Product Catalog > Willner's Own Formulas > Bone Complex

Bone Complex
A combination of vitamins, minerals, herbs, and phytotherapeutic agents designed to suport bone health and integrity.

"More than one million fractures per year in the United States are thought to be a result of osteoporosis. At the time of this writing, twenty-five million Americans have osteoporosis. Of these, 80 percent are women. The disease is severely debilitating and may be fatal. And the social cost of osteoporosis is staggering: almost $10 billion a year. It's not hard to see why osteoporosis is considered a disease of epidemic proportions.

"Caucasian women are in the highest-risk group, Some studies say that as many as 50 percent of today's fifty-year-old Caucasian women will someday experience a fracture as a result of osteoporosis. The three most common sites of fracture are the vertebrae, the wrists, and the hips. Hip fractures alone are responsible for as many as fifty thousand deaths annually, and most women who suffer hip fractures haven't had any syumptoms until thye fracture occurs.

"More than 50 percent of Caucasian women currently over seventy years old will suffer spinal compression, a severely painful collapse of the vertebrae that can cause paralysis, as a direct result of osteoporosis. And osteoporosis substantially increases the risk of death in the elderly within six months of an injury that involves a fracture.

"One of the most common-and dangerous-myths about osteoporosis is that it doesn't develop until we're in our eighties or older. Not true. Some people develop signs of osteoporosis as early as their mid-thirties. Compression of the vertebrae, fractures, and other symptoms of weakened bones are common and cumulative. We've all seen women in their midfifties with the beginnings of a rounded back-what is commonly known as a "dowager's hump." This condition is a direct result of osteoporosis.

"It has traditionally been assumed by both patient and physician that these developments are an inevitable by-product of aging. Now we know that's absolutely not true. There are many things you can do to prevent the onset of osteoporosis-and we're not talking about prescription medications here. Diet, exercise, and lifestyle changes are the most important factors in preventing and treating osteoporosis. And the most exciting developments in prevention involve natural substances that have no known side effects. ...In short, osteoporosis is not inevitable, and there are safe and natural ways to treat it."

"Osteoporosis Facts and Figures:

• More than seventy-five million people worldwide have - some form of osteoporosis.
• The risk of hip fracture in older women is greater than the risk of all female cancers combined.
• More than 50 percent of American women currently over seventy years old will suffer spinal compression as a direct result of osteoporosis.
• Osteoporosis substantially increases the risk of death in the elderly within six months of an injury that involves a fracture.
• Early signs of osteoporosis can be found in women in their twenties and thirties.
• Almost two million American men have osteoporosis, and another three million are at risk.
• Nearly one-third of elderly American men will suffer hip fractures as a result of osteoporosis. Of those, a third will a die within a year.
• Older men commonly experience fractures of the spine, and other bones as a result of osteoporosis.²⁸

Among the many factors contributing to healthy bones, nutrition is paramount. It is from foods that we acquire the nutrients necessary for building strong bones, maintaining them throughout the life cycle, and preventing debilitating diseases. The process of bone loss throughout life is inevitable. It is estimated that during a woman's lifetime, she will lose 50% of cancellous bone (the inner portion of the bone) and 30% of cortical bone (the outer covering of the bones), and men will lose approximately 30% and 20% respectively.1 Effective measures, however, can be taken to deter excessive bone loss and to preserve the integrity of the skeletal system. This is where nutrition is key.

Calcium:

Calcium is one of the most abundant minerals found in the body. Although this vital nutrient plays important roles in blood clotting, muscular contraction, nerve signal transduction, and glandular processes, it is known more for its role in bone metabolism.

