January 8, 2024
During the meeting, various health topics were discussed, primarily focusing on medical concerns, research, and dietary considerations. Here's a detailed summary of the key points:
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Dr Doug: is, I just go through the questions that have been submitted. The I like to give the people that are showing up live though the opportunity to ask questions as well. So if if you're here and you have a question that you want me to hit for sure, or something that wasn't submitted, you're welcome to just unmute yourself and ask that question. And we can start with that. If anybody has anything that they wanna ask.
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Shelly’s iPad: Yeah, I have a question, Doctor Doug, it's shyly. Jacoboni.
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Dr Doug: hey, Shelley, how are you doing? Well, thank you. Good can you just repeat the ratio for the p onenp and ctx, please, real quick. Yeah. So, and we've been continuing to do more research into this with our cause, we have all this data about it. So the way that we're doing it is
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Dr Doug: p. One. And p as it's measured in the unit. So the way it comes down in Lab core, I can look up the units, but it's the the units as they are for, and P. So that's generally a 2 digit number for most people, unless it's pretty high, in which case it's a 3 digit number, and then you divide that by C. Tx. In C. Tx. We have to adjust for units, we to bring them into the same units as and P. So it ends up being 0 point
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Dr Doug: something. And so you end up with, you know, like a 2 digit number over a point dot dot and so that ends up, being usually somewhere between kind of 50 and 250 with higher being better.
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Shelly’s iPad: Okay, thank you.
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Dr Doug: Yeah. Yeah. And I just had my research assistant go through. I think everybody's data, and we have all of those pulled. So we actually, I haven't looked at them yet, but
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Dr Doug: can look at and see what's what's happening with everybody, which is fun.
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Cathy: I have a question. Yes, ma'am, who is that? Kathy?
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Cathy: Hi in in regards to inflammation? How do you? What's the best way to? II know it. It's bad for the arteries and probably bad for the bones as well.
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Cathy: And what's the best way to counteract that?
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Dr Doug: Yeah, it's inflammation, chronic inflammation is bad for everything
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Dr Doug: we have to remember. That acute inflammation, like, if you injure yourself, is is good because we need inflammation to heal
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excuse me.
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Dr Doug: We also need inflammation even in the process of like building muscle. So inflammation itself is a good process. We have to have it to survive. But when it's elevated for long periods of time you run into issues because our body doesn't know what to do with that. We can't accommodate that. So when we do see signs of chronic inflammation which would be elevated. You know. Crp is the best thing to measure in blood. There are other markers, but elevated crp consistently means that something's going on.
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Dr Doug: The best thing to do, in my opinion, is to figure out what that is, but that's not always easy to do so. If we can find a source and a lot of times.
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Dr Doug: and if we see at one time, oftentimes it's just like an immune response to like a a virus, or you know some some acute thing, because we'll catch those, too.
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Dr Doug: But if you see it consistently elevated them for me, the question is what's going on? Is it? Gut dysfunction? Do you have an infection somewhere? Do you have chronic infection? Is it a dental thing?
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Dr Doug: And that's something. My PA is a big advocate, for you know, getting dental work looked at and making sure that you don't have chronic abscesses stuff like that. And then we also potentially will run tests looking at heavy metal toxicity, environmental toxins, mold toxicity, because all those things can create chronic inflammation.
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Dr Doug: Which then you have to. Once you figure that out, then you have to figure out what to do about it. But for me, I like to figure out what the problem is so that you can address the root issue of it if you can't figure it out. Or in the meantime you want to reduce levels of inflammation. This is a I don't know. It's kind of a challenging
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Dr Doug: space, because there are lots of different supplements out there that in theory do this so you could use the antioxidant route. And you could say, You know, like Glutathione is the master Antioxidant, you could go that route. Vitamin C is an important part of the immune system. So you could look at vitamin c a lot of people really love tumor
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Dr Doug: and there are different versions of turmeric that are out there and available, that in theory will reduce inflammation. I'll say, though, that I haven't been real impressed with anything
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Dr Doug: from a supplement perspective to significantly reduce like crp and blood. It might make you feel better, which is fine. But ultimately we need to figure out what's actually causing inflammation and reduce it that way. If that makes sense, what about the dietary?
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Dr Doug: Yeah. So an an anti inflammatory diet is an important part. II find that chronic inflammation is probably not coming from diet unless you're really eating a terrible diet, but like letting be like, for example, ahead of
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Dr Doug: a birthday party yesterday, and I did eat some cake, and it was amazing, and I do feel inflamed. I feel terrible like I woke up 2 pounds heavier and fluffy. But but, man, it was good. So you know, like every now and then, if somebody pops in, it's probably not the end of the world right. But if people eat like that every day, which unfortunately, a lot of people do, but if you eat terrible food all day long, every day, that itself could be a source of inflammation.
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Dr Doug: So then, we have to look at like what is an anti inflammatory diet, and that's pretty.
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Dr Doug: It's pretty broad as well. So I just did a recent video on the Doctor Doug show on my experience with carnivore.
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Dr Doug: which, if you, if you were to ask me what is the least inflammatory diet out there, I would say. It's a carnivore diet, however. While lots of people that are on the carnivore diet will say it is the way to eat, and it's totally something that you can do for the rest of your life. I would argue that most people don't wanna eat just meat for the rest of their life. But when I look at the things that are potentially inflammatory, they mostly come from plants.
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Dr Doug: grains.
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Dr Doug: beans, potentially some fruit.
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Dr Doug: a shocking number of vegetables, actually. But knowing which ones of those are inflammatory for each individual person is really tough. So that's why we will use an elimination diet to help to pull things out and then see how you feel, and then add things back in
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Dr Doug: before we started playing with carnivore. We were using the autoimmune paleo diet or aip aip is good because it's it's pretty restrictive, and it pulls up most of those likely inflammatory things, but it leaves in more options to be a little bit more varied than eating a carnivore diet. But I've found nothing to be as impactful from an elimination perspective as a carnivore diet, because it just eliminates everything
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Cathy: other than me. Yeah, what about root vegetables?
