How common is osteoporosis in vegans?

[davejones]

Just read a book called Vegan Diet Shock, in which the author is vegan but has osteoporosis. This has got me wondering how common this is in vegans, or whether his case is an exception. As we don't drink milk, maybe we're not getting enough calcium. And for those that live in places without much sun, maybe not enough vitamin D either. I know one vegan woman that has osteoporosis. My mum also has it, but she's not even vegetarian. But I suppose most people wouldn't know unless they got tested.

[Blueberries]

Hi DaveJones! I had a quick Google search for this book and its reviews and I found very little. All I found was that the book is available on amazon. I would like to know who the author is and what kind of vegan diet they ate. Can you tell me more about that?

Also I am sure that there are threads on the forum about calcium and vegan bone health that might be useful for you :)

[davejones]

Hi DaveJones! I had a quick Google search for this book and its reviews and I found very little. All I found was that the book is available on amazon. I would like to know who the author is and what kind of vegan diet they ate. Can you tell me more about that?

Also I am sure that there are threads on the forum about calcium and vegan bone health that might be useful for you :)

I read the book, but it mostly talks about his test results and doesn't really mention too much about his diet, other than he thought he ate a healthy diet. It's an interesting read, but maybe needs more info on what he ate.

[harpy]

As well as the forum threads, this article references a few studies, which perhaps you could look up http://www.livestrong.com/article/281690-incidence-of-osteoporosis-in-vegetarians/

[Robinwomb]

I think I have posted about this on here somewhere before. I have osteoporosis and I am a 40 year old female. However, I was diagnosed as an omnivore in 2006. I have only been vegan since 2011. I had many risk factors...I used to smoke a pack of cigarettes a day which will leach calcium from bones; I am small framed and fair; genetics; thyroid problems I have had for over 24 years; struggles with an eating disorder; and I had a total hysterectomy and both ovaries removed at 33 years of age in 2005 due to endometriosis (a disaster I wish I hadn't had done). The following year I had a baseline dxa scan because I was struggling to find a hormone replacement to feel human again. Surgical menopause was horrid for me and I could not function. I had to quit my full time job and go part time. At any rate my scores were horrible and I was shocked that my bones were so bad. I had been lactose intolerant and avoided cheese like the plague, but I did consume Greek yogurt daily (easier for me to digest becuase it is lower in lactose) and occasionally lactose free milk and it didn't stop bone loss. After my diagnosis I was more diligent about taking vitamin D and calcium supplements and started lifting weights and put on some needed weight and my scores did improve very slightly, but it was lost again due to losing weight later on. I still supplement with calcium and D, but I get my calcium and other bone nutrients from brocoli, leafy greens, sesame seeds, plant milks, soy products, etc. I did eventually find a bioidentical hormone replacement that I could tolerate and it did help stop further bone loss. I have tried natural progesterone and testosterone replacement (women make this hormone also in the ovaries and women who lose ovaries are very deficient) but I can not tolerate them. It is hard to synthetically replicate what the ovaries do for a woman, even in menopause. Hormones are often overlooked as a cause for bone loss. Dairy always seems to be the big focus, but calcium is a tiny fraction of importance in the overall needs of the bones, and dairy is only one way of many to get that need met. There are millions of women and men who have osteoporosis as omnivores, and in fact the countries with the highest dairy intake have the highest rate of osteoporosis in the world. Vitamin D is important for calcium absorption, but it is also not the total answer. I have had my D levels tested twice in the last two years and they have been robust and healthy each time (I ride bike six months of the year outside and supplement with D2 the other six months as I live in a northern climate).
Also, there are a number of medications that cause bone density loss such as Depo Provera, some of the SSRI anti depressants, acid inhibitors, steroids to name a few. People take far more medications now than years ago and this problem is often overlooked as a serious side effect.

So in effect I am a vegan with osteoporosis but I acquired it as an omnivore. It also takes years to acquire and is not an overnight disease. It is a long slow process, just as building bone is. Losing my ovaries did accelerate the process but it has already begun before then. Last year I got into running but ended up with two stress fractures and had to stop. The radiologists who interpreted the xrays for those fractures commented at the poor quality of my bone just from looking at my xrays. It is quite scary for me and is something I am trying to figure out how to treat as a vegan without going on the awful meds available for osteoporosis. I would never go back to dairy and seriously doubt it would even help, not to mention it made me quite ill.

