Ortho-Bone

Background

Core Bone-Building Nutrients

A superior nutritional supplement for bone health must be built on a foundation of ossein Microcrystalline Hydroxyapatite Complex (MCHC) as the calcium source, and fortified with well-established nutrient cofactors such as Magnesium, Zinc, Manganese, Copper, Vitamin C, and Vitamin D3 and Vitamin K2 now as both MK-4 & MK-7, whose revolutionary effects on bone health are now well-known. Ortho Bone offers all the essential vitamins and minerals for good bone health in their superior forms for optimal bone support.

Maintaining bone health is a hot topic today, yet there remains confusion in the minds of many health-conscious people about the right dose and form of even the most well-known bone health nutrients, while the importance of other key nutrients in keeping the skeleton strong remains largely unknown. Heres a review of the controversies and recent discoveries of important bone health nutrients and their various forms and doses.

Take Enough Vitamins D & K2

Aside from improving calcium absorption, vitamin D is needed for proper muscle function, which may play a role in protecting against fractures by reducing falls. But you simply cant rely on the sun to meet your requirements, especially in Northern climates. At least 800 IUs per day are recommended.

Similarly to Vitamin D,Vitamin K2 is essential to absorbing and properly utilizing the calcium you ingest. Vitamin K2 helps shunt the calcium from the bloodstream into the bones. In fact, taking a lot of calcium without adequate vitamins D & K can be dangerous.

Ortho Bone contains vitamin D3 and vitamin K2 in the forms of MK-4 & MK-7, the most effective forms of these vitamins.

Get the Right Kind of Calcium

Calcium is critical to the body for more than bone health, in fact it is essential for many vital functions such as normal nerve transmission, blood clotting and muscle contraction. Every cell in the human body uses calcium for basic functions and for this reason, the amount of calcium circulating in the blood (the calcium balance) is tightly controlled within a very narrow range. It follows that disturbances in the sensitive calcium balance are serious. Therefore, the body has developed efficient mechanisms to deal with acute alterations in circulating calcium levels. However, when the body needs to continually deal with either excessive (hypercalcaemia), or inadequate (hypocalcaemia) blood calcium, this can come at the expense of long term health. Indeed excessive calcium levels in the blood can result in a myriad of negative outcomes. At its extremes Hypercalcaemia is linked with kidney stones, bone pain, nausea, depression and insomnia. By contrast a shortage of circulating calcium will see the body strip the necessary calcium from the skeleton (the bodys natural reservoir). Over time this comes at a significant cost to overall bone health and can lead to osteopenia and, ultimately, osteoporosis which carries with it a much higher risk of bone fracture. The correct balance is maintained by the parathyroid gland, mediated by Parathyroid Hormone (PTH), which, through a complex series of functions is able to manipulate blood calcium levels for optimal function.

Too many health-conscious people believe that conventional calcium supplements (or conventional calcium plus vitamin D) can put an end to bone loss. They cant. As multiple studies have documented, conventional calcium supplements – such as calcium gluconate, calcium citrate, and calcium carbonate – slow, but do not halt or reverse, menopausal bone loss, whether taken alone or with vitamin D. You simply cant force the bones to take in more calcium, and build more bone, by taking more and more calcium: the mineral itself can only provide the raw material needed to support your existing bone mass, or to allow other factors in your skeletal health program to build up new bone. But there is one seeming exception.

Problems with conventional calcium supplementation

Given the importance of the calcium balance it has been somewhat surprising that some of the most popular and widely accepted calcium supplements on the market have been promoted on the basis of rapid absorption and, or, efficient once daily dosing.

MCHC: The Best Form of Calcium

Ossein microcrystalline hydroxyapatite complex (MCHC) consistently halts, or even reverses, bone loss in controlled human trials. When put head-to-head against other calcium supplemental forms, MCHC consistently trumps conventional calcium supplements. But MCHCs bone-building powers do not lie in the calcium itself.

True MCHC is not just a form of calcium, but is a calcium-based crystalline nutrient complex, which is how the mineral is actually stored in your bones. MCHCs unique support for the skeletal system is probably due to a combination of its intact crystalline structure, and the vibrant blend of peptides, mucopolysaccharides, and growth factors which accompany the calcium in true MCHC supplements – factors which are not present in conventional calcium supplements, in bone meal, or in pure, synthetic hydroxyapatite (also known as calcium orthophosphate). The bottom line is that the unique bone health support provided by MCHC derives from the whole supplement, and not just from its calcium content.

