Danshen: Chinese medicine for strong bones

My vocabulary has a new word: danshen. That’s the name of an old herb, used in traditional Chinese medicine (TCM) for over two thousand years to treat such diverse issues as hypertension, stroke, angina, heart attacks, diabetes, chronic renal failure, and bone healing. The plant, also known as red sage, is the Asian cousin of the common sage in western kitchens.

I’ve never explored traditional Chinese medicine; however, I’m convinced that a nutritious diet from healthy soil must be our foundation for good health. And it’s clearly no accident that our food supply is enhanced by flavourful ingredients – like onion, garlic, ginger, chilli, and many herbs – that bring us significant healing benefits in small doses… like good medicines. So why shouldn’t some of the Chinese herbs – perhaps even all of them – be in that group? As a wise man said in Sirach 38:4, “The Lord created medicines from the earth, and a sensible person will not despise them.

I find it very exciting, then, when the pharmaceutical world takes cues from what grows in the soil, and that’s what this story is about. For awhile drug companies have tried to develop osteoporosis drugs that block an enzyme called Cathepsin K (CatK), because that enzyme has the effect of breaking down collagen to weaken our bones. But to date the clinical trials have failed because of disturbing side effects like stroke, skin fibrosis, and cardiovascular issues. Serious fails.

Researchers at the University of British Columbia guessed that the root problem was these drugs were blocking all the effects of CatK – both the bone disease-relevant functions as well as its benefits throughout the body. That’s why the side effects were so severe. So they extracted a compound from danshen that they found can block CatK only in bone tissue, while allowing it to work in other parts of the body.

So far, this danshen extract has just been tested in mice, but early results are excellent: the treated mice gained 35% bone density, compared with the control group, without the troubling issues that have stymied the drug companies.

OK, I’m not a mouse, and neither are you. It’s really your bones and mine that I’m concerned about. But this is a very promising development that points to good news ahead. In the meantime, if western medical researchers are interested in what the Chinese know, why shouldn’t I be? Maybe I should find out what danshen can do for my bones…the way the Chinese use it.

There’s an old expression: “You learn something new every day.” In my experience, that’s not universally true. There are dull days when nothing new comes along. There are also people who appear to have stopped exploring new ideas long ago. But my good days – the truly lovely ones – always feature learning something new. Today that is the word danshen, which is infused with hope and promise.

 

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Misplaced Calcium on the Brain

Why are so many people struggling with anxiety and depression these days – more than ever before? Among young adults in particular there seems to be an epidemic. Clearly, something’s changed in the last decade! A recent study by Dr. Martin Pall suggests that EMFs (electromagnetic fields) are causing neuropsychiatric effects, producing these symptoms and others. And the increase in incidence coincides with the rise of smartphones, smart meters, and home WIFI – all potent household sources of EMFs.

I stumbled on the Pall study as I waited – smartphone in hand – to meet a young friend in a café. I couldn’t wait to tell her about it; I know that anxiety stalks her, despite careful attention to her diet and nutrients. I’ve long puzzled over the missing piece in her health story. When I blurted out the study results, she quickly made the connection with her initial experience of anxiety around nine years ago, when she was in her mid teens, and its meteoric increase over recent years after she got her first smartphone with a data plan. Today, her ever-present smartphone supplies her music, media, communication link, study assistant, entertainment, alarm clock, and boredom buster. It’s what she turns to for support during anxiety assaults. (Seeing the battery level drop even triggers anxiety!) Like many, she sleeps with it beside her in bed, and she lives, studies, and works bombarded by WIFI.

Martin Pall’s study explains the mechanism by which EMFs produce histological and functional changes in our central and peripheral nervous systems. And here’s the link to our bones: EMFs act on the voltage sensors of the brain’s voltage gated calcium channels (VGCCs), which are in charge of releasing neurotransmitters and neuroendocrine hormones. Intracellular calcium increases, causing widespread disruption of chemical balance, leading to faulty signals.

We don’t want excessive intracellular calcium in our brains! We want our calcium to settle decisively in our bones. And of course we all want to enjoy good mental health. Because of our genetic uniqueness, EMFs affect some of us more acutely than others, which explains why we don’t all experience depression or anxiety at the same level of exposure. Yet, it’s quite likely that there are still brain effects at the cellular level for the rest of us, and quite possibly an impact on our bones.

