Review of the completed urinalyses revealed a trend towards
elevated norepinephrine and
decreased serotonin in the AIS patients as compared to non-scoliotics.
Since these neurotransmitters are typically expressed in specific cortical areas, this pattern of imbalance may manifest as a functional hemisphericity, causing asymmetrical efferent responses to peripheral, afferent muscular inputs, and altering firing thresholds in their respective pathways.
Clues to Scoliosis Causes
Perhaps we don't know exactly what causes scoliosis, but we do know what can cause of many of the conditions that tend to appear in conjunction with scoliosis. Logically, it would make sense to consider that these conditions appear together because they have the same root cause. Here are a few of the conditions known to occur more frequently in people with scoliosis:
1. Mitral valve prolapse - Mitral valve prolapse occurs frequently along with scoliosis, both when they occur as "isolated" features, or together as common conditions found in many connective tissue disorders and other genetic disorders such as Down syndrome. A study in India found that 55% of the children with MVP had scoliosis. Multiple studies have shown that the majority of patients with mitral valve prolapse, as much as 85%, are magnesium deficient and that magnesium supplementation alleviates the symptoms of MVP. Magnesium deficiencies have also been linked to osteoporosis and osteopenia, conditions also associated with scoliosis. With this many links, it is would be logical to consider the possibility that a magnesium deficiency may be an underlying contributing factor in scoliosis.
Magnesium deficiencies are also known to cause muscle contractions, and contracted muscles may play a role in scoliosis, as noted in the studies in the previous section on scoliosis and posture.
Interestingly, like "idiopathic" scoliosis, mitral valve prolapse is much more common in females than males. Both mitral valve prolapse and "idiopathic" scoliosis more commonly develop or worsen after the end of childhood and the beginning of puberty. I suspect one reason for this may be because puberty is a high risk time for nutritional deficiencies. Dr. Roger J. Williams pointed out in some of his books that the same diet that is perfectly adequate for young children may not be adequate for a child going through puberty, when nutritional requirements rise to support sexual development.
Another reason I suspect that women may develop conditions like MVP and scoliosis at puberty is that puberty marks the start of menstruation, and menstruation brings with it a greater chance of loss of nutrients. It is well established that menstruating women are at greater risk of anemia than men or non-menstruating women because of iron lost through menstruation. However, iron is not likely to be the only nutrient lost during menstruation. Iron is a major component of blood, but it is not the only component. Blood has many biochemical components, and one of them is magnesium.
Females tend to get many conditions linked to magnesium deficiencies more frequently than men, such as mitral valve prolapse and fibromyalgia. These conditions are not only more common in females, but specifically they are more common in women of child bearing age, i.e. women who are likely to be menstruating. As such, it would be highly logical to consider the possibility that menstruating women have higher magnesium requirements and/or are at a greater risk of magnesium deficiencies than men or non-menstruating women.
If we consider this possibility, that magnesium deficiencies may be more likely to occur in menstruating women than in other types of people, then many of the of the following observations:
- scoliosis occurs more in females
- scoliosis occurs more in females at puberty than at other ages
- MVP occurs more in females
- MVP is more common in women of child bearing age than it is in men and women not of child bearing age
- most cases of MVP have been linked to magnesium deficiencies
- MVP and scoliosis occur together frequently
- scoliosis is frequently linked to lowered bone densities
- magnesium deficiency is one of the known causes of osteoporosis
all make sense. The findings from many studies all fit together like pieces from a puzzle. The table below illustrates one scenario of how all of these studies may logically interrelate:
Increased nutritional requirements needed to support sexual development, replace nutrients lost through menstruation
Magnesium and other deficiencies more likely to occur and cause:
Osteopenia/Osteoporosis => Weakened spinal column collapsing contributes to scoliosis
Mitral valve prolapse
2. Bleeding tendencies - Multiple studies have documented bleeding tendencies occurring in conjunction with scoliosis. Is there a condition that would cause both prolonged bleeding times and osteoporosis, another condition commonly found in scoliosis? There is. Vitamin K deficits are associated with both prolonged bleeding times and osteoporosis, and are, perhaps, a factor to be considered in the development of scoliosis.
If there is a connection, a deficiency of vitamin K would logically explain why the three conditions - prolonged bleeding times, osteoporosis and scoliosis, frequently occur together. Symptoms of prolonged bleeding times caused by a vitamin K deficiency include hematuria (blood in the urine), easy bruising, heavy or prolonged menstrual bleeding, nosebleeds, gastrointestinal bleeding, eye hemorrhages and nosebleeds.
See my section on Menorrhagia for more on this topic.
