Phytoestrogens for Bone Health

Genistein, a phytoestrogen isoflavone found in soy products, may help increase bone health by reducing bone loss in osteopenic postemenopausal women, according to a new study. Osteopenia causes the bones to become less dense.

Researchers from the University of Messina in Italy assessed the effects of genistein on bone metabolism in osteopenic postmenopausal women in a randomized, double-blind, placebo-controlled trial.

The study included 389 postmenopausal women with a bone mineral density (BMD) less than 0.795 grams per centimeter squared at the femoral neck and no significant comorbid conditions.

After a four-week stabilization period during which participants received a low-soy, reduced-fat diet, participants were randomly assigned to receive placebo (191 patients) or 54 milligrams of genistein (198 participants) daily for 24 months. Both the genistein and placebo tablets contained calcium and vitamin D.

The primary outcome was bone mineral density at the anteroposterior lumbar spine and femoral neck at 24 months.

The researchers found that bone mineral density increased in genistein recipients and decreased in placebo recipients at the anteroposterior lumbar spine and the femoral neck. Genistein decreased urinary excretion of pyridinoline and deoxypyridinoline, increased levels of bone-specific alkaline phosphatase and insulin-like growth factor I and did not change endometrial thickness compared with placebo. These results were statistically significant. More genistein recipients than placebo recipients experienced gastrointestinal side effects (19 percent vs. eight percent) and discontinued the study.

Study limitations were that the study did not measure fractures and had limited power to evaluate adverse effects.

The study authors concluded that 24 months of treatment with genistein has positive effects on bone mineral density in osteopenic postmenopausal women.

Integrative therapies with strong, good or unclear evidence for the treatment of osteopenia and related conditions include calcium, vitamin D, black tea, boron, copper, creatine, DHEA, gamma linolenic acid, horsetail, physical therapy, red clover, soy, tai chi, tamarind and vitamin K.

For more information about the therapies listed above and isoflavones, please visit Natural Standard's Foods, Herbs & Supplements and Health & Wellness databases.

Comments

[Rebecah Ziegler]

I believe yoga is beneficial to women with this condition. Any reason yoga wasn't mentioned in the integrative therapies? I am a Structural Yoga Therapist and a post menopausal woman, age 57 with strong bones.

[Paul]

After the Women’s Health Initiative, so many women and doctors have run into problem’s with preventing osteoporosis and osteopenia in post-menopausal women. It's pretty well know what causes it – less estrogen – but how to fix it is not easy.

This study does help confirm that soy is good for your bones, but without following up on cardiac events and other problems, I would still be hesitant to recommend this long term. The women’s health initiative showed that hormone replacement increases the risk of some cardiac events. This isn’t replacing with the same hormones, but these compounds still act like the hormones, so I’m not ready to say this is safe yet. I wish one of the other measures were safety related, especially stroke.

[Emily P.]

Hasn't genistein been linked with chemoprevention?

[Pierce]

Sometimes these medical studies are so dense! I wish they would use more layman’s terms so that average people like me could understand how to lead a healthier lifestyle. I’m assuming I will be an “osteopenic postmenopausal” woman one day, and it would be nice if I could understand what to do to prevent bone loss.

[Dr.Ali]

We have the best alternative therapy to cure chronic and acute pain

[D. B. Martin]

The results of this study seem pretty positive, but I would like to know more about the GI side effects, which were apparently severe enough to cause some women to stop taking the supplement. I would also like to know more about genistein itself. How much of it is present in soy foods? Would it be possible to get a meaningful amount of it through dietary consumption or would one have to take a supplement to get enough of it? Are there any risks associated with it? I am particularly curious about the cancer risk, as estrogens and phytoestrogens may increase the risk of hormone-dependent cancers. If this substance really has promise, I hope research continues and more information about these issues will become available. As someone who has recently reached the age where I am at risk, I would really like to know...

[Caren]

It is a shame that such a high percentage of the study population experienced gastrointestinal side effects. I wonder what their results would have shown had they remained in the study…

[marcia b]

I wonder how serious these gastrointestinal side effects are. Paul brings up a good point about how the decrease in estrogen leads to osteopenia and how this cannot be easily fixed by a change in diet or supplement. I feel things like changes in the diet, take some time to show results or improvements and this makes me wonder how effective this could be in the long run or how safe it is to take in supplement form.

[Karen]

This study left me with a lot of questions. How could the researchers have failed to measure fractures in the subjects? My mother suffers from osteoporosis, and bone fractures have been a serious problem for her in the past five years. Also, where are the studies about the effects of genistein ingested in soy products, rather than in tablet form?

Conventional treatments for osteoporosis like Fosomax already have severe gastrointestinal side effects. Researchers should be looking for integrative remedies that can be incorporated into a normal diet without causing digestive problems, not more pills.

[Sally]

This is such an unfair problem- and as has been stated above- treatments often come with their own problems, so it's kind of a catch-22 problem. So I guess, as a society, one solution should be to invest in education BEFORE this becomes a problem. Got milk ads are hardly enough to keep young women on top of their calcium intake. I think we need more awareness of this issue. So many women suffer from brittle bones in their old age, and just because it is not "life threatening" per say, it certainly decreases the quality of life drastically.

[GBuckley]

I agree with many of the comments here... I don't like taking pills (you never really know what your getting is supplements), and I prefer to get health benefits from food sources. Would eating soy provide similar benefits against osteoporosis? My last bone scan showed some osteopenia, and since I do not want to take estrogen, I would like to know how I can prevent more bone thinning through diet. There are so many confusing reports about soy... it works, it doesn't work, it may increase cancer risk, it may reduce cancer risk... so confusing! I am hoping for some clarity about this! In the meantime, I like tofu; it's a good source of protein and calcium, so I will continue to eat it in reasonable amounts and hope that it, along with exercise and other dietary sources of calcium, will help slow the bone loss.

[Jeffery Buckley]

I've been wondering with most of these studies the split between the placebo group and the treatment group isn't half. Here we have 389 subjects that were split 191/198. Why not the more equal way of 194/195?

[dalz]

I'd like to know how patients with estrogen receptor positive breast cancer are supposed to find natural treatment alternatives for osteopenia.

[Mialy]

Estrogen supplements can cause many unwanted side effects. Many doctors are unsure if the benefits outweigh the possible negative effects. Since phytoestrogen acts similarly to estrogen, can it cause similar adverse effects?

[Len Buknor]

Supplements like calcium, magnesium and phosphorous are minerals that are known to help build bone density. Various herbs also help build bone density, like coleus forskohli extract, passion flower and red peony. These work to provide protective antioxidants that support the body in healing injured bones. boron and vitamins d and k support calcium synthesis. Silica is necessary for forming collagen in bones and cartilage. While genistein may be still in the early stages of research, these ingredients have already been studied and known to increase bone density. You can even find supplements like PowerCal 600(http://www.newvitality.com/shop/powercal-600.aspx) that contain some of these ingredients.