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Dr Doug: Yeah. So if you get into root vegetables. And we start. II lean on my dietitians for this a little bit, but my understanding is that things like, you know, like white potatoes, for example, they live in the Night Shade family. Could they potentially be inflammatory? They could? I find most people seem to tolerate them well, but things like night shades. If they're causing inflammation, you don't necessarily feel it at the time you consume it.
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Dr Doug: And so that's that's one of the challenges around elimination and then adding things back in is you have to really give it some time?
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Dr Doug: but root vegetables like white potatoes could be inflammatory could be tolerated. Sweet potatoes seem to be more tolerated. Yams, etc., like that kind of group. That's why they live in the paleo space.
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Cathy: Okay?
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Cathy: Alright, thank you. Yeah. Sure.
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Dr Doug: the biggest thing is eliminate sugar.
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Dr Doug: sugar which I have coursing through my body right now.
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Dr Doug: alright! Let me pull up this list. Any other
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Dr Doug: questions while I get our list pulled up here. Good morning, Doctor Doug. This is Janina. Could I ask you a question? Hi, Janina, of course.
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Janina : Well, 2 things when I've been on carnivore diet for 10 months. So if anybody has any questions happy to answer it's been amazing. But my question is, I'm getting ready, I believe, to get a trainer
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Janina : to work out. I've previously worked out, and everything. But I've not worked out having osteoporosis in my lumbar spine. So you know, I know you guys have mentioned buff bones, and you know, having like jumping and things like that like, can you give me?
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Janina : I mean, I know about the 80% of one Max, and things like that. But what does a workout routine for? Somebody look like like, what am I gonna ask for a trainer to help me with such a great and challenging question? Thank you. No, no, it's great. So yeah, our
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Dr Doug: Our experience with exercise and osteoporosis and recommendations
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Dr Doug: has been challenging. And it's been a little bit circuitous. But we started out when we started the bone health program. We sort of relied exclusively on people finding somebody locally. But just as you're finding out, it's really hard to find somebody who has any kind of training whatsoever, or even understands the disease.
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Dr Doug: And so then we were sort of left with, well, let's at least
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Dr Doug: have something to offer, and that's where Buff Bones came in. And so I met Rebecca Rebecca Rothstein on social media, and she's the the founder of Buff bones. And so we incorporated it because it's something that I feel like anybody can do and not get hurt
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Dr Doug: unless you just literally fall over and hurt yourself. So for the most part, it's something that I think anybody can do.
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Dr Doug: But is it enough to build bone? It's not, in fact. I found a research study that included the buff bones, content that I didn't know about early on that showed clearly that it did not really have any impact on bone whatsoever. So it is helpful, probably for movement, for people that aren't doing anything. But is it? Gonna build bone? No, but what I've also learned over the last several months, really digging into this is that really no resistance training is gonna build bone.
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Dr Doug: And as controversial as John Jakeish is.
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Dr Doug: some of his research really does make sense. And one of the things that he shows in his research is that you really have to hit this 4 multiples of body weight in order to actually stimulate bone building.
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Dr Doug: and nobody's going to lift that much weight right? Like I
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Dr Doug: I mean, for some of the complex lifts. I'm not even getting close to 2 times my body weight right, I mean, and I weigh 200 pounds. So 400 pounds is way too much for any of us to consider lifting if you wanna save our joints.
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So resistance training itself is not going to build bone.
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Dr Doug: That doesn't mean that we shouldn't do it because we wanna build muscle muscle will indirectly build bone, support bone. Right? So it's all good. But we need to consider something else. And this is where I've really been pushing. So Nick Trueby, who does our exercise training programs within the the bone health program, we're creating an impact component to our program. And if you look at you mentioned the one 80% rep Max.
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Dr Doug: Janina, and that comes from the Lithmore trial, and people will quote the Lithmore trial to say, Oh, well. they built bone in this resistance training program, it's true.
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Dr Doug: but they also had an impact component.
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Dr Doug: So they were jumping off, of literally jumping off of pull up bars as part of their program. So which was it? Was it the heavy resistance training, or was it the impact? And the answer is, we don't know but I think that the impact probably had something to do with it, because if you look at the other research by Jakeish and Osteogenic loading. You can see that if you.
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Dr Doug: if you look at the research on like gymnasts, for example, they can generate 20 time. 20 multiples of their body weight landing.
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Dr Doug: Now, granted, these are gymnasts, and they're light, and they're young, and you know, whatever they can do that I'm not saying we should go do that.
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Dr Doug: But what he created through osteogenic loading and osteo strong is the idea of doing impact in a controlled manner.
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Dr Doug: I don't think we necessarily have to do that, although I support people doing it if they have access to it. But having some kind of impact is important. If you can't tolerate impact than looking at the alternatives like osteogenic loading. Or I just recorded a video on Friday on vibration, which is another way to kinda S, simulate that a little bit. So you can get cause you're doing multiple. Gs, so if you look at like power plate
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Dr Doug: products, for example you can get, you know, around 3 Gs, so it's in theory 3 multiples of body weight. And you could probably bump that up a little bit. And the research that they've shown is that you do generate some bone mineral density with that as a an intervention on its own. So I think, in combination resistance training for muscles, for strength for core but then, also, some kind of impact is how we're gonna have the
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Dr Doug: greatest stimulus on muscle and bone. That was a long answer. Sorry.
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Dr Doug: I guess I need to go to the Trampoline Park, then, is what you're saying. Well, so here's a funny thing. So rebounding, re rebounding as on a trampoline. Doesn't have the same impact. No pun intended. So there's research on on trampolines and they are good for fall prevention. They're good for probably muscle building, depending on your starting point.
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Dr Doug: But they do not build bone, and I think it's because there's the trampoline slows you down too too slow if you know what I mean. So it's not like it's not impact.
