When your skeleton has a few bones to pick with you…

Being “bad to the bone” loses its charm when you are complaining about back pain. Mopani Pharmacy Crossing Centre’s Responsible Pharmacist, Corné Cilliers, shared her very best tips on how to take care of your bones.

“You have to nourish your bones. Choose your supplements based on reputation, not price!” Corné compared the bones of a body to a nutrient bank of minerals. “It works like any other bank; the more deposits you make and the fewer withdrawals, the more you will have later in life!”

How does age play a role?

“From the age of 30, the density of bone starts to diminish. Bones become more fragile and are more likely to break. The word osteoporosis means “bones filled with tiny holes”. Osteoporosis often goes untreated and unrecognised. This is due to the fact that it is a silent disease. A bone density test will reveal the amount of bone in your skeleton. Prevention is better than cure!”

“The other likely ailment to pop up with age would be osteoarthritis. Cartilage inside the joints becomes thinner, and the proteoglycans (a protein) become altered. This makes joints less resilient and more susceptible to damage. Repetitive use of the joints over time irritates and inflames the cartilage, causing joint pain and swelling. Eventually, cartilage begins to degenerate. It causes friction between the bones, leading to pain and limitation of joint mobility”, she explained.

“Extra body weight adds stress to joints, particularly the knee joint. Therefore, maintaining a healthy weight is recommended to help prevent early on-set osteoarthritis in the knees”, she continued.

“Fun fact; Bones are constantly being replenished as old bone is removed and replaced by new bone. Our skeletons are remodelled every seven to ten years!”

Who is at risk of developing osteoporosis?

  • All adults, as we age our bones become weaker
  • Patients taking long-term steroidal medication
  • Certain medicines can contribute to osteoporosis such as anti-epileptic drugs, depot medroxyprogesterone acetate (form of contraception) and proton pump inhibitors (medicine reducing stomach acid production).
  • Women after menopause
  • Lack of exercise
  • Diet low in calcium and vitamin D
  • Smoking
  • Heavy alcohol consumption
  • Patients with endocrine disorders such as hyperparathyroidism.
  • Persons with a severe eating disorder
  • Family history of osteoporosis

What are we consuming that can harm our bones?  

“Caffeine is a stimulant and a diuretic. It is the diuretic properties that can lead to calcium loss in bones. Caffeine can also interfere with the absorption of Vitamin D. Vitamin D is necessary for the body’s absorption and use of calcium; therefore indicating that caffeine negatively impacts on bone health”, she explained.

“Alcohol can interfere with calcium and bone metabolism in several ways which could lead to an increased urinary calcium excretion and inadequate absorption of dietary calcium”, she continued.

“Fizzy drinks contain phosphoric acid. An excess of phosphorus may lead to poor bone density.”

What can we do to help prevent osteoporosis?

  • Increase calcium and vitamin D in the diet
  • Increase weight bearing exercise and maintain a healthy weight.
  • Stop smoking and reduce alcohol consumption
  • Ensure regular exposure to sunlight
  • Avoid caffeinated drinks and carbonated soft drinks
  • You can supplement with Menacal 7, Caltrate and Super Cal Bone Food, available in-store and online

What can we do to help prevent osteoarthritis?

“Glucosamine is an amino sugar, a building block of cartilage, ligaments, bones and blood vessels. It promotes the formation and repair of cartilage. You can supplement with glucosamine sulphate. Avoid this if you are allergic to shellfish. Alternatively, use glucosamine hydrochloride, suitable for vegetarians”, Corné explained.

“Chondroitin is a carbohydrate that occurs naturally in the body. It is a major component of cartilage. Clinical evidence has found it is useful in decreasing the pain of arthritis. It has also shown slowed down progression of the disease. Chondroitin is generally recommended to be taken with Glucosamine. Omega 3 decreases the production and activity of inflammatory substances”, she continued.

What is Wolff’s Law?

“The theory of “putting stress on bone, causing them to form more bone” is known as Wolff’s law. This has been a widely accepted theory for almost a hundred years. Weight training is the most beneficial activity for boosting bone density. Start slowly and progress gradually to avoid injury. Consult with a biokineticist for more information.”

How much and of what should we supplement as a rule?

This will vary from person to person. You may use the following guide;

  • For persons 19-49 years:
    • Calcium 1000mg daily
    • Vitamin D 400 iu
  • For persons 50 years and older:
    • Calcium 1200mg daily
    • Vitamin D 800iu daily
  • Additional:
    • Magnesium 500-600mg daily
    • Isoflavones 308mg daily
    • Multivitamin and Mineral Formula

Why should we be taking vitamin D with our calcium?

“Vitamin D supplementation maximizes the intestinal calcium absorption. It also decreases the excretion of calcium in the kidneys.”

Where does magnesium fit into the picture?

“Bone is a big warehouse for calcium and magnesium. Magnesium regulates the transport of calcium. It activates bone-building osteoblasts and increases soft-bone mineralization density. Chelated forms of magnesium are the best. Take calcium and magnesium in a two-to-one ratio. In other words, if you take 1000mg calcium a day you need 500mg of magnesium.”

Is there something else we should consider supplementing?

“Vitamin K is required by the osteoblasts – the bone builders- to produce the proteins found in bone.”

CAUTION: If you are on an anticoagulant, you should speak to your doctor before supplementing your diet with vitamin K.

“Boron is necessary for the conversion of vitamin D into its active form. Research has suggested that boron plays a role in bone metabolism. It activates certain vitamins, minerals and hormones important to bone”, she explained.

“Zinc is an important player in preventing osteoporosis. It regulates the secretion of calcitonin from the thyroid gland and influences bone turnover. Take a chelated zinc supplement in the morning or at lunch time”, she continued.

“Collagen forms part of the protein that forms bone and helps to give bone its elasticity. Vitamin C is needed to produce collagen.”

You can supplement with the following products available in-store and online:

How should we be taking supplements?

“Calcium citrate supplements has acid-independent absorption and need not be taken with meals. It has fewer gastrointestinal side effects, such as flatulence, than calcium carbonate.”

“Calcium carbonate contains the highest concentration of elemental calcium but is poorly absorbed. You should take with meals to increase absorption.”

“Take the calcium supplement at night for best results. Avoid taking zinc supplements, coffee, alcohol and antacids with a calcium supplement at the same time. These substances hinder the absorption of calcium.”

“Constipation is the most common complaint when taking a calcium supplement. It can be prevented with an increased water intake, dietary fibre and exercise.”

To remember

You should always refer to your doctor or to the staff at Mopani when you are adding supplements to your daily regimen. We are here to assist you in planning your intakes, as taking supplements and medications may decrease the oral absorption of others including iron, thyroid supplements, antibiotics and bisphosphonates.

We can deliver your medication, supplements and other Mopani online shopping, nationwide! More info: mopani.co.za | crossing@mopani.co.za | Tel: 013 755 5500 | WhatsApp: 066-192-1703

Read more: Exercise is Medicine – Aging gracefully

AgingBone healthCorne cilliersElbi dippenaarMedicineMopani pharmacyResponsible pharmacist