What does inflammation have to do with osteoporosis?
Article Type: Clinical report
Subject: Chronic pain (Care and treatment)
Chronic pain (Case studies)
Osteoporosis (Development and progression)
Osteoporosis (Care and treatment)
Osteoporosis (Risk factors)
Inflammation (Complications and side effects)
Inflammation (Case studies)
Anti-inflammatory diet (Health aspects)
Anti-inflammatory diet (Patient outcomes)
Author: Chen, Julie T.
Pub Date: 04/01/2012
Publication: Name: Townsend Letter Publisher: The Townsend Letter Group Audience: General; Professional Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2012 The Townsend Letter Group ISSN: 1940-5464
Issue: Date: April, 2012 Source Issue: 345
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 286257229
Full Text: Recently, I had a patient with osteoporosis whose bone density study showed a dramatic 5% improvement over the course of a year, purely based on improving her inflammatory status by providing her body with the fundamental building blocks that it needed to function optimally. She initially came to see me for treatment of thyroid disease and chronic pain. Since her thyroid disease was autoimmune in nature and she has chronic pain, a main focus of treatment was to decrease the inflammatory status in her body.

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By using supplements and an anti-inflammatory diet over the year we were able to decrease her level of migraines, chronic pain, and IBS symptoms, and significantly improve her bone density.

Throughout that year, we worked on rebuilding her body's innate supply of vitamins and minerals necessary for ideal physiological functioning.

The goal of this was to optimize the body's ability to naturally heal when given the foundational tools to do so. Most people are not thinking of these vitamins and minerals in our bodies as such, but it is crucial to do so. My clinical experience has shown me that, when provided with what it needs, the body's ability to heal frequently surpasses clinical expectations as to what it is able to do. The 5% improvement in bone density was much better than we had anticipated, yet that's what her body was capable of doing when given the right tools.

Let's discuss her treatment course to evaluate the important key points about her treatment that led her to improved overall health.

She is a 43-year-old woman* with a history of Graves' disease, chronic migraines, chronic pain in low back, and osteoporosis. She first came to see me to help her with her chronic pain, thyroid disease, and overall fatigue. During her first visit, she also informed me that she had osteoporosis and gave me a copy of her bone density study from the year before. Her medications had not changed since that study and she did not anticipate that they would.

We obtained labs on her and saw that she was deficient in many vitamin and mineral levels, that she had mild adrenal fatigue, and that her thyroid levels were stable on her methimazole at the time. She was placed on numerous synergistically functioning anti-inflammatory supplements, including but not limited to fish oil, curcumin with bioperine, ginger root, probiotic, fiber, boswellia, increased dosage of D3, B12, folate, free form amino acid powder, DGL, and other vitamins, minerals, and herbs.

These supplements were chosen based on laboratory findings as well as her clinical history with the goal of replacing fundamental building blocks up to the point of sufficiency and not beyond, as well as providing anti-inflammatory support via supplements and food. We delved into her diet to fine-tune her intake, such that her nutritional intake would work as medicine to help achieve a less inflamed body.

Our initial intention was to potentially do acupuncture at regular intervals to dispel liver heat as well as tonify jing. However, she did so well on just the nutritional and supplemental regimen that she did not need acupuncture. This was important because her health insurance did not have acupuncture coverage and my goal of treatment in my clinic is to keep the treatment regimens as affordable, feasible, and sustainable as possible for the patients.

We also addressed the impact of stress on the body since she has a low level of anxiety on a daily basis. Some of the mind-body techniques that helped her de-stress and calm her body were breath work, self-hypnosis, and joumaling. She tapped into her social support network for discussions about her worries when they arose so that she could have that cathartic experience with her trusted friends.

As we allowed her body to "brew" on this supplemental and nutritional regimen, all the while decreasing the exposure of stress on her body, she slowly noticed multiple aspects of her health improve. She noticed that her energy level improved, the dosage of methimazole needed to control her thyroid level was able to be titrated down, her migraines lessened, and chronic pain issues improved. But the piece de resistance that none of us had anticipated, including her rheumatologist, was that her bone density study showed a 5% improvement without any other medication change.

This is a great example of a patient where treatment of inflammation as a whole in the body may allow us to obtain much greater health benefits, well beyond our initial treatment goals. I frequently explain to my patients that the body's ability to heal far exceeds our expectations. When given the right tools and the right balanced physiological environment our bodies are naturally created in a way to heal every aspect that is off within them.

The importance of this patient's story is that chronic inflammation in the body has far-reaching negative impacts, even more than we realize. And based on scientific findings, we know that inflammation affects a broad spectrum of disease states, including but not limited to neurodegenerative disease, autoimmunity, osteoporosis, hormonal imbalance, chronic pain, and chronic fatigue. So, it behooves us to always look for ways to live an anti-inflammatory lifestyle as much as possible to help keep disease at bay.

So, even though my goal wasn't initially to obtain such dramatic improvements in this patient's bone density, her body knew how to do it anyway without any specific instructions. All that I had to do was provide her body with the optimal environment for healing, by decreasing the level of inflammation, and her body's natural healing ability did its job beautifully on its own ... much more efficiently than any of us could have ever imagined.

* Patient background information was slightly altered to protect patient confidentiality.

Reference

Armour KJ, Armour KE, et al. Activation of the inducible nitric oxide synthase pathway contributes to inflammation-induced osteoporosis by suppressing bone formation and causing osteoblast apoptosis. Arthritic Rheum. December 2001; 44(12):2790-2796.

by Julie T. Chen, MD www.makinghealthyez.com

Julie T. Chen, MD, is board-certified in internal medicine and is also fellowship-trained and board-certified in integrative medicine. She has her own medical practice in San Jose, California; is the medical director of corporation wellness at several Silicon Valley-based corporations; is on several medical expert panels of websites as well as nonprofit organizations; is a recurring monthly columnist for several national magazines; and has been featured in radio, newspaper, and magazine interviews. She incorporates healing modalities into her practice, including but not limited to medical acupuncture, Chinese scalp acupuncture, clinical hypnotherapy, strain-counterstrain osteopathic manipulations, and biofeedback.
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