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Dr Doug: It is a muscle contraction. But are you getting to 4 multiples of body weight
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Dr Doug: right? Otherwise, you know, if any any adult got on a trampoline and tried to generate 4 multiples of body weight, they would just collapse. So
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Dr Doug: yeah, my kids can do it. And I think it's great from a fall prevention perspective. But it's it's gotta be something else. So I think either vibration on a device that can generate 3 G's
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Dr Doug: osteogenic loading or some kind of impact training. And again, we're gonna we're coming up with our own which I meet with Nick. I think next week to go through that program. So that'll come out and you'll see more material on that soon.
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Janina : and then just on that. What do you think about like the jumping off the cross fit box? I don't do cross fit, but you know I can do the box, probably jumping. I mean, if if you look at the the Liftmore trial, they don't really define how high their participants were were falling from the pull up bar. II can't imagine it was that high.
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Dr Doug: you know. So how how far does it take? I don't think we know the answer to that. Nick's looking into the research on it right now. My guess is actually coming off of a a box like that would actually be adequate. My concern is, there are a lot of variables in there, and
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Dr Doug: one of the primary things we need to do is not get hurt. So how do you work up to that? How do you do that in a safe manner?
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You know. And then, depending on your starting point, you know, is that gonna actually put you at risk or fracture?
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Dr Doug: Yep, okay, that's what I wanted to know. Thank you so much. Yeah. So there's there's so many things to learn there, and I'm I'm very hesitant to tell people to start jumping off a stuff. Considering our population.
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Kitt Lurie: I have a question about the osteogenic loading. I understand. That if you do that like through Osteo strong that it's like once a week, what if you wanna be working out, including impact and resistance and weight training in between. Is that gonna be a problem, then? Not at all. So when II sat down with with John
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Dr Doug: John Jakeish and I had dinner with him and the CEO Kyle Zagrosky of of Ostia Strong, and we. We chatted about this for a couple of hours. So
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Dr Doug: when you, when you consider John's research on osteogenic loading once a week, makes sense because the bones need time to recover. However.
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Dr Doug: our goal is not just building bone, right? We want to build muscle, too. Now they would argue that from a sports perspective. they're building muscle as well, which is true, but not specific muscles, you know. Like it's a they're big muscles.
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Dr Doug: They're complex joint movements, and that's great.
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Dr Doug: If you then look at his research on x 3, he would argue that almost to the same extent you only need to do a 10 min workout once a week to optimize muscle building. And II know where he's getting those data from. And I understand the graphs.
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Dr Doug: But at the same time, I think we need more impetus. We need more stimulus it through muscles in a different pattern and in different ways. He makes fun of the term like muscle confusion.
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But really we need to challenge the body in different ways. Otherwise, your body's just going to get really good at doing one thing one way
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Dr Doug: right, and that's where we run into trouble because we, you know, are as
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Dr Doug: as humans in the real world we are challenged with, you know, things like curbs, and like having to suddenly make a move. Whereas if you're sitting on a machine and you're pushing in one direction, you don't have those things. It's the same argument, you know that, looking at like longevity and mice versus longevity in humans like we're not little rodents in a cage.
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Dr Doug: so I think that we probably we could certainly do osteo strong, or some kind of osteogenic loading, but then mix in a resistance training, and even, you know, 3, 4 times a week, depending on how much you wanna do. You know, my current training regimen is 5 days a week of resistance training, and I don't think that I'm just doing it for fun, although I do enjoy it. My goal is to to load my muscles in different ways, so that I am not only strong, but also. You know, agile.
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Dr Doug: And I can do different things and do different activities. I just started tae kwon do with my 11 year old like I couldn't do that if I could only move in one plane, you know.
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Kitt Lurie: that makes so much sense to me. And II just agree so much, and it makes me question the Osteo strong approach. You know. It just kind of undermines a lot of what makes good sense to me, I guess.
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Dr Doug: Yeah, I I'm challenged by their the rigidity of their stance, which is, it's frustrating cause. I think that what they offer is really good.
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Dr Doug: I wish that they could take a position of saying they are part of a bigger program, but from a marketing perspective they need to say that what they offer is all you need same thing with Jake. Wish in the bar. It's all you need. Well, yeah, it depends on your goals. Can you build muscle with the bar alone. Yes.
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Dr Doug: Is that what any bodybuilder does, or Nfl player does for a strength alone? No. it's a tool. I have one, too. I travel with it. It's great. But when I'm at home I don't use it.
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Kitt Lurie: Yeah. And I think for a marketing perspective, as being the consumer, that that to me is a turn off. But that's another conversation, perhaps.
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Dr Doug: Well, it's yeah. So you're you're not their avatar. So they're looking for people that are that that want to just believe and have faith that what they're doing is the right thing.
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Dr Doug: And and there's there's value in that. Because, I mean, Jake wish has a million followers right? So like there are people that are doing that he sold. I forget what he told me that like 300,000 units of. So
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Dr Doug: it works. But
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Dr Doug: that's not what I wanna do. I wanna be a part of the bigger picture. So yeah, I could serve a million people. But I could also serve 100 million people by being a part of the bigger picture. And that's why I do talk with Osteo Strong and II have a relationship with those guys. But I'm also not afraid to say that I don't necessarily agree with everything they say.
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Kitt Lurie: Great. Yeah. Well, I appreciate your perspective and sharing that. Thanks a lot.
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Ann Dickinson: Hi, I'm in your optimal bone health program.
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Ann Dickinson: No, we haven't pretty new. I'm trying to up my pro team right now I got my hands full with that while we're on the subject of the Osteo Strong, there's actually a place 10 min from where I live. I'm in New Jersey nearby. So but I question
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Ann Dickinson: the amount of research backing up the Osteostrong. The studies do not look big, you know, and so many followers. I really question
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Ann Dickinson: the research component.
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Dr Doug: Yeah. So I actually interviewed him a second time and asked him those questions specifically cause he does get a lot of a lot of negative feedback, and even the
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Dr Doug: what they even call themselves. Now, whatever our Osteostrong or sorry, our Osteoporosis Foundation in the US.