Calcium is the major bone mineral, and the bones of the body actually act as the major storehouse for this mineral. During times of low calcium levels, the body has two ways of restoring homeostasis: (1) dietary absorption and (2) bone resorption, that is, the release of calcium from stores in bone. Inother words, if the body cannot obtain the calcium it needs from food, it will pull it out of the bone (resorption). Unfortunately, the typical American diet is low in dietary calcium intake (only 300mg/day as opposed to the recommended 1000mg/day), and because of this, the latter (resorption from bone) may play a larger role than the former. Over the long term, robbing bone calcium leads to thinning and weakening of the bones. Effective prevention of bone loss, however, has been shown to result with calcium supplementation. Researchers have demonstrated calcium's ability to produce a sustained reduction in the rate of bone loss. They have also shown that calcium intake is positively correlated to bone mineral density (i.e. higher intakes of calcium results in an increase in bone mineral density)3 . Not only is calcium supplementation by itself effective, when combined with other regimens it can enhance bone health. In a study published in The Journal of the American College of Nutrition, supplements containing calcium (1000mg/day) were shown to be more effective in decreasing bone loss than the same supplements without calcium. Those who are currently following estrogen replacement therapy may find greater results when supplementing calcium in conjunction with their current treatment.

. In a two-year study, 122 normal women at least three years postmenopausal were randomized to receive either 1g of calcium (as gluconate, lactate, and carbonate) or placebo on top of their dietary intake averaging 750 mg of calcium per day. Bone loss was reduced by 43% in the supplemented group, affecting both axial and appendicular bone.38

. The results of another study indicated that continued calcium supplementation produces a sustained reduction in the rate of loss of total bone mineral density in healthy postmenopausal women. As a result, the incidence of bone fractures was far lower in the group taking calcium. Most previous studies had been relatively short-term. While it could be theorized that calcium supplementation would only produce short-term benefits, a stronger argument could be made for the theory that continued calcium supplementation would produce long-term benefit. This recent double-blind study provides further support for this theory.39

For optimal protection from osteoporosis, the type of calcium supplement taken is important, as well as the timing of the dosage. There is some controversy over the best time to take calcium supplements. There is some evidence that supplementation during the evening results in more bone benefit.

"In general, nutritionally oriented doctors recommend taking calcium (Ca) supplements with meals so that the small calciuretic effect of the supplements will be balanced by a reduction in urinary oxalate as a result of Ca's [calcium's] ability to bind oxalate in the gut and render it unabsorbable. In fact, taking Ca [calcium] with meals actually appears to reduce the risk of kidney stones as a result.

"However, it has also been reported that when Ca is given at bedtime, it suppresses bone resorption - suggesting that it may be better to take Ca at night. A recent report using "active absorbable algae calcium" found that taking 150 mg Ca tid [four times a day] with meals plus adding an additional 450 mg at bedtime suppressed the nocturnal rise in parathyroid hormone and other bone resorption markers compared with 300 mg after each meal. Thus, both dosing methods delivered 900 mg of Ca per day but the approach that included bedtime administration appeared to hold the promise of better bone mass down the road.

"The pieces of the puzzle all fit together - 'with food' administration best protects against kidney stones but 'at night' administration appears to optimize protection from osteoporosis. Clearly, with a history of kidney stones, there is only one safe choice - to supplement Ca only with meals. However, for people without such a history and with a concern about osteoporosis, it might make sense to use multiple dosing, including 50% of the daily dose at night. The increased risk of stones would probably be much smaller and less important in such an instance than the potential for protecting bone mass."40,41,42

The best "compromise" appears to be taking calcium in divided doses, throughout the day, with meals, being sure to include at least one-third to one-half the daily supplemental intake with dinner, or after dinner.

Ipriflavone:

"Despite the hype, calcium is not the only nutrient important to bones and to women at risk of osteoporosis. Scientific studies published during the 1980s suggested an operative role in bone biology for almost every available supplement on the market. In vitro studies from 1981 indicated that flavonoids, in particular, had the estrogen-like effect of protecting bone. Estrogens, and perhaps even progesterone/progestins, inhibit bone-degrading cells called osteoclasts..."Then in 1988, the Japanese registered an osteoporosis drag called ipriflavone (Osten?, a synthetic isoflavone. Italy, Hungary and a number of other countries soon followed suit."43

