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- <strong>Osteoporosis, aging, tissue renewal, and product science</strong>
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- The incidence of osteoporosis, like obesity, has been increasing in recent decades. The number of hip
- fractures in many countries has doubled in the last 30 or 40 years (Bergstrom, et al., 2009). An exception
- to that trend was Australia in the period between 2001 and 2006, where the annual incidence of hip fractures
- in women over 60 years old decreased by 28.3%. During those years, the number of prescriptions for "hormone
- replacement therapy" decreased by 54.6%, and the number of prescriptions for bisphosphonate increased by
- 245%. The publication of the Women's Health Initiative results in 2002 (showing that the Prem-Pro treatment
- caused breast cancer, heart attacks, and dementia), led to a great decrease in the use of estrogen
- treatments everywhere. After the FDA approved estrogen's use in 1972 for the prevention of osteoporosis the
- number of women using it increased greatly, and by 1994, 44% of women in the US had used it. After the WHI
- results were published, the number of prescriptions for "HRT" fell by more than half, and following that
- decrease in estrogen sales, the incidence of breast cancer decreased by 9% in women between the ages of 50
- and 54.With the incidence of hip fractures increasing while the percentage of women using estrogen was
- increasing, it seems likely that there is something wrong with the theory that osteoporosis is caused by an
- estrogen deficiency. That theory was derived from the theory that menopause was the consequence of ovarian
- failure, resulting from the failure to ovulate and produce estrogen when the supply of eggs was depleted.
- The theory was never more than an ideological preference, but the estrogen industry saw it as an opportunity
- to create a huge market.There are many studies that seem to imply that the greater incidence of osteoporotic
- fractures among women is the result of their exposure to estrogen during their reproductive years. This
- would be analogous to the understanding that it is the cumulative exposure to estrogen that ages the nerves
- in the hypothalamus that control the cyclic release of the gonadotropic hormones, causing the
- menopause.<strong>. . . the nature of science itself changed around the middle of the last century, becoming
- product and disease oriented, so that now relatively few people are continuing to study bones
- objectively.</strong>Animal studies show that estrogen stunts growth, including bone growth. The high
- estrogen levels in girls' teen years and early twenties accounts for the fact that women's bones are lighter
- than men's. In rat studies, treatment with estrogen was found to enlarge the space between the jawbone and
- the teeth, which is a factor in periodontal disease (Elzay, 1964). Teeth are very similar to bones, so it's
- interesting that treating male or female rats with estrogen increases their incidence of tooth decay, and
- removing their gonads was found to decrease the incidence (Muhler and Shafer, 1952). Supplementing them with
- thyroid hormone decreased the incidence of cavities in both males and females (Bixler, et al., 1957).One of
- the "estrogen receptors" appears to actively contribute to bone loss (Windahl, et al., 1999, 2001). Studies
- in dogs following the removal of their ovaries found that there was an increase of bone remodeling and bone
- formation rate in the first month, followed by a few months of slowed bone formation, but that by 10 months
- after the surgery the bones had returned to their normal remodeling rate, and that "at no time was a
- significant reduction in bone volume detected" (Boyce, et al., 1990). With the removal of the ovaries, the
- production of progesterone as well as estrogen is affected, but the adrenal glands and other tissues can
- produce those hormones.Until the influence of the estrogen industry overwhelmed it, ordinary science was
- studying bone development in comprehensive ways, understanding its biological roles and the influences of
- the environment on it. But the nature of science itself changed around the middle of the last century,
- becoming product and disease oriented, so that now relatively few people are continuing to study bones
- objectively.The outstanding physical-chemical property of bone is that it is a reservoir-buffer of carbon
- dioxide, able to bind huge amounts of the gas into its structure.When carbon dioxide increases in the
- bloodstream it is at first absorbed rapidly by the bones, and if the blood level of CO2 is kept high day
- after day, the rate of absorption gradually slows down, but in experiments that have continued for several
- weeks the bones were still slowly absorbing more carbon dioxide; the absorption curve seems to be
- asymptotic. When people move to or from high altitudes, their bones appear to continue adapting to the
- different gas pressures for years. A reduction of atmospheric pressure (which allows the tissues to retain
- more carbon dioxide) helps to reduce the calcium loss caused by immobility (Litovka and Berezovs'ka, 2003;
- Berezovs'kyi, et al., 2000), and promotes the healing of damaged bone (Bouletreau, et al., 2002). Ultrasound
- treatment, which accelerates bone healing, stimulates processes similar to reduced oxygen supply (Tang, et
- al., 2007). The mineral in newly formed bone is calcium carbonate, and this is gradually changed to include
- a large amount of calcium phosphate. Besides forming part of the mineral, carbon dioxide is also
- incorporated into a protein (in a process requiring vitamin K), in a process that causes this protein,
- osteocalcin, to bind calcium. The osteocalcin protein is firmly bonded to a collagen molecule. Collagen
- forms about 30% of the mass of bone; several percent of the bone consists of other organic molecules,
- including osteocalcin, and the rest of the mass of the bone consists of mineral.Thyroid hormone is essential
- for forming carbon dioxide. In the early 1940s, experimental rabbits were fed their standard diet, with the
- addition of 1% desiccated thyroid gland, which would be equivalent to about 150 grains of Armour thyroid for
- a person. They became extremely hypermetabolic, and couldn't eat enough to meet their nutritional needs for
- growth and tissue maintenance. When they died, all of their tissues weighed much less than those of animals
- that hadn't received the toxic dose of thyroid, except for their bones, which were larger than normal.