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Dr Doug: It's called now I forget but they even came out with a stance to say that they don't support osteosrom, because the research doesn't back it and
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Dr Doug: but I kind of disagree with it, but I agree with them. I know what they're saying, which is, there are not big studies which is totally true when you ask John about that. His perspective is, we don't need big studies. Where is the big study that shows that bench press causes peck muscle. Hypertrophy like that doesn't exist either. Right? But we know that it's true, because we see the results.
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So his perspective is, we've done enough research to say that it's safe.
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Dr Doug: And we know that from a safety perspective, you know they've had.
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Dr Doug: They've had probably, I think, what Kyle said, like 10 million
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Dr Doug: visits
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Dr Doug: like 10 million rounds through the equipment, and they have had fractures. They probably don't want me to say this, but they have had 5 reported injuries.
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Dr Doug: but you put 10 million people with osteoporosis in a room for more than an hour, and I think you're gonna get 5 fractures right just from sneezing.
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Dr Doug: So so I think that it is safe. And again, I think it's a way to stimulate impact without
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Dr Doug: doing impact. So for people where that's not appropriate. So I think there is value in that. There are some bigger studies coming, too. So there's a study out of Greece that I have.
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Dr Doug: I have some of the data on. I don't know that I'm allowed to share it. But they had a hundred 30 participants in their study, and this was not funded by Osteostrongs was an independent study and they showed benefit for bone mineral density as a stand alone intervention. But
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Ann Dickinson: and this is another area of Osteostrong controversy. It does not show the like. 15% increase in Bmd that they like to quote right?
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Dr Doug: Those numbers aren't a lie. They're just sort of it's a
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Dr Doug: an extrapolation of the data, right? The the data is there to support that statement. But what these data out of grease show is like a 2 to 3%, which is realistic.
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Dr Doug: right? Like osteoporosis, like any improvement, is, gonna be great. Well, that's good, right. And it has to be more than more than the standard of deviation, standard error, deviation of Dexa, which is around 2%. So we need to cross that 2% threshold and see it in multiple studies. And I've been told that there are other studies that are coming as well, probably all in 2024. So I think that the research is coming. They didn't feel compelled to do it, because it's expensive, and they didn't feel like they needed to.
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Dr Doug: I think they would be served well, too, because they could probably serve more people.
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Ann Dickinson: Thank you.
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Dr Doug: Yeah. But I think it's coming. And I do think it's safe.
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Okay, I know. We got a lot of questions to get through. So let's move on to that.
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Dr Doug: Gosh! We always have more questions than I have the capacity to get through. Let me start from the top of this list, and then I want to talk to my team and figure out if there's and a better way to do this.
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Dr Doug: I love all the questions, and thank you guys for answering or for putting them in.
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Dr Doug: Let's see here, I want to see where the top of the list is is at the bottom of the list.
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Dr Doug: Lorna, I see lots of questions from you.
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Dr Doug: Now, here's the top of the list.
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Okay,
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Dr Doug: let me see, Lorna, if these are all on the same topic.
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Dr Doug: please pull my question on cold therapy. But I love cold therapy, Lorna.
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Dr Doug: I think they pulled my Co. Your question on cold therapy, so I don't even see it. Anyway. Let's talk about igf one. So Lorna asks about her igf one dropping
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and concern about pituitary tumors being a secondary cause of bone loss.
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Dr Doug: So pituitary tumor like a true pituitary tumor.
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Dr Doug: I have to think about that. I'm sure it could be.
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Dr Doug: but I would have to look and see what's cause. The pituitary does so many things I have to look and see what the actual impact is. But igf, one, specifically Lorna. So it moves up and down. And this is one of the challenges of using Peptides for Igf, one is that we don't always see igf one respond the way that we think it will. I saw this originally, when I was working with Lifeforce, and we were using Surmorlin as one of our primary
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tools early on, and we would see people that didn't have an increase in IGF. One
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Dr Doug: for those that don't know what Ig, f, one is. It stands for insulin, like growth factor. And it's essentially the anabolic catabolic switch. So we want Igf one to go up if our goal is to build muscle and bone. If we were to be on a weight loss program, though, we would want Igf one to go down. So that's that anabolic catabolic switch. So seeing it drop from 2 60 to 2 12 doesn't really concern me too much, because it might just be a subtle swing.
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Dr Doug: It's definitely not headed the direction that I would expect it to see, but also keep in mind that it's over 200, which is relatively high. So you're still within the threshold, that if you were on an igf one peptide like we use. Mk, 6, 7, 7 in. Buttamoran. Cjc.
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Dr Doug: Epimoral, and like all those things, I would want you to be in the 200 s. As a therapeutic range. Yeah, Lorna.
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Lorna Nichols: I was under the
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Lorna Nichols: understanding that high was bad, and that because the reference range, you know, I'm I'm above it, and I was freaking out, and that's when they said, We've got to. Do you know, tumor, and we've got to do this test where I drink the glucose, and they reach do my blood.
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Lorna Nichols: I mean. So I was freaking out because it was high, and I was glad that the second time it went down. So you're turning me all the way around here.
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Dr Doug: Let me let me help explain that. So
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Dr Doug: Doctors are stupid. I'm just kidding doctors are great because they worried about their patients. That's fair.
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Dr Doug: but not they don't understand igf one. So igf one is is misconstrued as a sort of an anti longevity biomarker. And they get that. Doctors will get this thing because I gf, one has been talked about in like the blue zone diet. It's been talked about, and a bunch of other you know longevity papers David Sinclair talks about igf one
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Dr Doug: when you look at rodents
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Dr Doug: and you drive. I gf one down through calorie restriction. They live longer
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Dr Doug: like 25% longer like, that's not not a small thing.
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Dr Doug: But we're not rodents. And we know in humans. If you drive, IGF. One down, you will see muscle loss, a catabolic state, bone loss, osteoporosis, immune dysfunction, thyroid dysfunction, because it is essentially severe caloric restriction that will drive IGF. One. Down.
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Dr Doug: Now, in postmenopausal women we see a sort of subtly low idea of one. The post-menopausal state for women is this kind of like simmering, slow, catabolic breakdown state?
