December 18th HSN Q&A
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Continuous Glucose Monitoring (CGM):
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  - CGM is used for monitoring blood glucose levels and is especially useful for diabetics.

  - It can help non-diabetics optimize their diet by understanding the impact of specific carbohydrates.

  - The speaker shared personal experiences with CGM and its benefits in managing A1C levels.

  - A partnership with Nutrisense was mentioned, offering deals for HSN members and clients.

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Calcium and Bone Health:
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  - Discussion on the appropriate intake of calcium and its impact on arterial health.

  - The speaker met with AlgaeCal and discussed their product, which contains 720 mg of calcium.

  - The speaker recommends aiming for 800 mg of calcium from food sources and supplements if necessary.

  - It was suggested to take calcium with vitamin D and K2 to prevent arterial calcification.

  - The speaker advised against taking more than 500 mg of calcium at one time and suggested splitting doses throughout the day.

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Whole Body Vibration (WBV) Devices:
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  - The speaker is researching the benefits of WBV devices like Power Plate and Meridian.

  - There is a debate about the effectiveness and safety of high-energy versus low-energy vibration for bone health.

  - The speaker plans to interview experts from both sides to provide a clearer recommendation in the future.

Supplement Strontium:

  - Strontium can improve bone mineral density (BMD) on DEXA scans but it's unclear if it also increases bone strength.

  - The speaker uses strontium selectively for patients with very low BMD.

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Magnesium Supplementation:
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  - Magnesium is essential for metabolic health and is difficult to obtain in sufficient amounts from diet alone.

  - The speaker recommends a dosage of 5 mg per pound of body weight, cautioning against taking high doses at once due to potential for diarrhea.

  - Different forms of magnesium were discussed, including magnesium glycinate, magnesium threonate, and magnesium citrate.

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Collagen Peptides:
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  - Collagen peptides are absorbed well and may benefit hair, skin, and nails, but there is no clear evidence they improve BMD.

  - The speaker expressed skepticism about the claims made by the product Fortibone.

Height Loss and BMI:

  - Height loss can affect comfort and organ function but is not always addressed by healthcare providers.

  - BMI may increase as height decreases, but the speaker emphasized that BMI is not a perfect measure and losing weight is not always compatible with improving bone health.

Vitamin D and K Supplementation:

  - The speaker stated that vitamin D and K can be taken together as they are often found together in food sources.

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Copper Supplementation:
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  - Most people are likely deficient in copper due to dietary insufficiencies and should consider supplementation.

  - The speaker mentioned a dosage range of 2-6 mg and the importance of the biomarker serum ceruloplasmin.

Lab Tests and Supplements:

  - Generally, patients were advised to continue taking supplements before lab tests to see the effects of their current regimen.

  - Specific instructions for certain tests, such as discontinuing biotin before certain lab tests, were mentioned.

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00:05:06.850 --> 00:05:32.270Dr Doug Lucas: So then my, my thought today is that we start going through the question list. I didn't know where it was last week, and I found it. So now I can go through the questions that have submitted on the forms, and I think that'll be a nice way to do this, and there are a lot of them. So my thought is, I would just start plugging through these, I think, in reverse chronological order when they came in, unless there are any pressing questions from last week, or anything that has come up over the weekend for anybody.

:05:35.000 --> 00:05:50.320Dr Doug Lucas: No, okay, great. Alright. So this first one is actually from a patient of ours her name's Lisa. So Lisa Builtz also, ironically, a neighbor. I don't have too many of those but she lives in our neighborhood.

:05:50.340 --> 00:05:57.760Dr Doug Lucas: So, Lisa, ask a question about continuous glucose monitoring. And so let me just talk about

:05:58.230 --> 00:06:16.239Dr Doug Lucas: yeah, some of the details of her question. And what a Cgm is. So we actually have. We've have used Cgm or continuous glucose monitors quite a bit in the practice. They've sort of come in waves for us. We've we've had a a period of time, and we had a lot of pre-diabetic and diabetic patients that we were working with.

:06:16.290 --> 00:06:18.909Dr Doug Lucas: So then it became really, really important.

:06:18.950 --> 00:06:42.720Dr Doug Lucas: But let me just give you a little background on Cgm, so Cgm, like, I said, stands for continuous glucose monitor. These devices were, FDA approved, or Rfda approved for diabetics, and the original intent was to use them in conjunction with an insulin pump. And so you would get a constant reading of your blood glucose, and then it would give feedback to an insulin pump and essentially acting like your pancreas.

:06:42.720 --> 00:06:53.950Dr Doug Lucas: And it works. And it's pretty cool. So for diabetics, especially type one diabetics, it is. It is absolutely life-saving technology. It's really cool for people that are not

:06:54.200 --> 00:06:57.200Dr Doug Lucas: necessarily diabetic or not on insulin.

:06:57.280 --> 00:07:17.960Dr Doug Lucas: or even people that are just looking to optimize their diet. They can also be similarly powerful tools. So I've worn one. Personally, probably I don't know 4 or 5 times for months at a time, and the value is you get to understand what carbohydrate does specific carbohydrates do to you? After you consume them. So.

:07:18.320 --> 00:07:34.789Dr Doug Lucas: for example, for me, I've always struggled with over consumption of carbohydrates. It's just a like a craving thing. I'm so I'm so like addicted to carbohydrates and so I would always struggle with overconsumption, understanding which carbohydrates were having a negative impact, etc.

:07:34.790 --> 00:07:51.369Dr Doug Lucas: And in my blood work I tend to. If I just eat whatever I want, my, which is the glucose measurement over time will rise into the prediabetic zone, really, really quickly for me. And so Cgm really helped me to understand the content and and

:07:51.580 --> 00:08:00.459Dr Doug Lucas: quantity that had an impact on my blood glucose. And then I started taking this out to my patients to say, Well, if you're struggling, and this is Lisa's question which is.

:08:00.470 --> 00:08:19.390Dr Doug Lucas: can it help me to understand how much carbohydrate I'm getting, especially if I'm not seeing the results that I want to see? And so the answer is absolutely so. I'll give you some examples for me, which is, I've always considered, when I think of Carbs that I shouldn't consume. I think of added sugars, I think, of highly processed food.

:08:19.490 --> 00:08:28.800Dr Doug Lucas: but even if you look at some, you know very natural foods, single ingredient, whole foods, but more starchy carbs so like sweet potato potato

:08:28.840 --> 00:08:46.350Dr Doug Lucas: rice is another great example. You will get a remarkable sugar spike. And you wanna know, is your body going to handle that appropriately, meaning that the blood glucose will rise, and then your body will respond to it, and it should come back down, not go too low, and not stay up for too long.

:08:46.350 --> 00:09:04.980Dr Doug Lucas: cause that long term. Exposure is what eventually causes problems with glucose and issues that that diabetics end up suffering from and so for me, I was able to recognize, wow! If I eat a certain amount of these things, or if I consume them with other foods. So, for example, if I consume, you know, a half a cup of rice with

:09:05.320 --> 00:09:08.080Dr Doug Lucas:  what's a good example

:09:08.120 --> 00:09:35.259Dr Doug Lucas: like curry, for example, like if I eat rice with curry. The the dietary fat in the curry will help to blunt the insulin response and the glucose response of the rice. So then I could eat potentially more carbohydrate and get less of a response. If I were to eat that alone, or like oatmeal, is a great example. If I eat oatmeal without much dietary, fat, or any protein. In there you will see a massive glucosepike, and it stays up for a while because it's a complex carb which we think like, well, this is

:09:35.260 --> 00:09:45.230Dr Doug Lucas: complex. Carb is better. Well, maybe because now it takes your body longer to break it down, and you have sustained glucose release in your body for a longer period of time, and not everybody can tolerate that.

:09:45.230 --> 00:10:00.490Dr Doug Lucas: But then compare that to like ice cream. So I did this comparison of similar grams of carbohydrate and ice cream versus oatmeal and ice cream actually had a much more favorable response. I'm not saying eat ice cream for breakfast every day, but it gives you an example of of

:10:00.660 --> 00:10:24.089Dr Doug Lucas: how pairing carbohydrates with other macro nutrients can impact the way that the sugar will break down in your body and be absorbed by your body. So long. Answer to the short version which is Cgm's are amazing. They can really be helpful in dialing, in nutrition, especially if you're not seeing the results that you're seeing from a body comp weight, loss, perspective or if you're a one C starting to rise. You don't really know why.

