Archive | March 2017

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.

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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!