The years I’ve spent learning the medical business have made me respect how usually financial rules can permit one to know its advanced and contradictory conduct.
For instance, I consider most of the inconsistencies in medical ethics (e.g., “moms have an absolute proper to abort their youngsters” and “moms can not refuse to vaccinate their youngsters as a result of it endangers their baby’s life”) could be defined by merely acknowledging that no matter makes cash is deemed “moral.”
Gross sales Funnels
The gross sales funnel idea is essential to understanding the fashionable medical business. This technique entails initially concentrating on a broad viewers after which progressively narrowing right down to dearer services or products for the captured prospects. There are usually two overlapping gross sales funnels in drugs:
The primary funnel entails prescribing innocuous medication to many individuals after which promoting more and more costly prescription drugs to deal with issues. For instance, this usually happens with drugs given to ladies, resulting in dangerous penalties.
Notice: Sources for the above graph could be present in this text concerning the risks of SSRI antidepressants.1
The second funnel entails framing preventative drugs as screening people for potential well being dangers after which utilizing these outcomes to justify promoting medical providers like drug prescriptions. As these screenings turn into normalized, the business expands the vary of providers supplied, usually resulting in overdiagnosis and overtreatment. For example, tips for “protected” blood strain and levels of cholesterol have been repeatedly lowered,2 therefore placing extra folks on drugs.
Notice: The folly of this method is highlighted by a trial that discovered eradicating on common 2.8 non-essential medication from the aged at one facility triggered their 1-year demise price to go from 45% to 21%.3
DEXA Scams
One frequent method mass screenings are carried out is by giving many sufferers X-rays after which funneling these with irregular imaging into being handled. For instance, ladies over 50 get mammograms each two years to detect breast most cancers early. Nevertheless, research present these screenings usually lack general profit as a result of fast-growing cancers are often not caught early, whereas false positives are frequent and continuously result in dangerous therapies.
Notice: Many medical specialists rely on repeatedly performing the identical billable service (e.g., vaccinating a toddler, performing a feminine pelvic examination, or studying a mammogram).
One other frequent common screening follow for ladies is dual-energy X-ray absorptiometry (DEXA) scans, which measure bone density as an indicator of bone energy. The outcomes are in comparison with the common bone density of a 30-year-old, producing a T-score. Medical college students study {that a} T-score of 0 to -1 is regular, -1 to -2.5 signifies osteopenia, and -2.5 or worse signifies osteoporosis, prompting pressing remedy.
Nevertheless, contemplating pure age-related bone density loss, most people can have decrease bone density than a 30-year-old. Thus, the present method to managing osteoporosis acknowledges inevitable bone loss with age and focuses on prevention, as regaining bone density later in life is difficult.
How dependable are DEXA scans? Outcomes fluctuate considerably based mostly on machine, operator, and measured bones, with research exhibiting a 5% – 6% distinction4 in bone density. This variation can alter T-scores by 0.2 – 0.4, resulting in misdiagnoses of osteoporosis.
Is repeated scanning mandatory? A examine of 4124 older ladies5 discovered no further helpful data gained from repeating DEXA scans over 8 years. But, tips suggest scans each 1-2 years, with Medicare overlaying one each 2 years, regardless of prices starting from $150 to $300 per scan.
Do DEXA scans precisely predict fracture danger? Whereas typically predictive, research present discrepancies between scan outcomes6 and noticed bone energy underneath a microscope. Moreover, scans usually underestimate energy loss in intentionally weakened bones.
Notice: I just lately discovered from Dr. Mercola {that a} quicker and extra correct technique of diagnosing bone energy (which doesn’t expose sufferers to ionizing radiation) is starting for use in Europe.7 REMS expertise works by sending ultrasound waves8 into the bone after which analyzing the spectrum created to evaluate the well being of the bones.
