January 17, 2024
During the meeting, the following key points were discussed:
1
00:00:01.192 --> 00:00:31.022
Dr Doug: because of the awesome response. And you guys are so amazing. We have too many questions to answer in an hour. So what I'm having my team do is to go through all the questions as they come in, and then they're sort of lumping them the same topics, because we get a lot of the same, repeat questions, lumping them together. So I make sure that I hit those topics, and then what we'll do is if your question isn't answered. What I suggest that you do is to put it into the slack channel. Has everybody been on the slack channel, and I get a thumbs up.
2
00:00:32.132 --> 00:00:54.982
Dr Doug: Oh, yeah. So I know slack's not for everyone, and I get it, if it seems intimidating but it is a really good way to communicate. So if you don't get your question answered, drop it in the slack channel. We'll see if anybody else can answer it, cause that could get you an answer quickly, and then, if not, then we hopefully we can drop back into the next week, and we can get it answered. So we're trying to find a way to answer as many of the same questions as possible.
3
00:00:55.232 --> 00:01:08.432
Dr Doug: So I'll pull that document up. But we'll go through that. And then I also wanted to announce, if you guys have been on the Youtube channel, you've seen the videos coming out about vibration plates. Yeah. So
4
00:01:08.642 --> 00:01:25.892
Dr Doug: The the interview with Clinton Rubin came out last week, I think, and then the doctor, convinceder from power plate came out this week. I have my conclusion. Video is actually set to come out today. I delayed it because I I've sent
5
00:01:25.972 --> 00:01:28.942
Dr Doug: Dr. Ruben a couple of studies. I found that
6
00:01:29.552 --> 00:01:34.871
Dr Doug: I wish I'd have I interviewed him. But basically showing that the devices
7
00:01:35.132 --> 00:01:37.041
Dr Doug: at the rate that they
8
00:01:37.162 --> 00:02:01.921
Dr Doug: set their stand. Their their settings aren't very effective. And so I I sent him those, and he sent me some stuff back, so I haven't reviewed those yet. So I put that video on pause cause basically in that video, I say, I don't say it directly. But I kinda say, the research doesn't really support the the less than one G force devices. We should really be looking at the the more powerful devices like power plate.
9
00:02:02.232 --> 00:02:20.232
Dr Doug: So II think I'm still going to think that I but I wanna review that before I put that video out. So I don't have to retract that statement but in the meantime we have set up a really strong affiliate relationship with power plate. So if anybody's thinking about getting a power plate there is a link. I can drop this.
10
00:02:22.042 --> 00:02:36.071
Dr Doug: I can do this smart enough. I can drop this in here, and then you'll also get an email about it. But I'll drop this in the chat just in case anybody is thinking about it. And I think right now, actually, they're having a sale, anyway.
11
00:02:36.282 --> 00:02:59.382
Dr Doug: And I think this link will actually go above and beyond that their sale link. But just if anybody's thinking about that, I like the power plate devices. I think the question comes down to whether or not you can tolerate them. And so they're actually sending me one to do some videos on and my wife is one of those people that doesn't tolerate them very well. So I'm gonna see how she does on like the low settings of the power plate.
12
00:02:59.652 --> 00:03:01.962
Dr Doug: such a controversial topic. It's funny.
13
00:03:02.082 --> 00:03:19.952
Dr Doug: So we'll come to a conclusion on that. But I wanted you guys to see that cheryl asked in the chat. So do you think power plate is safe for people with low Bmd, and how low? Like negative, 4 low. Yeah, sure. Let's low. So if you have a T score of negative 4, I still don't think the power plates gonna break a bone.
14
00:03:20.322 --> 00:03:40.622
Dr Doug: You know the amount of force that you're getting through your spine by the time that the the force goes through your body goes through your legs, especially if you bend your knees a little bit. You're really not getting. And and there's there's no way to accurately measure this. But you're not getting the whatever 3 to 5G's that you're getting at your feet. You're not getting that in your spine. And so you could start on the low setting.
15
00:03:40.922 --> 00:03:57.372
Dr Doug: You could also put, you know, one leg on there. You could put half your body on there. But it makes sense to me that you would need more force to go through your body rather than what the meridian does. So I do think it's probably safe from a bone perspective. The question I have is, what about somebody that has inner ear issues?
16
00:03:57.442 --> 00:04:06.092
Dr Doug: What about somebody that has you know, like my wife, for example, like she gets really she gets a lot of like
17
00:04:06.222 --> 00:04:23.972
Dr Doug: nausea, and like uneasy feeling in her head. If she's on a vibration plate. I don't know that the cornea separation thing or the retinal se retinal detachment rather is an issue for short term use. I think that's more of an issue for long term use. You know, if you're like, in a
18
00:04:23.982 --> 00:04:26.881
Dr Doug: whatever you sit in a machine that vibrates all day long.
19
00:04:26.992 --> 00:04:34.922
Dr Doug: So that kind of thing. Does that make sense any questions on vibration devices? I can answer. Since I've I'm very steeped in the research right now.
20
00:04:35.152 --> 00:04:39.931
Cathy H - AZ: Yes, I ours is called Vmax Pulsar.
21
00:04:40.482 --> 00:04:52.142
Cathy H - AZ: and it, you know, it does the both things, one that just vibrates in the one that bounces you up and down. Which are they calling? Which I'm really unclear?
22
00:04:52.462 --> 00:05:06.792
Dr Doug: Yeah, it's it is really hard to to understand the terminology. So there's there's basically how to describe this. There's like 2 main ways that they create vibration. One is sort of a teeter totter
23
00:05:06.861 --> 00:05:13.932
Dr Doug: right? So there's like a fulcrum in the middle. And the things going do do do those generate potentially a lot of force?
24
00:05:13.982 --> 00:05:17.851
Dr Doug: The power plate uses a 3 dimensional kind of
25
00:05:18.151 --> 00:05:44.311
Dr Doug: rotating vibration. It doesn't feel like it's doing this, but this is what it's doing underneath you. And I think that gives you a more even amount of up and down. So the whole plates moving up and down at the same time rather than the back and forth because the back and forth, depending on where you're standing is gonna change the force that you're seeing dramatically. And there's there's no way for, you know a machine to know what that is. So that this this I think that most of the cheaper devices
26
00:05:44.412 --> 00:05:50.511
Dr Doug: are going to be the teeter totter because they're easier to build. That doesn't mean that they don't work.
27
00:05:50.732 --> 00:06:13.201
Dr Doug: I just there. There's isn't as much research with them. So I have. I've had a lot of comments on Youtube, of people asking for a less expensive device. And II just don't know. I don't know of one that is as good a quality as what powerplate does. I know they're expensive. They are really expensive. So I just, I'm concerned about the teeter totter design. And then also just from a durability perspective. But I hear some of them come with great warranties, too.
28
00:06:13.512 --> 00:06:25.991
Cathy H - AZ: Yeah. So this one, if you kept it on like real low, like one or 2, and you're doing a little Ti mean, I've just been doing. I was believing the maradine, so I was just doing the vibration.
29
00:06:26.122 --> 00:06:35.582
Cathy H - AZ: And now I'm hearing that's not enough from you. So the teeter just a little bit of the teeter taught it with the vibration. Maybe's okay.
30
00:06:36.052 --> 00:06:49.671
Dr Doug: Maybe it's hard to know right? And and that's the that's the unknown. And that's why I'm I'm hesitant to recommend any of the other devices, because they just haven't been researched. Power plates been all over the place.
31
00:06:50.152 --> 00:06:56.012
Dr Doug: so I'm comfortable with that style. My wife and her. Her clinics uses a teeter tower device, and
32
00:06:56.422 --> 00:07:02.582
Dr Doug: you know I don't know how many people been on them for how many minutes, but we haven't seen any issues so probably safe. But
33
00:07:02.902 --> 00:07:09.472
Dr Doug: but I can't say that for sure. Okay, thank you. Yeah, David.