- Experiments with the thin skull bones of mice have shown that the active thyroid hormone, T3, increases the
- formation of bone. To increase cellular respiration and carbon dioxide production, T3 increases the activity
- of the enzyme cytochrome oxidase, which uses copper as a co-factor. Increased thyroid activity increases the
- absorption of copper from foods.There is an inherited condition in humans, called osteopetrosis or marble
- bone disease, caused by lack of a carbonic anhydrase enzyme, which causes them to retain a very high level
- of carbon dioxide in their tissues. Using a chemical that inhibits carbonic anhydrase, such as the diuretic
- acetazolamide, a similar condition can be produced in animals. Acetazolamide inhibits the bone resorbing
- actions of parathyroid hormone, including lactic acid formation and the release of the lysosomal enzyme,
- beta-glucuronidase (Hall and Kenny, 1987). While lactic acidosis causes bone loss, acidosis caused by
- increased carbonic acid doesn't; low bicarbonate in the body fluids seems to remove carbonate from the bone
- (Bushinsky, et al., 1993), and also mineral phosphates (Bushinsky, et al., 2003). The parathyroid hormone,
- which removes calcium from bone, causes lactic acid to be formed by bone cells (Nijweide, et al., 1981;
- Lafeber, et al., 1986). Lactic acid produced by intense exercise causes calcium loss from bone (Ashizawa, et
- al., 1997), and sodium bicarbonate increases calcium retention by bone. Vitamin K2 (Yamaguchi, et al., 2003)
- blocks the removal of calcium from bone caused by parathyroid hormone and prostaglandin E2, by completely
- blocking their stimulation of lactic acid production by bone tissues. Aspirin, which, like vitamin K,
- supports cell respiration and inhibits lactic acid formation, also favors bone calcification. Vitamin K2
- stimulates the formation of two important bone proteins, osteocalcin and osteonectin (Bunyaratavej, et al.,
- 2009), and reduces the activity of estrogen by oxidizing estradiol (Otsuka, et al, 2005).The formation of
- eggshell, which is mostly calcium carbonate, is analogous to the early stage of bone formation. In hot
- weather, when chickens pant and lower their carbon dioxide, they form thin shells. A sodium bicarbonate
- supplement improves the quality of the eggshell (Balnave and Muheereza, 1997; Makled and Charles, 1987).
- Chickens that habitually lay eggs with thinner shells have lower blood bicarbonate than those that lay thick
- shelled eggs (Wideman and Buss, 1985). One of the arguments for stopping the sale of DDT in the US was that
- it was threatening to cause extinction of various species of bird because it caused them to lay eggs with
- very weak shells. Several other synthetic estrogenic substances, ethynylestradiol, lindane, PCBs, cause
- eggshell thinning, partly by altering carbonic anhydrase activity (Holm, et al, 2006). Estrogen and
- serotonin activate carbonic anhydrase in some tissues, progesterone tends to inhibit it. DDE, a metabolite
- of DDT, reduces medullary bone formation in birds (Oestricher, et al., 1971) and bone mineral density in men
- (Glynn, et al., 2000). Among its estrogenic effects, DDE increases prolactin (Watson, et al., 2007); one
- form of DDT inhibits progesterone synthesis and increases estrogen (Wojtowics, et al., 2007)In youth, the
- mineralization of the collagen framework is slightly lower than in maturity, and the bones are more
- flexible. With aging, the mineralization increases progressively, and the proportion of collagen decreases
- slightly, and the bones become increasingly brittle. (Rogers, et al., 1952; Mbuyi-Muamba, et al., 1987).