When to Take Your Calcium

Several recent studies have suggested that when you take your calcium can make a big difference in terms of both the amount of calcium youll absorb, and the effects of that calcium on your bones. For starters, take your calcium with food, as doing so will increase absorption. Its also important to spread your calcium supplements over the course of the day, which increases your total absorption of calcium and keeps parathyroid hormone (PTH) under control throughout the day. To get the best possible results, take the largest single dose of calcium later in the day, at dinner or with a late-night snack.

The Phosphorus Paradox

Its widely believed that Western diets are too rich in this mineral, and that excess phosphorus is bad for bone health. But phosphorus is an essential nutrient, which makes up more than half of the mineral content of bone and which is needed for osteoblast function. Nearly a third of older Americans dont get the new RDA of this essential mineral. Good thing phosphorus is a natural component of MCHC.

Magnesium

Magnesium is another mineral commonly associated with the maintenance of bone health, which is very easy to fathom when one considers that two-thirds of the bodys magnesium stores are located in our bone structure. Much of the magnesium within this bone structure is part of the bones crystal lattice (which can metaphorically be referred to as the bone scaffolding) where it binds together with the minerals phosphorus and calcium. Magnesium on its own has been shown to slow the rate of bone turnover, which is when the growth of new bone is outpaced by the degeneration of old. Magnesium shortages result in the reduced assimilation of vitamin D as well as the inhibition of parathyroid hormone, leading to low blood calcium levels.

Boron

Borons effect on bone appears to be mediated by its ability to reduce the urinary excretion of calcium and magnesium, and this ability is due to its actions in the kidney. As stated above, this calcium-preserving effect of boron becomes pronounced in circumstances in which dietary magnesium is low. Therefore, boron is in effect acting as a backup system for magnesium in order to preserve calcium in the blood and reduce urinary calcium loss.

Boron also appears to enhance vitamin D, and although there is likely a relationship between this and its calcium-preserving effect, an accurate description for the mechanism of action of borons vitamin D enhancement is unclear.

Zinc, Copper & Manganese

Several other minerals have also been identified as co-factors for enzymes involved in bone metabolism – notably zinc, copper, and manganese. The latter is essential for the proper function of the osteoblast cells that are responsible for building new bone. Manganese also increases the activity of the enzyme alkaline phosphatase and as well as growth factors such as estrogen and IGF-1 in a manner that is directly pertinent to these osteoblast cells. Copper is essential for producing an enzyme called lysyl oxidase which cross-links (strengthens) collagen. Zinc, in turn, is essential for the operation of copper, since unbalanced zinc intake can reduce copper absorption.

Silicon, Vitamin C, B12 & Folate

Additionally, recent research indicates that silicon stimulates the formation of type 1 collagen as well as playing an important role in the bodys glycosaminoglycan network, which utilizes compounds such as hyaluronic acid and chondroitin sulfate in the cartilage, bone, and skin. Even vitamin C, a substance not normally associated with bone health, has been identified as a possibly important modifiable risk factor for osteoporosis and bone fracture. Finally, methylating nutrients such as vitamin B12 and folic acid may also be important to bone health, perhaps due to their ability to counter the toxic effects of homocysteine on the protein fibers in bone.

Research

Calcium

MCHC is, in effect, a full-spectrum multiple nutrient source in its own right. However, it is particularly rich in calcium, and the type of calcium in MCHC has been clinically proven in over 30 years of randomized, double-blind, controlled clinical trials to be the best calcium source for bone building and maintenance.

Current official recommendations suggest an intake of 1000 milligrams of calcium for younger adults, and 1200 milligrams for people over the age of 50. Some evidence suggests that a still higher intake (1300-1600 milligrams) of calcium is more effective for lowering fracture risk in the elderly. But remember that these numbers are your total calcium need. The more calcium you get in your diet, the less you need from supplements.

A review published in 2012 cited that the most prevalent factors associated with both osteoporosis and atherosclerosis were low calcium intake, deficiencies in vitamins D & K, and high sodium intake. Clinical trials show that calcium supplementation provides better results when combined with vitamin D at doses greater than 300 IU per day.

A double-blind, controlled clinical trial on post-menopausal women examined the effects of a plain dairy product versus a dairy product enriched with 800 mg of calcium, 10 mcg of vitamin D and 100 mcg of either vitamin K1 or K2. While total bone mass density increased for all the dairy groups, lumbar spine bone mineral density increased significantly only in the two groups receiving the treatments enriched with calcium and vitamins D & K.