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Dr Doug: That's one of the things we need to break if we want to build muscle and bone. So my goal is to drive igf one up, not permanently. That would be
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Dr Doug: potentially bad, but at least temporarily, while we're trying to build muscle and bone
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Dr Doug: if that makes sense. So the fact that your Igf one went up and they thought you had a pituitary tumor is a little silly.
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Dr Doug: I would argue that if you were to calorically restrict, stop consuming dairy. Don't eat as much protein. You'll watch your idf. One drive through the floor
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Dr Doug: so we can control that through diet and peptides if that makes sense.
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Lorna Nichols: Thank you. That certainly makes me feel better.
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Dr Doug: Yeah, yeah, it's frustrating. the traditional medical system is very confused on a lot of these things. And what's one of the things that's challenging, too, is that as we start to get more and more biomarkers
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that would. You know we're getting. And I'm telling my patients to get this is almost like a challenge. Is
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Dr Doug: my patients, or at least are are clients and followers, rather, because they don't have access to me. They'll get biomarkers. Then they'll go to their traditional doctor, and they'll be like my IGF. One went up.
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Dr Doug: and their doctor says, Oh, my gosh! You have pituitary tumor, which doesn't actually make sense, anyway. But
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Dr Doug: you know they're they're doing the best with the knowledge that they have. But the knowledge that they have does not have anything to do with this space.
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Lorna Nichols: Can I ask a follow-up question. So 2 things
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Lorna Nichols: it's good to have it above 200, and
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Lorna Nichols: and should I go through with the test she wants me to do where they draw my blood, and then I drink this glucose which I don't want to do, and then they draw my blood again. What's that gonna do?
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Dr Doug: I don't know exactly what they're looking for, so I can't tell you not to go through with that test. I don't. I don't know what they're thinking, but if they're doing it based off of Igf one alone.
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Dr Doug: II don't think it's necessary, but again, I don't know what else they're they're looking at.
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Lorna Nichols: And I do want. It's a good thing to have it above 200
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temporarily, I mean, over the course of months. Yeah, I mean, think about most
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Dr Doug: people that consume is a highly caloric standard. American diet and dairy and drink alcohol. Their idf one is 300 400 all the time. That's why that type of consumption leads to cancer growth.
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So the concern is is that Igf one up all the time will increase the development of cancer. I don't know that it actually increases the
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Dr Doug: it create cancer risk. But if you had cancer that it would grow faster. That's where the longevity folks say, drive IGF. One through the ground this guy, Brian Johnson, that everybody keeps talking to me about. You know, his theory is, I wanna prevent cancer. So my, IGF. One to be under a hundred, and that's great, except that if you look at the guy he's sarcapanic, he's gonna develop osteoprosis. So he might not develop cancer. But he's gonna die from a head fracture.
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Dr Doug: So that's the long-term. You have to look at the long-term and look at the forest through the trees, if you know what I mean.
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Lorna Nichols: So this relates to a question I had also, is you mentioned Dairy a couple times? Can I actually get too much dairy because I got access to this raw milk, and it's so good, and and I
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Lorna Nichols: drinking it. And I'm getting a lot. And I'm thinking
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Lorna Nichols: maybe I'm getting too much, can you? And I'm getting pretty much all my calcium probably more.
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Dr Doug: I don't, so I don't know. Can you consume too much dairy. I think it depends on your weight.
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Dr Doug: and if you're gaining weight cause dairy will provoke weight gain in in human adults. So if you're gaining weight, then it's not all muscle mass, then potentially
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Dr Doug: outside of that, if you're tolerating the calories. I think it has so many benefits, if it's coming from raw sources, like, if you have raw, if you have access to raw dairy.
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Lorna Nichols: it's a great source of calories and nutrition. Yeah, it's milk in particular. I'm not using other dairy, because II know I'm getting enough with the milk, and II make my smoothie with it and all that. So it's just milk.
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Dr Doug: How how many servings a day are you consuming? Do you think I mean
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Lorna Nichols: minute, when I was doing the chronometer regularly? It? I would try to limit myself to like 2 cups.
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Lorna Nichols: but I wanted to drink more, and I could drink
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Lorna Nichols: 3. Maybe
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Lorna Nichols: you know, I mean, I don't know I wasn't keeping track.
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Dr Doug: Yeah, again, I would just keep. I would keep track of weight
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and I wouldn't worry so much about the IGF, one impact of dairy, although it does drive I gf one up.
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Dr Doug: But II don't think that there's any evidence to say that that would be bad over time, because it's a great source of of dietary fat of calcium, other micronutrients, and if it's raw immunoglobulins, lactophan like it is it's a super food if you have access to good raw dairy. But most of us don't.
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Dr Doug: Thank you very much. Thank you. Yeah. Sure. My dairy source just got busted by the the Pennsylvania police.
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Dr Doug: I feel so much safer
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Cathy: that brings up my question about the cheese. Were you able to look into that?
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Cathy: No, I didn't. I'm sorry I have so many birthday parties this weekend. Kathy. But that was the Yarlsburg study right? It's on. It's on my list to do, and I apologize. I didn't get to it. What was your question about the study, about specifically about that cause? I might be able to answer without reading it. Well, they say so much good stuff about it, because it
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Cathy: apparently has less lactose.
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Cathy: and but it's got the vitamin K in different forms.
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Cathy: because it's aged.
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Cathy: And so my question is really about the age cheeses because II really don't think I tolerate milk straight. but the cheese doesn't bother me a bit, and I love eating it twice a day. I have. So I have 2 ounces which I feel good because I'm getting an extra protein. I'm getting a couple of 200 milligrams calcium in each serving. So II feel good. II feel like I'm taking a calcium tablet which I've cut down on my supplement because of that.
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Dr Doug: Right? Yeah, I mean, I would. I always recommend people get calcium from whole food sources, if possible. I have a quick aside to that. That's just kind of interesting.