Ipriflavone, chemically known as 7-isopropoxy-isoflavone, is an organic derivative of isoflavones, a class of flavonoids that look and act very similar to estrogen. Estrogen replacement therapy (ERT) is a common treatment used to preserve bone mass, but its use carries significant risks, including endometrial cancer. Because isoflavones are only 1/1000 as potent as estrogen, they exhibit the bone preserving properties without the side effects associated with ERT. This makes them a suitable alternative for those who wish to forego ERT for a more natural approach. Ipriflavone was synthesized in the late 1960's. By the 1970's, it was found to increase the total amount of calcium retained in bones when orally given to rats, sheep, and chickens. Subsequent studies confirmed ipriflavone's inhibitory effect on bone resorption in conditions of high bone turnover.6 Double-blind placebo-controlled studies demonstrate very positive effects of ipriflavone in increasing or maintaining vertebral and peripheral bone mass in both animals and humans.7 To date, over 60 well-controlled studies, typically using a dosage of 600mg per day, confirm the safety and efficacy of ipriflavone as an effective agent to increase bone density. Based upon numerous studies demonstrating ipriflavone's safety and efficacy in treating osteoporosis, this supplement is stated to be a safer alternative to ERT. More information of Ipriflavone is provided at the end of this article.

Soy Isoflavone Concentrate:

Soy isoflavones have been gaining attention in the prevention of menopausal effects, including bone loss and hot flashes. Isoflavones fall under the category of "phytoestrogens" because of their ability to act as weak estrogens in the body. In cases where the body does not produce enough estrogen, as in menopausal and post-menopausal women, weaker phytoestrogens can serve as estrogen replacement. Animal studies have shown that supplementation with soy protein inhibited the age-related increase in parathyroid hormone, the hormone responsible for bone resorption. Additional studies have shown that isoflavones are biologically active in humans and may prevent postmenopausal bone loss and osteoporosis. Researchers have speculated that soy's effects on bone are the result of increased bone formation rather than decreased bone turnover (which is estrogen's purported mechanism of action).

"Soybeans contain an isoflavone called daidzein. Daidzein is similar in shape to a drug called Ipriflavone which is used in Europe to treat osteoporosis. Soy is the only dietary source of daidzein. Soy also increases the menstrual cycle length by 1 to 5 days, especially the follicular phase. This may have a positive effect on bone density due to longer exposure to elevated estrogen levels.

"We now have animal data that daidzein and genistein (another isoflavone) directly stop bone demineralization. In addition to its phytoestrogen content, soy protein isolates conserve body calcium by diminishing calcium excretion in the urine.

"There is a similarity in structure between genistein and estrogen. In postmenopausal women, phytoestrogens act as estrogen agonists and we can speculate that given in enough quantity and over a long enough period of time, they would have an effect on bone mass. Much like the drug Tamoxifen has a beneficial effect on bone density with simultaneous anti-estrogenic effects in breast tissue, medicinal and dietary phytoestrogens may offer these same benefits."44

Magnesium:

Magnesium is second only to potassium in terms of concentration in the body's cells. Magnesium is involved in many cellular processes, including over 300 enzymatic reactions. Although magnesium is particularly important in those processes involved in energy production (i.e. the production of ATP), scientific evidence has shown that this mineral is an important factor in bone health. It is magnesium's combined local and systemic effects that make it an important mineral for proper bone metabolism. Sixty-percent of magnesium is found within bone and is incorporated as a minor element in apatite crystals and thus, contributes to bone structure. Perhaps what is more important than bone content is magnesium's ability to influence calcitropic hormones (calcitropic hormones are those that regulate calcium levels in the body), Magnesium is essential for the normal function of the parathyroid glands (which synthesize parathyroid hormone-PTH), metabolism of vitamin D, adequate sensitivity of target tissue to PTH and active vitamin D metabolites, and active calcium transport. Magnesium deficit is usually associated with hypoparathyroidism, low production of vitamin D metabolites, particularly 1,25(OH)2D3 and resistance to PTH and vitamin D, resulting in impaired bone metabolism. Studies, using magnesium deficient subjects, have shown magnesium's ability to increase bone density and therefore may be a factor contributing to bone health. 13 Considering magnesium's importance, it is disturbing to note that the average American diet, high in processed foods, is deficient in magnesium.14 The average intake by healthy adults in the U.S. ranges between 143-266 mg; this is well below the recommended daily allowance of 400 mg.

