Understanding advice for dealing with osteoporosis and navigating info

Posted by galactica @galactica, Apr 23, 2023

I am looking at where I went wrong following the advice to exercise, eat well and take supplements. I did all of that - religiously for 9 months and I failed and in looking and how that could have happened I have been revising my actions and the advice I followed and what went wrong so I can correct it and hopefully help others. I am embarrassed to say that it was just not obvious to me.

I was told that walking is great for osteoporosis - so I did a lot of walking. Working up to 10k steps a day - But I am now learning that walking, just walking does not build bone density if it’s leisurely, even if for long duration. It has to be at a significant pace. And of course stair climbing and the elliptical but the heart rate has to rise to a particular level as well. Find out what that is for your body.

Weight bearing exercises - that is not enough. The exercises have to specially and safely address the spine and other bones and they have to be done properly or one loses the benefit of the exercise. I needed more of some exercises and fewer of the others and squats, for example, I was not doing them properly even though I had trainers watching me. My exercise physiologist helped me with proper form.

A wide variety of vegetables is recommended - but there are fruits, vegetables and nuts that are high in oxalates. If, like me, you have an issue with oxalates or are consistently eating a high oxalate diet - spinach, Swiss chard, rhubarb, almonds, prunes - like I was - day in and day out - oxalates bind to calcium and are excreted through urine.

I was eating copious amounts of rhubarb, Swiss chard, collards, sweet potatoes, almonds, almond flour in my crackers and foods. I thought I was eating calcium rich foods that were helping me but they were making me worse. Nobody told me this could be detrimental to my particular bone health.

I know look at not only calcium content but how high the oxalate content is. So I am actually absorbing the calcium intake in and it is going to my bones. It bears looking into this. My calcium oxalate level on the 24 hr urine test was 396. I brought it down to the normal level of 21 by changing my diet alone. No medication. However I had to be diligent and I am now navigating getting enough nutrients and calcium while regulating oxalates.

It’s not enough to “eat a lot of green leafy vegetables and have your plate look like a rainbow of colors”. Because many have high or moderately high oxalate content and either need to be boiled and the water drained in order to reduce the oxalate level, or avoided altogether depending on your situation. It’s important to read up on and understand how oxalates affect bone health and I had to figure this out the hard way because no one told me, not one doctor. Until it was a problem. With osteoporosis and bone health in general, I think this is a critical piece of information. I dont understand why this is not included in the general information.

The other part of the equation is our digestive system. I realized that if my digestive system was not absorbing nutrients properly, no matter how much or how nutrient dense my diet is, if my body is not absorbing and redirecting g these nutrients to the parts of my body that need it, the benefit is greatly reduced. The digestive system has to be healthy and able to absorb the nutrients you put into it. I thought just eating a pristine healthy diet would fix this but sometimes one needs a little more support in this area.

I wanted to mention this because for me, I realized that it was not enough to know what to do, and all I was told and all I read was what to do. I know now it has everything to do with how and to ask questions and when told I am making myself crazy (vs being given answers to my questions) to go elsewhere. I am learning to ask the how’s and the whys these things are happening and to research as much as I can instead of just following what I have been told to do, which is just not enough, at least for me and my body.

And I also believe that there is this assumption that everyone with osteoporosis is going to take medication so maybe it’s not important to know. And that the medication will just fix the bones. But it is important to know. So important, whether one takes meds or not, doctors and healthcare providers have to go a big step further to offer more than the status quo of walking, weight bearing exercise and eating leafy green vegetables, as do the sites that put out information on bone health.

This is what I am learning.

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

I think part of the issue is that

1. the information is available, some topics more than others, but no one is really talking about it until it becomes an issue, and we don't always know the relationship of, say oxalates, for example since this is the current discussion, to kidneys and bones if no one tells us and we don't know to ask.