:10:24.220 --> 00:10:46.439Dr Doug Lucas: So we've actually added this in recently. We partnered with a company called Nutrasense, who, one of our our dietitians. Ashley came from. She used to work for nutrasense full time, and and now I think I don't know if she's doing any work with them at all from a consulting perspective. But nutrasense is a company that if you join them and I think we have, they should be in our affiliate links.

:10:46.440 --> 00:11:15.660Dr Doug Lucas: But if you join them outside of that affiliate link as a full service member, then you have access to their dietitian, and she used to be one of those dieticians. So now she works for us. But she brought in the neutral sense cause. She had a good connection with the company. So now we have deals for Hsn. As well as for our clients, and for our our patients. It strips out the Dietitian part, since they already have access to that. And I think for Hsn, it's still added there! So that's something that if anybody's interested in that they could check out through Hsn. Alone, and that should be in the affiliate links area.

:11:16.320 --> 00:11:20.910Dr Doug Lucas: Any questions on that from those that are here. I know Lisa's not here, but

:11:24.150 --> 00:11:24.890Dr Doug Lucas: right.4200:11:28.220 --> 00:11:29.949Dr Doug Lucas: and I will move on.

:11:30.020 --> 00:11:45.750Dr Doug Lucas: Kathy has some questions, and I don't know Cathy's last name here, but I know we have. We have several Kathy patients. This might be a patient. But is this me with the C. Well, it says K. But I don't. I don't know if they would have accurately transposed that

:11:46.160 --> 00:11:52.469Dr Doug Lucas: Go ahead. Go ahead, Kathy, about calcium no, this one's about Powerplay. But why don't you go ahead and ask your question since you're here.

:11:52.820 --> 00:11:56.950Cathy: Oh, okay, well, I just send in one about calcium and

:11:57.250 --> 00:11:59.260Cathy: when to take supplements

:11:59.760 --> 00:12:05.079Cathy: and when to use food I've started. I added cheese to my diet.

:12:05.290 --> 00:12:12.040Cathy: and then I read that you shouldn't take more than 500 milligrams at one time.4900:12:12.540 --> 00:12:18.140Cathy: and should you space it out. And some people say, don't take any any more

:12:18.210 --> 00:12:25.570Cathy: because of the arterial problem. So I wanted to get your take on that.

:12:25.730 --> 00:12:33.860Dr Doug Lucas: Yeah, thanks for bringing it up. Such a great question. So I actually met with the company Aljakal last week.

:12:33.900 --> 00:12:37.490Dr Doug Lucas: So I'm doing a talk for Osteo Strong tomorrow evening.

:12:37.660 --> 00:12:41.550Dr Doug Lucas: and they have an affiliate partnership with Algaco

:12:41.740 --> 00:12:49.280Dr Doug Lucas: and so algacal is a company. If you're not familiar with it, they make a product that's really popular for bone health. and

:12:49.580 --> 00:13:10.530Dr Doug Lucas: the issue that I have with most of the products made for bone health is that they all have kind of between 701,000 milligrams of calcium, which is a lot of calcium and so I have in my for my patient population. I've we've backed off of that recommended Rda of 1,200 milligrams for postmenopausal women. We've kind of backed off and and really shot more for 800 milligrams.

:13:10.590 --> 00:13:14.159And the reason for that, Kathy, is the the calcification.

:13:14.610 --> 00:13:16.619Dr Doug Lucas: But if you look at the literature.

:13:16.850 --> 00:13:32.800Dr Doug Lucas: it's not, it's really not clear what's happening. When we take calcium as a supplement. We know that if you take calcium alone, without vitamin d, and especially without vitamin K, then probably we are going to start seeing some calcification of arteries and increased risk of of stroke and events. That's pretty clear.

:13:33.480 --> 00:13:42.559Dr Doug Lucas: But that goes away if you take even a tiny dose of vitamin D, and that was shown in the Women's Health Initiative, where they had 400 iu of vitamin D, which is not much of a dose.

:13:42.800 --> 00:14:01.400Dr Doug Lucas: So I think that we? It's probably not as much of a concern as maybe, I initially thought. And and when I was chatting with Al Jako reps they based their 720 milligrams in their product off of some pretty reasonable data. We're all guessing we? We don't really know

:14:01.410 --> 00:14:05.950Dr Doug Lucas: what the right amount is, but I'm gonna chat with them more

6200:14:06.440 --> 00:14:18.109Dr Doug Lucas: because they've obviously looked into it very deeply. So where I am right now with this is that for our patients, we say, get as much as you can from food, because it's always gonna be absorbed. Better if you absorb it from whole foods.

:14:18.200 --> 00:14:24.089Dr Doug Lucas: So for a lot of people, though that would mean dairy. And some people can't tolerate dairy. And it's okay.

:14:24.110 --> 00:14:27.340Dr Doug Lucas:  But we also have everybody track.

:14:27.570 --> 00:14:39.260Dr Doug Lucas: And this is one of the points I wanna make in my talk tomorrow, which is, if you don't know what you're missing, it's you can. You can test through either functional testing or some some serum viromarkers. But it's hard to know.

:14:40.340 --> 00:14:42.770Dr Doug Lucas: So we always have people track and see what they're getting6700:14:43.730 --> 00:15:01.889Dr Doug Lucas: based off of the results of that tracking. Then we'll say, Okay, if our goal is 800 milligrams minimum and you're getting 400 milligrams through diet on average. Then you probably do need to supplement. Let's call it, you know, 400 or 600 milligrams a day. And then, finding that product that can help you do that

:15:01.940 --> 00:15:04.580Dr Doug Lucas: So that's the approach that we take.

:15:04.820 --> 00:15:20.839Dr Doug Lucas: making sure that when you take calcium, that it has vitamin D and it, and that you're also taking a vitamin k as well, and our preferences. K. 2 is in k. 7, because it has a longer half-life, and that should help to reduce any. Let's call it what's the right word?

:15:22.620 --> 00:15:27.640Dr Doug Lucas: I can't think of the technical term. But anyway, calcification elsewhere. Next topic, I think, is the term

:15:27.820 --> 00:15:54.599Dr Doug Lucas: so that should help with that as far as absorption, you're right. You probably can't absorb more than 500 milligrams at a time in any one setting. So splitting up your dose, especially if you're gonna take supplementation. Takes some, you know, in the morning, some in the evening, and that's one of the things that out to, Cal said as well is of that 720. It comes in, I think, 4 tablets. So you do 2 in the morning and 2 in the evening, or split it up to 3 times a day. Probably the more you split it up the more you're gonna absorb

:15:54.820 --> 00:16:02.319Cathy:  and I know you mentioned the Mc. Well, this one is called Mca.

:16:02.500 --> 00:16:03.420Dr Doug Lucas: Yeah, Umhm.

:16:03.590 --> 00:16:11.260Cathy: But so that's the one I've been taking my friends. Natural path recommended.

:16:11.510 --> 00:16:21.049Cathy: and it, and the one that they use has silica in it. Yeah. And so I added a few drops of

:16:21.370 --> 00:16:29.420Cathy: that. And and then another question is with the algae cal is the strontium

:16:29.690 --> 00:16:32.980Cathy: they put in some of their product, which I didn't want to take.

:16:33.810 --> 00:17:01.010Dr Doug Lucas: Yeah. So let me hit a couple of those. So the the recommendation we've been making has been to use the Mchc. Or Ohc or Mca. There's so many different acronyms for it. But essentially it's it's ground up bone, right? So it is a a natural bone product that has hopefully the calcium in that form, because that's what's in bone as well as the growth factors of bone depending on how it's processed, and a lot of the Mch's or Mh. Mca's whatever

:17:01.440 --> 00:17:06.679Dr Doug Lucas: probably don't have the growth factors in it, because you have to really process the the bone

:17:06.710 --> 00:17:28.870Dr Doug Lucas: with a low heat and not kill those growth factors which we know from the whole raw, raw, dairy versus conventional dairy, that those growth factors are heat sensitive. So the only product I know that says that they have those growth factors in it would be the Jero Jero bone up products, and there's a few different forms of that. But Jero, bone up. Will

:17:30.980 --> 00:17:36.230Dr Doug Lucas: Gerobone up will have hopefully, those growth factors in it. A lot of the others are just calcium.

:17:36.410 --> 00:17:39.030Dr Doug Lucas: which is okay, because that's what you want, anyway.