34
00:07:09.542 --> 00:07:22.862
David Callen: So if you're looking at to having to spend your time using a vibration machine versus, and I'm also working out I'm I'm hearing you say.
35
00:07:22.962 --> 00:07:27.542
David Callen: correct me if I'm wrong, that probably your workouts probably the more important.
36
00:07:27.912 --> 00:07:44.691
Dr Doug: If you were to pick between the 2, then I would pick resistance training over vibration. Yes, however, the vibration only takes 10 min. So you're not going to get a workout in 10 min so you could vibrate on days. You don't have enough time to work out. You'd also vibrate, I mean, there's
37
00:07:44.852 --> 00:07:48.022
Dr Doug: if you can't find 10 min in your day, you might need to reevaluate your
38
00:07:48.152 --> 00:07:50.542
Dr Doug: your time priorities.
39
00:07:50.602 --> 00:08:02.072
Dr Doug: so I think that there's an easy way to get 10 min, and in addition to a workout, I think the biggest issue is, do you have the resources to get to get a plate? And it, you know, does that make sense, add onto the stack, and I think that it does.
40
00:08:02.102 --> 00:08:10.732
Dr Doug: But it is just one more thing. You know, I discovered that my physical therapist has a plate which means
41
00:08:11.002 --> 00:08:13.411
David Callen: insurance pays for.
42
00:08:14.672 --> 00:08:17.082
David Callen: Well, that's that's great.
43
00:08:17.162 --> 00:08:24.701
Dr Doug: You gotta get there. But still, yes, we'll we'll dedicate anything that insurance will pay for except for drugs.
44
00:08:24.792 --> 00:08:36.412
Xanet (Jenay): we will consider. Yes. Janet. Yeah. So just I had quite a bit of experience with the power plate at my osteogenic loading place
45
00:08:36.412 --> 00:09:02.962
Xanet (Jenay): and initially, when I got on it was like maybe super nauseous, and the vibrations went to my head. It took me almost a year, but I eventually was able to have both feet on kind of at the same time. And so there are ways to like build up your ability to be able to handle it. I don't know. During that period of time it was helpful. But we would do it like one leg at the time and one leg on the floor, and there's pads. You can put over it as well. That
46
00:09:02.962 --> 00:09:28.832
Xanet (Jenay): holds the vibration down so it is possible. I guess I would say, and that's what Mike Lewin, of strength. X here in Ashville or Black Mountain? Oh, yeah, so exactly. So. He yeah, he does that exact same thing right? So he has the. He has the cushion. You knew 1 one leg at a time. Yeah. And so he'll work people up to the point where they're standing on it. I actually, I think he told me about you, but didn't use your name.
47
00:09:28.832 --> 00:09:37.821
Dr Doug: Good! Well, I'm glad you got there? And then, sarah asked a question about just the metrics of G forces compared to Hertz.
48
00:09:37.862 --> 00:09:54.541
Dr Doug: There's so many numbers when you look at these studies. It is really confusing, and physics is. I love physics, but it's certainly not my my strong suit. So the when they talk about Hertz. That's the frequency of the device. So actually, power plate on a low setting. And the maradine have the same frequency.
49
00:09:54.792 --> 00:10:13.251
Dr Doug: It's the amount of displacement that's different, and the way that they do it. But the amount of displacement, meaning the amount that the the little plate goes up and down and that the amount of displacement is what's really different. So the meridian and the video, I said, this is between 50 and 200
50
00:10:13.672 --> 00:10:26.562
Dr Doug: micrometers. I think that's the right measure of unit, and there's a thousand of those in a millimeter. Right? And then there are so the displacement of the power play is about 2
51
00:10:26.762 --> 00:10:29.192
Dr Doug: And so it's
52
00:10:29.532 --> 00:10:45.232
Dr Doug: if, whatever the multiple is, it's a whole lot more. I'll put it that way right? So the amount that the Powerpoint is moving is substantially more than the amount that the meridian is moving. And that creates different amounts of Gs or G forces. So the meridian, they will say it's between
53
00:10:45.482 --> 00:10:58.941
Dr Doug: what do they say? Point 8 or point 4, I think point 4 point 4G's. And the the power plate is around 3 G's. One of the studies that that Ruben sent me actually.
54
00:10:58.942 --> 00:11:17.801
Dr Doug: as a as a counterpoint is that they, when they, when they were measured outside of the powerplate environment that they measured it more like 10 Gs. So I sent that over to the CEO of power plate, and I haven't heard back from him yet, so I think it's supposed to be around 3 to 5G's. And that's what the research supporting those devices would say so.
55
00:11:18.102 --> 00:11:19.562
Dr Doug: That's what all that means.
56
00:11:19.622 --> 00:11:24.321
Dr Doug: Sure, Cheryl says I'm on a meridian now. Great! Where are you, Cheryl?
57
00:11:24.472 --> 00:11:33.512
Cathy H - AZ: Yeah, 1 one more quickie question. So I'm trying to lift my weights and stuff while I'm standing on it. Is there a benefit to that?
58
00:11:33.822 --> 00:11:46.352
Dr Doug: So some of the research they they did exercises on it. II don't think that the I don't think that the bone benefits are better necessarily. Although, Janet Mike does exercises on it right?
59
00:11:46.952 --> 00:11:59.361
Dr Doug: Yeah. So II don't know if it's just from a convenience perspective. I mean, obviously, you're saving time, right? You're doing 10 min of resistance training while standing on the on the unit. Th. There are some studies that did do that.
60
00:11:59.492 --> 00:12:07.631
Dr Doug: but there are not well enough controlled and comparable studies to know that the resistance training was actually better than just standing on the machine alone.
61
00:12:08.222 --> 00:12:08.962
Dr Doug: Okay.
62
00:12:09.972 --> 00:12:11.022
Dr Doug: alright.
63
00:12:11.282 --> 00:12:21.341
Dr Doug: So let's dig into some of these other things. Some big topics here. I always like to talk about hormone topics first. I've just been in such a hormone.
64
00:12:22.012 --> 00:12:25.501
Dr Doug: such a love of hormone research lately.
65
00:12:25.792 --> 00:12:33.441
Dr Doug: let's talk about men since since David's here. My, my, my one guy thanks, David, for showing up. I appreciate a little manpower.
66
00:12:33.482 --> 00:12:54.471
Dr Doug: So this is a question from Greg. Greg asked, when taking testosterone by injection, what blood love blood levels easier for me to say, should we expect to be normal also? What is considered the half life of the injection. 2 great 2 great questions. And this is valid for both women and men. So pay attention. Everybody. So normal testosterone levels are not normal.
67
00:12:54.912 --> 00:12:59.691
So testosterone levels when you look at lab, core or quest, and they're both different.
68
00:12:59.962 --> 00:13:29.242
Dr Doug: The the reference range is either one of 2 things. It's either completely arbitrary or it's a statistical average of the population. Both men and women have had declining testosterone over the last several decades. So if a statistical average is not normal. If it's arbitrary, it was probably chosen by somebody who doesn't know anything about testosterone, and that's probably not good either. So normal. You have to talk to somebody who knows what they're talking about.
69
00:13:29.332 --> 00:13:30.942
Dr Doug: So
70
00:13:30.952 --> 00:13:33.561
Dr Doug: my camera just did something weird. We'll see what happens.
71
00:13:33.942 --> 00:13:36.301
Dr Doug: That was apparently a signal for it to do something.
72
00:13:37.962 --> 00:13:43.841
Dr Doug: It's still on. Okay. Good. So oh, that was to go to whiteboard mode. I don't even know what that is
73
00:13:43.842 --> 00:14:09.581
Dr Doug: okay. So for men, we look at total testosterone. But we also look at other factors. So for men, we're kind of aiming arbitrarily between 800 1,200 total testosterone. But we see. And this is really important for women, too. We see that depending on the sex hormone binding globulin. SH. Bg, that that total testosterone could actually be great when you look at free testosterone, or it could be not enough.