2. because we are not physicians or healthcare practitioners, we need help connecting the dots and understanding what the relationship is to other parts of the body, nutrition, medication, how it affects our current medical conditions, or medications if any, etc., side effects, short and long term etc.

I found this on the Mayo site and there is more there depending upon your search parameters and of course, elsewhere.
https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-kidney-stones-and-calcium/#:~:text=The%20highest%20amounts%20of%20oxalate,are%20generally%20low%20in%20oxalate.
There is a book that came out earlier this year called Toxic Superfoods. I have just started reading it. From what I understand, and I have noticed first hand, is that different sites list different oxalate levels for the same fruits, vegetable and nuts. So it's important to know that. Since I have not yet finished reading the book, I can't say much about it. I am just being open minded and seeing what is or is not ringing true for me and investigating other sites that discuss.

You can go on line and look for oxalate charts - I was curious about the Chinese Medicine table of vegetables and their oxalate content, that were mentioned earlier (if I understood that correctly).

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@galactica

Does she also take meds in addition to drinking calcium citrate? I’m curious.

The atypical fractured worry me especially bc my femoral dexa is barely in osteopenia.

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@glactica at the time I did the master class, almost two years ago, Dr. Simpson was deciding about which med to take. As I remember, and I could be wrong, it was between Tymlos and Evenity- and I was trying to decide the same thing.

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@resort

Have you thought about taking collagen supplement? It can help build bone and muscles.

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Has that been proven? And which collagen supplement? there are different kinds of collagen as well!

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@windyshores

@glactica at the time I did the master class, almost two years ago, Dr. Simpson was deciding about which med to take. As I remember, and I could be wrong, it was between Tymlos and Evenity- and I was trying to decide the same thing.

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When I read Lani Simpson's book several years ago, it stated that she had a preference for Forteo as a bone builder. That was before Tymlos and Evenity were available and she did state that she had some sort of personal connection with the person (?) who created this drug?? Something like that. She may have revised her book though since I read it.

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@galactica

Thank you for the links!! My nutritionist just turned me on to chronometer and I am getting familiar with it! Yes - it all makes so much sense to me. I completely agree with you. Salad greens like romaine, arugula have virtually no oxalates so I will be having more of those as well as other lettuces like red oak, butter leaf etc to get other valuable nutrients. I have reintroduced dairy and I understand sheep’s milk yogurt and goat’s milk yogurt are easier on the digestive system than cow’s Milk yogurt and also contain 390 mg of calcium per serving - about a third (of 1200 mg). There is also lactose free organic milk and lactose free kefir and unhomogenozed Whole milk which is naturally high in k2. Then canned sardines in olive oil or canned wild caught salmon will be a good supplemental food.

I don’t know given the salt content of canned fish and other factors how often it’s okay to eat them per week as salt is not good for bone density.

The oxalates bind to calcium and direct it away from bone. I need to understand still how to better manage this. Learning curve.

Thanks everyone for your very valuable input.

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Yep, sheep and goat are generally easier to digest than cow's milk because sheep and goat contain A2 casein (milk protein) versus the A1 casein which is found in most dairy from cows. The A2 casein protein is generally considered less inflammatory. Grass fed/pasture cows also produce more A2 casein and a good brand that's pretty available is Alexandre Family Farms. They produce dairy products from grass fed/pasture raised cows.

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This may be a repeat as my last comment disappeared. I'm an 80 year old woman with severe osteoporosis who has been experimenting with pressure cooking pork hocks and feet from Asian stores for the collagen. Now I get to think about my increasing risk of heart disease.

Pouring off the water from boiled spinach & chard . . . does that eliminate the oxalates and calcium as well?

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@windyshores

After menopause, bone density loss may be inevitable, but I admire your efforts. Does boiling spinach retain calcium but eliminate oxalates? How can we get calcium from almonds? I am asking more for my daughter, but she and I both cannot eat dairy. (I am just finishing Tymlos and need to go back to being cognizant of holistic approaches.)