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Dr Doug: But I think you're right. A lot of people don't tolerate the amount of lactose that's in milk, because it is a fair amount, even if it's coming from a raw source. But as soon as you start processing it in a good way, ie. Making like key fur fermenting it, fermenting some of the lactose out making, you know, fermented or hard cheeses. The more you process it in that direction. Then, yeah, you're gonna get more of the you're gonna maintain the lactoferrin you're gonna maintain and actually increase the vitamin K, because of the fermentation. So there's definitely a role for that.
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And if you could get all of your calcium through
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Dr Doug: through those types of food sources rather than supplementation is probably better.
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Cathy: Okay.
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Dr Doug: yeah. I had an interesting conversation. After I did a talk with Osteo strong on their on supplements.
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Dr Doug: we pulled in Alga Cal. Because us too strong and algae have an affiliation. So I got introduced to the CEO of Algacal a couple weeks ago now. and
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Dr Doug: he's funny. He looked at their data and recognized that I used to recommend it. And then I stopped. And then he looked at my Youtube videos and saw that I was telling people not to take calcium supplements. So it was an interesting conversation, but I ended up having a follow up with all of their marketing teams. It was me, and like 35 people from Al Jakal.
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Dr Doug: and one of the things that they brought up which was interesting. And this is their perspective, which is that algae is a whole food source of calcium.
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Dr Doug: which seems reasonable.
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Dr Doug: So I'm gonna I'm actually asking a question right now, cause I don't know what to think about this. So I've been recommending whole food sources through dairy, if you can tolerate it, and then we recommend the Oh. CC. Or M Mchc. Form of calcium, because it comes from a whole food source.
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Dr Doug: But it's basically ground up bones. Right? So with different types of processing. So, Mike, the question in my head is, at what point does a whole food source become supplemental calcium
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Dr Doug: versus?
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Dr Doug: What is a, you know, essentially like a ground up rock, right? Like calcium oxide is a ground up rock. Right? It's chalk but getting it from bones or getting it from algae, are you gonna have the same potentially negative impacts. And they have all these studies that show that food sources of calcium don't increase risk of calcification and and heart disease and stuff.
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Lorna Nichols: So it's kind of an interesting thing anybody, any thoughts on that. Has anybody looked into that? Lorna does? Well, I have a question. Alga cal has strontium in it, and that sort of can falsely
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Lorna Nichols: raise your boat mineral density. And I was understanding. And so that doesn't that just throw off all of Alga Cal's data studies? Well, II put a Youtube video out, kind of talking about their studies.
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Dr Doug: And
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Dr Doug: my interpretation of the studies was that a they were funded by algae. So there's bias present out of the gate, but I don't think we can necessarily exclude them because of that. Now you're right, Lorna, that the strontium in the studies was present. So they use strontium in the studies. But it's not in their basic product. So to get strontium from Algal, it's a separate add on product.
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Dr Doug: So you can do Algacol without strontium.
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Dr Doug: and they also now make a similar product to the one that I was recommending from health. Jevudy, the Protect plus that has a DE and K. They have a similar product with less d, which is compelling to me. So we're kind of playing around with this a little bit and I'm still trying to figure out how I feel about algae as a whole food source of calcium.
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Dr Doug: because I think that there's probably it's probably better than calcium supplementation.
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Dr Doug: My question is, is, is it better and safer than ground up bones? And I
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I'm thinking the answer is probably yes, but I haven't come to a conclusion on that yet.
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Dr Doug: But anyway, quick aside on that, I took the Lg with the strontium boost for 6 months.
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Janina : In addition to the carnivore diet, and then had a bone density scan, and my bone density in my lumbar spine did go up more than 2%. But my hip stayed stable. So just an FY. But I don't know which one to attribute it to. That's the problem. But I've stopped taking that. And I take other supplements. Now.
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Dr Doug: yeah. yeah, I mean, II don't know. I there are.
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Dr Doug: My comment to the marketing team is that I wish that they had some other products, some other forms of of nutrition or sorry some other forms of nutrients in their products. So I wish that their vitamin C was a whole food form of C, and not ascorbic acid. But it's a it's a smidge of Ascorbic acid, anyway, so it's probably not doing any harm. I just don't think that's doing any good.
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Dr Doug: And then their magnesium is is Magoxide. They do that, though, cause they can get more Mag in there. I had this long conversation with actually the CEO of health. Jevudy about magnesium magnesium is hard to get in a supplement, because it's so bulky, and you can get more mag in if you use Mag oxide so they can get 300 milligrams in with mag oxide. But anyway,
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Dr Doug: I would redo their product if they let me, but then it would probably end up being like 16 capsules instead of 4. So you know, I'm not a supplement guy. Anyway. So, Lorna, your last question for today. Sorry, guys, this is taking forever
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Dr Doug: thermography as an assessment tool. Are you referring to breast cancer screening.
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Lorna Nichols: There's a local person that does it. You can do just the breast or half body or full body, and supposedly it shows up something even like a dental abscess.
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Dr Doug: Yeah. So I I've not seen it for anything other than breast. I've looked at it for breast, because mammogram is such a crappy study. and I wasn't impressed by the data for it for breast.
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Dr Doug: Obviously you're avoiding the you know the radiation
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Dr Doug: and you're in a setting where you're less likely to get the quote unquote, false, positive, and the the needle guided biopsy which happens to so many women and provokes so much anxiety and stress.
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Dr Doug: But I just don't think it's sensitive enough.
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Dr Doug: so I don't recommend it currently. I wish there were an alternative to mammogram for breast. I just don't think that there is well, it's not true. There is.
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Dr Doug: Ultrasound and MRI are both great alternatives to mammogram, but
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Dr Doug: insurance is going to cover them out of the gate, and they're expensive.
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Dr Doug: Thank you. Yeah. And stuff. I wish there were a better solution. But
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Dr Doug: at this point I don't think that there is, especially with as much Hrt. As we use. We still recommend that people do it.
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Dr Doug: even though I hear all the time they had to do a biopsy. It made me really nervous, you know, just over and over and over again. Okay, Angela.
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Dr Doug: So this is a question about mindset.