74
00:14:09.722 --> 00:14:21.261
Dr Doug: The Shbg binds on to testosterone. And so if you have a high SHBG. Which is mostly genetically driven, if you have a high SHBG. Then even a testosterone of 1,000 might be insufficient.
75
00:14:21.302 --> 00:14:23.261
Dr Doug: So we just had a guy yesterday
76
00:14:23.592 --> 00:14:42.062
Dr Doug: he had a testoster10, my gosh! What was it? It was like 800 or something, but his free testosterone was still like in the single digits, in like low single digits, like postmenopausal women, single digits, and it just blew his mind because he was like, I've been to the doctor so many times. I have all these symptoms of low testosterone, and nobody will treat it
77
00:14:42.062 --> 00:15:05.862
Dr Doug: right, because they only check your total and your total looks amazing for your age. But you don't have any free testosterone. So there's some ways to to to deal with that. But ultimately we'll probably end up replacing that. The other question is, what's the half life of the injection? And, Greg? It depends on what type of testosterone the vast majority of practitioners will use testosterone sippine. 8. What I use for both men and women when you do an injection, the half life is.
78
00:15:05.862 --> 00:15:18.521
Dr Doug: I think it's like a day and a half something like that. That's why we do twice weekly injections. So we'll inject like Monday, Thursday, or some some schedule like that, so that you can keep relatively consistent.
79
00:15:18.712 --> 00:15:34.992
Dr Doug: Some people have gone to everyday injections. That's a lot of intramuscular injections for my taste. You can also switch to sub queue. But people that get issues with sub queue injection. Because the oil is really made for IM application, not sub queue. So there's some different ways to play with that
80
00:15:35.032 --> 00:15:41.291
Dr Doug: from a woman's perspective. This is really important, because we now have, because we have so many women on testosterone.
81
00:15:41.692 --> 00:15:47.231
Dr Doug: women will come back with their labs. We get this all the time they'll write in. Oh, my God, my testosterone is so high
82
00:15:47.702 --> 00:15:56.511
Dr Doug: total testosterone, you know, 80 to a hundred, which is high. But these women also have high Shpg, and they have low, free testosterone, and they still have symptoms.
83
00:15:56.612 --> 00:16:17.381
Dr Doug: And so the the reference range for testosterone for women is, is much much lower than that. But yet we should be treating to symptoms, not to lab ranges. So as long as they're not having side effects we'll keep tight trading up until we get to resolution of symptoms. And that for for some women is is over a hundred, and which used to make me nervous, but not so much anymore.
84
00:16:17.882 --> 00:16:22.791
Dr Doug: alright! Any questions on that
85
00:16:27.112 --> 00:16:37.341
Dr Doug: no great? Oh! David asked, so do you take these shots for the rest of your life? Great question, David. So the short answer is, yes, you can come off of it.
86
00:16:37.942 --> 00:16:41.432
Dr Doug: But my question is, if you had low testosterone, why would you ever want to?
87
00:16:41.732 --> 00:16:58.221
Dr Doug: You can reboot the system. I can't guarantee you what your performance would be like with the system rebooted versus on replacement. But if you had low T in the beginning, you're gonna have low. T again. It's not gonna get better. So generally I tell people to be committed to, to to take it for the rest of their life. Same with women.
88
00:16:58.952 --> 00:17:01.261
Dr Doug: Speaking of women.
89
00:17:02.082 --> 00:17:29.461
Dr Doug: there's a question here from Thomas about high Psa, and and prostate and testosterone. The short answer to that is Thomas, is that the the prostate has a saturation of testosterone at a very, very low level. So unless your levels are like below, 200 like super low. Then you're unlikely to have any impact on Vph when you replace testosterone cause. It's already been saturated. As far as your prostate knows, there's no additional testosterone.
90
00:17:30.962 --> 00:17:36.261
Dr Doug: Okay, women's hormones. Yes, ma'am. Who is that? Oh, sure.
91
00:17:36.272 --> 00:17:40.402
Sheryl: The testosterone.
92
00:17:40.642 --> 00:17:49.711
Sheryl: test that I was. II got before I started on Hrt, had a total and free, direct
93
00:17:49.882 --> 00:17:51.492
Sheryl: and
94
00:17:51.842 --> 00:17:58.722
Sheryl: and you're saying that it doesn't really matter what the levels are has to do with your do your symptoms
95
00:17:58.862 --> 00:18:25.722
Dr Doug: like, is there not not a goal? So we we use both. I'm not quite comfortable just going off as symptoms, because we don't, especially with testosterone. We don't know exactly which symptoms we're aiming for. I was just at a conference this weekend with Gabriel Lion. She had her first forever strong conference, which was super fun, and she had a panel of of people, including Mary Claire, if you guys know who that is. She's a big menopause advocate, overgoyn huge
96
00:18:25.922 --> 00:18:29.511
Dr Doug: huge following on Instagram. She's good to follow.
97
00:18:29.522 --> 00:18:55.201
Dr Doug: But her and another kind of men's directed testosterone expert were talking about this, and that's how they practice both of them. We don't even measure. We just go based off of symptoms. I'm not quite comfortable with that cause. I don't wanna drive a woman to have a very high testosterone high dh, and then have some funky side effects like that's just not not how I practice so I would still look at the total and look at the free. But then ask you about your symptoms, and then we can come to a conclusion there.
98
00:18:56.372 --> 00:18:57.462
Dr Doug: that makes sense.
99
00:18:57.522 --> 00:19:06.671
Sheryl: Okay, yeah. Sh vg, was high before I started, and I wasn't able to do testosterone. So
100
00:19:06.932 --> 00:19:13.161
Sheryl: I just retested, and of course the sh Pg. Has gone up. Is there a concern with
101
00:19:13.722 --> 00:19:20.502
Dr Doug: Hi? SH. Bg, other than it? So it's it's associated with things, but not
102
00:19:20.522 --> 00:19:27.531
Dr Doug: not strongly. And and it's not. It doesn't cause anything. It's just what your body your body's just making protein to carry around hormones.
103
00:19:27.582 --> 00:19:35.301
Dr Doug: And there's really not a lot you can do about it. Some people will try to manipulate Shpg with dietary patterns, but I've never seen anything to be effective.
104
00:19:36.292 --> 00:19:37.152
Sheryl: Thanks.
105
00:19:37.512 --> 00:19:38.172
Dr Doug: Yeah.
106
00:19:39.032 --> 00:20:05.882
Dr Doug: Sarah asked. Real quick about oxytocin. Is oral versus nasal spray. Better from a viability perspective. I've not seen any studies on oral, so I don't know the answer to that. I've only seen it for given in nasal spray, so I would assume that it's probably going to work better that way. If you think about where you want it to work, you want it to work in your brain. And the easiest way to get to your brain is actually through your crib form plate in your nose.
107
00:20:08.092 --> 00:20:10.592
Dr Doug: And then.
108
00:20:10.682 --> 00:20:16.821
Dr Doug: Janet asks, what's the relationship between estrogen and histamine intolerance? That's a really interesting question.
109
00:20:17.002 --> 00:20:25.112
Dr Doug: So I think, as estrogen drops, you become more histamine intolerant. And I was just listening to.
110
00:20:25.602 --> 00:20:27.661
Dr Doug: Do you guys know Stacey Sims?
111
00:20:30.832 --> 00:20:38.462
Dr Doug: So Stacey Sims is an author. This is her first book. She has a follow up book called Level Up, next Level, next something. Where is it?
112
00:20:39.042 --> 00:20:45.102
Dr Doug: Somewhere? but it's basically her performance book for women
113
00:20:45.152 --> 00:20:52.901
Dr Doug: in the post menopausal phase. So she actually talks quite a bit about this and so it seems like as estrogen drops. Histamine tolerance goes up
114
00:20:53.522 --> 00:21:14.231
Dr Doug: which is weird. So many things happen when extra check goes away. let's talk about alright. So women's hrt So Sarah's asking if you take aromatase inhibitors as an estrogen blocker, would the aromatase inhibitor also negate any benefits of testosterone supplementation? No.
