1 and even 2:1 if you can tolerate it.
b. do weight bearing exercises
c. natural progesterone cream
d. avoid coffee, tea, and sugar.

Your homework is to read this article on magnesium and osteoporosis


Question:
I would like to rebuild the disc in my back. My Chiropractor said they are made of collagen. I have gained 30lbs in the last year, I have had Thyroid meds for years and a doctor changed the amt. My body has been yo-yoing. I would like to detox and get healthy. I’m 57 and have been a cosmetologist for 34 yrs…Can you suggest a plan for me?

Answer:
Disc is made of soft tissues including collagen, water, and other mucous material. To rer-built is not an easy process. Consider drinking a lot of water, and cartilage building nutrients such as chrondoitin sulfate and glucosamine. Collagen building requires high dose of pitman C, proline, lysine, and fat soluble ascorbate such as ascobyl palmitate. The process is very slow, and you should not expect immediate results. You can also reduce burden on the disc by assume a good posture, application of brace for support, and maintain normal weight if you are over-weight.

Feel free to write if you have further questions, but do make sure you enclose this email so I can have a reference point.


Question:
How does one increase arterial flexibility? From reading your case study, I’m hopefully assuming that can happen! I had a “screening” today and got worried: my ASI in 111.

I’m 52 years old, 5’7, 126 lbs, 18.9% body fat, BP 104/64, pulse 74, HDL 85, TC/HDL ratio 2.0, LDL 78, triglycerides 53. I walk 3 miles up and down hills every day (climbed and summited Mt. Hood last May!), and am beginning to lift weights twice/week.

Again, do you have any suggestions on how to increase my arterial flexibility? Would specific supplements help?

Answer:
All your parameters look very good. I think you may want to double check your ASI again to ascertain it is correct. To increase elasticity, building up of the collagen structure is needed. This can best be done by taking in vitamin C, ascobly palimiate, lysine, and proline in terms of supplementation.


Question:
There is lots of controversy about whether soy is good for breast cancer risk. What supports the thought you have that type A people should eat lots of tofu?

Answer:
There is tremendous debate occur as to the benefit of soy and breast cancer. Five years ago, studies are showing soy is good. Now it is the other way around. There are researches pointing to the use of tofu (10% dry weight contains lectin) which binds to cancer cells especially for type A people. I think this whole arena of research is unclear at best. The reason is simple: We are still at the infancy stage of understanding what nutrient can do what at what dosage. So it is common to have opposing studies since each study try to isolate the nutrient and come to a cause-effect relationship which is not possible. You have to understand that nutrients do not behave like drugs. The curve is not linear, and the results often are paradoxical, depending on dosage. For example, 100 mg of Vitamin C is an anti-oxidant, while 10,000 of vitamin C acts as an oxidant. It is therefore common to be confused unless you are into the research.

I would suggest that until the science is more definitive, which will take another 10 years; you stay on the side of moderation. Fermented soy such as miso, tempeh, and natto are very good. Unfermented soy such as tofu should be taken in moderation at best.


Question:
I have recently been diagnosed as having mild gout. My middle knuckle of middle finger on each hand and index finger on one hand are sensitive and have dull aches. Making a fist is mildly uncomfortable and actions such as knocking on a door hurt.

It is not giving me a great deal of pain so I have not been given any medication. I am not overweight; I am 39 years old and am active in terms of cycling at least 20 kms a day, and doing a certain amount of weight training. But I do not follow any particular healthy diet although the food I eat is home cooked with no fast or junk food.

I do drink alcohol on weekends. The problem arose over the festive season. I have stopped drinking alcohol for over two weeks now and am showing no signs of the ache abating. I have cut down on red meats, nuts, cereals, beans, peas, and have increased my water intake to about three litres a day. No coffee or tea.

Will the gout go away eventually, should I be on a medication to clear the problem, and if I do take medication is it medication for short term or do I have to stay on medication all the time?

In terms of crystallisation in the colder extremes of my body, I am in Africa, where at this time the temperature is never below 20 degrees celsius and averages in the 30’s during the day.

Answer:
Gout flares up as a result of high uric acid in your body. And the crystals are deposited in certain joints causing the pain. What you are doing is the common practice to eliminate gout and prevent it from occurring. Once the gout flares up, it is better to take medication to get rid of the symptoms. Allopurinol is the standard medication first. There are no side effects in long term usage of the gout medication. In your case, since it is mild, you may want to consult your physician to see whether you need to take the medication on a long term basis.

There are a couple supplements that you can take for long-term prevention:

  1. Bromelain.
    In some studies, bromelain relieved the joint and tissue swelling and severe pain related to an attack of gout. If taken regularly, bromelain may also prevent recurrent attacks.
    Leading Food Sources of bromelain: Pineapple
  2. Vitamin C.
    By promoting uric acid excretion in the urine, vitamin C reduces the risk that the often painful symptoms of this metabolic disorder will develop.
    Leading Food Sources of vitamin C: Broccoli, Brussels sprouts, Kiwi fruit, Kale, Tangerines, other mandarins, Green and red bell peppers, Oranges, Cauliflower, and Green Cabbage.