We are going to follow a path in exploring what is causing accelerated bone loss in the patients who come visit us for a hormone analysis. This accelerated bone loss is not the path every person follows, but it is a common path.
Low hormone levels and bone loss
Low hormone levels and bone loss have been linked together for a long-time. A paper from 2006 (1) cited as a reference by hundreds of other studies offers an introduction to the understanding of the role of hormones in bone loss and the difficulty in managing this problem.
“Estrogen plays a fundamental role in skeletal growth and bone homeostasis in both men and women. Although remarkable progress has been made in our understanding of how estrogen deficiency causes bone loss, the mechanisms involved have proven to be complex and multifaceted. Although estrogen is established to have direct effects on bone cells, recent animal studies have identified additional unexpected regulatory effects of estrogen centered at the level of the adaptive immune response (Inflammation). Furthermore, a potential role for reactive oxygen species (the accelerated breakdown of cells via an impaired immune system – inflammation) has now been identified in both humans and animals.”
We have been treating hormone deficiency for decades. The problems noted in 2006 are the problems we noted in the 1990s and the same problems we note today. Patients who come in for hormone assessments have challenges created not only by hormone deficiency, but by chronic uncontrolled inflammation. One of these problems is developing frailty caused by accelerated bone loss.
Menopause Hormone Therapy should be considered in women with premature estrogen deficiency
One of the papers citing this 2006 research is a November 2019 update published in the journal Current osteoporosis reports (2) which suggests:
Estrogen, but not antiresorptive therapies (examples Brand name: Fosamax™, Fosamax™ Plus D) can attenuate (reduce) the inflammatory bone-microenvironment associated with estrogen deficiency. However, already on second year of administration, Menopause Hormone Therapy is associated with excess breast cancer risk, increasing steadily with duration of use.
Menopause Hormone Therapy should be considered in women with premature estrogen deficiency and increased risk of bone loss and osteoporotic fractures. However, Menopause Hormone Therapy use for the prevention of bone loss is hindered by increase in breast cancer risk even in women younger than 60 years old or who are within 10 years of menopause onset.
The increase in breast cancer risk as well as other damaging health risks were noted in the famous 2004 study “Effects of Conjugated Equine Estrogen in Postmenopausal Women With Hysterectomy: The Women’s Health Initiative Randomized Controlled Trial.”(3) Here the strong recommendation to stop the use of Conjugated Equine Estrogen (Horse estrogen) for chronic disease prevention in postmenopausal women was made. Subsequent research confirmed increasing health safety risks and despite the benefits estrogen could offer is reducing bone fractures and other benefits. The use of horse estrogen hormone or Menopause Hormone Therapy was virtually halted.
At the Magaziner Center for Wellness when suggesting hormone supplementation therapy we suggest the use of Bio-identical hormones. Bio-identical hormones are derived from plant sources (nor pregnant horse urine) and compounded precisely for each patient. These hormones have similar chemical structures as that the human body produces; not an altered or adulterated form as you’ll find in synthetic hormones. We place great emphasis on restoring your hormones back to levels associated with peak performance as gently and naturally as possible.
Estrogen can help with bone loss and reduce fracture risk in women
Conventional medicine is still trying to find that delicate balance of how to administer horse estrogen safely. Why? Because there are benefits. Here is a June 2020 study: (4)
“Menopausal hormone therapy is effective in preventing menopause-related bone loss and decreasing vertebral, non-vertebral and hip fracture risk. Menopausal hormone therapy contains estrogens that exert both antiosteoclastic (prevents bone breakdown) and osteoanabolic (regrows bone) effects. These effects are dose-dependent, as even ultra-low doses preserve or increase bone mineral density.
Hormone replacement therapy is the treatment of choice to preserve skeletal health in women with premature ovarian insufficiency and early menopause. Menopausal hormone therapy can be considered in women aged under 60 years or within 10 years since menopause as, in this population, benefits outweigh possible risks, such as breast cancer and cardiovascular events.” Again that is if you are using horse estrogens as the therapy.
At the Magaziner Center for Wellness, we do a complete analysis of dozens of hormones and metabolites, using blood and urine testing. If we find an imbalance, it can be corrected with natural remedies and/or bio-identical hormone replacement therapy, which has the same chemical structure as the human body produces, not an altered or adulterated form. Our treatments are gentle, natural and completely harmonized to the individual patient.
If you would like to explore more information, please contact our office so we can start a conversation with you.
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References
1 Weitzmann MN, Pacifici R. Estrogen deficiency and bone loss: an inflammatory tale. J Clin Invest. 2006 May;116(5):1186-94. doi: 10.1172/JCI28550. PMID: 16670759; PMCID: PMC1451218.
2 Stepan JJ, Hruskova H, Kverka M. Update on Menopausal Hormone Therapy for Fracture Prevention. Curr Osteoporos Rep. 2019 Dec;17(6):465-473. doi: 10.1007/s11914-019-00549-3. PMID: 31741221; PMCID: PMC6944675.
3 Anderson GL, Limacher M, Assaf AR, et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women’s Health Initiative randomized controlled trial. JAMA. 2004;291(14):1701-1712. doi:10.1001/jama.291.14.1701
4 Anagnostis P, Bosdou JK, Vaitsi K, Goulis DG, Lambrinoudaki I. Estrogen and bones after menopause: a reappraisal of data and future perspectives [published online ahead of print, 2020 Jun 9]. Hormones (Athens). 2020;10.1007/s42000-020-00218-6. doi:10.1007/s42000-020-00218-6
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