115
00:21:14.262 --> 00:21:21.691
Dr Doug: this is something we're playing with for women that either aren't allowed to or refuse to take after gym.
116
00:21:21.852 --> 00:21:38.281
Dr Doug: so you can give testosterone and give aromatase inhibitors which block the conversion of estrogen to testosterone and then still get the benefits of testosterone, which are, gonna be all the things that are that are known with testosterone, except for the ones that come from the the trans transfer of estrogen.
117
00:21:38.362 --> 00:21:53.061
Dr Doug: So you still get a lot of benefit of testosterone with an AI, and that's something that we've started doing actually with patients. The alternative to that is to use drugs like Relaxophen. But we've had some patients not have good side effects as a result of those drugs. So we don't do that anymore.
118
00:21:53.332 --> 00:21:57.731
Dr Doug: Meredith asks.
119
00:21:58.512 --> 00:22:16.571
Dr Doug: what levels of the various hormones should we be aiming for when undergoing. Hrt. If cycles have resumed during HRT. Would this, then, complicate the levels? So let me just start there. So for Emredith, are you here? No, no, no, no, okay. So
120
00:22:16.912 --> 00:22:39.471
Dr Doug: if a woman is in the kind of perimenopausal state where she still has cycles, but maybe they're inconsistent. And she starts estrogen. If her cycles return, then yeah, that gets a little wonky. Right? So what's happening is, the ovaries are sort of, you know. They're like an engine running out of gas. Right? It's like then off and then and then off. And that's why symptoms can be terrible.
121
00:22:39.472 --> 00:22:48.272
Dr Doug: So I hear so I would actually back off of estrogen, or at least use a very low dose, because you're gonna be essentially adding fuel to the fire of the up and down.
122
00:22:48.882 --> 00:23:14.921
Dr Doug: Once the cycles have stopped. Then we're aiming from an estrogen perspective around 40. I think it's remember the units but on lab cores between kind of 40 and 80 is the range we're looking for. Not physiologic. And there are some protocols out there like the Wiley protocol, is something that people may have heard of. Where the the attempt is to use high levels of estrogen and progesterone to actually recreate menstrual cycles.
123
00:23:15.012 --> 00:23:22.611
Dr Doug: I don't know why anybody would want to do that, but it's out there, and I don't know what the risk profile of that is. So we don't do that.
124
00:23:22.702 --> 00:23:26.772
Dr Doug: She goes on, and then ask,
125
00:23:27.122 --> 00:23:31.341
Dr Doug: does a short cycle indicate? Progesterone levels are too low? Not necessarily
126
00:23:31.472 --> 00:23:39.812
Dr Doug: She is on a bi-identical with a biased 50 50
127
00:23:40.322 --> 00:23:55.101
Dr Doug: cream and testosterone, plus a micronized progesterone. So and that's okay. I've I've shifted away from biased as well. So for those aren't familiar. Estrogen creams kind of come in 2 forms. There's Estradiol alone, and then biased versus Estradiol and Estriol
128
00:23:55.352 --> 00:24:05.852
Dr Doug: Estriol. II don't know the origin of this move. I think this happened kind of in the functional medicine space where people were looking for a quote unquote, safer solution.
129
00:24:05.932 --> 00:24:17.421
Dr Doug: and estriol is safer than astral dial, mostly because it hasn't been studied as much. But if you think about Estri Estriol from a a functional perspective, Estriol
130
00:24:17.472 --> 00:24:20.692
Dr Doug: is only really present in high amounts during pregnancy.
131
00:24:20.712 --> 00:24:50.572
Dr Doug: And so we don't really like we. It doesn't do much in the body, otherwise it's not very. It's not a very strong agonist for the estrogen receptor. So really, the estriol is getting in the way, and it's not letting extra dial do what it's supposed to do. So we pulled everybody off of bias, or at least we're in the process of that and putting people on astronle alone, so that we're just using the one that we want to actually use and then otherwise it's a matter of looking at symptoms. And then dialing in dose both with symptoms again and with
132
00:24:50.622 --> 00:24:51.972
Dr Doug: lab values.
133
00:24:53.422 --> 00:24:55.512
Dr Doug: Caitlin asks.
134
00:24:57.382 --> 00:25:03.801
Dr Doug: why is cyclic progesterone and estrogen better for bone health if both of these hormones promote osteoblast development? Oh, good question
135
00:25:04.382 --> 00:25:15.622
Dr Doug: wouldn't constant exposure via oral contraceptives. Therefore be a good thing. So 2 big components there, Kaylin, so number one is the cyclic progesterone and estrogen
136
00:25:15.852 --> 00:25:29.491
Dr Doug: is important when a woman still has cycles because they counteract each other, so Progesterone is osteoblast promoting the estrogen is osteoclast inhibiting.
137
00:25:29.672 --> 00:25:49.352
Dr Doug: so you could say that they're both on the same side of that metabolic thing, but they do it in different ways. So you want Progesterone to boost osteoclast function on one side, and that's when it goes up and it comes down, and then estrogen will come up and block osteoclast. And so you're getting you're still manipulating it from one side. But you're still getting the C saw back and forth.
138
00:25:49.572 --> 00:26:03.742
Dr Doug: Does that make sense? So? Oh, my camera is doing something again. I gotta turn these things off. So you're still getting that C saw back and forth every month. That's why Amen are such a big deal. For women. If you run into a man area. You will
139
00:26:03.752 --> 00:26:09.102
Dr Doug: likely have lower bone density issues. Sorry gotta turn all these things off.
140
00:26:10.452 --> 00:26:12.572
Dr Doug: I don't know why my camera decide to be. Fancy.
141
00:26:13.312 --> 00:26:15.571
Dr Doug: There we go! Pop it.
142
00:26:16.162 --> 00:26:18.172
Dr Doug: stop it! There we go. Okay.
143
00:26:18.922 --> 00:26:26.651
Dr Doug: oh, and then hormone hormone replacement through contraceptives is not a good thing, because, first of all.
144
00:26:26.892 --> 00:26:34.281
Dr Doug: you don't get the cyclic back and forth. Secondly, all contraceptives are using proges, not progesterone
145
00:26:34.422 --> 00:26:51.482
Dr Doug: so progestins or synthetic progesterones developed in the 1950 s. They are the causative agent. That look that caused the increased risk of breast cancer in the Women's Health Initiative. They will cause an increased risk of breast cancer, blood, clot, low bone, mass mood changes.
146
00:26:52.062 --> 00:26:59.331
Dr Doug: probably something else that I'm forgetting. But progestins should not be used by anybody under any circumstances. In my opinion.
147
00:27:00.572 --> 00:27:03.752
Dr Doug: Why would you? You have Progesterone? Use the thing that works
148
00:27:04.012 --> 00:27:08.982
Dr Doug: that's safe. Oh, Julia's here.
149
00:27:09.642 --> 00:27:15.001
Dr Doug: Hi, Julia! So Julia is one of our coaches
150
00:27:15.622 --> 00:27:18.802
Dr Doug: who just popped on to learn more about what we talk about.
151
00:27:19.002 --> 00:27:22.201
Julia Priest: I assume. Hey? Y'all good to see ya
152
00:27:23.332 --> 00:27:32.381
Dr Doug: all right. And then last hormone question, oh, there's 2 more. Ok, next hormone question regarding Hrt. Karen asks.
153
00:27:32.642 --> 00:27:47.641
Dr Doug: she's gonna start estrogenic Progesterone Bio identical. But number one. What do you think of just the estrogen ring alone? And if I go with estrogen and Progesterone is the patch. Okay? And pill for Progesterone? So let me just start there.
154
00:27:47.902 --> 00:28:01.121
Dr Doug: So the estrogen ring is going to only provide a local administration in the vagina is my understanding. I'm not an obgyn but I don't think you're going to get systemic release that way.