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I’m reading all this and after having watched most all of the lectures given and taken notes at the “More natural approaches to osteoporosis and bone health “ symposium a few weeks ago , and also seeing on this site a few days ago a mention about the Bone Coach program, he was featured on that symposium, I am wondering who has done it, signed up for it, and what the cost is?? There is a lot to osteoporosis , root causes that can identified that can be interfering with all our good intentions if we aren’t aware. I can start looking on my own to find “good“ informed people in my area , but that will take time. Feedback will be so appreciated !!! Thanks!!!

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@notmoff

This may be a repeat as my last comment disappeared. I'm an 80 year old woman with severe osteoporosis who has been experimenting with pressure cooking pork hocks and feet from Asian stores for the collagen. Now I get to think about my increasing risk of heart disease.

Pouring off the water from boiled spinach & chard . . . does that eliminate the oxalates and calcium as well?

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I am told and have read that boiling and draining the water from the veggies works.

However if you have oxalate issues - spinach and chard have among the highest oxalate content and I dont really know how much you are actually eliminating. Kale, bok Choi, mustard greens are low. You need to read up on and consult with someone who can better advise. It also depends how frequently you are eating these and if you are eating with other calcium rich foods to balance that out. I would consult with someone who is aware.

But I would think you have to balance with no/low oxalate raw - lettuces (except spinach) primarily are low/no oxalates. Because I’m their raw state if you can tolerate them and they are fresh and organic - provide more complete nutrients that might be lost in the boiling for vegetables that are higher in oxalates.

Consider pastured chicken neck, bones and feet for collagen so your not just consuming pork.

I also make a rich vegetable broth with kelp, variety of mushrooms, onions, and watercress and other low oxalates vegetables (add root vegetables if you can tolerate) and your also then getting minerals as well. Of course if you have no oxalate issues I imagine the sky is the limit 😃

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I want to add my thanks Galactica for sharing your experience. I feel like I am in a similar boat that has been slowly sinking. I found out last week according to my Endocrinologist I am still actively loosing bone and have been recommended to go the anabolic bone building therapy route to reduce fracture risk. I too feel the underlying issue is related to oxalates. I've taken up battle positions with oxalates for some time now. I suspect my doctor has found a solution for themself, I received a email yesterday that I have been placed in a "Coordinated Care Program". It remains to be seen if this will work for me. I remember the childhood game of "telephone" where once a message gets passed around it completely changes! Not my past experience at the Mayo Clinic by the way.

I've been reading a book by De Lamar Gibbons, M.D. where he attributes calcium's ability to neutralize the acidity of the bowel contents, to how calcium is able to limit it's absorption. I thought it was it's binding/combining (tying up) action that reduced it's absorption. I had missed the piece that it was the actual act of neutralizing acidity. This book is on the dated side, so hopefully this is still true.

My hope at this point is to obtain some pharmacogenomic testing insight on these anabolic drugs. I actually did pharmacogenomic tests in 2018 and to my amazement the company emailed me a updated comprehensive test report for free yesterday. Unfortunately I didn't see any references to this class of drugs, so more digging to go.

One thing I have now returned to for better or worse is a calcium product I saw sold on Mayo Clinic Connect online store by Thorne called DiCalcium Malate. It is billed as absorbing well. I think I still need to rely on the known oxalate friendly calcium citrate (whenever calcium food intake is lacking), and use DiCalcium on a more PRN basis.
Good luck Galactica with the ongoing oxalate adventures.

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Thank you for your share.

In addition to all of the experiences that make up our individual bodies: oxalates, overactive parathyroid, cancer, stress, etc.

What I am realizing for me is that a healthy, optimally functioning digestive system is very important. I don't believe I am getting nutrients from even the healthiest foods, calcium and mineral supplements to my bones and the rest of my body and brain, if my digestive system is not working properly to break down, absorb and effectively release these elements into the body.

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