:17:39.160 --> 00:17:49.570Dr Doug Lucas: The form, though, Mchc versus algae is something that I hope to explore more with Alga Cal. As well. I want to know why

:17:49.800 --> 00:17:52.229Dr Doug Lucas: they choose to use that product

:17:52.470 --> 00:18:02.289Dr Doug Lucas: or that form of calcium, because there is some evidence to support the Mche. That's why I recommend it. So I'm going to learn more about that, and I'll get back to you on that.

:18:03.240 --> 00:18:09.570Dr Doug Lucas: My concern about Algae is that if it comes, if it comes from the ocean and the ocean's polluted in that area.

:18:09.630 --> 00:18:19.849Dr Doug Lucas: then are we just, you know. Are we condensing the pollutants into a capsule and then taking it? That's my concern. So I hope that they can alleviate that for me a little bit.

:18:19.890 --> 00:18:30.409Dr Doug Lucas:  as far as silica. So it's interesting. Actually, I was just looking at this this morning because I was prepping for that talk tomorrow night. There is some. There is some

:18:30.610 --> 00:18:51.040Dr Doug Lucas: theoretical evidence that that would suggest that it should be beneficial for bone. You needed to make collagen. There was actually one intervention study that used silica as a supplement that did show an increase in bone mineral density as a as a individual intervention. So that was actually the first time I've seen that. So it does look like silica could potentially be helpful. So that's reasonable.

:18:51.320 --> 00:18:59.389Dr Doug Lucas: How much is a little bit of an unknown, because they didn't show in that study. They did not show a linear relationship to their dosing. So it didn't seem to matter the dose.

:18:59.860 --> 00:19:00.570Cathy: Hmm.

:19:00.740 --> 00:19:03.889Dr Doug Lucas: yeah, that was the other thing you mentioned. You mentioned silica.

:19:05.420 --> 00:19:33.469Dr Doug Lucas: Oh, the strontium! Oh, the strontium! Thank you. Yeah. So strontium is an interesting one. So there's a lot of confusion around strontium. Because if you look it up, if you just Google it, or even if you look on pubmed and you're looking for research, you'll find studies on strontium rannellate, which is a synthetic compound that was popular in Europe. For a while it had some nasty side effects associated with it. So they pulled it off the market. So it's no longer available. But you can't extrapolate those side effects from a synthetic

:19:33.780 --> 00:19:35.040drug.9500:19:35.050 --> 00:19:46.680Dr Doug Lucas: The Ranelate part of it, which is the synthetic part versus Strontium citrate, which is the over-the-counter supplement you can get in the United States. The citrate is something that's added to a lot of

:19:46.830 --> 00:19:57.150Dr Doug Lucas: elements to make them a digestible or absorbable supplement. So it's not reasonable to think that you would see those same side effects, but it hasn't been studied large enough

:19:57.300 --> 00:20:05.520Dr Doug Lucas: populations to really know the studies that do exist. There's 2 of them. There's one study that uses strontium in addition to

:20:05.520 --> 00:20:29.700Dr Doug Lucas: I think it was melatonin. It was what is it? M. SDK, so I think it was melatonin, melatonin, strontium vitamin d and vitamin k as an intervention. And they did show significant increases of momentural density. But you would expect to see increases in Vmd with both melatonin and vitamin, K and vitamin d together, so they did not break it down and show that, you know, strontium was individually better.

:20:29.820 --> 00:20:49.099Dr Doug Lucas: So we don't really know what strontium's doing from a bone, strength, perspective. We know it will increase bone density because it is a heavier atomic element than is calcium, and it will be substituted into the bone for calcium, because it's utilized and metabolized very similarly. So we use it.

:20:49.170 --> 00:21:12.460Dr Doug Lucas: I use it for patients where II really wanna see an increase in bone marrow density. I would love to know that it's doing more for strength than just improving their Bmd. But we really don't know the answer to that. So II don't use it a lot. But for people that have really low. Bmd, I think it could be helpful, if not just emotionally and mentally to see that Vmd score come up and then hope that it's also improving their their strength born strength.

:21:13.600 --> 00:21:14.679Dr Doug Lucas: Does that make sense?

:21:15.520 --> 00:21:16.540Cathy: Thank you?1

:21:16.730 --> 00:21:24.080Dr Doug Lucas: So, then the the question that the Kathy with a K had was actually on power plate.1

:21:24.320 --> 00:21:43.349Dr Doug Lucas: We have a code for both power plate as well as meridine as far as whole body vibration goes, and I am not convinced to be honest about what is better. At this point I interviewed recently Clinton Rubin from meridine.

:21:43.430 --> 00:21:54.930Dr Doug Lucas: and he makes a very compelling argument for the low energy vibration that they use in their and their product. And he has some research that's published on that, and it seems like it. It makes sense1

:21:55.170 --> 00:22:01.020Dr Doug Lucas: when you look at the literature, but from a physiologic perspective, I feel like it. Kind of doesn't make sense.

:22:01.180 --> 00:22:03.900Dr Doug Lucas: because it's such a low10800:22:03.920 --> 00:22:10.769Dr Doug Lucas: energy frequency. And it's so much below even the level of force that you would see with walking.

:22:11.310 --> 00:22:15.289Dr Doug Lucas: But it's it's like taking.

:22:15.500 --> 00:22:19.079Dr Doug Lucas: I don't know. It's like the force is like point 8.

:22:19.370 --> 00:22:27.709Dr Doug Lucas: Let's say this correctly. The force is less than one G's, so like point 8 G's, or, you know, one

:22:27.730 --> 00:22:48.640Dr Doug Lucas: gravity gravitational pull in your body. When you walk, you kinda go from point A to 1.2. So like when you impact, you're going down. So your body experiences this increase in gravity. But it's subtle, so kind of the way that that Dr. Ruben describes it is you're getting a sub-threshold stimulus of that point 8 Gs.

:22:48.780 --> 00:22:56.250Dr Doug Lucas: but you're getting, however, many of them a second. Right? So I think you're getting like 60 of them a second. So imagine like walking 60 steps every second.

:22:56.720 --> 00:23:04.610Dr Doug Lucas: That's like 60 Hertz. Right? So it's up, down, up, down, up, down. and so that increase in the number of of

:23:04.760 --> 00:23:09.649Dr Doug Lucas: stresses of the 0 point 8 is what causes the the benefit for bone health.

:23:10.150 --> 00:23:21.389Dr Doug Lucas: If you listen to the people that support the idea from power plate. So power plate is a much larger amplitude, much greater force you're talking about like 6 G's 8 G's 12 Gs

:23:21.670 --> 00:23:36.839Dr Doug Lucas:  they're gonna tell you that you need more force because such a s

mall impetus with that 0 point 8 G is going to be absorbed by even you know the skin and the muscles of the foot. It's not going anywhere.

:23:36.980 --> 00:23:44.620Dr Doug Lucas: So they're gonna say, Hey, you need more force. And then, if you I mean, if you've ever been on a power plate like it's intense. I mean, it can be intense.

:23:44.790 --> 00:23:54.210Dr Doug Lucas:  if you listen to Dr. Ruben, and that's this interview that I think is it's either up or it'll be up this week, I think, for on our Youtube channel1

:23:54.260 --> 00:24:03.200Dr Doug Lucas: he says that using that device is dangerous, and that anybody that sells that device or supports that device should be locked away.

:24:03.430 --> 00:24:05.690Dr Doug Lucas: And so there's this really interesting, like.

:24:08.470 --> 00:24:11.040Dr Doug Lucas: back and forth between the 2 groups.

:24:11.210 --> 00:24:28.440Dr Doug Lucas: So I don't actually know what the right answer is. At this point I'm gonna interview one of the medical supervisors from power plate and ask them some pointed questions on it. I'll publish that in its entirety. And then I'm gonna do a follow up kind of making a clear recommendation based off of that. But right now I don't know the answer.

:24:28.950 --> 00:24:36.780I had a conversation with John J. Kush, from Osteo Strong a couple weeks ago about this issue and and his okay.

:24:36.960 --> 00:25:04.690Dr Doug Lucas: he's such a controversial guy. His opinion was that neither of them are really doing you any good for your bone. But that the the marodine, the Low intensity version is doing you no good for anything at all. And he sent me some evidence to review. That's basically people trying to reproduce Dr. Rubens work that couldn't find any benefit. So big question mark for me right now. So I look forward to digging more into that. That for for you, Kathy.

:25:04.700 --> 00:25:06.220Dr Doug Lucas: or for you, Kathy.

:25:07.590 --> 00:25:09.720Dr Doug Lucas: and so I hope that makes sense.

:25:10.700 --> 00:25:12.290Dr Doug Lucas: or at least for what it is right. Now.

