Antibiotics disrupt gut bacteria, impact bone health

A new study about the side effects of antibiotic treatment reveals that it may dysregulate post pubertal skeletal development by interfering with gut bacteria.

The trillions of bacteria living in our bodies are crucial for our health. They support the gastrointestinal and immune systems. They also help the body absorb nutrients from foods and supplements. People often call the "good" bacteria within us "commensal," because they live together in harmony without causing any harm. However, we often treat the "bad" microbes that cause disease using antibiotics.

Some researchers from the Medical University of South Carolina (MUSC) in Charleston specialize in osteoimmunology, the "interface of the skeletal and immune systems." The scientists analyzed the impact of antibiotics on post pubertal skeletal development and published their results in The American Journal of Pathology. The study demonstrated that antibiotic disruption of the gut microbiota causes a proinflammatory response that may lead to less bone resorption, a process by which osteoclasts, or large bone cells, release the minerals and transfer them to the blood.

According to Chad M. Novince, Ph.D. — who studies the link between microbiome and skeletal health — the study "introduces antibiotics as a critical exogenous modulator of gut microbiota osteoimmune response during post pubertal skeletal development."

The post pubertal phase of development supports the accumulation of about 40 percent of peak bone mass. Previous research by Novince and team had already shown that the gut
microbiota contributes to skeletal health.

Vitamin A supplements could harm bone health

Vitamin A is a vital nutrient that supports the body’s development and strengthens the immune system. Because our bodies do not naturally produce vitamin A, some choose to take supplements. However, too much vitamin A is likely to harm bone health, researchers warn.

Normally, we derive vitamin A form the food we eat, such as carrots, sweet potatoes, beef liver, salmon, and several dairy products. How much vitamin A someone needs depends on their age, as well as other factors. The National Institutes of Health (NIH) state that the ideal daily intake of vitamin A is 900 micrograms retinol activity equivalents for men and 700 mcg RAE for women aged 19-50.

Over time, supplementation of vitamin A might lead to an overload of this nutrient, which can actually increase a person’s risk of experiencing bone fractures. Researchers from the Sahlgrenska Academy at the University of Gothenburg in Sweden reported in the Journal of Endocrinology that taking too much vitamin A can make bones “thin out,” thereby putting them at risk of fracturing easy.

Dr. Ulf Lerner and team administered doses of vitamin A the equivalent of 4.5-13 times the RDA for humans – for 1, 4, or 10 weeks. The scientists saw that after only 8 days of oversupplementation, the mice’s bone thickness had started to decrease. Over 10 weeks, the rodents’ bones became increasingly fragile and prone to fracturing.

High-Impact Exercise Strengthens Men’s Bones

Men who engage in high-impact physical activity and resistance training as teens and young adults are likely to have greater bone density by middle age, according to new research.

Over time, high-impact activities – such as tennis and jogging – help boost bone mass in the hip and lumbar spine, the researchers said. Greater bone mass can help stave off the bone –thinning disease known as osteoporosis.
“While osteoporosis is commonly associated with only postmenopausal women, it is, in fact, a serious issue for men as well,” said study author Pamela Hinton. She is an associate professor in the department of nutrition and exercise physiology at the University of Missouri-Columbia College of Human Environmental Sciences.

“Indeed, research has shown that the consequences of osteoporosis can be much worse for men, as they are less likely to be diagnosed and are at a greater mortality risk from fracture that occur as a result of a fall,” Hinton explained in a university news release.

For the study, Hinton’s team analyzed medical data compiled on 203 men aged 30 to 65. The participants had various levels of experience with sports and exercise, and engaged in different types of activities.

The men who engaged in bone-loading or weight-bearing exercise as teenagers had more bone density later in life, the investigators found. High-impact activities, in particular, were important for bone health throughout men’s lives, according to the report published recently in the American Journal of Men’s Health.

“The most important take-away is that if you are healthy, it is never too late to begin high-impact activities or resistance training to improve bone mineral density,” Hinton said.

Almost 1 in 5 Americans Plagued by Constant Pain

The poll of roughly 35,000 American households reveals almost one-fifth of Americans experience daily crippling, chronic pain according to a new report published in the October issue of the Journal of Pain.

“I wasn’t particularly surprised by our findings,” said study author Jae Kennedy, a professor of health policy and administration at Washington State University in Spokane. “But I found it sobering that so many American adults are grappling with persistent pain.”

The study authors analyzed responses to a 2010 National Center for Health Statistics survey. Those who said they had experienced serious continual pain during the prior three months were the focus of the poll, rather than participants who said they had experienced short-term pain or pain that was intermittent or moderate in nature. Overall, 19 percent of the adults polled were deemed to have experienced “chronic” and severe daily pain.