[micthemini]

Hi davejones
There is a bit of a conversation on things meat eaters say (http://www.veganforum.com/forums/showthread.php?31242-quot-How-our-vegan-diet-made-us-ill-quot) about this.
Dairy is not the major source of calcium, that's a bit of a myth.
There are things you can do to strengthen the bones, bone loading exercises (yoga, pilates, walking etc), not drinking carbonated drinks (http://www.hindawi.com/journals/josteo/2011/102686/abs/), not smoking. (The link is one I've not read the full article on, sorry).
But as for dairy and calcium, it's not the best provider, really.

[Blueberries]

I read the book, but it mostly talks about his test results and doesn't really mention too much about his diet... maybe needs more info on what he ate.

I think writing a book about how a vegan diet caused you health problems without outlining what you ate is a bit strange.


he thought he ate a healthy diet.

That could mean anything! Some people eat very restrictive high raw, fat free vegan diets in the name of health while others just eat vegan junk food and assume it must be healthy because it is vegan. Vegan diets are as diverse as vegans.

[davejones]

I think writing a book about how a vegan diet caused you health problems without outlining what you ate is a bit strange.



That could mean anything! Some people eat very restrictive high raw, fat free vegan diets in the name of health while others just eat vegan junk food and assume it must be healthy because it is vegan. Vegan diets are as diverse as vegans.

I think the point he made in the book was that he THOUGHT he ate a healthy diet, so there must be others who also THINK they eat a healthy diet that could be affected. He didn't claim that being a vegan caused his healthy problems, only that they were caused while he was a vegan. He resolved most of his problems while still being a vegan. So I think he just wanted to make people more aware of potential problems. I read the book a few weeks ago and only quickly skimmed through it. I'll read it properly to see what he says about his diet, although I'm pretty sure not much is mentioned.

[Andy_T]

Hmm,

but most scientific articles (e.g. take a look at the "China Study") on the subject that I have heard of seem to agree that while dairy products have some calcium, they also make your body acidic. In order to counter the acidic nature, the body uses the calcium from the bones, thus leaching it out of them.

I remember reading about some studies (they are also mentioned in the "China Study"book) that looked at the statistic correlations between occurrence of osteoporosis and consumption of dairy that found that the countries with the highest occurrence of osteoporosis were also those with the highest dairy consumption (e.g. Netherlands, New Zealand, etc.) and those with low dairy consumption also had lower occurrence of osteoporosis.

Best regards,
Andy

[Robinwomb]

I just wanted to update about my own osteoporosis status and it isn't good. I have been vegan since February 2011. Here is a quick history of my osteoporosis and timeline:

2006 had first dexa scan due to having hysterectomy and ovaries removed the year prior at the age of 33. Needed a baseline to monitor due to post surgical menopausal status. Scores were quite bad already with T score -3.2 in L spine and -1.8 in hips

2007 to combat the bone loss I started to supplement with calcium and vitamin D (was an omnivore at that time and used D3) daily, as well as started a weight bearing exercise program. I went from underweight to middle healthy weight range, and was able to find a hormone replacement my body absorbed better. For a six month period I was prescribed miacalcin (salmon hormone) but it was a nasal spray and I had sinus issues so stopped it. I had another dexa scan done exactly one year after the first and my scores were -3.0 L spine, -1.2 hips so a bit of an improvement.

2008-2009 I had a relapse into anorexia nervosa and my weight plummeted to a very low weight. I restricted my intake severely.
In 2010 I went through a period of recovery and gained a lot of weight but was still slightly underweight. I was still supplementing calcium and D and on my hormone replacement. Had another dexa in 2010 and scores were -3.0 spine (still stayed same) and -1.6 hips (slightly worse again).

I went vegan in February 2011. I switched my D supplement to D2 but had issues with side effects and eventually switched to the new vegan D3 that is out. I supplemented with a vegan calcium supplement, continued with my hormone replacement, and my weight stayed in a similar range although I initially lost six lbs (and put it back on intentionally). I was still exercising and doing weight bearing exercise program. I have made an effort all along to drink plant milks daily and get at least two cups of leafy greens each day, as well as sesame seeds, molasses, and other bone building foods here and there. In 2012 I suffered several stress fractures from running. The radiologist who read my xrays said my bones were in bad shape for my young age. Still I ignored the warning signs.
In 2013 I relapsed back into anorexia and got to a very low weight again. Over the last year I have regained most of that back very slowly.
A week ago I had my fourth dexa scan and was shocked to learn that my L spine score dropped to -3.6, a significant decline from all the other scans. My hip score dropped to -1.8, where it was in 2006. But the L spine has me very worried, and the fact that my score dropped so much more severely since being vegan.