13000:25:12.950 --> 00:25:21.009Dr Doug Lucas: that being said, I think there is benefit to vibration. I just don't know that we know exactly what it is. It definitely moves around length, it can make joints feel better.

:25:22.300 --> 00:25:24.980Dr Doug Lucas: My wife uses them in her weight loss. Clinics

:25:25.100 --> 00:25:30.110Dr Doug Lucas: and people find a lot of value in them, so I don't have one in the house, but II might want to.

:25:31.250 --> 00:25:38.460all right. So same Kathy with a K. Asked if we can give our opinions on the supplement strontium done?

:25:39.230 --> 00:25:51.889Dr Doug Lucas:  Oh, yeah, one. Well, I guess I did. Let me just say this about strontium. She asks about the impact on Dexa, I said that it will. It will make your dexa look better, because it substitutes for calcium.

:25:52.100 --> 00:26:02.370Dr Doug Lucas: When people say, Does it falsely elevate your calcium? I don't think that's really the right way to look at it. I think what we should say is that it will have a bigger impact.

:26:02.490 --> 00:26:10.709Dr Doug Lucas: And I think I just said calcium. I meant bone marrow density. Will it have a bigger impact on bone marrow density than then? Calcium? And the answer is, Yes.

:26:10.820 --> 00:26:15.690Dr Doug Lucas: but that's expected, so I don't think it's false. We just don't really know.

:26:16.320 --> 00:26:22.420Dr Doug Lucas: Is it increasing your strength as well as calcium would, with the same increase in bone marrow density.

:26:22.470 --> 00:26:39.249Dr Doug Lucas: How strongly are they even related, anyway. So I don't think it's false. I think if you're on strong team you should expect to see an a more significant improvement in Bmd than you would if you were just on calcium. We just don't really know what that means. So again. II do use it in some circumstances, but not that often. Really.

:26:40.700 --> 00:26:47.540Dr Doug Lucas: if that makes sense right. Well, here's Kathy with a C. Got it

:26:48.070 --> 00:26:50.770Dr Doug Lucas: answered. When did you submit that.

:26:51.100 --> 00:26:52.080Dr Doug Lucas: Cathy?

:26:55.070 --> 00:26:57.160Cathy: I think about 3 days ago?

:26:57.270 --> 00:27:01.629Dr Doug Lucas: Okay. I'm just I don't know which side of the list I'm I'm answering from.

:27:01.650 --> 00:27:03.940Cathy: Okay, probably the most recent side that

:27:04.210 --> 00:27:11.400Dr Doug Lucas: that's okay. Let's see here. So this is from a member whose name is Kit KITT.

:27:11.730 --> 00:27:40.339Dr Doug Lucas: So Kit says, I've listened to your podcast on the importance of magnesium and getting magnesium from diet as well as from supplements. Full script has so many options. That's true. Kit doesn't seem to provide much product information. Do you have any suggestions? Or is it too complex and based on each individual situation? Me. No, we can definitely make some recommendations here. So magnesium is critically important for bone health, but also for just metabolic health in general.

:27:40.370 --> 00:27:47.349Dr Doug Lucas: magnesium is involved in thousands of different reactions in the body. Without magnesium we don't function.

:27:47.460 --> 00:28:02.000Dr Doug Lucas: Unfortunately, magnesium, like many nutrients, has really been stripped out of our food supply, so it is probably impossible to get enough magnesium in the diet without supplementation is one of those things that I think that everybody just needs to accept that they need to supplement

:28:02.280 --> 00:28:07.150Dr Doug Lucas:  the

:28:07.340 --> 00:28:08.969Dr Doug Lucas: I was. Gonna say one more thing about that.

:28:11.970 --> 00:28:14.869Dr Doug Lucas: No, I lost it, anyway. So the

:28:15.320 --> 00:28:27.580Dr Doug Lucas: benefit of magnesium. Oh, I know I was gonna say so. And not only is it not in diet, but also there is this principle that was brought forward by a researcher named Morley Robbins, and I really like the way he puts it.

:28:27.600 --> 00:28:34.230Dr Doug Lucas: the way Morley describes magnesium and the use of magnesium is, he calls it the magnesium burn rate.

:28:34.480 --> 00:28:50.310Dr Doug Lucas: And I like that because he essentially relates magnesium use to stress. So the more stressed you are. This is like physical stress increased cortisol, or the more demand that you're putting on your body, whether it be physical, emotional, mental, whatever

:28:50.390 --> 00:28:53.269Dr Doug Lucas: the more you do, the more magnesium you need.

:28:53.360 --> 00:29:04.999Dr Doug Lucas: And so he relates this to people that are struggling with things like, you know, chronic fatigue, syndrome, and fibromyalgia, and just kind of chronic stress syndromes, that their magnesium burn rate is incredibly high.15800:29:05.150 --> 00:29:18.299Dr Doug Lucas: and that they almost can't absorb enough orally. And this is where, like, I've started recommending people to actually go get things like Myers cocktail and like Iv infusions of magnesium because they just can't get enough in their body, and they just can't

:29:18.430 --> 00:29:24.919Dr Doug Lucas: reduce their stress because of the you know, whatever situation that they're in.

:29:25.450 --> 00:29:30.949Dr Doug Lucas: So I think magnesium is is really really important, because we're burning a lot of it, and we can't get enough of it.

:29:30.990 --> 00:29:56.310Dr Doug Lucas: So we are supplementing a lot of magnesium and the ratio that we've started to use for people for oral supplementation is 5 milligrams per pound. That's probably pound of actual body weight for very obese people. Maybe it would shift a little bit but there's so much need for magnesium that that's our goal. Now, to be fair. If I were to go. So I'm 200 pounds. If I were to go, take a thousand milligrams of magnesium, which would be the math

:29:56.960 --> 00:30:02.100Dr Doug Lucas: at one time I would have horrific diarrhea. So be careful with that dosing.

:30:02.190 --> 00:30:16.390Dr Doug Lucas: You have to take it in forms that are well absorbed. So any of the chelated forms and not the the oxide forms so like magnesium. Oxide is a literally oxide form, but other salt forms.

:30:17.350 --> 00:30:18.949Dr Doug Lucas: can't think even without my head.

:30:19.090 --> 00:30:43.320Dr Doug Lucas: but chelated forms would include, like glycinate or bisk, glycinate, citrate, I think, is a chelated form. It's gonna have more of a an impact on your gut, though different forms will impact your gut differently. And different people will respond differently. So that's sort of the side of the question that Kit was saying. Is, is it individualized? It is I just had a patient ask me. She was like I'm on 3 different forms of magnesium. Is this too much?

:30:43.790 --> 00:30:54.189Dr Doug Lucas: But she's taking Mag glycinate or biscly, as her kind of general increasing her magnesium form. She's taking Mag. L. 3 and

:30:54.220 --> 00:31:06.449Dr Doug Lucas: to help with sleep, and that crosses the Blood brain barrier. So, taking that at night can help with sleep. And I think she's also taking Mag citrate because she struggles with constipation, and that'll help you with constipation more so.

:31:07.470 --> 00:31:11.369Dr Doug Lucas: it's not unreasonable to take 3 different forms of magnesium.

:31:11.630 --> 00:31:29.169Dr Doug Lucas: just watching for the side effect cause she was. She was complaining that she was having diarrhea, so you know, for in that circumstance. Then, you know, if she was getting, I think she was around 800 milligrams a day backing off the mag citrate would help, because Mag citrate is gonna again, give you more of a a diarrhea loose tools impact.

:31:30.320 --> 00:31:34.040Dr Doug Lucas: So yeah, it's a critically important nutrient that we don't get enough of

:31:35.440 --> 00:31:37.589Dr Doug Lucas: any questions on that to our live audience.

:31:38.000 --> 00:31:59.680Shelly’s iPad: Yeah, can you mention which one you recommend? Because again, like the gentleman said, there's so many, and like you broke it down to citrate, and all that, and the whole supplement world is just too overwhelming to me. So it's like, tell me what you recommend, and and then sometimes I always set the lower end of anything and work my way up.

:31:59.750 --> 00:32:03.429Dr Doug Lucas: And that was another thing this this patient actually was.

:32:03.660 --> 00:32:13.810Dr Doug Lucas: She was frustrated because she added everything at once, and it was she was on a lot of stuff because we were working on a lot of things so that should have been made more clear to her. That don't start.