As this presentation exhibits, it precisely predicts bone density, and moreover, predicts bone energy. In brief, this can be a dramatically superior method to Dexa scans, however it faces stiff resistance in america due to how closely invested many already are in performing Dexa scans. For these , extra data could be discovered at EchoLight’s web site.9
Notice: This remark was affirmed in an NPR article.10
Bisphosphonates
As soon as osteoporosis is recognized, the preliminary remedy usually entails beginning a bisphosphonate, which can proceed for 3-5 years relying on the administration technique. A wide range of elements affect the event of bone.
Two of an important ones are the cells that construct bone up (osteoblasts) and the cells that break bone down (osteoclasts). Bisphosphonates, (e.g., Fosamax or Actonel), focus in bones and inhibit osteoclasts,11 resulting in elevated bone density by shifting the steadiness in direction of bone constructing. Nevertheless, this method faces two main points:
• Bisphosphonates are related to quite a few unwanted effects,12 resembling abdomen irritation, extreme muscle and bone ache, flu-like signs, osteonecrosis of the jaw,13 uncommon hip fractures, atrial fibrillation, hypocalcemia, fatigue, and kidney issues. Remarkably, the American Dental Affiliation even cautioned its members14 to keep away from engaged on sufferers who’re taking bisphosphonates.
• Bisphosphonates disrupt the physique’s pure bone-building course of, ensuing within the preservation of “outdated bone” relatively than selling wholesome bone formation.
Notice: Along with the bisphosphonates, there are different problematic osteoporosis medication which additionally goal the osteoclasts.
Bone Reworking
One of many key adaptive processes within the physique is its response to stresses and hundreds positioned upon it. An often-overlooked marvel of the physique is its continuous reshaping of bones to bear hundreds optimally. Whereas we seldom take into consideration this course of, its significance turns into obvious in sure eventualities. Contemplate house journey: astronauts, disadvantaged of gravity’s weight alerts, expertise fast bone loss,15 posing critical fracture dangers upon returning to Earth.
On this bone-building ballet, osteoclasts play a vital but underappreciated function. They sculpt bones to face up to gravity’s calls for, however when blocked by medication like bisphosphonates, bones turn into denser but extra brittle and fewer versatile.
This underscores a standard problem in drugs: specializing in treating numbers (e.g., decreasing ldl cholesterol) assuming it equates to well being enchancment. Research usually assess advantages by worth modifications (e.g., vaccine-induced antibodies), overlooking precise affected person outcomes (e.g., in Pfizer’s COVID vaccine research,16 antibody manufacturing did not correlate with decreased deaths).
In brief, I might posit that whereas bisphosphonates could also be efficient at enhancing a DEXA rating, they aren’t essentially good at enhancing bone well being.
What Causes Osteoporosis?
Bone metabolism is intricately linked to numerous key physique processes, making it difficult to pinpoint the first determinants of bone well being. Nevertheless, a number of elements stand out:
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Mobility — Sedentary existence contribute to osteoporosis, highlighting the significance of weight-bearing actions in bone well being.17 Strolling is especially useful and if finished repeatedly all through life dramatically improves bone well being. |
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Hormones — In a earlier article, I mentioned the extreme risks of medication like Lupron which work by disabling the physique’s manufacturing of intercourse hormones. One of the crucial frequent unwanted effects noticed from them is a big weakening of the bones. In flip, hormonal loss accompanying getting old additionally weakens the bones. |
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Irritation — Continual inflammatory circumstances enhance the danger of osteoporosis by activating bone-dismantling processes.18 |
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Amino acids — Since one of the important parts of bone well being is the elasticity collagen imparts to them (as this enables bone to bend and yield to outdoors forces relatively than shattering) collagen well being is critically vital for bone well being. In trendy society, we are sometimes poor in these amino acids due to widespread abdomen acid deficiency19 (which impairs our potential to metabolize protein into amino acids) and us predominantly consuming softer cuts of meat which lack the collagen constructing amino acids present in more durable elements of meat (e.g., gristle). Notice: Colleagues resembling Dr. Mercola have discovered consuming 30g – 40g of collagen every day sourced from beef knee joints is an optimum amino acid repletion protocol and in a brief time frame considerably improves bone well being (together with usually enhancing a wide range of associated elements resembling one’s top and one’s metabolic well being). |
