Prevention and treatment of osteoporosis with traditional herbal medicine

‘Kidney tonifying’ herbal medicine has been traditionally using in treatment of fractures, joint diseases, and gonadal dysfunctions in Asia for thousands of years. In the last 2 decades, many such herbal formulae have also been developed and evaluated clinically in smallscale trials for prevention and treatment of osteoporosis. In order to explore the potential underlying mechanisms as to how these herbs or herbal formulae work on their target cells, tissues or organs, both in vitro and in vivo experimental studies have been conduced. The related English literature is however lacking and majority of such studies are published in local journals, such as in China. Up to date, no single herb or herbal component has been found to be effective since osteoporosis is a multifactorial deteriorating skeletal condition. Phytoestrogen, found in many herbs or plants, shows structural similarities to estrogen and binds to estrogen receptors, suggesting an important pathway for maintaining bone mineral homeostasis and as a bioactive component in quality assurance. This paper provides a brief overview of the herbal preparations developed for the prevention and treatment of estrogen deficiency induced bone loss in rodent animals and postmenopausal women. The outcomes of the majority of the previous investigations are encouraging. This warrants further studies, including identification and purification of active components for development of new herbal formulae and evidence-based clinical trials in prevention and treatment of osteoporosis and its related medical conditions. The potential beneficial effects on non-skeletal elements associated with prevention of fragility fractures are also briefly mentioned. In order to enhance the quality of the research, "General Guidelines for Research & Development of Herbal Medicine and Evaluation of Its Efficacy in the Prevention and Treatment of Osteoporosis and Fragility Fractures" have therefore been proposed.