:32:13.900 --> 00:32:24.969Dr Doug Lucas: you know, 10 different products. At the same time, you're likely to not have a good experience. So yeah, always add kind of one thing at a time, and then start low and and start low and go slow is the

:32:25.110 --> 00:32:32.459rule there. So the products that we use we use a bunch of different ones. But the products that we lean on right now, there's a

:32:32.460 --> 00:32:56.839Dr Doug Lucas: a company called Biospec, BIOS. PEC. And that's on full script. And what I like about their Mag glycinate is that you get 510 milligrams and 3 capsules. So it's it's pretty heavy, hefty dosing. So if people can start with adding that 500 milligrams through Biospec, that's a really good starting point. I can take all of that at one time and absorb it. Just fine.

:32:57.360 --> 00:33:08.500Dr Doug Lucas: I don't know that I'm absorbing it, but I've got. I don't have diarrhea with it, so doesn't have that side effect. So we like that one. And then the 3 and 8 form that we use, I think, comes from.

:33:08.980 --> 00:33:10.610I think comes from Jero.

:33:10.930 --> 00:33:13.819Dr Doug Lucas: That JARO. W. Company.

:33:14.260 --> 00:33:20.969and then, mag citrate, there are a million forms, or a million companies out there that have a mag citrate, one of the ones that we like.

:33:21.430 --> 00:33:33.569Dr Doug Lucas: There's this is not on a full script, but I like their products. There's a company called Rna Reset. An Rna Reset actually has a great vitamin c as well.

:33:33.640 --> 00:33:37.320Dr Doug Lucas: I think it's called vitamin c reset, maybe

:33:37.790 --> 00:33:57.429Dr Doug Lucas: but it's a whole foods form of vitamin c that comes in a liquid. The taste is a is a little bit of an acquired flavor for the record but their mag citrate also, although also has an interesting flavor. But if you can get them through liquids, then you're probably gonna absorb them better, and it cuts down on capsule fatigue.

:33:58.540 --> 00:33:59.930Shelly’s iPad: Okay, thank you.

:34:00.040 --> 00:34:00.840Dr Doug Lucas: Yeah.

:34:01.140 --> 00:34:23.889Dr Doug Lucas: So it sounds like you. You can. You don't need to necessarily space out your magnesium like you would your calcume? II would. I would. Just because you're gonna be limited in the amount that you can absorb at one time based off of gi tolerance. So if you were to take 1,000 milligrams, I've I've done this. If you were to take 1,000 milligrams of probably any form of magnesium. At one time you will end up spending some time in the bathroom.

:34:24.739 --> 00:34:25.830Cathy: Okay?

:34:27.320 --> 00:34:40.619Cathy: And you see, you've mentioned Jarro twice. Now, do you find their products to be good? I do so. There are a lot of companies that make good products that use third party testing to verify that there is in there what they say is in there.

:34:40.620 --> 00:35:01.269Dr Doug Lucas: So yeah. So Gerald's one of them jigsaw or the molecular. There's so many good ones. My wife actually just started to supplement company as well. So you might start seeing some Doctor Ashley wellness products pop up on our radar. Just cause. I have absolute control over how those things are made and where they're stored. So

:35:02.370 --> 00:35:27.260Dr Doug Lucas: there are a lot of good companies. But yeah, Gerald is definitely makes a good product for sure. And then algae Cal, too. I mean, I'm I'm again talk with them more and maybe there's some room for either improvement in their products for which, for me, would be having a lower calcium product. But otherwise, what's in their product is great. There's just isn't an option that doesn't include 720 milligrams of calcium, which I think is too much.

:35:27.980 --> 00:35:39.859Dr Doug Lucas: Yeah, so full script you should have access to through through the affiliate area. And I'm gonna make sure. Cause I think that's something that probably should be

:35:40.150 --> 00:35:41.940made more clear.

:35:42.440 --> 00:35:45.410Dr Doug Lucas: I'm gonna let Bretta know our developer.

:35:46.920 --> 00:35:50.409Dr Doug Lucas: that everybody should have access to our dispensary.

:35:50.610 --> 00:36:13.899Dr Doug Lucas: And so what that does for you is it gives you discounts off of what is already a discounted price on full script compared to most places. They're not gonna probably be cheaper than Amazon, but don't buy supplements on Amazon, because you never know. You never know what you're getting. There's so many, so many fake companies that will slap a label on whatever it could be. A literally a box chalk. You have no idea.

:36:14.130 --> 00:36:31.159Dr Doug Lucas: So full script. I like full script because they get their products directly from the the manufacturers, and then they store them, and what they describe as a, you know, responsible way. So they make sure they're they're rotating products. They're not expired. They're not sitting in a truck in the sun.

:36:31.180 --> 00:36:33.030and so you couldn't1

:36:33.250 --> 00:36:46.180Dr Doug Lucas: rest assured that probably if you're getting a good brand from full script, it's probably coming to you in the form that it's supposed to. So you should have access to our dispensary, which will then give you an additional discount off of the whatever. The retail price is on full script.

:36:46.350 --> 00:36:51.149Cathy: so you don't have to use our dispensary, but I think it'll be cheaper if you do so

:36:51.310 --> 00:37:00.850Dr Doug Lucas: I would encourage you to. And I'll have Bretta maybe send out an email on that because II pretty sure it's in the affiliate area. But if you don't know where to go or how to set it up, then it might not be that obvious

:37:02.470 --> 00:37:23.699Dr Doug Lucas: cool. So then the next question here is also from Kit, and Kit says, at one of the first zoom calls there was a question about Peptides, and if they were related to collagen. I'm wondering if taking collagen powder as a supplement is beneficial. Can we digest and absorb, collagen and make use of it for bone, health, or any other health benefits? So a great question.

:37:24.550 --> 00:37:36.350Dr Doug Lucas: I did a video on collagen a while back mostly because there was a product called Ford Bone. If you guys are familiar with that one. So so Ford Bone, I was somebody in the Youtube comments.

:37:36.920 --> 00:37:56.969Dr Doug Lucas: Excuse me, made me aware of. And II went to their website. And it's kind of a a fishy looking website to me because they talk about research. And then they don't actually cite the research that stuff drives me nuts. And so I looked into it. A little deeper in Ford Bone is owned by a a company that has a proprietary collagen. They have

:37:57.050 --> 00:38:04.030Dr Doug Lucas: the paid for research on that proprietary collagen to show that it it could impact bone mineral density.

:38:04.110 --> 00:38:19.749Dr Doug Lucas: But it's such a biased perspective, and the way that they did the studies, I think, is kind of trashy, so I don't trust that that particular collagen is any better than any other collagen peptide, especially and I also don't trust that it's doing anything

:38:20.160 --> 00:38:22.350Dr Doug Lucas: particularly useful for bone.

:38:22.460 --> 00:38:40.500Dr Doug Lucas: We need collagen for bone, but does taking collagen improve Vmd. And there are no other studies on any other form of collagen to say that it does so. I don't really trust the 4 to bone, because I think that it's their their methods are a little too fishy for me to to feel good about

:38:40.590 --> 00:38:56.350Dr Doug Lucas: And then any other collagen peptide which we know, has better absorption than collagen as of a molecule by itself. But any other collagen peptide. We don't know that it's doing anything specifically for bone, however, from a health span perspective, we do

:38:57.540 --> 00:39:01.720Dr Doug Lucas: produce less collagen as we age, so it is not

:39:02.240 --> 00:39:26.019Dr Doug Lucas: It is not something that we have to consume through diet. But for those things that we stopped producing as much of as we age from a health span and anti-aging perspective, it might make sense to consume them as a supplement. If we wanna have adequate levels. And we, if you break down, collagen into collagen peptides, you do absorb it pretty well. So I think it's pretty reasonable to use collagen, but with the expectation that it's gonna have an impact on your hair, skin and nails.

:39:26.190 --> 00:39:31.540Dr Doug Lucas: maybe internally, in your bone attendance. But we don't really know the answer to that. If that makes sense

:39:33.480 --> 00:39:35.529Dr Doug Lucas: any questions on collagen peptides.

:39:37.030 --> 00:40:06.609Dr Doug Lucas: the one thing to mention there, too, is that when I talk about Peptides in general, I'm not talking about over the counter. Peptides like collagen peptides. What I'm generally talking about is the prescription Peptides that you get from compounding pharmacies. All of them are the the term peptide just means a series of amino acids less than I think. It's 40 amino acids in length, so anything could be a peptide. But in general, when I say Peptides, I'm referring to the prescription versions of generally they're fragments of hormones that are acting as signaling molecules.