These are the factors I have come up with so far as to why this has happened as a vegan. :

I have had to have my thyroid meds lowered three times since becoming vegan. I am on the lowest dose of thyroid med I have been on in years. Something about being vegan is making my thyroid work better, even with consuming soy. This means I have been on too much thyroid med however, which can cause hypercalcemia and I had all the symptoms of that which prompted me to have my TSH checked and sure enough I was on too much med so it was lowered yet again.

As a vegan, and with an eating disorder, I have consumed far less protein than I used to. I was never a huge meat or dairy eater as an omnivore, and restricted heavily then due to an eating disorder, but I did consume a lot of Greek yogurt (very low calorie per cup but a lot of protein and calcium for one serving) and salmon/sardines/tuna. that was how I got my protein needs met as an omnivore even though I restricted. As a vegan and struggling with restricting, I was only getting 30 to 40 grams of protein on average each day with eating a few servings of dried beans and some whole grains and vegetables. I eat a few servings of seeds here and there too. You always hear how too much protein can leach calcium from the bones, but too little can also have a detrimental effect and this tends to be ignored because it isn't hard to get enough protein as a vegan...unless you have an eating disorder. So I fully believe that this is the crucial difference between my lifestyle as a vegan and as an omnivore that has made my bones so much worse (in addition to overmedication with thyroid). All the other issues were close to the same (exercise, weight, calorie amounts, etc.) except the thyroid meds I needed as an omnivore were at a higher dosage.

It is very discouraging to lose so much more bone density as a vegan but it has been a real wakeup call to take better care of myself. I am scheduled to see a rheumatologist in May but just don't know what to do as far as treating it because it is so severe at this point that even if I increase my protein and caloric intake (which I have) the damage is too severe and risk too great to just assume a lifestyle change is going to be enough to protect me over the short term. I have already fractured in 2012 which puts me at even greater risk. I have constant pain in my lower spine which I have assumed was related to my sciatic issues. But now I don't know. I really don't want to take the harsh bisphosphonates but what else to do? I am committed to remaining vegan and doing what I have to to improve my diet and fight my eating disorder, but I don't feel confident that this is enough right now. Any advice would be greatly appreciated!

[dropscone]

Robinwomb, I am sorry to read of your troubles. I don't really have any advice, the only thing that struck me was I don't see you mention tofu in the list of protein foods, do you avoid that? I would have thought calcium-set tofu might be helpful? I hope your appointment brings up some useful suggestions for improving things and that you make a good recovery.

[mini_mi]

Sorry to say, but your osteoporosis doesn't have anything to do with being vegan. You problem is you keep starving yourself and your body is eating itself to try and survive.
If you continue in this way your body will continue to degrade and eventually will not be able to recover. You best bet is get professional counseling and eat a diet of vegan whole foods. Use one of the nutrition tracking web sites and start eating at least 2000 kcals a day. Be sure to include plenty of leafy greens which will help replenish your bones.


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[dropscone]

Did you actually read what Robinwomb posted in this thread? She's not blaming veganism. Read the post before the last one to get more context.

If telling someone with anorexia to eat more worked it would be a miracle cure. Unfortunately it's not that easy.

[Robinwomb]

Robinwomb, I am sorry to read of your troubles. I don't really have any advice, the only thing that struck me was I don't see you mention tofu in the list of protein foods, do you avoid that? I would have thought calcium-set tofu might be helpful? I hope your appointment brings up some useful suggestions for improving things and that you make a good recovery.

Hi dropscone,

I ate tofu in the beginning, but seemed to develop an intolerance to it for some time. I would get cramps and diarrhea almost immediately after ingestion, no matter what kind I tried or how it was prepared which was frustrating because I loved tofu! So I have avoided it for a long time. But recently, in trying to find more ways to increase protein and calcium, I gave it another go with tofu and amazingly it agrees with me now (at least the super firm and organic variety). I also eat tempeh and seitan, and beans have been a huge staple for me for years. I also continue to get in my low oxylate leafy greens daily. I just really need to up my calories a lot which is a struggle but slowly coming along. I have managed to put on a few more lbs now. Every meal is a battle but making slow improvements. Thanks for your support!