So what’s to be done to restore some balance? It’s too late to put the WIFI genie back in the bottle. But here are some steps we can all take:

  • Test your nutrient status. The very nutrients that affect calcium utilization are key in managing EMF sensitivity. These are vitamin D, magnesium, boron, and vitamin K2. All are vital for bone health. If you need more than your diet can supply, take some as supplements.
  • Put some distance between yourself and your smartphone. It’s become a vital communication link, but it doesn’t have to be on your body at all times. Leave it a few feet away, rather than in your pocket, while you’re not actively using it. Find a charging spot away from your bedroom at night.
  • Look to old ways for new habits. Remember when we used to read books? Waken to alarm clocks? Watch movies on TV? Speak face-to-face?
  • Turn off your household WIFI at night. Even small steps can reduce your exposure.

Bone Weary

Bad sleep? I understand. For many years my typical night was really a series of short naps, with lots of thinking time in between. I welcomed the morning light, not because I felt rested, but so I could call an end to the futility of trying to sleep. My days were foggy, my head ached, my immune system was low, and the irritating people around me thought I was the grumpy one! I really understand the disability of poor sleep.

Dr. Stasha Gominak is an American neurologist whose practice developed around poor sleepers like I was. In the course of treating chronic pain, she discovered that for most of her patients the root cause of their pain would heal if they could sleep well. Although her starting point to improve their nights was sleep apnea machines and sleeping drugs, she found that optimal healing only followed when she could restore natural sleep – which means the right amounts of time in the proper cycles, without drugs or breathing aids. How did she accomplish that?

First, she identified, to her surprise, that all her patients with abnormal sleep were deficient in vitamin D. She discovered that by raising their vitamin D levels she improved their sleep. What’s not to love about a vitamin that helps us sleep?

Her patients didn’t heal right away, though. Then she found the next missing piece: these same patients were also deficient in B vitamins! What was the link to vitamin D? It turns out that the healthy bacteria in our intestines rely on vitamin D in order to make the B vitamins we need. Not enough D? We run out of the B family, and end up with a secondary B deficiency.

What do B vitamins do? The family of B vitamins are needed throughout the body, acting as cofactors for countless metabolic and neurologic processes. They’re essential for the widespread repair work that is supposed to happen while we sleep. We need good D levels in order to sleep deeply, but we need the B family to heal. The more our bodies are affected by inflammation and disease, the more support we need from B vitamins. Not enough B vitamins? Our bodies will succumb to pain, autoimmune conditions, and even mental decline.

Which brings me to osteoporosis. As I’ve written before, we must have optimal D levels in order to properly mineralize our bones. In fact, Dr. Gominak calls osteoporosis a vitamin D deficiency state! Calcium and magnesium, along with the other minerals, won’t settle into their proper places without the support of vitamin D. But a shortage of B vitamins will throw off the delicate dance of the osteoclasts and osteoblasts – cells that clean away old bone while building new bone – and our bones won’t be able to maintain or repair. There really is a scientific explanation to feeling tired right to the bone.

As I’ve described in earlier posts, I made some major nutritional changes in response to my osteoporosis diagnosis. These included raising my vitamin B and D levels, as well as eliminating foods that inhibited my nutrient absorptions. I expected my bones to fare better, but it was an incredible surprise and blessing when I found I was also sleeping well – every night!

So following the cues from Dr. Gominak – and countless other researchers – have a blood test to check your vitamin D level. If your level is low, you can take steps to raise it into a healthy range with a combination of supplements and safe sun exposure. That should improve your sleep. Next, consider taking a vitamin B complex supplement. Your whole body will thank you.

In Defense of Vitamin A

In the bone health world, vitamin A has a bad reputation. Some studies have suggested that it’s toxic to bones because it increases the activity of the osteoclasts. These are the cells that do the important work of cleaning away old bone. If they get carried away, though, there can be a net loss of bone if they outpace the osteoblasts that are working to build new bone.

But recent research has found that this isn’t actually the fault of vitamin A itself, but of a failed partnership. If there’s a shortage of vitamin D or vitamin K2, then A can’t do its job properly; the three fat-soluble nutrients are meant to work together for bone care. If we absorb too much of one of them, that creates a corresponding need for more of the others. Since a huge percentage of people are deficient in both D and K2, this means that for the bones of some people, taking preformed vitamin A can be detrimental.