155
00:28:01.422 --> 00:28:11.062
Dr Doug: The estrogen and progesterone you do want to pair those 2 together. Of course, I would also say testosterone for most women, assuming that you need it.
156
00:28:11.072 --> 00:28:18.582
Dr Doug: but an astra dial patch is okay. The dosing is not always great, and it's hard to test
157
00:28:18.622 --> 00:28:37.951
Dr Doug: most ovas won't test your levels if you're using an estro dial patch. But you can get adequate levels of estradial with a patch and then a micronized progesterone capsule in addition. Yes, don't let them put a progestin and a patch with the extra dial and give it to you that way, cause that is also available. And then you're getting that project in
158
00:28:38.582 --> 00:28:48.382
Dr Doug: I mentioned in my class that estrogen cream progesterone and testosterone cream. Can you enlighten me? What is the estrogen cream you're referring to? And of course,
159
00:28:49.702 --> 00:29:00.172
Dr Doug: what's your take on the ring? Yeah. So the estrogen cream is astronle, and then testosterone cream can be combined into that. We start them separately, and then we combine them later. Once we get the dosing dialed in
160
00:29:01.072 --> 00:29:13.702
Dr Doug: so Cheryl is educating me that there are 2 rings, one local and one supposedly systemic. Cheryl, do you know, is that still vaginally applied, I would assume
161
00:29:14.942 --> 00:29:17.032
Dr Doug: we'll let our answer that. Oh, yes.
162
00:29:17.192 --> 00:29:31.801
Dr Doug: So I know that it's possible we've had women who've used vaginal Estradiol creams with the goal of achieving systemic levels. So I know it's possible to do it through the vaginal mecosa. Yeah, femur
163
00:29:32.022 --> 00:29:58.941
Dr Doug: I've not seen femme studies showing what levels it actually gets to, and that would be my concern. Because when I've had women try to use compounded creams for that purpose, they can't get enough cream in there, and it's kind of a sloppy, goopy disaster. The femme obviously wouldn't be that but my question would be, can you actually get high enough levels. It might alleviate symptoms of menopause. But is it actually gonna achieve levels of estrogen for bone, brain and heart elf
164
00:29:59.772 --> 00:30:00.952
Dr Doug: be my concern?
165
00:30:01.882 --> 00:30:13.331
Dr Doug: Okay? And then adverse effects. And Hrt, these are always fun. So can you tell us whether the benefits of Hrt can be realized if someone is 20 years out from menopause. Great question.
166
00:30:13.452 --> 00:30:21.911
Dr Doug: so let me just start there. So when someone's 20 years out from menopause, we see this quite a bit that 10 to 20 year
167
00:30:22.032 --> 00:30:38.142
Dr Doug: age group is right when the Women's Health Initiative came out. Right? So there's an entire decade or 2, almost really an entire generation of women that got the shorthand of hormone replacement because all the doctors were scared away because of the Women's health Initiative and other studies.
168
00:30:38.632 --> 00:30:46.582
Dr Doug: So now we're forced to ask this question of Can we use it for women that are 1520 years out? And the short answer is.
169
00:30:46.822 --> 00:30:59.531
Dr Doug: Yes, but the risk goes up, and the risk is going to be variable from person to person. And so the risk that we're concerned about here is the risk of cardiovascular disease, not the risk of breast cancer. For most people
170
00:30:59.572 --> 00:31:06.391
Dr Doug: the risk of cardiovascular disease goes up because once you remove estrogen from the body, your arteries get harder.
171
00:31:06.662 --> 00:31:15.972
Dr Doug: There's more chance for those arteries than to get dysfunctional and develop plaque. And then if you add estrogen back and you loosen those things up, you could potentially break off a chunk of plaque, and you do see a signal for that.
172
00:31:16.232 --> 00:31:28.441
Dr Doug: So what we do is we look at some of these risk factors. What has their cholesterol been? What is their family history? Do they have any imaging of their heart? And if they don't, let's get some, and let's see what your disease looks like. If you've got clean looking pipes.
173
00:31:28.712 --> 00:31:36.922
Dr Doug: and you have severe osteoporosis, it probably makes sense to treat the thing that we know and not be worried about the thing that we are worried about.
174
00:31:37.002 --> 00:31:40.661
Dr Doug: I can't say that that wouldn't potentially cause an event.
175
00:31:41.032 --> 00:31:46.031
Dr Doug: But I'm if I'm worried about you breaking your hip versus having a heart attack with clean arteries.
176
00:31:46.412 --> 00:31:48.222
Dr Doug: I'd probably rather put you on Estrada
177
00:31:48.632 --> 00:31:57.592
Dr Doug: even if we can't, then we would potentially use progesterone and testosterone because they're not gonna have that same impact and still benefit somebody. So those are kind of our 2 plays there.
178
00:31:58.542 --> 00:32:01.681
Dr Doug: I talked about the Progesterone already.
179
00:32:03.312 --> 00:32:05.632
Dr Doug: and I just talked about that great
180
00:32:06.362 --> 00:32:09.352
Dr Doug: alright. And then last hormone question.
181
00:32:09.762 --> 00:32:12.892
Dr Doug: I don't know how to say this, Oranka aranta
182
00:32:13.112 --> 00:32:20.392
Dr Doug: she says it's my understanding that the risk of stroke is higher in Hrt. Than in Bisphosphonates. even evinity. And Forteo.
183
00:32:20.482 --> 00:32:33.182
Dr Doug: however, you do use Hr. T. Much more frequently than other types of medication. What are the advantages and real risks I like how you said that. Also, I don't find any research about the benefits of bio identical hormone supplementation versus traditional
184
00:32:33.202 --> 00:32:37.392
Dr Doug: treatments. Are there any proven advantages? And those are all great questions.
185
00:32:37.622 --> 00:32:45.902
So let's deal with this first one. So the risk of stroke is higher in Hrt. Than in bisphosphonates affinity or forteo
186
00:32:46.082 --> 00:33:13.651
Dr Doug: so I think what she's getting at here is she's saying that we're exposing people to a higher risk of stroke with Hrt. Rather than with the bone. Health drugs. And indeed, there is not a high risk of stroke in the bone. Health drugs. So if there's any signal for increase in stroke with Hrt, then yes, it would be higher. But we're treating different things and for different purposes. So we're treating people with Hrt for all the things that come along with aging in addition to bone health.
187
00:33:14.132 --> 00:33:30.572
Dr Doug: whereas the Bisphosphonates, affinity and Forteo are short lived only gonna impact bone and have potential negatives. So they have other side effects. So that's the trade off. I'm not just looking at one side effect from one to the other. Is there actually an increased risk of stroke? Not if you use estrogen topically
188
00:33:30.712 --> 00:33:36.751
Dr Doug: testosterone topically, and micronized progesterone. Orally, I don't believe that there is actually an increased risk of stroke.
189
00:33:38.002 --> 00:33:40.232
It's here
190
00:33:41.532 --> 00:33:45.172
we use HIT much more frequently than other types of medication. True.
191
00:33:45.502 --> 00:33:51.992
Dr Doug: And then is there an advantage of bioidentical hormone supplementation versus traditional.
192
00:33:52.022 --> 00:33:59.101
Dr Doug: And what we have to look at here is that there we are. Only we have to use the commercial
193
00:33:59.232 --> 00:34:04.691
Dr Doug: driven research to understand what's happening with the the biodenical hormones.
194
00:34:05.422 --> 00:34:06.742
Dr Doug: Now, fortunately.
195
00:34:07.332 --> 00:34:13.522
Dr Doug: we actually do have commercial research on this to to leverage. So Estradiol is used in
196
00:34:13.722 --> 00:34:38.061
Dr Doug: most studies. And you can even leverage what the Women's Health Initiative used, which is primaran, which it was mostly estr dial to understand what those risks are. So when we're talking about bio identical extra dial, it's the same that's in the patch. It's almost the same that was in premarin and the Women's health initiative. So I think it's safe to say that those things are all the same. The route is different. Primarents, oral patches, or patches and creams, or creams, both going through the skin.