[Robinwomb]

Sorry to say, but your osteoporosis doesn't have anything to do with being vegan. You problem is you keep starving yourself and your body is eating itself to try and survive.
If you continue in this way your body will continue to degrade and eventually will not be able to recover. You best bet is get professional counseling and eat a diet of vegan whole foods. Use one of the nutrition tracking web sites and start eating at least 2000 kcals a day. Be sure to include plenty of leafy greens which will help replenish your bones.


Sent from my iPad using Tapatalk HD

Thanks mini mi for the input! I will probably stay away from the nutrition tracking websites as they seem to contribute to making my obsessive tendencies worse and I already keep a detailed account of what I eat and ratios, but I am trying to push my caloric range up over 2000 (currently at 1600 and overwhelmed but working on it). Though I do eat a very healthy whole foods vegan diet (I really hate to use the word diet but can't think of another word), I understand that I do need to eat a lot more to meet my needs as a vegan. I would be able to meet my protein and calcium needs if I ate enough I am sure. It is extremely difficult for me and I probably do need a heck of a lot more support than I am currently getting. I have been through many eating disorder treatments, some conventional and some alternative styles of therapy, and spent a fair few years paying off some serious debt due to lack of insurance coverage for long term ED treatment. Getting support for an ED as a vegan is even more of a challenge because most dietitians and eating disorder therapists are adamantly opposed to it. It's been a difficult road but I do understand that my eating disorder is killing me and I need to do something more. I was fairly stable for a while but last year things fell apart. I don't blame veganism for my demise, but I do think there is a relaxed attitude that protein is not important as a vegan. While it is true that typical Western diets get far more protein than they need, it is also true that not enough protein in the diet can contribute to bone loss. This is something I need to be diligent about and hope that someone can learn from what I shared.

Also, my osteoporosis started long before my eating disorder, long before I had my hysterectomy, and long before I became vegan. No doctor has been able to pinpoint why I lost so much bone at such a young age (I was even tested for Celiac disease), but I suspect it is the years and years I have been on thyroid meds. I was a healthy weight and active for most of my life until my hysterectomy that I never wanted unraveled me inside and out. The anorexia didn't start til I was 34 years old. When I first went vegan I was in a much healthier place in recovery. I really hope I am not putting veganism in a bad light because it is very important to me. One of my motivations for getting better as of late, besides the worse dexa scores, is that I leaflet and do other forms of advocacy for animals and I don't want to give the impression that my sickness is because of veganism. I appreciate your concern and feedback. I will work on seeking out counseling where I can. Thanks again!

[Robinwomb]

Just wanted to update and mention I have put on two lbs since my last post. I am really trying to get better and have broken some barriers and made some milestones. VERY hard but fighting. I want to be the person who down the road can say I have gained bone density as a vegan. Just one of many goals.

[dropscone]

Yay! Good for you, Robinwomb!

[harpy]

So glad to hear things are going better, Robin :thumbsup:

[Clueless Git]

Just wanted to update and mention I have put on two lbs since my last post. I am really trying to get better and have broken some barriers and made some milestones. VERY hard but fighting. I want to be the person who down the road can say I have gained bone density as a vegan. Just one of many goals.

Admirable and inspirational, Robin :)

[Robinwomb]

Thanks for all the encouragement! I can't believe this, but I have finally reached a healthy weight range for the first time in six years. My last DXA scan really scared me and motivated me to do something. I am so sick of being sick. It has been a really tough road but I want recovery so badly I am working through it. I am going to start going to a support group next Monday that meets once a week. I have gotten some encouragement and support from some friends at work and a few family members too which helps. I started cycling again to work and this too has helped me take better care of myself.