Too little vitamin A, though, is also a problem. A deficiency can also cause bone loss, as well as impaired vision, dry eyes, and a pre-disposition to a host of diseases, including cancer. The key is having good nutritional balance.

As for my story, I was able to bring my vitamin D level into a healthy range with supplements. Check. And I added vitamin K2 to my diet by eating natto three times a week. Check. My vitamin A, though, persistently tested low, even though I eat a lot of foods with beta-carotene, which is supposed to convert to vitamin A. What was that about? Why couldn’t I raise my level of vitamin A?

It turns out that many people can’t process beta-carotene much or at all, for a variety of reasons. For some, the problem is a diet lacking the healthy fats needed to stimulate absorption. For others, it may be that they drink too much alcohol, or that they have inadequate bile flow. Or their gut ecology may be out of balance, perhaps because of low stomach acid levels, celiac disease, or parasites. And to complicate the issue, a large percentage of the population were just born with a genetic variation that prevents them from absorbing beta-carotene or converting it into the active form.

So what can we do to get enough vitamin A in our systems? First, get tested to determine whether you’re in the majority who need some more. If you are, then make sure you eat plenty of retinol foods. The top of this list is cod liver. The second, third, and fourth options are other kinds of liver. If this makes you shudder, then you may benefit from taking preformed vitamin A, or retinol, as a supplement. It often comes in tiny capsules made from cod liver oil, but you won’t taste a thing. It’s also available in dry tablets. But since vitamins A, D, and K2 are fat-soluble, which means they can build up in our tissues, it’s important not to overdo them.

And here’s a side note if you’re hoping to see your hundredth birthday: vitamin A sufficiency is now recognized as a key contributing factor to longevity.

Keep Those Facts Coming!

A fascinating new study in Aging reaffirms the benefits of appropriate micronutrients on bone density. In this one-year double-blind study, test subjects were given a combination of melatonin, strontium citrate, vitamin D3, and vitamin K2, then compared with a random group that received a placebo. Bone density, bone marker turnover, and health-related quality of life were compared at the start, six months through, and after 12 months.

Compared to the placebo group whose bones lost density, those who took the nutrient combination experienced significant bone density increases (4.3% at the lumbar spine), declines of bone turnover, and better mood and sleep.

What were they taking each day?

  • 5 mg melatonin
  • 450 mg strontium citrate
  • 2000 IU vitamin D3
  • 60 mcg vitamin K2 (MK7 form)

Previous studies referenced in the paper have shown bone benefits from all of these nutrients, although this is the first study that has combined them. Rather than uncomfortable side effects, those who took the micronutrients saw their quality of life improve.

How does this compare to the 2012 COMB study? Well, COMB didn’t include any melatonin, which generally helps with sleep. The same amount of vitamin D was used, but more strontium citrate (680 mg) and more vitamin K2 (100 mcg) in COMB. As well, COMB subjects consumed DHA and magnesium, and their bones improved even more: 6% at the lumbar spine. Here’s more about that research.

The new study used a statistically significant but much smaller test group (20 vs 114), made up of postmenopausal women with osteopenia, whereas the COMB study subjects began with worse density – already in the osteoporosis range.

My personal response to this? I will keep going with the approach I’ve committed to: my own combination of micronutrients along with a healthy diet and lifestyle. My bones are with me for the long haul!

Take Two on K2

When I posted previously about Vitamin K2 I knew enough to say that if we’re not eating natto, we all need a K2 supplement. But how much? What kind? I really didn’t know.

A few months later an exciting new book caught my eye: Vitamin K2 and the Calcium Paradox: How a Little-Known Vitamin Could Save Your Life, by Canadian naturopath Dr. Kate Rheaume-Bleue.

The apparent contradiction the title’s referring to is that a calcium deficiency in the bones often exists at the same time there’s a calcium excess in the arteries of the same people, as osteoporosis and heart disease frequently show up together. There’s really the right amount of calcium, it’s just in the wrong places. The incidence of both these conditions has increased dramatically in the past century. What’s going wrong, and what’s changed?

Rheaume-Bleue points to a deficiency in Vitamin K2 in our modern diet. K2 is very different from the K1 that’s known for clotting. The function of Vitamin K2 is to move calcium around the body, guiding it into the bones and teeth where it belongs, and out of our arteries, where it causes problems.