MCHC

A recent study compared the bone turnover effects of MCHC with conventional bone supplements and concluded the following:

MCHC is clinically proven to deliver calcium without causing undesirable spikes in blood calcium levels.

Peak blood calcium levels after ingestion of MCHC by study participants were 45%-49% lower than peak blood calcium levels after ingestion of the same amount of calcium from either calcium carbonate or calcium citrate.

After ingestion of MCHC, average increase in blood calcium levels compared to the control group over an 8 hour period did not reach statistical significance. By contrast after ingestion of the same amount of calcium as either calcium carbonate or calcium citrate, average increase in blood calcium levels were statistically significantly different to control.

(Area under the curve data shows that) The total amount of calcium delivered to the blood over an 8 hour period after ingestion of MCHC did not differ significantly from the total amount of calcium delivered to the blood over the same time period after ingestion of either calcium citrate or calcium carbonate

MCHC is clinically proven to deliver the same levels of efficacy as both calcium carbonate and calcium citrate as measured by the ability to supress key markers of bone turnover (bone resorption).

After 90 days of continuous supplementation, MCHC supressed CTX and P1NP, two key makers of bone turnover, by an identical amount to calcium carbonate and calcium citrate.

MCHC is not artificially modified calcium, it does not rely on chemical coatings and additives which delay release but not the rate of release.

MCHC has been designed, developed and clinically proven to deliver calcium in a 100% natural protein complex which the body is able to digest, as it would a food, releasing the calcium slowly and steadily into the body without the undesirable spikes.

MCHC has demonstrated ability to promote bone matrix deposition and mineralisation (bone formation).

Proteins extracted from MCHC demonstrated osteo inductivity, the ability to stimulate bone formation, as measured by osteoblast (bone cell) differentiation and mineralisation in vitro.

Independent testing has verified the presence of critically important bone stimulating growth factors and bone matrix proteins in MCHC.

Unlike conventional calcium supplements, such as calcium citrate and calcium carbonate, MCHC contains protein (25% on average) rich in essential bone matrix components, including Type I collagen and Osteocalcin, and bone stimulating growth factors.

Specifically, testing has verified the presence of the osteo inductive growth factors IGF I and 2, and TGFb 1 and 2.

Vitamin D: 800 IUs

From what we now know, the old RDA of 400 IU will not protect you from vitamin D insufficiency except in the sunniest of climates. Even in sunny Spain, researchers have found that 80% of children have inadequate vitamin D levels in March and October. In fact, in one remarkable recent study, researchers at Creighton University were able to document that even North Americans who spend nearly all day in the sun during the summer (such as landscapers and agricultural workers) were still at a 58% risk of being too low in vitamin D to support optimal calcium metabolism by the end of the winter! Studies show that a 400 IU vitamin D supplement is just not enough to keep serum levels of the active vitamin above the cutoff for insufficiency, and the use of 400 IU supplements have not been shown to reduce fracture rates. Even 600 IU has little effect on BMD. Instead, controlled studies show that vitamin D, together with calcium, helps to reduce the risk of fracture at a dose of at least 800 IU per day and recent trials suggest much higher dosages are needed to maintain optimal blood levels.

Vitamin K2

Recent studies have suggested that vitamin K2 is better absorbed and persists longer in the plasma then vitamin K1. Studies have also shown that it also has greater benefits to the skeletal and vascular systems than vitamin K1. Vitamin K is important for bone health as it is able to regulate calcium through the amino acid gamma-carboxyglutamic acid (Gla), and in particular the protein osteocalcin, which helps maintain calcium in bone, but at the same time keeps it out of soft tissue.

The advantages of taking both MK-4 and MK-7

More recently, Vitamin K2 in the forms of MK-4 and MK-7 has emerged as bone-building superstars. MK-4 is a specific form of vitamin K2 produced in the body from phylloquinone (vitamin K1) or even the bacterial menaquinones (which are also forms of vitamin K2). It is thought that other forms of vitamin K are converted to MK-4 in order to be absorbed by cells. Multiple clinical trials show that megadose MK-4 supplements reduce fracture rates in osteoporotic women as much as Fosamax-type drugs by improving the quality of the bone itself, measured by bone mineral content and width. Another study found that MK-4 combined with 1500 mg of calcium carbonate significantly increased bone density in the lumbar spine and decreased the amount of undercarboxylated osteocalcin compared to just the 1500 mg of calcium alone.