- Collagen is a major part of the extracellular substance everywhere in the body, and its concentration
- increases with aging in the non-calcified tissues. There is considerable renewal and modification of
- collagen, as new molecules are formed and old molecules broken down, but its average structure changes with
- aging, becomes less soluble and more rigid, as the result of chemical cross-links formed between molecules.
- These cross-links are involved in regulating the differentiation of bone cells (Turecek, et al., 2008).
- Recently (August 2, 2011), Deasey et al., have published evidence showing that cross-linking is required for
- bone mineralization (2011).<strong>The outstanding physical-chemical property of bone is that it is a
- reservoir-buffer of carbon dioxide, able to bind huge amounts of the gas into its structure.</strong
- >Around 1950, Fritz Verzar began studying the changes of collagen that occur with aging, and his work led to
- the "collagen theory of aging." He showed that older, stiffer, less elastic tendons have a higher "melting"
- or contracting temperature than young tendons. (This effect is responsible for the curling of a piece of
- meat when it is frying.) Verzar and his colleagues investigated the effects of hormonal treatments on the
- aging of rat collagen, especially in their tail tendons. They found that estrogen treatment increased the
- stiffness and the melting temperature of collagenous tissues. While estrogen increased the cross-linking
- with aging, removing the pituitary gland was found to retard the aging. Later, the cross-linking enzymes
- transglutaminase and lysyl oxidase, which are induced by estrogen, were found to be a major factor in the
- cross-linking of collagen and other molecules.When estrogen was found to age the connective tissues, it was
- assumed that continual breeding during an animal's life-time, greatly increasing the total exposure of the
- tissues to estrogen, would increase the aged rigidity of the connective tissues, but these animals were
- found to have less rigid tissues. During pregnancy other hormones, especially progesterone, were also
- increased, and it was suggested that this reversed the effects of aging and estrogen. Since most people had
- believed that frequent pregnancies would cause a woman to age more rapidly, a large survey of records was
- done, to compare the longevity of women with the number of pregnancies. It was found, in the very extensive
- Hungarian records, that life-span was increased in proportion to the number of pregnancies.Despite these
- very interesting results in the 1950s and 1960s, the growing influence of the estrogen industry changed the
- direction of aging research, favoring the belief that decreasing estrogen accelerated the deterioration of
- tissues in aging, and the popularity of Denham Harman's "free radical theory of aging" led many people to
- assume that random reactions produced by lipid peroxidation were responsible for most of the cross-linking,
- and that theory was gradually replaced by the "glycation" theory of aging, in which sugar molecules break
- down and form the cross-links, by random, non-enzymic processes. Estrogen's role in aging was completely
- by-passed.The meat industry is interested in reducing the toughness of meat, by influencing the nature of
- the collagen in muscle. Castrated animals were found to produce meat that was tenderer than that of intact
- males. When castrated animals were treated with testosterone, the amount of collagen was increased, making
- the meat tougher. But when dihydrotestoserone, which can't be converted to estrogen was used, the meat
- didn't become tough. Treatment with estrogen produced the same increase of collagen as treatment with
- testosterone, showing that testosterone's effect was mainly the result of its conversion to estrogen
- (Miller, et al., 1990).In the 1960s and '70s the estrogen industry was looking for ways to build on the
- knowledge that in puberty estrogen is responsible for accelerating the calcification of the growth plate at
- the ends of the long bones, and to find a rationale for selling estrogen to all women concerned with the
- problems of aging. As bone metabolism was investigated, two kinds of cell were found to be active in
- constantly remodeling the bone structure: Osteoclasts (breaking it down), and osteoblasts (building new
- bone). Estrogen was found to slow the actions of the osteoclasts, so the idea that it would delay
- osteoporosis became the basis for a huge new marketing campaign. Slowing bone metabolism became the focus.