197
00:34:38.462 --> 00:34:42.562
Dr Doug: and then micronized progesterone, as
198
00:34:42.762 --> 00:35:02.062
Dr Doug: Prometrium is also a commercially studied product that has FDA approval. So we know what the the risks of that are. And then, testosterone. There are a lot of studies. And I'm I'm actually writing a book on testosterone and women right now. So I can tell you. There are a lot of studies. They are mostly driven around sexual function, not around other advantages of testosterone, but
199
00:35:02.132 --> 00:35:10.652
Dr Doug: none of the studies show any concerns other than the potential androgenic risks. So I think I'm comfortable using those things for those reasons.
200
00:35:11.032 --> 00:35:13.232
Dr Doug: Alright. Any other hormone questions before we move on.
201
00:35:15.512 --> 00:35:18.722
Dr Doug: So great. All right, let's
202
00:35:21.692 --> 00:35:25.032
Dr Doug: Let's we guys want to talk about supplements
203
00:35:27.022 --> 00:35:34.222
Dr Doug: and a lot of supplement questions, or exercise your choice supplements, exercise somebody, throw it in the chat
204
00:35:34.482 --> 00:35:36.201
Dr Doug: supplements. Alright, Alan.
205
00:35:38.752 --> 00:35:40.202
Dr Doug: let's talk supplement.
206
00:35:40.312 --> 00:35:46.532
Shelly’s iPad: Here's a good question that would. You can decide what's more important, supplements are exercise.
207
00:35:46.562 --> 00:35:56.711
Dr Doug: Well, II would say, exercise of of the 2, if you're gonna pick one. But the good news is you don't have to pick one.
208
00:35:56.962 --> 00:35:59.461
Dr Doug: So alright. Let's talk supplements here.
209
00:35:59.522 --> 00:36:05.372
Dr Doug: Oh, yeah. So this this came from
210
00:36:05.512 --> 00:36:06.922
Dr Doug: Dell actually
211
00:36:06.992 --> 00:36:19.232
Dr Doug: thought that was for a short for my my name, anyway. Those are also my initials. But Dell asks about this new calcium collagen product called coact. It's KOAC. T.
212
00:36:19.912 --> 00:36:30.921
Dr Doug: And I've seen this before I went to their website. And they have. They have the results of a study, but they don't actually cite the study, which is always annoying to me.
213
00:36:31.332 --> 00:36:52.102
Dr Doug: It sounds cool, but I haven't read the study, so I put this on my list to talk to my team about I'll have my my PA or Npa take a look and see if we can find the actual studies on it. They claim a 9% increase in bone minor density. With this over a calcium alone group. My concern with that claim is that if you're just giving somebody calcium.
214
00:36:52.132 --> 00:37:11.741
Dr Doug: that's probably a bad idea. But secondly, you're basically looking at the decline of bone health compared with maybe maintaining, and that you could actually achieve a 9% difference between those 2. So we'll see more to come on that. I have that on my list of things to research. So coact coming, it's on a bunch of different products.
215
00:37:12.982 --> 00:37:23.572
Dr Doug: Jennifer asks. She has severe osteoporosis and celiac disease. Her doctor wants her to give herself a shot every 2 days. So that'd be for Teo or Timlos.
216
00:37:23.582 --> 00:37:28.271
Dr Doug: I want to try. She wants to try our recommendations first. Great congratulations.
217
00:37:28.352 --> 00:37:39.302
Dr Doug: I had a back surgery to cement 3 fractured vertebrae in October. Pouch fractures happened from horseback riding. Oh, a horse bucketing. I didn't go off okay.
218
00:37:39.452 --> 00:38:00.872
Dr Doug: but rode through it. She's 70 years old and done riding horses. That's sad. Should she start? Osteoprev is what she's asking, so I can't give specific recommendations. But here's the recommendations that we do for for calcium for patients, which is, we have patients track their calcium chronometer or chronometer, depending on how you say it is a
219
00:38:01.052 --> 00:38:09.111
Dr Doug: a free app. We use a pro version in the practice, but it's a free app. You can track all your food, and you can see how much calcium you're getting through diet.
220
00:38:09.302 --> 00:38:32.091
Dr Doug: If you're getting 1,200 milligrams of calcium through diet, you don't need a calcium supplement. I think you should probably still have a micronutrient supplement, you know, like a central minerals trace minerals. But you don't need a calcium supplement. So osteop I like, because Osteop doesn't have a lot of calcium in it, and it has a lot of other stuff in it. So it is a cool product. We do use that. I've also been back to using alga Cal.
221
00:38:32.352 --> 00:38:35.472
Dr Doug: And the reason why is because
222
00:38:35.562 --> 00:38:47.612
Dr Doug: I've been. I had this conversation with the CEO of Algae Cal, a few weeks ago, and and he fed me a lot of data on why, they're using what they're using with the idea that algae is a whole food source of calcium.
223
00:38:47.672 --> 00:39:00.941
Dr Doug: and that whole food sources of calcium do not bear the same risks as calcium supplementation. So we're definitely in a gray area with that, because ground up bones are also whole food sources.
224
00:39:01.122 --> 00:39:14.222
Dr Doug: maybe, you know. But is algae? Once you dry it and put in a capsule, is that still a whole food source? So I don't know. I think that both of those are better than, say, calcium carbonate, which is literally ground up rock.
225
00:39:14.602 --> 00:39:27.282
Dr Doug: so I'm sort of in a discovery phase with that and with them but either one of those 2, I think, is good. If you need calcium. Those would be my preferences. probiotic question.
226
00:39:27.392 --> 00:39:42.162
Dr Doug: So there, yeah, there was a study II heard about but did not read this study. The potential of probiotics is therapy prostate process. When we did our our gut health module we found a couple of studies like this.
227
00:39:42.212 --> 00:39:48.951
Dr Doug: The thing about all of the studies on on the microbiome is that we don't really
228
00:39:49.502 --> 00:39:54.812
Dr Doug: know the difference between association and
229
00:39:55.812 --> 00:40:02.072
Dr Doug: intervention. Right? So like I was just, I'm recording with my wife this afternoon a
230
00:40:02.082 --> 00:40:06.631
Dr Doug: kind of a rebuttal to the the Netflix movie, the twin study
231
00:40:06.782 --> 00:40:10.062
Dr Doug: all about eating plant-based diet. And so
232
00:40:10.102 --> 00:40:23.292
Dr Doug: they talk about this in there, too, and it's like when you look at the microbiome of somebody who has a desired health state, whether it be healthy or lean or muscular, or absent of a particular disease, or with a particular disease.
233
00:40:23.412 --> 00:40:25.831
Dr Doug: You can see a trend in their microbiome.
234
00:40:26.482 --> 00:40:45.341
Dr Doug: but there's no evidence to say that giving a probiotic, or, you know, any kind of manipulation of the microbiome will actually change the disease state. So I think it's a question of, you know, like the tail wagging the dog right? So I think the the microbiome is demonstrative of what's happening in the host
235
00:40:45.502 --> 00:40:46.532
Dr Doug: be in the human.
236
00:40:46.632 --> 00:40:58.062
Dr Doug: But I don't think we can manipulate the microbiome to change the host. Now the research behind what's it called? Oh, fecal transplant
237
00:40:58.122 --> 00:41:09.942
Dr Doug: sounds like a superfine procedure. The evidence behind fecal transplant would show that that is potentially true. But you're changing the entire microbiome with another microbiome, and that is not the same thing as taking A supplement.
238
00:41:09.962 --> 00:41:33.382
Dr Doug: So for me, I recommend probiotics. I don't really know that they're doing much other than repopulating for people that have had. You know, dysfunctional microbiome that we, you know, decimated with antibiotics or or natural antibiotics. So I don't know. I don't think that we're gonna reverse osteoprosis. I think we're just seeing a a consistent state of people that have dysfunctional microbiome with osteoprosis. But I don't know that we know what that means.
