Sunday, November 11, 2018

Hormones, Bones & Brains

As a Functional Medicine physician, I see lots of patients who are aging more rapidly than they expected and two of their main concerns are Alzheimer's and osteoporosis. This week I want to focus on how hormone imbalance or hormone deficiency can impact your aging body.

Did you know that up until age 30 your body builds more bone than it breaks down? Your body is constantly 'remodeling' bone by breaking it down in a process called resorption and building it back up which is called bone formation. Before age 30 bone formation occurs at a higher rate than bone resorption and after age 30 the process of bone resorption becomes more and more dominant.










<---Appearance of normal bone



                     Appearance of osteopenic bone -->



As women go through menopause, the hormone shifts cause a dramatic increase in bone loss and thinning of bone which is called osteopenia. For women, the fastest bone loss occurs in the five years after menopause so taking steps to prevent bone loss should being before menopause and you should work with your doctor to correct your hormones as you go through menopause and beyond to prevent bone loss.

Bone loss occurs for both women and men but let's talk about women first.

Three problems arise at menopause that will hinder your bone health. The major problem is declining estrogen. There are estrogen receptors on bone so without adequate estrogen our bones will begin to thin out which increases your fracture risk. Besides fractures, the thinning of your spine bones (vertebrae) results in compression of those bones by the weight and activity of your body so that you lose height and become 'hunched' (medically known as kyphosis).

The second, less common issue, is hypothyroidism which increases in incidence as women age. Thyroid hormone is essential to bone formation and the incorporation of needed minerals (selenium, boron, magnesium and calcium) into bone.

Thirdly, bone formation requires testosterone and many women experience a decline in testosterone as they go through menopause. Loss of testosterone with aging is also the mechanism by which men develop osteoporosis. Men can also develop hypothyroidism but it is less common in men.

So to sum up - women need to replenish their natural estrogen (not to pre-menopausal levels but just to a functional post-menopausal level) and testosterone and balance or replenish their thyroid hormones to prevent excessive bone resorption. Men need to replenish testosterone and thyroid hormone. Both sexes need to increase calcium-rich food intake and supplement with the minerals needed for bone formation: calcium, magnesium, boron, strontium.

If you are dairy-free like me then you can get a decent amount of calcium from chia seeds, almonds, white beans, collard greens, kale, edamame, tofu, rhubarb, amaranth and canned salmon and sardines.

Vitamins and phytonutrients that help absorption and incorporation of minerals are essential to increasing bone formation. I take a supplement called OsteoVegan Rx from NuMedica that contains all the recommended vitamins and nutrients in two bottles - one for the calcium, magnesium and boron and the other for the strontium because you get better absorption if you take it separately from the calcium.

If you are concerned about bone loss the NuMedica program guarantees to increase your bone density. It costs about 69.95 for a one month supply but if you are like me and forget to take it (or only take half the dose every day due to being busy) then it may last two months! If you would like to get it from Fullscript (a reputable supplement website which partners with supplement makers who are known for their quality and purity) then let me know and I can send you an invitation. You must work with a practitioner to access their site because many of the supplements are therapeutic doses (not the much lower RDA in the over the counter stuff you find at Walmart or Target).

Next month I'll tackle hormones and Alzheimer's - between now and then the number one thing you can do to increase brain health is eliminate sugar - added sugar - to decrease brain inflammation. I know Halloween just happened and the holidays are upon us but you brain deserves some TLC so be nice to your brain and EAT LESS SUGAR.

Here is a good calcium rich recipe to enjoy on a cold Fall day:

Cajun sausage, white bean and kale soup -

1/2 to 1 pound smoked Cajun sausage (I used mixed beef and pork), sliced into 1/4 inch slices
1 - 2 cans organic low sodium white beans
2 bunches organic kale, washed and stripped from stems
3 T grapeseed oil
2 medium organic onions, chopped
2-4 garlic cloves, minced (or garlic powder if you are sensitive to fresh garlic)
home made bone broth or organic chicken broth - 4 cups
1 can organic diced tomatoes (I like the no salt added option)
Italian flat leaf or curly parsley - 1/4 c chopped
shaved organic parmesan, Romano or asiago cheese (to top off the soup)
sliced baguette bread (or GF bread)

In a medium stockpot heat the oil and add the chopped onions and garlic. Once wilted (4-5 minutes) add the sliced sausage to brown. Add stock and enough water to equal about 8 cups of liquid and add canned tomatoes and bring to low boil. Add chopped kale and canned beans and let greens wilt (only takes a few minutes) and turn down to simmer. Simmer about 15 minutes and taste for seasoning. If you used the low salt options you may want to add a sprinkle of Himalayan salt and some fresh cracked black pepper to taste.
Serving options - toast slices of gluten free or baguette bread (brushed with olive oil and sprinkled with garlic powder) and serve soup with shaved dry Italian cheese and a side of bread. My son likes pasta so I sometimes boil some gluten free rotini pasta and add a serving to his bowl and top with soup.

Happy Veterans Day!