- Although estrogen was known to increase prolactin, and prolactin was known to accelerate bone loss, nearly
- all publications began to focus on substances in the blood or urine that corresponded to the rate of bone
- turnover, with the implication that increasing bone turnover would correspond to a net loss of bone.This was
- the context in which, during the 1980s, articles about thyroxine's role in causing osteoporosis began to
- appear. The thyroid hormone supports bone renewal, and increases indicators of bone breakdown in the blood
- and urine. If estrogen's use was to be justified by slowing bone turnover, then the effects of thyroid,
- accelerating bone turnover, should be interpreted as evidence of bone destruction.A basic problem with many
- of the publications on thyroid and bone loss was that they were talking about an unphysiological medical
- practice (prescribing the pre-hormone, thyroxine), which frequently failed to improve thyroid function, and
- could even make it worse, by lowering the amount of T3 in the tissues.Later, it was noticed that high TSH
- was associated with the signs of lower bone turnover. TSH rises when there is less thyroid hormone, but
- (after the recombinant TSH became available for medical use) a few publications argued that it was the TSH
- itself, rather than the absence of thyroid hormone, that was "protecting" the bones (lowering the evidence
- of bone turnover). The doctrine that had been developed to support estrogen therapy was now used to oppose
- thyroid therapy. Keeping the TSH high would slow bone turnover. Working in this cultural context, genetic
- engineers at Amgen identified a protein that inhibited the formation of osteoclast cells, and slowed bone
- metabolism. It was suggested that it was responsible for estrogen's suppression of the osteoclasts, and many
- publications appeared showing that it was increased by estrogen. It was named "osteoprotegerin," meaning
- "the bone protecting protein." Prolactin increases osteoprotegerin (OPG), reducing bone resorption just as
- estrogen does. Serotonin also increases OPG, and it turns out that OPG is elevated in all of the
- pathological conditions associated with high serotonin, including cancer, pulmonary artery hypertension,
- vascular calcification, and even bone loss.While Arthur Everitt, Verzar, and others were studying the
- effects of the rat's pituitary (and other glands) on collagen, W. D. Denckla investigated the effects of
- reproductive hormones and pituitary removal in a wide variety of animals, including fish and mollusks. He
- had noticed that reproduction in various species (e.g., salmon) was quickly followed by rapid aging and
- death. Removing the pituitary gland (or its equivalent) and providing thyroid hormone, he found that animals
- lacking the pituitary lived much longer than intact animals, and maintained a high metabolic rate. Making
- extracts of pituitary glands, he found a fraction (closely related to prolactin and growth hormone) that
- suppressed tissue oxygen consumption, and accelerated the degenerative changes of aging.Aging, estrogen,
- cortisol, and a variety of stresses, including radiation and lipid peroxidation, chemically alter collagen,
- producing cross-links that increase its rigidity, and affect the way it binds minerals. The cross-linking
- enzymes induced by estrogen are involved in the normal maturation of bone collagen, and at puberty when
- estrogen increases, bone growth is slowed, as the cross-linking and mineralization are accelerated. With
- aging and the accumulation of heavy metals and polyunsaturated fats, random oxidative processes increase the
- cross-linking. In bones, the relatively large masses of cartilage absorb oxygen and nutrients slowly, so
- internally the amount of oxygen is very limited, about 1/5 as much as at the surface, and this low oxygen
- tension is an important factor in regulating growth, differentiation, cross-linking, and calcification,
- maintaining bone integrity. But in blood vessels the connective tissues are abundantly supplied with oxygen
- and nutrients; this is normally a factor regulating the production of collagen and its cross-linking, and
- preventing calcification. When the factors promoting collagen synthesis and maturation are increased
- systemically, with aging and stress, the excess cross-linking slows the biological renewal process in bones,
- but in blood vessels the same processes creating excess cross-linking initiate a calcification process,
- involving the various factors that in youth are responsible for normal maturation of bone.Prolactin, like
- estrogen, interferes with thyroid function and oxygen consumption (Wade, et al., 1986; Strizhkov, 1991;
- Spatling, et al., 1982). Many years ago, repeated lactation was considered to cause osteoporosis and loss of
- teeth, and prolactin, which mobilizes calcium from bones for the production of milk, was recognized as an
- important factor in bone loss. Drugs that increase prolactin were found to cause osteoporosis. In the 40