3. Hypoestrogenism (low estrogen levels) - Low estrogen levels have been linked to scoliosis in a variety of studies. The data in a study of ballet dancers suggested that a delay in menarche and prolonged intervals of amenorrhoea that reflect prolonged hypoestrogenism may predispose ballet dancers to scoliosis and stress fractures. Low estrogen levels are a known cause of osteoporosis and osteopenia, the conditions many other studies have linked to scoliosis. Ballet dancers are thought to suffer from hypoestrogenism because they tend to over exercise and keep low body weights, conditions that can cause low estrogen levels. Besides ballet dancers, elite female athletes who train a lot also tend to suffer from low estrogen levels, delayed menarche, fractures and scoliosis. A 10-fold higher incidence of scoliosis was found in rhythmic gymnastic trainees (12%) compared to a control group. 1.1%). Delay in menarche and hypermobile joints are common in rhythmic gymnastic trainees.
Females athletes in general have high rates of scoliosis. A likely reason for this is because women who exercise excessively, like professional dancers and athletes, may stop menstruating, which lowers their estrogen levels and makes them at risk for osteoporosis, a condition closely linked to scoliosis. This increased risk of scoliosis and osteoporosis is similar to what happens when women reach menopause. Both athletes and post menopausal women are at risk for low estrogen levels, fractures, osteopenia, scoliosis and osteoporosis. Perhaps it is because the low estrogen levels that occur in both groups of women cause weakened bones which result in osteoporosis, scoliosis and fractures.
Besides over exercising and menopause, hypoestrogenism and many of the other conditions from the studies noted above that occur along with scoliosis have also been linked to a variety of nutritional deficiencies. These include:
Fractures - Fractures are linked to osteoporosis, which can be caused by a wide variety of nutritional deficiencies. A primary cause of both fractures and osteoporosis is a vitamin K deficiency. As noted above, vitamin K deficiencies can also cause bleeding tendencies, a condition which has also been linked to scoliosis.
Hypermobility (double jointedness) is a feature of rickets which has been linked to a wide of nutritional deficits, including deficits of vitamin D, calcium, magnesium (see mitral valve prolapse and magnesium above) and zinc.
Hypoestrogenism, delayed menarche and low body weights can be caused by deficiencies of zinc. Monkeys with zinc deficiencies had delayed sexual maturation, reduced weight gain, and poorer bone mineralization, many of the same conditions found in humans with scoliosis. Zinc deficiencies in humans have been linked to delayed puberty and low body weights. Zinc deficiencies in animal studies have been shown to cause rickets.
4. Pectus excavatum (sunken chests) - There is a statistically significant relationship between pectus excavatum and scoliosis. Pectus excavatum can be caused by rickets, which as noted above, can be caused by a wide variety of nutritional deficiencies.
Interestingly, scoliosis is a feature of rickets, as are fractures, pectus excavatum, hypermobility and osteopenia, the same conditions that are all linked to "idiopathic" scoliosis in the studies above. Could many cases of "idiopathic" scoliosis really be caused by mild and undiagnosed forms of rickets? It seems pretty likely to me if you look at all of these studies with an eye toward the big picture.
Zinc deficiencies in monkeys have been known to cause a rachitic syndrome similar to rickets in humans. Interestingly, I found a study that showed gymnasts tended to suffer from zinc deficiencies, and a separate study that found gymnasts often had scoliosis and hypermobile joints, which are features of rickets. (For more on this topic, see my section on Zinc.)
Many scoliosis researchers tend to spend a lot of time searching for a singular cause of scoliosis. Their theories tend to consider singular and isolated causes such as a defective gene, a symmetry problem in the brain, and a melatonin shortage. Yet these theories fail to take into account all of the thousands of other studies that have already been done on scoliosis, and therefore tend to leave a lot of unanswered questions.
If scoliosis was caused solely by a melatonin shortage or a defective gene, then why would it occur more frequently in females? Why would it occur more frequently at puberty? Why would there be a link between scoliosis and mitral valve prolapse, a condition which can often be corrected with magnesium supplementation? Why do many people with scoliosis have osteopenia or osteoporosis? Why do athletes, ballets dancers and rhythmic gymnasts get scoliosis more often than the general population? Why do many people with scoliosis have pectus excavatum, osteopenia, fractures and hypermobility, conditions which are all features of rickets? Why is delayed puberty linked to scoliosis?
We know that osteoporosis is a highly multifactorial condition. There are probably well over a hundred different factors that have been identified to date as possible contributing factors in osteoporosis. Osteoporosis and scoliosis frequently occur together. If you consider the possibility that scoliosis, like osteoporosis, is a multifactorial disorder and that two of the major causative factors are likely to be nutrition and estrogen levels, then there are highly logical answers to all of the questions and associations noted above.