That grouping did not, for the most part, include adults who said they struggled with arthritis or back and joint pain, as those people tended to say their pain was not constant and persistent, the study authors noted.

The chronic pain figure exceeded 18% among specific groups of respondents, including those between the ages of 60 and 60, women, those who said their health was fair or poor, those who were obese or overweight, and those who had been hospitalized in the prior year.

Kennedy suggested that for those experiencing chronic, crippling pain there are a variety of potential interventions including physical and occupational therapy, exercise, dietary changes, weight loss, massage and psychotherapy, alongside alternative interventions such as acupuncture, yoga and chiropractic services.
Medicines, including narcotic painkillers like hydrocodone, oxycodone and morphine, can also be helpful, but only if long-term use is avoided, Kennedy said.

“We are clearly overusing opioids [narcotics],” he noted. “The US consumes about 60% of the world’s opioid supply, and 99% of the hydrocodone supply. These medications are effective in the short term for managing postoperative pain, but long-term use often leads to dependency or addiction.”

Bone Marrow Hormone Influences Metabolism and Health

Until recently, scientists believed bone marrow had mostly a negative effect on health, but mounting evidence supports the idea that the fat tissue inside our bones – known as bone marrow adipose tissue – may be part of the body’s endocrine system.

In the journal Cell Metabolism, researchers from the University of Michigan explain how bone marrow adipose tissue is a significant source of the hormone adiponectin, which helps to break down fat and maintain sensitivity to insulin. The hormone has also been linked to reduced risk of various obesity-related diseases, including certain cancers, cardiovascular disease and type 2 diabetes.

Previous studies of bone marrow adipose tissue have primarily linked it to negative health consequences such as reduced bone mass, and raised risk of fractures and osteoporosis.

But in this study, where they looked at the role of bone marrow adipose tissue in patients having chemotherapy, or who have anorexia, the researchers found that under conditions where calories are restricted, the fat tissue may also do some good.

Senior author Ormond MacDougald, professor of internal medicine at U-M, says the findings are important because it appears bone marrow adipose tissue “may have positive, protective roles, and influence adaptive functions outside of the bone tissue, at least during calorie restriction.

Vitamin D Supplements Do Not Improve Bone Health?

According to a new study published in the The Lancet, adults taking vitamin D supplements did not improve their overall bone mineral density, reports Medical News Today. Researchers from the University of Auckland in New Zealand analyzed data from 23 studies involving 4,082 healthy adults with an average age of 59. They found that adults who took supplements of vitamin D for an average of two years did not see any improvements in their bone health, apart from a small increase in bone density around their femoral neck. “Most healthy adults do not need vitamin D supplements,” said lead author Ian Reid from the University of Auckland.

MY TAKE:
First and foremost, bone density does not measure bone health. Dense bone is often old, brittle bone as exemplified by all the hip fractures caused by taking biophosphonates, like Boniva and Fosamax. These drugs preserve bone density by keeping the body from removing bone as it ages and preventing the body from forming new bone. Is this any way to treat osteoporosis?

Second, vitamin D has many, many functions in the body. It really is not a vitamin but a hormone. It is necessary for the absorption of calcium from the digestive tract, the first step to incorporating calcium into bone. However, there are many additional factors involved in calcium metabolism. Besides, bone is just a repository for calcium, which is exchanged continually with the blood stream to act as a buffer to control the pH of the blood. The real strength of bone comes from collagen, the protein matrix of bone that holds the calcium.

Third, vitamin D deficiency is epidemic, even in South Florida, where I practice, and the daily sun stimulates production of vitamin D in the skin. In the northern half of the United States, every winter a majority of the population is deficient from lack of adequate sunshine and poor diet. In my practice, it is the most common factor associated with an impaired immune system.

The nutrition board allows practitioners to recommend up to 4000IU per day of vitamin D, without any lab work to identify any deficiency. For supplementation above that level, laboratory testing is recommended.

Finally, the use of the prescription strength 50,000IU dose taken once a week is a dramatic overdose to the body. Unfortunately, many physicians have prescribed this dangerous dosage under the guise of “evidence based medicine”. They fail to understand that the study used a high, weekly dose only to monitor the test subjects. That is, in order to know that they were taking the supplement, they watched them swallow it every week. Daily monitoring just is not logistically feasible. In really, double blind, placebo controlled, crossover studies comprise only 1/3 of an evidence based practice, like mine. Another third is the practitioner’s clinical experience, and the final third (and most important) is patient preference.

THE BOTTOM LINE:
Have your vitamin D level checked. The medical norms are 30-100, but I prefer levels above 40. If you are unwilling to test, then just supplement 2,000IU per day. That may not be enough, but it could very well prevent a chronic, life threatening illness.