239
00:41:34.082 --> 00:41:35.162
Dr Doug: That makes sense.
240
00:41:35.912 --> 00:41:59.321
Dr Doug: Candy had a follow up question around Lorna. Thank you, Lorna. You've been paying attention. Candy. And Lorna had a follow up question about calcium. Lorna is is calling me on being inconsistent with my milligrams of calcium so I've been. I've said in the past. If you have, if you consume over 800 milligrams of calcium through diet. Then you don't need to supplement. I just said 1,200.
241
00:41:59.562 --> 00:42:03.752
Dr Doug: And, Lorna, I'm not. I'm not going back on that I think 800 is enough.
242
00:42:04.012 --> 00:42:11.512
Dr Doug: because most countries it is 800. But when it comes from calcium, from whole food sources, and this is where this gets so tricky.
243
00:42:11.612 --> 00:42:20.612
Dr Doug: like. One of the reasons why I stopped using algae cal is because it has 720 milligrams of calcium. If that were coming from calcium carbonate. I think that would be too much for almost everybody.
244
00:42:21.002 --> 00:42:27.272
Dr Doug: but it's coming from a whole food source. If someone wanted to drink 3 cups of raw milk a day, and they were getting.
245
00:42:27.572 --> 00:42:32.061
Dr Doug: you know, 600 milligrams of calcium. But I tell them it's too much calcium. I wouldn't.
246
00:42:32.392 --> 00:42:33.462
Dr Doug: So
247
00:42:33.482 --> 00:42:41.552
Dr Doug: I think there's just there's probably a big range, and as long as you're getting it from whole food sources, you're getting it with vitamin d. And Vitamin KI don't know that we need to be that nitpicky.
248
00:42:41.882 --> 00:42:57.601
Dr Doug: but if you're getting 800, do you need to add another 800? Probably not, you know. Then I would just focus on the other micronutrients. and then Candi also asks if we get enough calcium through food. It would be beneficial to take the second tab from Algacel with strontium.
249
00:42:57.922 --> 00:43:02.352
Dr Doug: Yeah, I mean strontium for me. II think that there's value.
250
00:43:04.042 --> 00:43:09.901
Dr Doug: How much is it going to impact our bones. It's going to impact our dexa. We don't really know how much it impacts bone strength.
251
00:43:09.912 --> 00:43:21.592
Dr Doug: And so this is where for people that have really low T. Scores. I'm totally fine with using it. I think it can help both mentally to see your T. Scores come up and Bmd. Come up.
252
00:43:22.442 --> 00:43:35.572
Dr Doug: but I wouldn't push into it if we don't. You know, if you're not in that group, if you have relatively mild osteoprocess, I wouldn't take strontium. I don't think there's any risk I think we just run into. You know, we run into financial and capsule fatigue challenges.
253
00:43:36.992 --> 00:43:45.771
Dr Doug: Sharerall asked a great question about the Gi effects. Does no growth mean deficient or just inconclusive? Lab?
254
00:43:45.872 --> 00:43:55.561
Dr Doug: I have to look at have to look at those results. Cheryl. No growth generally means no growth, as in that. That bacteria is not growing.
255
00:43:56.592 --> 00:44:04.592
Dr Doug: And candy said, negative 4.1. Yes, the candy that's low. So yeah, candy. If you were my patient I would have you on strontium.
256
00:44:10.512 --> 00:44:15.812
Dr Doug: You're welcome. Okay, so let's move on
257
00:44:17.002 --> 00:44:19.031
Dr Doug: a lot of calcium questions.
258
00:44:21.132 --> 00:44:30.202
Dr Doug: Okay, Debbie asked about getting conflicting advice about how much calcium to take. She had bariatric surgery 9 years ago, and as a result have malabsorption.
259
00:44:30.252 --> 00:44:34.521
Dr Doug: She was recently diagnosed with osteoporosis, which is super common after bariatric surgery.
260
00:44:34.612 --> 00:44:38.612
My recent lab showed vitamin D was low at oh.
261
00:44:38.972 --> 00:44:42.262
Dr Doug: was low, normal of 30. It was 15. Well.
262
00:44:42.282 --> 00:44:46.311
Dr Doug: that's better. My Doc told me you have to go on prolia
263
00:44:46.402 --> 00:45:00.361
Dr Doug: So, Debbie, I can't tell you it really is right for you, because I need to know a whole lot more information. However. The amount of calcium that you have to take to get absorption through your gut is going to be really tough to know. Unfortunately.
264
00:45:00.362 --> 00:45:17.352
Dr Doug: You know, we could do what I would recommend doing actually is and we're playing with this. I have it sitting right here beside me is doing a HTML here tissue mineral analysis, or using a a tool like neutral eval to look at byproducts of
265
00:45:17.442 --> 00:45:44.441
Dr Doug: of calcium absorption. I'm pretty sure neuter eval does it? I know HTML does it, and the reason for that is that I don't think there's any way for you to know if you're getting enough calcium, or if you need to take big doses of calcium, or is that gonna hurt you? There's no way to know other than knowing what's happening in your blood and in your body. So I would try to use one of those 2 tests. To see if you actually need more calcium. It's a little hard to know, too, you know. Which portion did they remove, and how much calcium you're getting absorbed? It's so tough
266
00:45:44.562 --> 00:45:53.372
Dr Doug: so a tough position to be on as far as having to go on pro laya. We just need more information for sure. Thank you.
267
00:45:53.592 --> 00:45:56.432
Dr Doug: Oh, Hi, Debbie, yeah, you're welcome.
268
00:45:57.152 --> 00:46:16.152
Dr Doug: So the the Karen asked about algae Cal. I think we just covered that. Their omega 3 fish oil. It's a good quality of fish oil. The challenge I have for patients with a liquid based fish oil is whether or not they can tolerate it. They? They say in the ads that it tastes great. I've never tasted it, but I've also never tasted the fish oil. It tastes great. So
269
00:46:17.292 --> 00:46:18.722
Dr Doug: see
270
00:46:18.892 --> 00:46:22.381
Dr Doug: see what you think. It's a good quality one, but there's lots of good quality ones.
271
00:46:22.822 --> 00:46:43.691
Dr Doug: And Susan was asking, I guess, actually right right about Aljakal. She said that she emailed the admin of Algae Cal. It read the Consumer lab. So they were slightly elevated. Lead, content, and she's been taking the garden of Life, vitamin code, rock house on the top of the price.
272
00:46:43.862 --> 00:46:54.101
Dr Doug: and they say that it's sourced from the same place. Yeah. So I think it just depends on
273
00:46:54.192 --> 00:47:12.561
Dr Doug: it depends on who you want to commit your dollars and faith to the thing about, you know, saying that there's elevated lead content. You gotta remember that these things are naturally occurring like lead is naturally occurring in the environment. So if you pick up algae, and this is my concern about algae is that you're gonna get whatever's in the environment.
274
00:47:12.962 --> 00:47:30.831
Dr Doug: You're gonna get some of that same thing, though, like with the with the ground up bones like, what have those cows been exposed to? That's in their bones? You know we don't. It's it's really hard to have a perfectly clean life as a cow. So there's probably stuff in those bones that we
275
00:47:31.842 --> 00:47:41.252
User: that we're gonna end up getting through a supplement that's that's made from ground up bones. So I think we're always gonna have some contaminants. So I think you have to trust the company. Now.
276
00:47:41.562 --> 00:47:54.572
Dr Doug: Garden of life, you know. Have they done the same testing? If it's coming from the same source, I would assume that it probably has some of the same contaminants. Right? And so I think it just depends on who you want to commit your your faith and your dollars to. I try to
277
00:47:54.662 --> 00:48:05.202
Dr Doug: use the best products that I can for myself, and if you trust garden of life, then use garden of life. You know half the price sounds great. I would also look at the other components, though, and are they of high
278
00:48:05.252 --> 00:48:13.511
Dr Doug: quality? And so that's there's so many things that go into a supplement and definitely considered making our own, but it is
279
00:48:13.992 --> 00:48:15.361
Dr Doug: not easy to do.