"Fifty percent or more of all the magnesium in the body is found in the bones. Magnesium deficiency has been shown more than once to be related to osteoporosis. Magnesium status appears to have a major influence on the type of calcium crystals present in the bones and therefore a deficiency is associated with abnormal calcification of the bone.(39) This may be in part the explanation why some women who have reduced bone mineral density do not have an increase in the fracture rate. These women may have a lowered bone mass but they have excellent structural calcification, due in part to adequate or even above adequate levels of magnesium. In 1990, Dr. Guy Abraham published a study in which he administered a dietary and supplement program emphasizing magnesium instead of calcium. His study demonstrated an 11% increase in bone density in the group that was given dietary advice plus hormones plus nutritional supplements (500 mg calcium citrate and 600 mg of magnesium oxide) versus an average increase of only 0.7% in the group that was given dietary advice and hormones but no supplements. (40) This study analyzed findings after a period of only 8 to 9 months, which implies that additional bone mineral density could be accomplished during longer periods of time."44

Vitamin D:

The importance of vitamin D lies in its role of regulating serum calcium and phosphorus metabolism. Vitamin D is primarily associated with influencing the absorption of these minerals and their deposit into bone. It has been clearly established that vitamin D increases calcium absorption from the small intestines and that a vitamin D deficiency produces large calcium losses in the feces. Adequate vitamin D enhances the level of phosphates in the body because of improved absorption from the intestines and reabsorption from the kidneys. Vitamin D therefore, enhances bone mineralization and increases bone density. Vitamin D is unique among the nutrients for a very important reason: the human body has the ability to synthesize vitamin D. Exposure to sunlight stimulates the body to convert 7-dehydrocholesterol to vitamin D3 (cholecalciferol). Biological activation of D3 depends on a properly functioning liver and kidneys to convert vitamin D3 to 1,25(OH)2D3. The process of exposing oneself to sunlight for the synthesis of vitamin D sounds relatively simple, but there are instances where exposure may be inadequate. Studies have shown that elderly individuals confined to extended care facilities, those in the northern latitudes, and seasonal variations (particularly winter) all antagonize vitamin D production.15,16,17 The result is decreased synthesis of vitamin D with concomitant aberrations in calcium and phosphorus metabolism. Numerous studies have demonstrated vitamin D's ability to correct calcium/phosphorus levels and to increase bone mineral density.18,19 The RDA for vitamin D is currently set at 200 to 400 I.U. daily.

Vitamin K:

In 1935, Professor Carl Peter Hendrik discovered a new fat-soluble substance that prevented fatal hemorrhaging in chicks. He named this newly discovered factor the "koagulation vitamin" which eventually went on to become known as vitamin K. Presently, the term vitamin K is used to describe a group of closely related chemical compounds known as quinones. Vitamin K1 (phylloquinone) is the natural form found in plants, and K2 (menaquinone) is derived from bacteria that normally flourishes in the gut. Menadione, also known as vitamin K3, is a synthetic derivative and the one most commonly used in nutritional supplements. Vitamin K is perhaps best known for its role in the manufacture of clotting factors needed to prevent excessive bleeding. However, recent studies show that vitamin K is also necessary for building healthy bones. Osteocalcin is the major noncollagen protein found in bones and is responsible for "holding" calcium into place within the bone. In order for osteocalcin to be effective it must first undergo a process called carboxylation, that is, the replacement of a hydrogen atom with a carboxyl group (-COOH) on the molecule of osteocalcin This entire process requires vitamin K (specifically, vitamin K1).20 Researchers have shown that both trabecular and cortical bone appear to contain substantial concentrations of both K1 and K2 .21 To give further credence to vitamin K being a necessary component for healthy bones, investigators examining osteocalcin levels found that undercarboxylated osteocalcin is frequently found in postmenopausal women and supplementation with extra vitamin K caused the markers of bone formation to increase.22 Additionally, many hemodialysis patients with a history of bone fractures have indications of poor vitamin K status and a concomitant increase of bone fracture risk.23 It has also been speculated that vitamin K may inhibit osteoclast (cells involved in bone breakdown) cell formation and calcium excretion.24 This is evidenced by decreased calcium and hydroxyproline excretion suggesting a decrease in bone resorption. Considering the fact that the typical American diet contains less then 100 mcg/day (it is recommended that humans consume between 150-500 mcg/day) supplementation may be warranted.