I have been working with a rheumatologist regarding my osteoporosis. Because of all my risk factors and the severity of my bone loss, he wants me to start on one of the osteo meds. I am scared to death of the side effects of those and the long term safety, but I am also in a position where I could fracture any time and my bones are in bad shape. It is a tough place to be in. He said that down the road I will be in a world of trouble if I don't start trying to rebuild my bones (difficult to do when in surgical menopause and on thyroid meds as it is). He was not at all against my being vegan which was refreshing, and he was encouraging about my efforts to recover from my anorexia. He was very angry that my gynecologist removed my ovaries so young and said this was a "shame", that a woman should not have her ovaries removed unless it is cancer or a life threatening infection/problem, which I fully agree with. He didn't seem confident however that weight gain/eating more etc would be enough for me at this point. He wants me to try Prolia which is an injection (I shared that I can not risk taking the oral meds which cause GI problems as I am trying to maintain the weight I have gained and this would make it more challenging). I am thinking that I might just try it for a year and see how it goes and continue to work on getting healthier and then who knows? Maybe with more body fat I will better absorb the HRT I am on and the calcium/d and other nutrients I get and stimulate my bones to grow? He tested my calcium and d levels and both were in healthy range. D was 44 (which is not bad for where I live in a northern climate). I really don't know what else to do. I have contacted a few vegans locally who seem to specialize in bone health but they have not returned my emails or calls and it is getting frustrating trying to figure this all out. I have been drinking two to three glasses of plant milk daily and at least 2 to 4 cups of low oxylate leafy greens each day, and also incorporating molasses and sesame seeds into foods. I discovered I can tolerate tofu if it is sprouted and organic as opposed to the traditionally made tofu.

If anyone here has struggled with bone density loss and tried any of the osteo meds or found a way to increase bmd without meds, I would love to hear from you!

[Lilystein]

Just wanted to update and mention I have put on two lbs since my last post. I am really trying to get better and have broken some barriers and made some milestones. VERY hard but fighting. I want to be the person who down the road can say I have gained bone density as a vegan. Just one of many goals.

That is fantastic news. I don't think people who haven't had anorexia can truly grasp how difficult eating more is, I can recall many times standing in the kitchen shaking and crying trying to force myself to eat something but not being able to push through that mental barrier telling me not to eat. Even when you're getting better, every day is a monumental battle. Keep pushing through it, keep focusing on being healthy. I wasn't even able to get help for having an ED, I even ended up in hospital having to have emergency surgery because starvation caused my gallbladder to become full of sludge and stones.. Doctors wouldn't listen when I kept having attacks, eventually stones got stuck and bile from my gallbladder flowed backwards into my liver, causing a severe liver infection. I had to have 2 operations. And even after all that, still no help for my ED. I've cried to doctors, told them I binge, restrict and take loads of laxatives, they just ignored me. But anyway I've stopped taking laxatives a while ago, still struggling with binges but determined to fix myself. I know I can do it. It's a case of one day at a time.

I hope things continue to improve for you, you can do it!!!

[dropscone]

... determined to fix myself. I know I can do it. It's a case of one day at a time.

I hope things continue to improve for you, you can do it!!!

I'm so sorry to hear doctors have not been at all helpful in your case! I wish you every success, you sound very determined so I'm sure you'll get there :)

[Robinwomb]

Thanks Lilystein for your encouragement! I am still holding out at a low normal weight range. I still struggle but i am in a much healthier place. The shot I was put on so far has not had any side effects. I wish you all the best with your recovery also!

[Robinwomb]

Below are comparisons of me from last year in March and this year in early June. I have put on a total of 21 lbs since March of last year. It has been very very hard but I do feel so much better at least physically. I don't know if it is the osteoporosis shot I am on or having substantially increased my calcium and protein intake but my bones hurt so much less than before. It has been a subtle change but about a week ago I noticed that I don't have that constant pain and aching in my middle spine and hips like I used to get. I still have a chronic pain in left hip/pelvic area but that is muscle/injury related. Anyway, I just wanted to "show" that I have been working very hard to remain committed as a vegan and to be healthier and fight my osteoporosis. All my weight gain has been as a vegan and on relatively healthy food.



https://farm4.staticflickr.com/3776/14308177061_251d1b603d_s.jpg (https://flic.kr/p/nNn9xX)

https://farm4.staticflickr.com/3819/14308177221_d1c9e3e825_s.jpg (https://flic.kr/p/nNn9AH)

https://farm6.staticflickr.com/5071/14408316811_2699d66df4_s.jpg (https://flic.kr/p/nXdoBn)

https://farm6.staticflickr.com/5513/14408316951_23161321d0_s.jpg (https://flic.kr/p/nXdoDM)

[harpy]

Well done, Robin. Apart from anything else, it's great to have evidence that you can solve this problem while staying vegan, not that we doubted it of course ;)