THANKS FOR ASKING

Virginia Responds to Reader Questions

Bone Density Testing

Q: My wife and I read your article, More Drugs that can Cause Osteoporosis. My wife has read all your books with Dr. Lee and has a question about bone density testing. She read the density of bones is an inadequate indictor of fracture risk because it's the flexibility of the bones that matters more. Is it worth having the test (and the low level whole-body radiation exposure) if she is already taking progesterone and estriol cream, eating right and exercising? She would never take the drugs the doctors would push on her. So if she's already doing everything she would if she learned her bones were thinning, then why bother with the test? She's struggling with that question right now.

A: Bone elasticity is as much or more important than density in assessing bone strength. There's some fascinating new research on the subject which I’ll share in detail a future issue. The other problem with bone density tests is that they don't account for women with larger or smaller than normal bones—thus a petite woman with small bones will almost always show as having low bone density, and a large woman with large bones could measure normal even if she has osteoporosis. However, at the moment it's the best test we've got.

The key to a useful BMD test is to compare it to your previous tests. Ideally you would get a baseline test in your 40s and then retest it every 3 to 5 years after the age of 50, depending on your risk factors. Even if your first BMD test is later in life, you can use it for comparison in future tests. The BMD tests are also a hedge against unknown risk factors like heartburn drugs—if you’re seeing bone loss you can play detective and try to figure out what’s causing it.

Estriol doesn't seem to help too much with bones, but a wholesome diet, weight-bearing exercise and progesterone are a good foundation. Personally, I also get a saliva hormone level test once or twice a year, just to make sure my hormone balance is on track. Low progesterone, estradiol or testosterone, and chronically high cortisol, can contribute to excess bone loss.

The updated edition (2004) of What Your Doctor May Not Tell You about Menopause by Dr. John Lee and myself, has a very comprehensive and detailed chapter on osteoporosis that should be useful to anyone concerned about bone loss.

How to Find a Food-Based Supplement

Q: I so appreciate your latest newsletter on the benefit/detriment of using lots of supplements (When Good Vitamins are Bad). I am interested in switching to food-based supplements, but don't know how to get started.  Can you help guide me to various lines of supplements which could help?

A: Lots of people asked this question, and it’s a good one! One of the oldest and most trusted companies that makes food-based supplements is Standard Process (www.standardprocess.com). For example, they have a calcium supplement called Calcifood, made from defatted wheat (germ), veal bone, carrot (root), date (fruit), rice (bran), and peanut (bran). Standard Process doesn’t sell products on their website, but you can go there to find supplements of interest and then google the product name to find a website that does sell them.

Andrew Lessman has some high quality food-based supplements and his prices are very reasonable. (Google “Andrew Lessman vitamins” and it will take you to a Home Shopping Network page.) Twin Lab, a major vitamin brand found in most health food stores and even some supermarkets, has a line of food-based supplements, although I can’t vouch for their quality.

Some of the best food-based supplements are only available through health care professionals. You can call Naturopath Larry Permen, who I interviewed in this article, at 800-822-3712 to get his favorite food-based supplements and enzymes.

If you’re shopping on the internet or at your local health food store, be sure to read labels. For example, Rainbow Light has a product called Food-Based Calcium, but when you read the label the main ingredients are calcium carbonate and citrate, which is what we’re trying to avoid.

You can get a good concentrated dose of nutrition in vegetable juices. Not V-8 or other canned juices, but freshly juiced veggies. You can juice vegetables and fruits at home, but what usually happens is that you spend a lot of money on a juicer, juice everything in sight for a few weeks and then never use the juicer again because it’s labor intensive and messy. Your other option is to visit your local juice bar or health food store and let them clean up the mess. One of my favorite veggie juice combos is beets, celery and carrots, a sweet and nutritional concoction. You can also create veggie drinks that include protein powder (use whey-based not soy), nutritional yeast (for B vitamins) and yogurt (for the calcium and probiotics) and you’ve got a quick and nutritious meal. It’s important to also eat whole fresh vegetables because juicing leaves out the fiber, an important part of a healthy diet. Fruit juices are high in nutrition, but they’re also high in sugars, so drink in moderation.

Bottom line, your best source of nutrition is a variety of fresh, whole, organic food, but if you need a nutritional boost, add food-based supplements and vegetable juices.

Saliva Testing Compared to Blood Testing

Q: I’m a health care professional who doesn’t use saliva testing because it doesn’t correlate with blood tests, so I don’t believe it’s accurate. Please respond.

A: Saliva testing isn’t supposed to correlate with blood testing because they’re measuring two different parts of the blood. A blood test measures the watery or serum portion of the blood, while a saliva test measures the “free” or bioavailable hormones in the red blood cell portion of the blood. One of the reasons saliva testing works so well is that it measures the free hormones, which is what really matters when looking at hormone balance. If you read the article I recommended for health care professionals, The Bichemistry of Saliva Testing, Dr. John Lee explains these concepts in detail.