Boron:

Since 1980, evidence indicates that boron may play a role in calcium and magnesium metabolism and the maintenance of healthy bones. A deficiency in boron may be associated with an increased risk of postmenopausal bone loss via enhanced calcium/magnesium excretion and depressed serum concentrations of estrogen.14 Boron is necessary for the activation of vitamin D to its active form, 1,25(OH)2D3, and ,enhancing the effects of estrogen (a hormone known for its bone-sparing properties). Investigations into boron have shown that bone from fracture patients is significantly lower in boron concentrations than control subjects. Supplementation with boron results in an increase in both plasma estradiol (a potent estrogen derivative) levels and bone mass.27,28 Additional studies, using animal models, have shown boron to increase bone strength and resistance to fracture.29

"Dr. Forrest Nielsen studied the effect of boron on postmenopausal women and bone loss and published those results in 1988. He found that boron supplementation reduced the urinary excretion of calcium by 44%, reduced urinary magnesium excretion, and markedly increased the serum concentrations of 17 beta-estradiol and testosterone. The findings in this study definitively implicate boron's beneficial role in calcium and magnesium metabolism, hormonal stabilization and the subsequent prevention of bone loss."44

Zinc:

Zinc is in every cell of the body and is involved in more enzymatic reactions than any other mineral in the body. High concentrations of this mineral can be found in the skin, liver, pancreas, retina, prostate, and bone. Although severe zinc deficiency is quite rare, marginal deficiency, as may be seen in the elderly and/or vegetarians, is common.14,30 Zinc is truly a diverse nutrient involved in many cellular processes, one of which is the proper calcification of bone. This mineral's importance may be more pronounced during the adolescent growth spurt when bone growth and mineral accretion is the greatest. It has recently been shown in animal studies that moderate zinc deficiency, in the presence of an adequate supply of all other nutrients (including calcium), can limit skeletal growth and mineralization during adolescence.31 Zinc's importance in bone metabolism has also been shown to manifest itself during later stages of life. In a study examining plasma and urinary concentrations in 30 postmenopausal osteoporotic women, researchers found that, even though plasma levels of zinc were normal, urinary excretion of zinc was higher in the osteoporotic group as compared to a control. Urinary zinc concentrations correlated significantly with total body bone mineral density in osteoporotic women, suggesting that urinary zinc elimination in osteoporosis is dependent on bone resorption.32 This raises the question as to whether or not zinc supplementation may be effective in increasing/maintaining bone mineral density. Researchers answered this question when they revealed that higher intakes of zinc in premenopausal women was correlated to higher lumber spine bone mineral density.33

Copper:

Copper is the third most abundant trace element in the body, after iron and zinc. Of the estimated 70 to 80 milligrams of copper in the human body, approximately 19% is found within the skeleton. Copper plays an important role in the normal development and maintenance of bone because of its incorporation into the enzyme lysyl oxidase. This enzyme is necessary in the bonding of collagen molecules to one another. Collagen is a protein that imparts strength and flexibility to bone but to do this it must be properly bonded to other collagen units. A copper deficiency, therefore, is associated with poor collagen integrity that may manifest itself as bone abnormalities including osteoporosis. Others have contributed copper's ability to spare bone tissue to its inhibitory effects on osteoblast/osteoclast cell activity. Both of these cells play key roles in bone building and degradation respectively.34 Animal studies suggest that copper deficiency may exacerbate aberrations in bone metabolism, especially in postmenopausal women (when estrogen levels are diminished).35 Supplementation with 3mg of copper however, was shown to preserve bone mineral density in women between the ages of 45 and 56 years.36 It is apparent that, along with the other trace minerals, copper is necessary for proper bone metabolism.

Summary

Many factors influence bone metabolism, and they include age, diet, and hormones. With the dawn of technological advances in nutrition, scientific understanding of nutrients is growing. Although the trace elements, such as copper and zinc, are minor building components in teeth and bone, they play important functional roles in bone metabolism and bone turnover. Exciting research into the effects of isoflavones on bone metabolism is demonstrating positive results.