- years since the drug industry began its intense promotion of estrogen to prevent and treat osteoporosis,
- there has been very little attention to the fact that estrogen increases prolactin, which contributes to
- osteoporosis, but some people (e.g., Horner, 2009) have noticed that oral contraceptives and menopausal
- hormone treatments have damaged the bones of the inner ear, causing otosclerosis and impaired hearing, and
- have suggested that prolactin mediates the effect.A few years ago, the "serotonin reuptake inhibitor"
- antidepressants, already known to increase prolactin by increasing the effects of serotonin, were found to
- be causing osteoporosis after prolonged use. Estrogen increases serotonin, which besides promoting the
- secretion of prolactin, also stimulates the production of parathyroid hormone and cortisol, both of which
- remove calcium from bone, and contribute to the calcification of blood vessels. The association between
- weakened bones and hardened arteries is now widely recognized, but researchers are being careful to avoid
- investigating any mechanisms that could affect sales of important drug products, especially estrogen and
- antidepressants.Following the recognition that the SSRI drugs were causing osteoporosis, it was discovered
- that the serotonin produced in the intestine causes bone loss, and that inhibiting intestinal serotonin
- synthesis would stop bone loss and produce a bone building anabolic effect (Inose, et al., 2011). One group
- that had been concentrating on the interactions of genes commented that, recognizing the effects of
- intestinal serotonin, they had suddenly become aware of "whole organism physiology" (Karsenty and Gershon,
- 2011).In previous newsletters I have talked about the ability of intestinal irritation and the associated
- increase of serotonin to cause headaches, asthma, coughing, heart and blood vessel disease, muscular
- dystrophy, flu-like symptoms, arthritis, inflammation of muscles and nerves, depression, and inflammatory
- brain diseases. With the new recognition that serotonin is a basic cause of osteoporosis, intestinal health
- becomes a major issue in aging research.The protein that inhibits intestinal formation of serotonin is the
- low density lipoprotein receptor-related protein. This seems likely to have something to do with the fact
- that "low" HDL is associated with better bones. A low level of LDL is associated with increased vertebral
- fractures (Kaji, et al., 2010).Cartilage synthesis and turnover are highest at night. It is inhibited by
- metabolic acidosis (increased lactic acid), but not by respiratory acidosis (CO2) (Bushinsky, 1995). Since
- most calcium is lost from bone during the night (Eastell, et al., 1992; even in children: DeSanto, et al.,
- 1988) in association with the nocturnal rise of the catabolic substances, such as free fatty acids,
- cortisol, prolactin, PTH, and adrenalin, things which minimize the nocturnal stress can decrease the bone
- turnover. These include calcium (Blumsohn, et al., 1994) and sugar. Catabolic substances and processes
- increase with aging, especially at night. Babies grow most during the night when bone turnover is high, and
- even a daytime nap accelerates collagen turnover (Lutchman, et al., 1998). Discussions about whether a
- certain person's osteoporosis is "menopausal osteoporosis" or "senile osteoporosis" have neglected the
- possibility that osteoporosis doesn't begin in either menopause or old age, but that it is the result of
- life-long developmental processes that interact with all the factors that are involved in aging. The fact
- that the collagen content of old bone is lower than in young bone (as a percentage of bone weight) shows
- that the problem in osteoporosis isn't a lack of calcification, it's a deficiency of tissue renewal,
- parallel to sarcopenia, the decrease of muscle mass with aging. Systemically decreased tissue renewal would
- account for the association of bone loss with other processes such as male baldness (Morton, et al., 2007)
- and Alzheimer's disease (Zhou, et al., 2011, Duthie, et al., 2011).A high level of respiratory energy
- production that characterizes young life is needed for tissue renewal. The accumulation of factors that
- impair mitochondrial respiration leads to increasing production of stress factors, that are needed for
- survival when the organism isn't able to simply produce energetic new tissue as needed. Continually
- resorting to these substances progressively reshapes the organism, but the investment in short-term
- survival, without eliminating the problematic factors, tends to exacerbate the basic energy problem. This
- seems to be the reason that Denckla's animals, deprived of their pituitary glands, but provided with thyroid
- hormone, lived so long: they weren't able to mobilize the multiple defenses that reduce the mitochondria's
- respiratory energy production. Several things that the geneticists would never be able to fit into their
- schemes of "bone regulatory molecules" such as OPG, growth hormone, parathyroid hormone, and estrogen, fit