:40:08.420 --> 00:40:12.579Dr Doug Lucas: Alright. Well, there's so many

:40:13.310 --> 00:40:15.050shelley

:40:16.080 --> 00:40:18.690Dr Doug Lucas: Shelley I don't want. I don't wanna say her last name wrong.

:40:19.070 --> 00:40:24.030Dr Doug Lucas: Jockoboney Jacobi, you got it. Yeah. Oh, are you on here?

:40:24.040 --> 00:40:25.339Shelly’s iPad: I'm I hear? Ya.22000:40:25.960 --> 00:40:31.650Dr Doug Lucas: Oh, that's you, Shelley? Hi, Shelley! I was close. Okay.

:40:31.940 --> 00:40:34.550Dr Doug Lucas: do you? Wanna do you wanna ask this question? Do you want me to read it?

:40:34.590 --> 00:40:37.290Shelly’s iPad: Yeah, is that the one regarding the A desktop?

:40:38.250 --> 00:40:40.440Dr Doug Lucas: Yes.

:40:40.600 --> 00:40:42.190Dr Doug Lucas: yeah.22500:40:42.340 --> 00:40:46.160Shelly’s iPad: Yeah. So I've always just looked at the total T scores

:40:46.200 --> 00:40:50.600Shelly’s iPad: and the taxes, and I've had probably 4 and

:40:51.330 --> 00:41:07.940Shelly’s iPad: When you get the report, it seems like they just give you the I'm gonna say, front page and just shows you your scores for hip and spine and usually just hip and spine. I just recently had one done this July, and I was looking through it recently and noticed that they did break up the spine by

:41:07.940 --> 00:41:24.549Shelly’s iPad: L. One l. 2. Whatever right. Those numbers shocked me because they were extremely bad, and I was. I was taken back on my colleague Kyle. Why did my doctor ever say cause? And that's that's really frustrating is the internus or your primary care. With most of us, with as a process of an internist

:41:24.550 --> 00:41:49.309Shelly’s iPad: specialists, and even the specialists. I went to one time ever even said anything about breaking it down. So I've been looking at total the whole time, and I oh, negative. 2.7 could be worse could be much better. But then I looked at those individual ones, and I think one was 3.2 3.6 6. Yeah. And I almost fell off the chair. Luckily I didn't. I'm like, Oh, my gosh, so!

:41:49.510 --> 00:42:08.940Shelly’s iPad: And then I listen to Keith Mccormick. He had a video recently, and he had. It was really interesting to case studies. He put everything up about these individual patients, what their doctor recommended, and wanted the audience to say, what do you think? And then he would tell us what he's gonna do? And he he also, and all of his case studies looked at total T scores.

:42:09.460 --> 00:42:11.240Dr Doug Lucas: So I do, and I do, too.

:42:11.600 --> 00:42:25.429Dr Doug Lucas: So here's something to remember about. Dexa is that it's a pretty crappy study. It's not particularly accurate. And I was actually having this conversation with Dr. Mike Lewin, who's a chiropractor in the Asheville area that hazard rems.

:42:25.520 --> 00:42:45.400Dr Doug Lucas: So we're sending him, I mean, because of because of our volume of Bone health patients. We have a lot of people coming to Asheville doing Rems with Mike. And so we get this opportunity, then, to look at the difference between Rems and Dexa to look at these patients. And of course this is not a scientific perspective, but anecdotally.

:42:45.840 --> 00:42:47.840Dr Doug Lucas: Dexa, for spine is

:42:47.920 --> 00:42:51.349Dr Doug Lucas: all over the place, I mean, just all over the place.

:42:51.360 --> 00:43:12.409Dr Doug Lucas: And so we had a patient. I think I just posted this on on my Instagram, where somebody commented in Youtube that they they sought out a Rems cause. They were petrified because of their negative. 3 something t-score on Dexa and then on their rems. I think they didn't even have. They didn't have osteoporosis, and I think they maybe not even had osteopenia. I mean, it was that different?

:43:12.660 --> 00:43:30.909Dr Doug Lucas: And so then the question is which one's right, and and we don't know. But when I see a rems that shows that they have better bone material density, which isn't always. Sometimes it looks worse on rems, but when they have better bone, marrow density on rams, and they have a good quality, score

:43:31.290 --> 00:43:45.629Dr Doug Lucas: or risk of fracture. Then it makes me feel better to say, Look, this isn't really as big of a deal, you know. Yes, we should probably still address your bone health, but we don't need to be worried that if you fell out of your chair you're gonna break all of your lumbar spine

:43:45.900 --> 00:44:00.120Dr Doug Lucas: right? So we're we're kind of stuck because we have to use Dexa, because not everybody has access to rems. So we have to use Dexa. But when you see and if you look at yours. So your L. One is negative, 1.8 and your l. 4 is negative. 3.6.

:44:00.880 --> 00:44:14.709Dr Doug Lucas: How is that even possible? Osteoporosis is not a sight specific thing unless you're like non weight bearing on an extremity your spine, your through vertebrae, assuming you have normal curvature of your spine. They're all seeing the same force.

:44:14.730 --> 00:44:18.099Dr Doug Lucas: So why would one be double the bone density as the other?24200:44:18.620 --> 00:44:24.050Dr Doug Lucas: So we take the average. And I think we do that because24300:44:24.110 --> 00:44:32.510Dr Doug Lucas: we know that it's inconsistent. So if you lump them together, you're probably going to be closer to the truth. But even that we don't really know.

:44:32.940 --> 00:44:46.399Dr Doug Lucas: That's just a crappy study in general. I would still, you know, with an average T score of negative 2.9 still worth addressing your bone. Health right? Still have osteoporosis.

:44:46.490 --> 00:45:03.840Dr Doug Lucas: But I wouldn't put you in the category. Let's say that your your average T score was negative. 3 6, you know, or let's call it a little bit worse, like negative 4, you know. Then we'd be having a different conversation and be like Whoa, look a get a rem. So let's see what it looks like. And b like, we should be very aggressive about your bone density

:45:03.990 --> 00:45:12.119Shelly’s iPad: okay, I appreciate that, but it but at negative 2.9 I wouldn't say, let's be very aggressive I still wouldn't know more. But24700:45:12.520 --> 00:45:19.249Dr Doug Lucas: hope that makes sense. Hopefully, we will assume Michigan.

:45:19.380 --> 00:45:21.500Dr Doug Lucas: Michigan, Michigan.24900:45:22.220 --> 00:45:29.069Dr Doug Lucas:  yeah, II have a patient in Michigan. But she went to. She went to Ohio to see me to see me.

:45:29.200 --> 00:45:30.040Shelly’s iPad: Oh.

:45:30.150 --> 00:45:32.170Dr Doug Lucas: yeah, never thought about that.

:45:32.210 --> 00:45:33.699Shelly’s iPad: It's not a bad idea.

:45:33.880 --> 00:45:36.170Shelly’s iPad: Yeah, it's not something I can say publicly.

:45:36.320 --> 00:46:01.580Dr Doug Lucas: So silly, right? Like she's like, well, I have a friend in in Ohio. Can I see you in Ohio? Sure. And II know lots of doctor friends, too, that do. They? Do telehealth without being licensed in the State, anyway. I just think that's that's asking for trouble. And if we are you know, as a I don't know. I wouldn't call us high profile, but we have the potential to be

:46:02.540 --> 00:46:07.950Dr Doug Lucas: criticized that medical boards could come after us. So we we do stick to that role.

:46:08.530 --> 00:46:32.549Shelly’s iPad: I have another question. But I don't. Wanna so I really appreciate you because of this stall on your license. You're giving us some free blood work that we are taking advantage of advantage of it on Wednesday

:46:32.700 --> 00:46:44.250Shelly’s iPad: and I'll have all those tests for you. And at some point you and I are gonna have our console. So those will be sent to you. And I'm assuming at that point when

:46:44.950 --> 00:46:54.389Shelly’s iPad: Whoever those are going to be going to in your organization. I'll be getting that call. We can sit down and talk about all our scores because I am so ready for HRT.

:46:54.590 --> 00:47:17.190Shelly’s iPad: I. I've researched it. I've listened to you. I talked to my primary care or my internist, and he's like, Hi, you know, Shelly, whatever you want. That's what you're listening to the research. You probably know more about us to process, and I do. I just don't know what dose to start yet. And I said, Well, eventually I'll come back with those doses, and you can write me the script. And I'm gonna go. So so that's what I'm really waiting for, because I've done the research. And I

:47:17.200 --> 00:47:23.409Shelly’s iPad: heard about through you and others. So hopefully, some of those labs will help you.