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Dr Doug: yeah, great. So she's basically asking for resources on mindset. So for those that aren't familiar with our health optimization period
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Dr Doug: period pyramid. Excuse me.
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Dr Doug: we have 6 fundamental pillars. So nutrition, exercise, sleep.
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Dr Doug: social connection.
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Dr Doug: spiritual development and mindset
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Dr Doug: mindset is one of the tougher ones for us to provide resources on, because everybody's needs are different. So essentially, she's asking for some assistance and mindset.
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Dr Doug: I can't even recommend a specific book on this, because it really depends on the scenario. She was talking about her personal situation, of being a caretaker for elderly mom and needing to find
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Dr Doug: time and space for herself to take care of herself. So that's you know. II do hear that a lot. I personally have worked with a coach whose name is Sally Maxwell. She came out of a kind of a bigger coaching program, and now runs her own show. She and I are and talks to create something specifically for our patients.
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Dr Doug: but it is still so tough because I mean. I've needed
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Dr Doug: one on one coaching. I've I've been working with her for like 4 years, you know, and she's helped me to get through this. The process of like get out of orthopedics and not feeling bad about it, and all the insecurity that goes along with that. Like all these, you know, challenging things.
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Dr Doug: and having the right mindset has been the the biggest part of that
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Dr Doug: having an individual resource like that is
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Dr Doug: incredibly valuable. But I mean, I don't know how to point people toward anything specific. So I would say the biggest thing would be to find somebody in the in kind of in the coaching mindset space that jives with you. But I can't even think of like a book that would be the right
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Dr Doug: resource for that. Can anybody else think of a mindset book specific to like finding time for yourself?
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Kitt Lurie: I don't know if this would be the type of thing. That someone would be interested in or someone else. But i've been reading living untethered by Michael Singer, and I feel like it's very profound.
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Dr Doug: I agree with that. I haven't read all of it my wife read it and I read parts of it, so yeah, I think that's a that's a great one. So living, untethered by Michael Singer. Yeah. And his audio book, he reads it, and that's how I got through it more than once.
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Dr Doug: Yeah. no, I like that. That's great. Thank you.
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Jim: I have a suggestion. For 20 years I've been using a morning meditation with
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Jim: binary. All beats, you know, with headsets from an outfit from Portland, Oregon, called Center Point.
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Dr Doug: Yeah.
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Jim: And it really calmed me down when I needed it.
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Dr Doug: Yeah. Center point. I haven't looked into them. I used a product that sounds like it was probably similar that Tony Robbins supported called Newcombe, NUCA, LM
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Dr Doug: I use that for a little bit. I like it But like most Tony, things like it's, it's a lot about Tony.
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Dr Doug: But yeah, I think there are so many good tools out there. I mean the biggest thing for me from a mindset perspective. Once I understand what I'm what my goals are is actually the the journaling and the meditation component, and I'm better at the former and worse at the louder of actually getting that in
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Dr Doug: but that's one of my 2024 visioning tasks is to make space for the meditation on a daily basis
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Dr Doug: cause. It really helps me to maintain that mindset.
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Dr Doug: So this next question is from Susan, Susan J. She's asking about calcium, because a lot of physicians are not recommending taking calcium any longer, and this speaks to the the circle that you live in, Susan, because most physicians are recommending calcium still. But can you take spirina or chorella tablets if they come from a reliable source to supplement calcium A. D. And K.
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Dr Doug: And then could you address the issue of dementia and postmenopause women all HRHR. T. As it relates to Co. Q. 10 decreases. Yeah. So this is there's a lot of things in here. So let me just speak to the spirulina and chlorella components. I haven't looked into those supplements in depth
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Dr Doug: mostly because I don't see a strong need for them. I would recommend getting calcium A. D. And K. Through food, if if at all possible.
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Dr Doug: and then any supplement that's going to potentially have negatives. This goes back to what we were just talking about.
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Dr Doug: you know, is a whole food form of calcium from algae in a capsule, a supplement, or is it a whole food form?
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Dr Doug: I don't know. So II would say same thing with Spirulina and Clarella. Is it better that way? Or if you're taking other forms of calcium, would it be the same? And I don't know that there's any way to know the difference there.
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Dr Doug: as far as dementia, and HRTI was just listening to Stacey Sems. She has 2 books, one called Roar, the other one's called level
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Dr Doug: up, I think, level something.
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Dr Doug: The first one is on performance around
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cycles for women, and the other one is around kind of post menopause and
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Dr Doug: expectations, and she's very performance driven. She's a Ph. D. Around performance.
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Dr Doug: She was talking a lot about the research on Hrt. And dementia, and so
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Dr Doug: it it makes me want to look at her references and go back and look at this more in depth. My training and the research that I've done on it thus far does not show that there is really an increase, certainly no increased risk
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Dr Doug: as far as the Association. I think we'd have to look at this where the study's coming from, and my guess is, it's probably coming from the same place which shows that there are associations of men on Trt with heart disease risk.
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Dr Doug: It has to cause it has to deal with. Who's getting a prescription for HRT. From a traditional medical provider? And what are their associated diagnoses?
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Dr Doug: So when do we actually recommend HRT. For women? Is this in a scenario where they're starting to have cognitive decline? And now they wanna start em on something to help with that. If you look at the associations, then of prescriptions and diagnosis, you're gonna see an increased risk. But it's not causal. It's just an association. So I'm gonna look at that in more depth.
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Dr Doug: There is no rational
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Dr Doug: physiological reason why Hrt would cause dementia. This goes back to the same thing with like, with prostate cancer and testosterone for men. and even estrogen and breast cancer for women? If estrogen caused breast cancer, why don't we see breast cancer in younger women. Same thing with testosterone cause prostate cancer. Why don't we see prostate cancer in 20 year olds?
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Dr Doug: So it doesn't make physiologic sense that these naturally occurring hormones would cause a chronic disease to occur like that, especially when it has so many other positive physiologic benefit. But maybe it's because of the form. Maybe it's because of the route. So I'm not saying it's not
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Dr Doug: true. I just haven't seen any explanation of why it would make sense. So I'm gonna say right now that I don't think that that's true.