- neatly with the idea that bone health is maintained by respiratory energy and tissue renewal, under the
- influence of thyroid hormone. For example, adrenaline, which is increased by stress, aging, and
- hypothyroidism (and in many cases by estrogen), causes bone loss. Even the bone loss caused by immobility
- can be blocked by an adrenaline blocker such as propranolol. (The stress of immobility also famously
- increases serotonin.) Adrenaline tends to decrease carbon dioxide and increase lactic acid, and it strongly
- increases parathyroid hormone (Ljunhgall S, et al., 1984). Calcium activates mitochondrial respiration, and
- lowers adrenaline (Luft, et al., 1988), parathyroid hormone (Ohgitani, et al., 1997), and prolactin (Kruse
- and Kracht, 1981). Copper, which is the co-factor for the cytochrome C oxidase enzyme, activated by thyroid,
- is essential for bone formation and maintenance, and is consistently deficient in osteoporosis. Thyroid
- hormone increases the body's ability to assimilate copper. Aspirin, which stimulates bone formation, has
- other thyroid-like actions, including activation of mitochondrial respiration and energy production, with an
- increase of cytochrome C oxidase (Cai, et al., 1996), and it lowers serotonin (Shen, et al., 2011). It also
- apparently protects against calcification of the soft tissues, (Vasudev, et al., 2000), though there has
- been surprisingly little investigation of that. "Aspirin can promote trabecular bone remodeling, improve
- three-dimensional structure of trabecular bone and increase bone density of cancellous in osteoporotic rats
- by stimulating bone formation. It may become a new drug for the treatment of osteoporosis" (Chen, et al.,
- 2011).A wide range of inflammatory mediators that accelerate inflammation and bone loss also inhibit thyroid
- function. People who ate more polyunsaturated fat, which inhibits thyroid and oxidative metabolism, were
- several times more likely to have osteoporotic fractures (that is, essentially spontaneous fractures) than
- people who ate the least (Martinez-Ramirez, et al., 2007). Arachidonic acid stimulates prolactin secretion,
- and prolactin acts on the thyroid gland to decrease its activity, and on other tissues to increase their
- glycolysis (with lactate production), while decreasing oxidative metabolism (Spatling, et al., 1982;
- Strizhkov, 1991). Living at high altitude, which strengthens bones, increases thyroid activity and decreases
- prolactin (Richalet, et al., 2010) and parathyroid hormone (Khan, et al., 1996). It lowers free fatty acids,
- which lower bone mass by reducing bone formation and increasing bone resorption (Chen, et al., 2010). In
- menopausal women, polyunsaturated fatty acids and even monounsaturated fats are associated with bone loss,
- fruit and vegetable consumption protects against bone loss (Macdonald, et al., 2004).While it's very
- interesting that the drug propranol which blocks adrenaline, and drugs that block serotonin formation, have
- bone protective and restorative effects, they also have undesirable side effects. Food choices that optimize
- oxidative metabolism are the safest, as well as the most economical, way to approach the problem of
- osteoporosis and other degenerative changes. A person can easily perceive changes in appetite, quality of
- sleep, changes in skin, hair, and mood, etc., but blood tests could be used to confirm that the right
- choices were being made. Tests for vitamin D, parathyroid hormone, free fatty acids, and CO2/bicarbonate, as
- well as the hormones, can be helpful, if a person isn't sure whether their diet, sunlight exposure, and
- thyroid supplementation is adequate. The popular medical understanding of the organism is based on a
- mechanistic view of causality, in which genes have a central role, causing things to develop and function in
- certain ways, and that hormones and drugs can cause genes to increase or decrease their activity. Genes that
- build bones can be activated by one substance, and genes that tear down bones can be inhibited by another
- substance. The "osteoprotegerin" story illustrates the problem with that kind of thinking. Vernadsky's
- description of an organism as a "whirlwind of atoms" is probably a better way to think of how "causality"
- works. The moving air in a whirlwind forms a self-intensifying system, with the motion reducing the
- pressure, causing more air to be drawn into the system. The atoms moving in coordination aren't acting as
- separate things, but as parts in a larger thing. The way in which increased metabolism in the bones acts
- favorably on the metabolism of kidneys, blood vessels, lungs, liver, digestive system, etc., which in turn
- favors the bones' renewal, is analogous to the tendency of a whirlwind to intensify as long as there is a
- source of energy. <strong>The intensity of oxidative metabolism is the basic factor that permits continuing
- coordination of activity, and the harmonious renewal of all the components of the organism.</strong>
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