In a recent study comparing MK-4 against MK-7, one of the first actually comparing the two head-to-head, it was found that when subjects took a single dose administration of 420 μg of MK-4 or MK-7, the MK-7 was well absorbed and reached maximal serum level at 6 h after intake and was detected up to 48 h after intake. MK-4 was not detectable in the serum of all subjects at any time point. It is not yet clear whether this is because MK-4 was metabolized very quickly (some nutrients actually benefit from a short half-life) or because it was not absorbed. Consecutive administration of MK-7 at 60 μg for 7 days demonstrated that MK-7 increased serum MK-7 levels significantly in all subjects and activated osteocalcin at this dose. Further research is warranted on the benefits of both forms of vitamin K2, as MK-4 has shown many beneficial effects in humans that have not yet been studied with MK-7 (for example, liver cancer), and there appears to be a cellular receptor specific to MK-4 in humans. Therefore, AOR has chosen to provide both MK-4 and MK-7 in Ortho Bone to maximize the potential benefits of each.

Absorbable Magnesium

Take a magnesium you can absorb. Magnesium citrate is absorbed at 29.64%, but much better absorption is available from other forms – especially fully-reacted magnesium aspartate, with a remarkable 41.7% bioavailability.

In a two-year, open, controlled trial, 71% of women receiving magnesium supplements experienced increased bone mineral density where as the women not receiving supplements suffered bone loss. The amount of magnesium in even the highest quality multi-vitamin/multi-mineral supplements is still well below levels which researchers believe are needed for prevention in high risk demographics.

Market Trends

You Need More Than Just Calcium

Calcium supplements are among the highest sellers among elderly people, especially women. However, healthy bones require more than just calcium. Other minerals also contribute to healthy bone material, and vitamins D & K help with calcium absorption and usage. Massive dosing with calcium salts (like calcium citrate, the most common form) alone may certainly contribute to other health issues. Orthomolecular medicine requires that all of the nutrients be provided for optimal health at appropriate doses and in the right forms.

Dont fall for the Coral Calcium Hype

Some companies are making wild claims about the efficacy of calcium taken from coral reefs, not just for osteoporosis but for almost every ailment under the sun. These claims are simply bogus. There is nothing magical about coral calcium: it is actually almost entirely calcium carbonate, with a sprinkling of some trace minerals. Not one clinical trial has ever been performed to show that coral calcium is better absorbed or better utilized than other conventional calcium sources. Instead, astoundingly, the claims of high bioavailability for coral calcium are not based on controlled studies in humans, but on the stuffs ability to dissolve in water; and as has been shown, such a silly test bears little relationship to the ability of a living body to absorb calcium.

References

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Castelo-Branco C, Ciria-Recasens M, Cancelo-Hidalgo MJ, Palacios S, Haya-Palazuelos J, Carbonell-Abelló J, Blanch-Rubió J, Martínez-Zapata MJ, Manasanch J, Pérez-Edo L. Efficacy of ossein-hydroxyapatite complex compared with calcium carbonate to prevent bone loss: a meta-analysis. Menopause. 2009 Sep-Oct;16(5):984-91.

Castelo-Branco C, Dávila Guardia J. Use of ossein-hydroxyapatite complex in the prevention of bone loss: a review. Climacteric. 2015 Feb;18(1):29-37.

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Abstract

Use of ossein-hydroxyapatite complex in the prevention of bone loss: a review.

Climacteric. 2015 Feb;18(1):29-37.

Castelo-Branco C, Dávila Guardia J.

Background and objective The ossein-hydroxyapatite complex (OHC) is a microcrystalline form of calcium which provides a number of additional minerals (magnesium, phosphorus, potassium, zinc), and proteins (osteocalcin, type I collagen, type I insulin growth factor I and II, transforming growth factor beta) associated with bone metabolism. The objective of this review is to examine the role of OHC in preventing bone loss in different conditions.

Material and methods A review of clinical trials assessing the relationship between OHC and bone loss was made using the following data sources: Medline (from 1966 to December 2013), the Cochrane Controlled Clinical Trials Register, Embase (up to December 2013), contact with companies marketing the supplements studied, and reference lists.

Results

Different randomized, clinical trials and meta-analysis suggest that OHC is more effective than calcium supplements in maintaining bone mass in postmenopausal women and in different conditions related to bone loss. In addition, OHC improves pain symptoms and accelerates fracture consolidation in patients with osteopenia or osteoporosis.