What does K2 deficiency look like? Osteoporosis, heart disease, cancer, diabetes, varicose veins, wrinkled skin, dental cavities, Crohn’s disease, kidney disease, narrow crowded dental arch, alzheimer’s, arthritis, MS, infertility – all these and more point to a K2 deficiency. And the author goes on to conclude that essentially everyone who eats a standard North American diet is deficient; how the deficiency manifests is the only question.

So what’s changed to cause such a widespread shortage? It was largely the shift from pasture-feeding to grain-feeding animals that happened in the middle of the last century. Until then, farm animals grazed on grasses that were high in Vitamin K1, which they converted to K2 for us, and we then consumed. We can get our own K1 from greens, so a deficiency of K1 is rare in humans, as long as they eat vegetables; but our bodies don’t effectively convert it to K2. Our best sources of Vitamin K2 used to be meat, eggs, and butter from pasture fed animals, but now most animals eat grain, so they are deficient and so are we.

If you’ve ever come across the work of Dr. Weston Price – he was a dentist in the early 20th century who studied the diets of isolated primitive cultures – he identified an ingredient that he named “Activator X” that was responsible for keeping people in those cultures healthy until they left their traditional ways and adopted processed diets. That ingredient is now known as Vitamin K2.

So if you think you’re deficient in Vitamin K2, what can be done? The high road would be to source all your meat, eggs, and butter from pasture-raised animals, thus eating the way our ancestors did. That may be outside your budget.

There is one more food option, the traditional Japanese superfood called natto made of fermented soybeans. In the eastern part of Japan where it’s commonly eaten the incidence of hip fractures is much lower than in the rest of the country, pointing to natto’s major impact on K2 supply. Unfortunately, though, not everyone can get used to natto. It has a strong smell that has been likened to gym bags, and a stringy slimy texture that some people call mucousy.  It’s actually not hard to make – it cultures something like yogurt, with a particular inoculant. I learned to eat it to be polite when I lived in Japan. There it’s said to be the one food a foreigner can never love, and I don’t love it; but I make it and eat it.

If trying new foods with foul smells and disturbing textures is not for you, then Dr. Kate Rheaume-Bleue strongly recommends a Vitamin K2 supplement. It turns out there are two main forms of K2, which are abbreviated MK4 (menatetrenone) and MK7 (menaquinone). MK4 is the form in meat sources, and its supplements are synthesized from a tobacco extract. MK7 is extracted from natto, the soybean food. If you’re sensitive to soy, you won’t want to take MK7.

Here’s where it’s particularly helpful that the author’s Canadian: She explains a dose discrepancy that I hadn’t been able to resolve between studies I’ve read and what’s on the shelves of stores. It seems that Health Canada doesn’t know there is a Vitamin K2, so the limit they’ve put on Vitamin K1 supplements – 120 mcg per dose – also applies to Vitamin K2 sold in Canada. This works quite well if you’re taking the MK7 form, as 120 mcg is an effective daily dose according to many studies. But with MK4, it would take about 38 of the legal Canadian dose pills per day to have a measurable impact on our bodies. The price alone is prohibitive. For those who are sensitive to soy, MK4 is the only form you’ll be able to tolerate, so it might be worth a drive across the border to where you can buy MK4 in therapeutic doses at a reasonable price.

There are some other potential issues with MK7 that the author doesn’t identify. Some people develop heart palpitations when they take it. Personally, I stopped sleeping well after taking it for a while, and the problem went away when I gave up the supplement. Natto doesn’t seem to bother me, though. Of course, as with all these things, your experience may be very different from mine.

The book contains a wealth more information on the interactions between nutrients.  The author firmly believes, as I do, that no one nutrient can solve all our problems, and that supplements can’t take the place of a healthy diet and lifestyle. She devotes a fair bit of time to discussing the interaction between Vitamin D, Vitamin A, and Vitamin K2, as none of these fat-soluble vitamins can work if there’s a shortage of one of the others. She also has sections on magnesium and Vitamin E.

For me, my particular interest in Vitamin K2 has to do with turning around osteoporosis, but my family line is riddled with the other conditions that are linked to a K2 deficiency. I’d started taking a lot more Vitamin D for the sake of my bones, but it’s very helpful to know that all this extra D is useless with inadequate K2.