:47:23.490 --> 00:47:26.880Dr Doug Lucas: Yeah. Well, it is actually great. I mean, we had we

:47:27.710 --> 00:47:36.809Dr Doug Lucas: with our the medical licensing company that we're using. They were very optimistic in our timing. And then it turns out that that

:47:37.060 --> 00:47:54.499Dr Doug Lucas: the with process that they were using. I'm sure I explained this, but the process that they were using it wasn't actually gonna work, because they were trying to use the the compact. There's there's a thing called the Medical Compact, so some states will allow somebody, if you're licensed in that state to to kind of have licensure in the other state without going through the full process.

:47:54.590 --> 00:48:00.910Dr Doug Lucas: But I'm not in a state that is actually a compact state, and they wanted to use another state that I was licensed in to do that.

:48:00.980 --> 00:48:27.570Dr Doug Lucas: But that doesn't work, because my practice is not in that state. So we went through the whole process. And then at the end, it was Colorado. Colorado, said, Where can we? Where can we find that you are licensed, or that your business is in the State, and that you're, you know, a Colorado State business. And I was like, Well, we we don't have one. And so yeah. And so then that reset the whole thing. So that's that was really frustrating. But the company wanted us to lie about it and like create a po box. I was like, no

:48:27.580 --> 00:48:47.929Shelly’s iPad: like lying. I don't like lying in general, and I definitely don't like lying to medical boards. That seems like a really bad idea. So anyway, I thank you for your patience. The good news is, though, is that for people like yourself that are are waiting. And we have multiple sets of data. It's actually really nice. So we can look at data over time. It's a much better look. So I know it is.

:48:48.160 --> 00:48:50.719Dr Doug Lucas: It requires patience. But I appreciate it.

:48:52.380 --> 00:49:05.699Dr Doug Lucas: So then Cindy Lutz asked a question. This is a really long one. I'm just gonna read it. So Cindy says she starts out by saying, this is kind of frivolous.

:49:05.980 --> 00:49:18.439Dr Doug Lucas: she asks, do I have any thoughts or insights into how height loss affects one? She says that she's lost 3 inches from 5 5 to 5, 2, and that her ribs officially now meet her hips, and it is not comfortable.

:49:18.450 --> 00:49:34.389Dr Doug Lucas: See? Very little online. And my in person, doctor seems pretty completely flummoxed. Great word, like their best answer is, yes, it affects you, and yes, you're right. We should track your height, but it's more, it's more efficient not to. And most people don't change that much.

:49:34.480 --> 00:49:45.769Dr Doug Lucas: she goes on to say. I feel like everything works differently now. Sadly, I'm making some adaptations that aren't helpful. Probably you're just training my muscles to contract even more probably doesn't matter, since

:49:45.850 --> 00:49:49.749Dr Doug Lucas: since you were a I don't know what that means.

:49:51.590 --> 00:50:17.149Dr Doug Lucas: I don't know what that means. But anyway, then her so her concern is legitimate. So loss of height is a real problem. And this is something that II think about because I talk about hip fracture a lot. I don't talk about spine fracture that much. And the reason why I talk about hip fracture is because the potential morbidity of having a hip fracture is so dramatic. Right? It is such a big deal to have a hip fracture. It is life, changing, lifestyle, changing and potentially life-ending.

:50:17.370 --> 00:50:33.519Dr Doug Lucas: But that doesn't mean that spine fractures aren't a big deal, because they can certainly change your lifestyle. They could potentially change your independence. If you have enough of them, they can cause medical problems. If you have enough deformity, and it ends up, you know, compressing things like your lungs.

:50:33.540 --> 00:50:50.830Dr Doug Lucas: so they are something to be avoided. But, as her doctor said, like, well, you know, we could measure height. But there's a lot of variables and blah blah blah. But if you start having significant deformity, it is an issue. And so this is why we should be preventing all fractures, not just hip fracture

:50:50.860 --> 00:50:55.190Dr Doug Lucas: spines are just as I said earlier, with Dexa spines a little bit more difficult to

:50:55.240 --> 00:51:08.970Dr Doug Lucas: to navigate as far as what the quality is, and how do we avoid fractures because they do seem to happen? And they're caught incidentally on imaging. So they're just sort of like kind of a bit of a mystery. How do you fracture your spine and not know?

:51:09.090 --> 00:51:10.729Dr Doug Lucas: But yet we hear it all the time.

:51:11.320 --> 00:51:24.680Dr Doug Lucas: So so. Yes, it affects people. The question is like how much and we don't. We don't really know until you start seeing a lot of deformity, and then it becomes like compression of the heart. The lungs. You know other organs that that will have an impact on their function.

:51:25.950 --> 00:51:37.849Dr Doug Lucas:  Then her follow-up question is, what about my Bmi as I get shorter, and my weight didn't change. And now my Bmi is higher. That's kind of funny.

:51:37.870 --> 00:51:43.430Dr Doug Lucas: not funny for her, I'm sure, but it's true, and it just goes to point out like the the weakness of Bmi.

:51:43.910 --> 00:52:00.990Dr Doug Lucas: And so her concern here is that she's now she's overweight. When she didn't used to be overweight, and II wouldn't. I wouldn't could be concerned about that. Also. Keep in mind that dieting to lose weight and and appropriate nutrition for gaining bone are opposite goals.

:52:01.130 --> 00:52:05.650Dr Doug Lucas: So we do have people that come in that want to potentially lose weight.

:52:05.780 --> 00:52:17.699Dr Doug Lucas: improve bone at the same time. And I asked them to pick one. We can optimize body composition. That's something that we do not generally in our bone health population. But that's something that we do. But

28500:52:18.080 --> 00:52:38.129Dr Doug Lucas: to lose weight, you need to be catabolic. You need to be breaking down stuff like fat to build muscle and bone. You need to be anabolic. So it's hard to do both at the same time, and you potentially could, but both results would be very slow. So I asked people to pick one. And for her, specifically, I mean, she didn't actually gain weight. She just got shorter. So I wouldn't worry about that at all.

:52:40.540 --> 00:52:41.790Any questions about that.

:52:43.760 --> 00:52:44.460Okay.

:52:47.100 --> 00:52:59.869Dr Doug Lucas: Kim asks a question that I get asked a lot, which is, can I take vitamin d and vitamin K. At the same time there's concern that they compete. and the answer is, yeah.

:53:00.050 --> 00:53:21.690Dr Doug Lucas: But whenever I look at potentially conflicting consumption, like zinc and copper together, they're going to literally bind together, so they don't get absorbed. Iron and calcium. Not that most people should be taking iron anyway, but iron and calcium will also bind together so that they don't get absorbed. It's not that they're competing for absorption.

:53:22.090 --> 00:53:28.629Dr Doug Lucas: Vitamin k and vitamin d, though they're both fat, soluble vitamins. I think they're competing for the same

:53:29.640 --> 00:53:53.249Dr Doug Lucas: area of absorption might be the right way to put it. In other words, they get absorbed similarly because they're both fat, soluble vitamins, so I think there is competition there, but they don't bind together to prevent absorption. Also, they occur naturally in food products together. So whenever I see things that occur naturally in food together, I don't really worry about them not being absorbed. Well, because if we weren't able to absorb them, I don't think that we would

:53:53.250 --> 00:54:05.019Dr Doug Lucas: find them naturally in food together. I think Nature's much smarter than us, and so if they're if dairy puts together vitamin d and vitamin k in the same food product, then we can probably absorb them just fine.

:54:05.110 --> 00:54:12.330Dr Doug Lucas: Also, most of the vitamin DK. Products are. They come together? So I think that's hard to split out. You could split it out. But I don't think you need to.

:54:14.120 --> 00:54:24.009Dr Doug Lucas: So zinc and copper, zinc and copper spread them out totally. Spread them out. Yeah, if you're consuming zinc and copper together. You're not consuming anything at all.

:54:24.120 --> 00:54:25.340Cathy: Okay.29600:54:25.450 --> 00:54:51.980Dr Doug Lucas: absorbing anything at all. You're consuming it. Just fine. But you're also excreting it. Just fine, too. Yeah. And zinc to I. Most people don't need zinc. You can get enough zinc through diet pretty easily, copper, though you can't. And so copper is something that is chelated out by glyphosate by other pesticides. And so copper is something we probably all need to be supplementing that most people aren't.

