Bone Health

Most of us are avid TV watchers, so I'm sure we are all familiar with the many ads drug companies generate to promote a healthier lifestyle. Let's face it, as we get older, our bodies may need some help. There are weight loss, smoking cessation, asthma, impotency, and heartburn drugs. Today we will focus on bone mineralization. Often we have seen actress Sally Field on the commercial explaining how she takes her Boniva tablet once a month to maintain healthy bones. Because there are so many bones in the feet, Podiatrists are especially interested in maintaining patient's healthy bone. In this article, we will go over bone mineral homeostasis - the process of maintaining a constant healthy bone.

There are two major components that are important to bone composition; calcium and phosphate. These must be maintained in order for a person to have healthy bones. One could think of calcium and phosphate as being cars, and the drivers of the cars would be Vitamin D and parathyroid hormone (PTH). These are the main regulators of making sure that bone mineralization stays regular.

PTH and Vitamin D regulate bone mineralization and affect the body in different ways. PTH's main goal is to increase calcium and decrease phosphate. PTH has three destinations; bone, kidney, and intestine. In the bone, PTH is responsible for a process which we call osteolysis. Osteolysis is where calcium is pulled from the blood and put into the fluid around the bone, the extra cellular fluid (ECF).

In the kidney, PTH is going to stimulate the kidney to increase absorption of calcium and magnesium and decrease the phosphate reabsorption. The intestine is indirectly affected by increased absorption of calcium and phosphate.

Vitamin D on the other hand has quite different functions. Vitamin D would be the primary regulator of bone mineralization. You see, vitamin D is what we would call the "front man", it doesn't do the actual work. The liver and kidney make vitamin D into its active form called calcitrol. Vitamin D likes to go the same places as PTH; bone, kidney, and intestine. In the bone it's going to increase bone formation by increasing calcium and phosphate resorption.

Vitamin D in the kidney is responsible for decreased calcium and phosphate excretion. Increases in absorption of calcium and phosphate also take place in the intestine.

Now that was a lot to take in - or out. Maybe you would be more familiar with the term osteoporosis.

This is the gradual loss of bone mass to the point that the skeleton is compromised. Osteoporosis mainly affects older women who have decreased calcium intake. It would be ainteresting to note that the daily calcium intake for women older than 65 years should be 1500mg. If you enjoy dairy products, shellfish, green leafy vegetables, and tofu, then you have daily added calcium intake.

A popular pharmaceutical calcium therapy is the popular drug Boniva. Boniva is a calcium supplement that can be taken as a daily tablet, once a month tablet, or an injectible which is taken every 3 months.

The key to healthy bones in the body and longevity is to ensure that calcium levels are met.

By allowing a healthy lifestyle, bone mineralization homeostasis can be achieved and maintained.

If you are experiencing any of the symptoms addressed, we strongly recommend that you seek the advice of your podiatrist for proper diagnosis.