The author presents an enticing statistic, in case you still need convincing: She quotes studies that showed a 50% reduction in arterial plaque after only six weeks of taking Vitamin K2 as menaquinone (MK7). That’s impressive! Also, she says that K2 supplementation seems to reduce hip fracture rates more than increases in bone density can explain. That is, it appears to improve the strength or flexibility of bones.

You don’t have to have osteoporosis or heart disease to learn something useful from this book. I suggest you read the book. But if you aren’t going to do that, then buy some Vitamin K2 and start taking it.

I passed the test!

First, I should apologize for the long gap between posts. My writing time has been absorbed into 1400 square feet of gardening bliss, which legitimately counts as bone-building activity. But now that we’ve had our first heavy frost, I’m down to a couple of short rows of greens under covers, and it’s time to get back to my desk.
It’s also time to announce that my bones passed their big test – the one that really counts: They held together beautifully when I had a bad fall. The scene was the garden, and the accident involved me recklessly trying to move an oscillating sprinkler while outrunning it to stay dry. I scrambled onto the half-meter high stile to get over a fence, but when my wet feet met the slick top step I crashed down – very hard – my entire weight on my hip onto the packed path. There I lay, stunned and wetter, but suddenly very excited: Nothing broke!!!  I wore a mammoth bruise for a long time, yet wasn’t even stiff the next day. Despite my doctor’s dire warnings, and the High Risk of Fracture on my chart, my bones were able to do their job and absorb the impact.
Now, a year after my bone density T-score of -4, I can reflect on the approach I’ve taken, as my bones seem to be serving me well:
  • Exercise: I changed my gym workout, now choosing the treadmill over an elliptical trainer. This causes more impact to my bones, which should challenge them to grow stronger. I’ve continued using weight machines to work my lower body, but now choose free weights for upper body work, and do those exercises standing up so my spine can carry the extra weight. On days I don’t get to the gym I go for a brisk walk. Keep moving.
  • Supplements: I added strontium citrate (680 mg per day), Vitamin K2 (100 mcg per day of the MK7 or menaquinone form), silica, and 3 mg per day of boron. I was already taking B complex, a balanced mineral supplement, fish oil, magnesium, Vitamin D, and Vitamin C.
  • Diet: I gave up most dairy products. Yup, to improve my bones I stopped drinking milk. I found out through testing that I’m sensitive to milk (not that I noticed any symptoms) which means it would have tended to cause inflammation, and that is bad for bone health. Also, dairy products metabolize to form acidic residue, which increases bone loss. I get my calcium from leafy greens, nuts, and salmon, with about 600 mg per day from a supplement. (The 1500 mg per day supplement my doctor recommended is way too much!) I put more emphasis on making and drinking mineral-rich bone broths. I already ate a lot of vegetables, and that hasn’t changed. I had already given up gluten, and any foods that contain it. Since lower body weight is one of the major risk factors for osteoporosis, I gave myself permission to abandon my life-long pursuit of weighing a little less. That must have been effective, as I have gained about 3 kg, and mostly feel fine with that :).
  • Reading: I devoured some excellent books that helped form my understanding. My favourites are Your Bones by Lara Pizzorno, The Whole Body Approach to Osteoporosis by R. Keith McCormick, The Myth of Osteoporosis by Gillian Sanson, and Vitamin K2 and the Calcium Paradox by Kate Rheaume-Bleue.
  • Support: I joined an online community of people who share what they’re learning about osteoporosis. I also continue to meet with a local Health Pursuits Reading/Study Group where lots of wise people have spurred me on with their insights into natural approaches.
  • Drugs: I have not taken any. I don’t plan to take any. Since I haven’t needed to return to my nice well-meaning doctor who told me I had no choice but to take Actonel, she doesn’t know. I have a choice, and I’m exercising it by venturing into realms that are beyond her training.
  • Followup bone density test: Although I was told I would get an automatic recall, that hasn’t happened. I considered initiating the appointment  myself, but then wondered: What would I do differently if I got a worse test result? I’m already doing everything I know how to improve my bones. Since I’m very numbers-oriented, I know I’d obsess over the new scores, way beyond their accuracy or their ability to predict fractures. So I’ve let it go, and I’ve stopped having bad dreams in which I’m about to get my retest scores. One day, if the test centre calls, I’ll go for a repeat test. But I am more than a test score.
Still, I made a note to myself to avoid risky activities like outrunning sprinklers in wet obstacle courses. Instead I should focus on developing true superpowers that will allow me to leap over garden stiles in a single bound.