:54:52.460 --> 00:55:14.380Dr Doug Lucas: What's the what's the dosage. Yeah, I'm not giving specific advice. But if I were, gonna take copper like I do anywhere between 2 and 6 milligrams depending on how your stomach tolerates it. Copper is also kinda hard to test. You can test serum copper. But really, what we should be testing is this biomarker which we just started in our practice testing.

:55:14.700 --> 00:55:29.799Dr Doug Lucas: but it's called serum cerelloplasm sorel lu plasm. I have a hard time. Explain that CER. Siru. I think it's cerruloplasm, CERU. LOPL. A. SM. Cerruloplasm.

:55:29.870 --> 00:55:37.509Dr Doug Lucas: But anyway, that's a copper based protein that helps to mobilize iron, and

:55:37.630 --> 00:55:57.780Dr Doug Lucas: most people are low because we don't get enough copper through diet, and when that happens, you start building up iron in places, and iron is is very oxidative. So it generates oxidative stress. So a lot of times underlying dysfunction, in fact, that researcher I mentioned earlier Morley Robbins, he wrote a book called Cure your Fatigue and cure is. See you

:55:58.040 --> 00:56:19.600Dr Doug Lucas: for copper cure your your fatigue. I don't know that I agree with everything he says in that book. It's a really interesting read which will change the way that you think about supplementation. I'm interviewing him. Maybe we could do that on Hsn. Actually would be great. But I would love to interview him and and have you guys pick his brain about supplementation. He's a super super nice guy.

:56:19.600 --> 00:56:43.599Dr Doug Lucas: and we wrote an interesting book, but he points out that we are probably almost all of us iron heavy. And now we are starting to get these labs and looking at this in our patients, and indeed, most of us probably have iron overload. I'm certainly one of them, and I think that might explain some of the abnormal abnormalities that I see in my own labs that I haven't been able to correct so definitely learning more about that over time. But copper is a key component to that.

:56:44.790 --> 00:56:46.359Dr Doug Lucas: Yeah, big big time.

:56:48.260 --> 00:57:02.579Dr Doug Lucas:  this is a patient who was asking about different time for doing this, which we could move it around so hard because everybody's in different time zones.

:57:04.360 --> 00:57:09.609Dr Doug Lucas: So, Thomas, I've heard you, and we're looking at different timing options. I'll say that.

30600:57:10.920 --> 00:57:29.129Jo Ann Hardig:  Excuse me, I have a question about labs. I have an order, you know, to get some lands done. Am I correct? And you saying at 1 point, when your videos not to take supplements like 3 days before labs, so that you can get a more accurate reading.

:57:29.390 --> 00:57:33.800Dr Doug Lucas: Yeah. So no. And maybe

:57:34.670 --> 00:57:42.680Dr Doug Lucas: I'm actually just making a note to myself. So we historically have asked everybody to continue taking what they're taking.

:57:42.710 --> 00:57:48.910Dr Doug Lucas: because I want to know what your labs look like on program. There are some things like

:57:49.150 --> 00:58:05.159Dr Doug Lucas: like b vitamins, for example, have a very short half life if you take them through supplementation. So if we have you on a methylated B or a B complex or whatever. And then we recheck your B 12, and you're folate, and you're still low because you stopped taking them 3 days ago. We're gonna increase your dose

:58:05.340 --> 00:58:22.369Dr Doug Lucas: because we don't know what we're doing right. And so for things like B. Vitamins, I want you to keep taking it, cause I wanna know how you're metabolizing those things. That being said, it's still a shot in the dark because they move up and they move down, and it depends on how well you absorb them, and how long it's been since you took them, etc.

:58:22.370 --> 00:58:39.019Dr Doug Lucas: So that's kind of tough. And we're we're looking at different ways. We're looking at what's called HTML, which is hair tissue, mineral analysis. And so I have a team member that's going through some training on this right now, so we might start incorporating this as another way.

:58:39.760 --> 00:58:42.829Dr Doug Lucas: Thanks, Susan. I'll take a look at that.

:58:42.860 --> 00:58:47.699Dr Doug Lucas: But it's another way to look at at nutrient

:58:48.450 --> 00:58:58.819Dr Doug Lucas: body levels rather than just serum levels, because serum levels are just sort of what's happening at the moment we use a test called Neutra Val or Neutrae Val

:58:58.990 --> 00:59:06.640Dr Doug Lucas: to do that as well. But it's pretty expensive. It's like an $800 test. And so, using that on everybody on a regular basis would be

:59:06.660 --> 00:59:10.990Dr Doug Lucas: incompatible with most people's budget. But HTMA. Is like a hundred bucks.

:59:11.010 --> 00:59:18.079Dr Doug Lucas: and it's just a sample of hair that you send in. So we're looking at that as another way to do it. So

:59:19.080 --> 00:59:23.670Dr Doug Lucas: so the answer is, take most things. There are some.

:59:24.190 --> 00:59:31.589Dr Doug Lucas: There are some areas where you don't want to do that. So if you're doing like a stool test, for example, there's some things you need to stop and

:59:31.640 --> 00:59:36.280but for most biomarkers, blood biomarkers, I would say, just stay on everything.

:59:36.650 --> 00:59:40.620Dr Doug Lucas: Thyroid's another tough one that we're trying to figure out the answer to as well, because

:59:40.800 --> 00:59:53.450Dr Doug Lucas: people don't take their thyroid, the money that they're getting their blood drawn. And then we look at their numbers, and they're not good. And so then we're. you know, incorrectly manipulating their dose. So there's just these really subtle things that make a big difference in the recommendations.

:59:53.580 --> 00:59:59.410Jo Ann Hardig: So in the Genova test, which I'm also going to be doing. Which ones don't you recommend taking

:59:59.530 --> 01:00:11.529Dr Doug Lucas: I would reach out to the Admin team. We have a full list about that so reach out to the Admin team and ask them cause we have, one of our well, 2 of our dieticians, both Kyle and Carrie.

:00:11.580 --> 01:00:30.209Dr Doug Lucas: used to work for vibrant America, and so they were the, you know, the physician trainers. So if you're like as a physician, if I called vibrant and said, Hey, how do I? How do I interpret this test? I would have talked to one of those, too. So they know all of the the dirty details of the thousands of variables that you should manipulate before you take that test.

:00:30.810 --> 01:00:42.279Dr Doug Lucas: Alright. Thanks. Hey, Dr. Doug, I did receive the email regarding the lab that I'm gonna be getting this week, and in there it said to discontinue by attend

:00:42.330 --> 01:01:00.940Shelly’s iPad: that comes from Kyle and II don't really. She says that it changes a lot of other biomarkers. But I'm just trusting her. And most people that are on our program aren't on biotin, anyway. So and Susan drop something in the chat I just wanted to mention, too.

:01:01.020 --> 01:01:07.130Dr Doug Lucas: so she says that consumer labs looked at Al Jako and said it was a bit high in lead.

:01:07.180 --> 01:01:26.209Dr Doug Lucas:  she said. I wrote them. I wrote them because I'm in the fabulous community, and they always reply, but they did not reply to that question. So I can ask. It's like when you ask Osteostrong about fractures they're like, Huh!

:01:26.570 --> 01:01:42.800Dr Doug Lucas: So, anyway. But I can ask them directly, so I will. I will bring that up when I chat with Dean from Al Jacal, and then, since I mentioned, I'll just say the the back side of that from so from osteostrong perspective. If I haven't mentioned this here.

:01:43.150 --> 01:01:57.419Dr Doug Lucas: I do have some patients. I have one patient that's reported a fracture using Osteostrong of her spine. I asked the CEO about this, and he said that they have had, I think, 8 reported fractures in over 10 million visits.

:01:57.670 --> 01:02:12.359Dr Doug Lucas: So I think if you put 10 million people with osteoporosis in a room, you would have 8 fractures in a very short period of time for them, doing absolutely nothing. So still, probably very, very low risk, so I still recommend it for people. The patient that had a fracture, I mean.

:02:12.730 --> 01:02:27.009Dr Doug Lucas: I don't know. Did she sneeze while she was sitting on the machine like I've looked at the mechanics of the machines. I don't really see how you could have a spine fracture just based off of the direction of what you're pushing. So, anyway, I still think they're. It's very safe, but it's funny that they do kind of.

:02:27.080 --> 01:02:30.029Dr Doug Lucas: They sort of look over their shoulder, and people ask that question, what?

:02:31.700 --> 01:02:44.580Dr Doug Lucas: So, anyway? Alright, it is 1001. Thank you. Everybody for showing up this morning. Keep bringing the questions in like this, and we'll we'll just keep going through this question list as we go. So I appreciate you guys being here. Thank you so much.