MAGNESIUM        

Magnesium is a fundamentally important macro mineral of the body and is required as a co-factor for the activities of hundreds of different enzymes, especially those involved in generating and using cell energy and maintaining the integrity of the intracellular environment. Therefore  no type of human cell can be in health if it is suffering from relative deficiency of magnesium. Bone cells are no exception and, furthermore, magnesium is a co-factor for the enzyme alkaline phosphatase, a particularly important enzyme in bone. The conversion of vitamin D to its active form also requires magnesium. Osteoporotic women have low whole body content of magnesium and low bone concentrations of the element. Low dietary magnesium is extremely common in both the UK and the US and several studies have shown that it is quite critical for bone health.

Magnesium deficiency in osteoporotic patients has been studied by Driessens F.C.M. et al (16) They used magnesium lactate and estimated the dose that would be required in osteoporotic patients to establish normal intracellular magnesium concentration. The required dose was between 660mg and 1,050mg per day, elemental. This then is a treatment dose. It is so far above the UK RNI for magnesium of 270- 300mg/day that osteoporotic patients, unless specifically directed, will rarely receive such an amount either by diet  or by supplements. It is possible to obtain such an amount of magnesium through diet, but it has to be a very special one. This explains, perhaps, why a few other studies, which used only low intakes of supplementary magnesium, produced only modest changes in the osteoporotic condition. However, all such studies are affected by the fact that only single nutrients are being used. It is not known for sure, but it seems inherently likely that these nutrients will usually be relatively more effective against osteoporosis at a given intake when used together than when used singly. Therefore, the therapeutic amount of magnesium for osteoporosis may not be so high if other minerals are given at the same time.

ZINC AND MANGANESE        

Zinc and manganese are necessary for bone formation and mineralization and this has been reconfirmed many times in work on small, developing, young animals. Like magnesium, zinc is a cofactor for some 200 enzymes within the living cells, and so is fundamental to healthy and balanced metabolism. It also increases vitamin D activity and promotes immune functions. When supplementing with zinc and manganese at higher doses and for long periods of time, it is necessary to also ingest copper, since high dose zinc reduces copper absorption and may produce copper deficiency. Several studies have also been undertaken in human subjects, both osteoporotic and otherwise. In particular, Strause, L. (17) reported a two-year study in non-osteoporotic late menopausal women fed a supplement containing Ca (Calcium), Mn (Manganese), Zn (Zinc), and Cu (Copper). These women gained 1.3% in bone mineral density. In contrast, a group that was only calcium supplemented lost 1.6% in bone mineral density. So much for the current widespread notion that calcium supplements alone are good for osteoporosis. Zinc supplement intakes generally advocated within alternative nutrition circles are from 10 to 25mg per day and for manganese from 5 to 15mg per day (elemental).

CHROMIUM          

The strong case for using chromium supplements in osteoporosis has been made already. 200-400 mcg per day can be used. The GTF form (Glucose Tolerance Factor form) should be used and this distinction is important.

COPPER      

Copper is thought to be involved in bone, both through its effects upon  the production of bone matrix and upon bone mineralization. The effect upon matrix formation occurs because copper is needed for the action of an enzyme called “lysyloxidase”. This enzyme is needed to give the correct properties to the main structural protein of the bone matrix, collagen. In particular it forms cross-linkages between the fibres of protein – such  an important aspect of bone strength. The adverse effects of copper deficiency on mineralization is thought to be through the impact of cellular deficiency within the cells which form new bone, called the osteoblasts.

Apart from the work of Strause, mentioned above, there is a shortage of human work on copper in osteoporosis. One of the most relevant pieces of animal work on copper is that by Yee, C.D. et al (18) They worked with rats deficient in oestrogen and suffering from bone loss, feeding them diets that were either copper deficient or copper enriched. The  bone loss was found to be rather  more severe when the diets were copper  deficient.  However,  replacing the dietary copper afterwards did not necessarily alleviate the extra bone loss induced by the copper deficiency. This is in accord with many other studies on osteoporosis, which often show that once bone loss has occurred, inducing the remineralization by reversal of the process is much more difficult. This puts quite a premium on to maintaining good intakes of the nutritional minerals throughout life, and specifically both pre and post menopause.

SILICON      

The non-metallic bulk mineral silicon is often available herbally in the form of plant extracts, such as from “horsetail”. However, one must depend upon foods and supplements for one’s main intake. Silicon aids calcium absorption into bone. Like copper it probably influences both matrix formation and mineralization. The appropriate dosage level has not been determined as yet. A study has been made by Eisinger, J (19) in which they showed that silicon had a significant effect upon the density of the femur bone of the upper leg. They used 50mg injections of an organic form of silicon, twice weekly for 4 months. Rather more has been done in animal work. For example, Hott, M et al, “Short Term Effects of Organic Silicon on Trabecular Bone in Mature Ovariectomised Rats”, found that 1.0mg/day of the organic silicon compound, silanol, increased the formation of new bone, mineralization and the number of bone-forming osteoblasts by 30%. These are rather strong indications that silicon is a significant supporting mineral for the maintenance of strong bones and, therefore, for prevention and/or treatment of osteoporosis.

FLUORIDE  

Fluoride has often been shown to help increase bone density. Black tea has 1 to 4 mg fluoride per cup. Fluoride supplementation is currently available only by prescription; excessive ingestion can harm bones and is toxic. Therefore the question of including it in nutritional supplements does not arise. In any case, some studies suggest that fluoride addition, which may be helpful in some cases, or in some parts of the body, may be unhelpful in others, so its use, even at modest levels, would probably not be wise.

ALUMINIUM          

This is a toxic metal which has been reported to aggravate the tendency towards osteoporosis, perhaps by stimulating the parathyroid glands to produce extra hormone, favouring bone resorption and loss. The main sources of unwanted extra aluminium intake are (a) use of aluminium cookware, and (b) antacid preparations obtained, usually on medical  prescription, for indigestion, containing aluminium hydroxide.