280
00:48:16.672 --> 00:48:26.262
Dr Doug: I'll let that go
281
00:48:26.492 --> 00:48:31.831
Dr Doug: alright. Some d 2 sorry vitamin DK. 2. Hopefully. Not d 2
282
00:48:31.952 --> 00:48:39.292
Dr Doug: questions. So let's talk about this. So Kim asked. Oh, and Diane, I see you added some information. Here, let me just run through this. So
283
00:48:39.652 --> 00:48:43.341
Dr Doug: Dan's giving us some background.
284
00:48:44.382 --> 00:48:48.831
Dr Doug: and I'm sorry, Diane, which
285
00:48:49.392 --> 00:48:53.581
Dr Doug: well, I guess you weren't. This was a good question. All right. Let me just read this question from Dan.
286
00:48:54.112 --> 00:49:03.972
Dr Doug: So Diane's T score is in the negative threes. She's taking strontium as well as hormones. Dexa improved by point 2 and point 4 in 6 months. That's pretty quick.
287
00:49:04.102 --> 00:49:09.252
Dr Doug: Are you saying? This does not necessarily indicate my bones are getting stronger. Yeah, Diane, that's the rub with strontium.
288
00:49:09.862 --> 00:49:16.672
Dr Doug: Now, that doesn't mean that it's bad. It just means that we, you know. I wouldn't expect to see significant change in Dexa in 6 months.
289
00:49:16.882 --> 00:49:18.741
Dr Doug: Where's Diane?
290
00:49:21.822 --> 00:49:24.752
Dr Doug: I don't see you, Diane. somewhere.
291
00:49:24.982 --> 00:49:28.811
Dr Doug: Well, anyway, I know you're here. So oh, there you are!
292
00:49:29.042 --> 00:49:47.872
Dr Doug: So that's the rub with with strontium, is. It's going to improve your Dexa, and some people would say it falsely improves your Dexa. I wouldn't say falsely. It just is improving your Dexa, so how much of that is an improvement in bone strength we don't know, but arguably we never know. So it's heading the right direction. Great keep doing what you're doing.
293
00:49:48.812 --> 00:49:55.801
Dr Doug: I would recommend getting a rams because rams. I don't think it's gonna be impacted by strontium. If you have access to one
294
00:49:56.492 --> 00:50:14.892
Dr Doug: we're gonna see improvements in T score. And hopefully, you're gonna see the architecture get better for bone strength. That's why I wish everybody had access to it. Rems but I still recommend it, you know. Add negative 3, 9. I mean, I'd be okay with trontium because we wanna see that that T score get better. There's a there's a mental capacity to that that would be helpful.
295
00:50:16.312 --> 00:50:21.331
Dr Doug: Let's hear. Alright! So Kim is asking about
296
00:50:22.672 --> 00:50:28.892
Dr Doug: the vitamin d. She's taking 5,000 of vitamin d. And 300 of K. 2 is MK. 7.
297
00:50:29.462 --> 00:50:45.462
Dr Doug: She's saying she knows they need to be consumed with a meal containing fat, which is great should they be taken together or separate? Does it matter? So this is one of those controversial things? I think that arguably, if you wanted to have the best absorption of both. You could probably take them separately.
298
00:50:45.582 --> 00:51:05.612
Dr Doug: it's hard, though, so what I tell my patients is, I would rather you take them together than not take one at all. And most of the products that we use have them together anyway. So all my patients are getting them together. If you can separate them, separate them. If you have that if you have that discipline, I don't. I would forget one
299
00:51:05.662 --> 00:51:23.062
Dr Doug: so I don't think it matters that much. You also find them together naturally in in the environment. So you find them together in cheese, and you find them together in some, some whole food products. So anytime, I see nutrients that are generally found together, then I'm not as concerned that they're gonna interact because Mother Nature is smarter than that.
300
00:51:24.662 --> 00:51:30.102
Dr Doug: Let's hear, Susan J. Asked. Supplement person at whole foods recommended
301
00:51:30.282 --> 00:51:33.861
Dr Doug: bone solid with cell food, essential silica.
302
00:51:34.182 --> 00:51:41.661
Dr Doug: and has shown improvement of their bone density scores, she said. One lady had reversed osteoporosis. And then you have a link here.
303
00:51:41.832 --> 00:52:07.471
Dr Doug: yeah. So the silica component, I think, is reasonable. I've looked at that recently, and silica does seem to have an independent impact on bone density. So I think that's totally reasonable. The question is, is, you know how important is it? And you know, is it gonna make the stack? I would say honestly, from most of our patients, it doesn't and we don't even recommend this on a regular basis
304
00:52:08.442 --> 00:52:35.582
Dr Doug: another. So Susan also asked about another product has a guarantee in his website that if you take his formula exactly, you will never fracture, or you get your money back leaves incremental dosing of vitamin. K throughout the day is the key to not having any fractures. I mean, it's a bold statement, but from a from a business perspective. If you were to just think about this from a business standpoint. That's a really smart play.
305
00:52:35.582 --> 00:52:53.122
Dr Doug: You're offering people an unbelievable offer and an unbelievable guarantee and the number of people that have osteoproses versus the number of people that fracture. If you just do the statistics on that that's gonna pay off in the long run. So just from a marketing perspective. That's a smart move.
306
00:52:53.392 --> 00:52:58.711
Dr Doug: is it true? I've never seen any long-term studies on Vitamin K to show that that's true.
307
00:52:58.742 --> 00:53:06.991
Dr Doug: Sounds cool. So I believe in K, we're obviously providing K, but from a marketing perspective. That's it's wise.
308
00:53:07.362 --> 00:53:09.611
Dr Doug: I could also say the same thing about our program.
309
00:53:09.712 --> 00:53:14.941
Dr Doug: join our program, and I guarantee you'll never fracture or your money back. And then I would refund what
310
00:53:15.472 --> 00:53:20.521
Dr Doug: you know. Maybe 1% of people. some people that have ever fractured on our program.
311
00:53:20.662 --> 00:53:30.341
Dr Doug: Had one patient fracture while using Osteostrong on our program. That was unfortunate. But she just started so to be fair. Nothing had happened yet.
312
00:53:32.132 --> 00:53:41.432
Dr Doug: So Diane asked if she could stop the strontium with those scores and see what happens. Yeah, you you can. I would. I mean
313
00:53:41.652 --> 00:53:42.752
Dr Doug: if I
314
00:53:42.762 --> 00:53:51.691
Dr Doug: if we decided that we like it, then I would keep using it until we got to a point where we were really solid, you know, like not osteoporotic, or barely
315
00:53:52.002 --> 00:54:00.402
Dr Doug: If you want to cut down on capsules, then it's a reasonable thing to cut down, because for me again, it. It only makes the stack. I don't know
316
00:54:00.572 --> 00:54:02.031
Dr Doug: less than 10% of the time.
317
00:54:04.272 --> 00:54:11.481
Dr Doug: And somebody asked us calcium in your blood from Neutraeval. Show how much
318
00:54:11.592 --> 00:54:27.141
Dr Doug: you are absorbing. I'd have to look so nutri. Val is a a study that looks at both blood and urine. I'd have to go back and look and see actually what it does show with calcium. I haven't. We haven't used this for that purpose, so II don't know the answer to that.
319
00:54:29.622 --> 00:54:35.622
Dr Doug: Oh, 1156. Alright, we're gonna do.
320
00:54:35.862 --> 00:54:36.891
Dr Doug: One more question.
321
00:54:39.512 --> 00:55:00.567
Dr Doug: Oh, and then this is another question about the garden of life. Grow bone system. Yeah, I've reviewed this a bunch of times. I don't remember the exact components of it. It's fine. It just has a lot of calcium so if you need this much calcium then it's a reasonable product. It's a has a lot of other things in it. So I think it's I think it's a reasonable product. I just concern that there's a lot of calcium that potentially people don't need.
