If someone has low bone density being diagnosed with osteopenia or osteoporosis what treatment options do they have? For those avoiding the pharmaceutical approach, conventional wisdom has been calcium and vitamin D supplementation. While studies show a reduction in fracture risk, I have not found any studies showing increased bone density in patients with normal levels of D.
The American Academy of Family Physicians’ treatment guidelines for osteoporosis recommends bisphosphonates such as Fosamax as the initial treatment. Unfortunately, there are concerns about the long-term use of these medications because of studies like the one in the October 2017 Journal Bone and Joint Research The effect of long-term bisphosphonate treatment on trabecular bone strength and microcrack density. The conclusion was that the drugs resulted in weaker bones!
I must admit that I have been recommending calcium and vitamin D along with exercise for years, until recently when a patient asked about calcium. I did a search of the research for other approaches when I ran across the COMB study.
COMB stands for a combination of micronutrients for bone, which is a study that examined the effect of a combination of nutrients with exercise on bone density. This study examined the effects of a combination of nutrients with daily impact exercise. The study had 77 subjects with 72 females, 22 were osteoporotic, 32 osteopenic, and 4 reduced bone mineral density. Bone mineral density was examined after one year of COMB protocol and found that total spine improvement was 6%, which may not sound great but biophosphonate drugs alendronate and risedronate showed 4% improvement at one year.
The COMB protocol;
1. 250mg/day of DHA from fish oil
2. Vitamin D3: 2000IU/day
3. Vitamin K2 (non-synthetic MK7 form): 100ug/day
4. Strontium citrate: 680 mg/day
5. Elemental magnesium: 25mg/day
6. Dietary sources of calcium recommended
7. Daily impact exercising encouraged.
If you are interested in this protocol feel free to contact me because some of these supplements can be difficult to find.