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Minerals — Dietary consumption of minerals resembling boron and manganese20 is essential for bone energy, and deficiencies can impair bone well being. Elements like abdomen acid deficiency21 and soil depletion contribute to mineral deficiencies. Notice: The widespread deficiency of manganese within the inhabitants is partly as a result of it being chelated from the soil by glyphosate (Roundup).22 Manganese serves an important function in constructing collagen, so when it’s poor, it continuously creates systemic ligamentous laxity,23 and in flip hypermobile sufferers resembling these with EDS (who are usually extremely delicate and prone to pharmaceutical accidents) discover a big enchancment of their ligamentous energy after a couple of months of appropriately dose manganese.24 |
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Water fluoridation — Whereas fluoride will increase bone density, it could compromise bone well being and performance. Some research hyperlink fluoride to osteomalacia and elevated fracture danger.25 |
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Pharmaceutical medication — Medicines like glucocorticoid steroids26 (e.g., prednisone) and opioids can weaken bones27 and enhance fracture danger. Notice: Glucocorticoid induced bone loss is so extreme it’s truly one of many few accredited indications for bisphosphonate remedy.28 |
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Environmental toxins — Publicity to toxins like organophosphates, bisphenol A, nicotine, and heavy metals inhibits bone formation and contributes to osteoporosis.29 |
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Parathyroid adenomas — These tumors trigger extreme secretion of parathyroid hormone, resulting in calcium depletion from bones, bone loss, and a spread of signs. Surprisingly, regardless of being a widely known situation, parathyroid adenomas are continuously missed. Figuring out persistently elevated blood calcium ranges can function a key indicator, prompting additional investigation right into a parathyroid adenomas. |
Notice: Chinese language Drugs has linked the age-related lack of the kidney’s vitality to bone loss for hundreds of years. Many attribute this to the kidneys essential function in regulating vitamin D and the blood ranges of the minerals bone consists of (e.g., calcium).
I believe their regulation of the physiologic zeta potential (the decline of which is a key reason behind getting old) can also be key. That’s as a result of zeta potential30 governs the tendency for blood to stream freely or clump collectively, and the arduous exterior bone blood vessels should move by makes them extra prone to their blood provide changing into interrupted (e.g., from the bone shifting misplaced).
Conclusion
It is fascinating to understand that bone is way over only a structural element; it is a dwelling tissue with its personal dynamic conduct. After I’ve had the chance to deal with bone instantly, resembling throughout orthopedic surgical procedures, it is evident how completely different it’s from the lifeless bones we usually encounter. Sadly, this expertise is uncommon, main many to see bone as inert and unchanging.
The factors I’ve mentioned on this article are based on the significance of recognizing bone’s vitality and understanding how our interactions with it form our well being and longevity. Historic medical traditions, like Chinese language drugs, appreciated this facet of bone well being. They noticed it as integral to general well-being, acknowledging its interconnectedness with the physique’s methods.
By embracing this attitude, we are able to acquire new insights into bone well being and its significance for holistic healthcare. It is my hope that this text sheds mild on the dynamic nature of bones and encourages a deeper understanding of their function in our well being journey.
Writer’s notice: That is an abridged model of an extended article on the topic which discusses the above factors in additional element and plenty of others resembling our different most popular approaches for enhancing bone well being. That article and its further references could be learn right here.
A Notice From Dr. Mercola Concerning the Writer
A Midwestern Physician (AMD) is a board-certified doctor within the Midwest and a longtime reader of Mercola.com. I respect his distinctive perception on a variety of matters and I am grateful to share them. I additionally respect his need to stay nameless as he’s nonetheless on the entrance strains treating sufferers. To seek out extra of AMD’s work, remember to try The Forgotten Aspect of Drugs on Substack.
