New York Times Highlights Necessity to Prevent Fractures

On November 7, 2008 the New York Times ran a story titled, Once Just an Aging Sign, Falls Merit Complex Care. This article highlights the dangers many people face with fractures as they age. I encourage everyone read this article and begin educating themselves about fragility fractures, which are fractures that occur as a result of fragile bones.

With the population aging rapidly, this issue will strain our healthcare system unless doctors and the general public embrace aggressive, preventative measures. There are two major factors that predispose people to fragility fractures. First, is bone health. The second is the risk of falls.

Currently bone health is only measured by a bone density scan, called a DEXA scan. DEXA scans, however, only measure the amount of minerals in bone, thus their "density." However, they do not measure bone quality. Yes, DEXA scans can be predictive of fracture risk, but relying only on bone mineral density is a grave mistake that literally can kill, because it alone does not predict well enough the risk for fractures. In fact, the World Health Organization (WHO) is recommending doctors and patients begin taking a more comprehensive view of osteoporosis, and move away from the narrow view of looking just at bone mineral density, to evaluating fracture risk as a whole.

As discussed in our article, Osteoporosis: Beyond Bone Mineral Density (Part 1), which was the cover article for the journal Integrative Medicine, 12-40% of the elderly who sustain a hip fracture die within six months. The cost for treating the more than 2 million osteoporotic fractures that occurred in 2005 was nearly $17 billion.

The standard of care for osteoporosis is drug therapy with medications such as Fosamax and Actonel. However, many people are unable to take these medications due to their side effects they can create, such as ulcers. And even if they were to take these medications, they decrease fracture risk by less than 50%.

Research now shows that the best way to reduce fracture risk is to take high doses of vitamin K2, along with supporting nutrients such as vitamin D and calcium. There have been many clinical trials using vitamin K2. So many, in fact, that the esteemed Archives of Internal Medicine published a review of all the clinical trials for osteoporosis that used vitamin K2. The researchers concluded that 45 mg of vitamin K2 (as MK-4) decreases the risk of vertebral fractures by 60%, hip fractures by 71% and all nonvertebral fractures by 81%.

The research on 45 mg daily of vitamin K2 (MK4) points to it being better than Fosamax without any of the Fosamax side effects. Additionally, evidence is accumulating that taking Fosamax for five years or more may actually increase your risk of fracture because Fosamax increases bone density without enhancing bone quality. Bone quality refers to the complex mixture of minerals and connective tissue that help bone absorb an impact from a fall without breaking. Vitamin K2 (MK-4), on the other hand, works by promoting formation of the connectivce tissue in bone, thereby allowing bone to better absorb the impact from a fall without breaking.

There are several different forms of vitamin K--K1, K2 and K3. And even within these forms, such as vitamin K2, there are different sub-forms (eg, vitamin K2 as MK-7 or MK-4). And readers must understand the only form and dose shown in clinical trials to reduce fracture risk is 45 mg of vitamin K2 as MK-4. When trying to promote bone health naturally, it's crucial that people only take dietary supplements with the amount and form of nutrients shown in clinical trials to protect them.

The only bone formula currently on the market that contains this amount of vitamin K2, plus calcium and vitamin D is Osteo-K, which I formulated with my partner, Dr. Steve Pieczenik, who has a MD from Cornell Medical College, a PhD from MIT, and who was a board examiner in both Neurology and Psychiatry. We created this product for two reasons. In searching for ways to help my patients in my clinic, Montana Integrative Medicine, I was unable to find a dietary supplement that contained the dose and form of nutrients shown in clinical trials to reduce fracture risk. We created this product also because Dr. Pieczenik's wife was unable to take Fosamax due to its side effects.

Some people ask if vitamin K2 increases clotting risk because they've heard that people taking blood thinners such as warfarin (eg, coumadin) shouldn't take extra vitamin K. Clinical trials that used vitamin K2 evaluated this question and showed no increase in the tendency to clot. However, people taking coumadin should absolutely not take extra vitamin K as a dietary supplement unless they speak with their healthcare provider first.

In addition to prescribing Osteo-K to my patients to help them prevent fractures, I also discuss other ways in which they can decrease their risk. A major factor for fractures is the risk for falling. The North American Menopasue Society (NAMS) has published very practical recommendations for decreasing this risk, which include ensuring optimal lighting, removing clutter and low-lying objects from the environment and providing non-skid rugs, among others. The complete table of recommendations can be viewed in our Osteoporosis patient handout, Preventing Osteoporosis and Modifying Fracture Risk, which accompanied our Osteoporosis: Beyond Bone Mineral Density (Part 1) article in the journal Integrative Medicine.

The bottom line is this: the best evidence-based medical research points to the powerful role vitamin K2 (MK-4) can play in reducing fractures. The only dietary supplement that contains the form and amount of this nutrient is Osteo-K.