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Victoria Epilepsy & Parkinson's Centre

Epilepsy Blog

Eat Well, Exercise & Supplement to Save Your Bones!


What is Osteoporosis?
Osteoporosis is a condition in which bones become thin and porous, decreasing bone strength and leading

to increased risk of breaking a bone. Osteopenia is an earlier stage of osteoporosis.

A few facts about bone density, osteoporosis and epilepsy:

  • Women and men alike begin to lose bone in their mid-30s
  • Women lose bone at a greater rate, from 2-3 per cent per year as they approach Menopause.
  • Many anti-epilepsy medications are associated with increased osteoporosis and risk of fracture
  • Osteoporosis can be diagnosed using a test called “Bone Densitometry”
  • Fractures from osteoporosis are more common than heart attack, stroke and breast cancer combined
  • The prescription medications which treat osteoporosis are effective, but they should be used only when a diagnosis of osteoporosis has been confirmed and should be taken in conjunction with the measures described in this article
  • Osteoporosis is often a preventable condition, however active steps to maintain bone health need to be taken

What do Bones Need to Stay Healthy?

Like so many other aspects of health, exercise is a key component of maintaining bone health. Weight bearing exercise stresses muscle which in turn puts stress and weight load on bones, causing bone to remodel and re-mineralize where it is needed.



Protein is a key part of our daily diet. Generally speaking, each day, we need to eat enough protein to maintain existing muscle mass and repair muscles which support bone and joints. A registered dietitian is a great person to speak with if you have questions about protein. High protein diets that contain multiple servings of meat and protein with each meal can also cause the body to lose calcium. So too much protein can be unhealthy, just as too little protein can be unhealthy!


These are the general recommendations from Dietitians on Canada for protein intake:

  • 0.75 g/kg for adult women
  • 0.84 g/kg for adult men eg a 200 lb man (91 kg) requires 76 g (~ 3oz) per day
  • 1 g/kg for pregnant and breastfeeding women and for men and women over 70 years.

Most products in the supermarket will list the amount of protein on the package. It is an important consideration when planning your meals to incorporate some protein in each meal. If you have impaired kidney function or diabetes, talk to your doctor and dietitian about your specific requirements for protein intake.

What about Calcium and Magnesium?
Calcium and Magnesium are both minerals essential for bone formation, bone density and strength. It is generally best to maximize dietary source and only use supplements to “top up” the remainder.

Average recommended daily Calcium intake from all sources:

  • 1000 mg for an adult man (1200 mg for a man over the age of 70)
  • 1200 mg for an adult woman

Average RDI for Magnesium is 500 mg, or approximately 50% of the RDI for Calcium.

The Dieticians of Canada website lists the Magnesium and Calcium content of some common foods. Please note, if you are taking a supplement of either Calcium or Magnesium (including Tums and Antacids), please discuss this with your physician and pharmacist, to be sure that you avoid any interactions with your prescription medications.

Vitamin D – the “sunshine Vitamin”

Vitamin D is essential for absorption of Calcium and Magnesium from the Intestine. Vitamin D enters the body through our diet or supplementation or it may be produced by skin exposure to UV rays from the sun. In a northern climate such as Victoria, B.C., for many months of the year we do not receive enough daily sunshine to produce adequate Vitamin D levels. Also, sunscreen, which protects the skin from certain forms of cancer, also inhibits the formation of Vitamin D. Therefore, Vitamin D supplementation remains a strong recommendation including from the Osteoporosis Society of Canada.

Top Recommendations for Maintaining Bone Health:

1. Exercise regularly, with weight bearing exercise to stimulate bone growth and bone density.

2. Avoid smoking and excessive alcohol and caffeine intake.

3. Eat well, obtain adequate protein to maintain muscle mass to support bone and joints and prevent injury.

4. Obtain adequate Calcium and Magnesium from your diet, supplement to “top up” what is still needed (see the Dietitians of Canada web-site for the mineral content of common foods). Only start supplementation after talking to your doctor and pharmacist about potential interactions. You may still need to supplement, but the timing of the supplementation may matter.

5. Take Vitamin D. In our climate, routine Vitamin D supplementation is cheap, safe and data-supported for bone health. At least 800 IU is recommended and up to 4000 IU per day for adults is safe.

6. Learn About Your Anti-Epilepsy Medications. Do they cause osteoporosis? If so, talk to your doctor, pharmacist and health care team about what steps are possible to increase your bone health.

To contact the author, please contact Jonathan Cox, Pharmacist and co-owner, Vital Health Pharmacy at 778-433-6060 or visit our web-site at:
Vital Health Pharmacy, is an independent, Victoria, B.C. based health-only specialty pharmacy located at 1825 Fort Street (Fort at Bank Street).

Posted by Jonathan L. Cox, B.Sc. Pharm, Co-owner on 31st Jul 2014 2:42pm