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Dr Doug: And even if it were, I kinda look at it like this, too, which is.
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Dr Doug: I'm focusing on improving health span, which is how long you live a healthier life, so to help you live better longer.
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Dr Doug: that for me sometimes might come at a trade off for longevity and actually lifespan. We don't know that that's true. That's impossible to study, but I would rather live really well for 90 years, and have great energy and vitality than live for 100 years, but feel like crap for the last 30.
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Dr Doug: So I would actually trade. And this is where I feel about hormones. I would trade staying on testosterone until I'm 90, and having a heart attack at 90 versus not having adequate testosterone for 50 years. Is that you, Laughing Jim? Is that not having adequate testosterone for 50 years? In in feeling like crap, but living longer. So we just don't know the details on how significant these risks are. II will go back and look at the data on dementia and Hrt. Since I'm such an advocate for Hrt.
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Dr Doug: But I've not seen any compelling evidence, and Jim knows how I what I mean having low testosterone sucks, and I can only imagine what it feels like for women to go through menopause and to not have any sex hormones. Sure you can get used to it.
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Dr Doug: But should you? And that's the question that I ask a lot of women
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Jim: speaking of testosterone when I did my lab for
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Jim: it came in at 3, 19, and then I asked my primary care physician, if I should do any Trt. And he said, Well, let's test it again. And it came in at 201, shock me that it would drop that much. Do you think there's something screwy with their measurement? Calibration?
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Dr Doug: so say again you went, it went down to 2, 18. And what did you do in the interim? From 319 to 201.
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Jim: And in the interim I went on, really high protein.
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Dr Doug: No, that's not typically what we see
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with a higher protein diet. Typically, you'll actually see it go up.
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Dr Doug: But there are a lot of factors with testosterone. And honestly, if you're if the first number starts with a 2 or a 3, then it doesn't matter. It's low. I don't care cause. There's no way to have adequate free testosterone in a total of 300 something.
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Dr Doug: And and so remind me your primary care. Doctor said that that was okay. I'm assuming.
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Jim: I'm trying to remember what he said. He, he just wanted to test it himself.
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Yeah. So
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Dr Doug: I mean for me. Looking at, even we look at total testosterone, free testosterone. This is true for women, too. And so what we're finding in in men especially, is that we're seeing low testosterone almost globally. Occasionally I'll see somebody with optimized testosterone naturally was really rare.
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Dr Doug: And so there are a lot of reasons for that. But we have to look at the free. Because if you have a total of 3, whatever, you could argue that that's quote unquote, normal. And from a test. Statistical average perspective it is. But that's because men have low testosterone across the board. So that doesn't mean that it's good.
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Dr Doug: Your free testosterone, though, is likely in the single digits, and I've been there. I know what that feels like, and I can tell you that it feels better to not have that
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Dr Doug: and so so my recommendation would be to, you know, discuss whatever optimization or replacement based on the the risk benefit profile.
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Dr Doug: at 300 and honestly, I mean, we're replacing it in in men with total testosterone up into the 600 s. If they still have single digit, free numbers.
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Dr Doug: Does that make sense
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Jim: right?
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Dr Doug: And then for women. This is a really interesting topic that I love talking about. Women don't necessarily lose testosterone as they go through menopause, because the adrenal glands can make half or more
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Dr Doug: but we find that women that have stress, whether it be from you know whatever, but oftentimes from, you know, medical concerns women that have stress have higher cortisol, lower dha in there for lower testosterone. So we see low testosterone and women pretty much across the board as well. So we've really started putting more and more women on testosterone, and if you haven't seen me say it, I'll just say it again.
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Dr Doug: which is that testosterone is the primary sex hormone in women. At any point in a woman's life she has 5 to 10 times more testosterone than she does estrogen when you adjust for units.
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Dr Doug: And yet when we talk about hormone replacement for women we don't talk about. Well, I do. But most doctors don't talk about testosterone.
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Dr Doug: which is crazy for me.
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Dr Doug: Charles Ackerman asked about the P. One and PCX. Ratio. So, Charles, we did that right out of the gate. So you should be able to hear that there?
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Dr Doug: where we at? Okay?
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Dr Doug: Yeah. So she's asking a question about some different supplement things what she's actually gonna get
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Dr Doug: in her review with us. So I'm gonna hold off on that part. But she's bringing up power plate, and I mentioned power plate earlier. So let me just say, we are launching an affiliate program with them. So if you're considering power plate hold off.
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Dr Doug: Because you're gonna see that pop up into the health span nation affiliate area.
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Dr Doug: I don't know exactly what the percentage off is, but I know it was significant.
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Dr Doug: So after all, the research I did in the video that I recorded on Friday of last week, my conclusion is that you really need to have the amount of displacement that a product like powerplate or power plate will provide. There's several of them on the market. The reason why we like power plate is because they're the the low energy
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on the low energy setting on their move product is they're kind of they're more expensive of the home products. Is exactly what the research shows that you need to build bone so that 30 hertz or frequency of 30 Hertz at the displacement of around 2 will result in around 3 Gs of force.
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Dr Doug: So you can use that product for 10 min a day. So we're we have a wholesale deal with them now, so we can provide them for cheaper for our patients and Hsn members.
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You'll see a discount code on Youtube if you're on Youtube. But don't use that one. Use the one in Hsn cause you'll get a bigger discount.
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Irina Ryjova: Okay.
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Dr Doug: your benefit for being an Hsn. Member.
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Susan Jaye: Doctor Doug, I have a question.
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Dr Doug: Hi, Susan Sujay, Hi.
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Susan Jaye: I watched your last Youtube that you sent about the thyroid.
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Susan Jaye: and I was interested to know I have a thyroid nodule, and every time I get an ultrasound, despite what I try to take for it, any kind of supplement, it's going down slightly, but it's going up more.
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Susan Jaye: It's it's one lobe is getting bigger. Then, you know, right lobe left lobe, whatever centimeters and everything. And I'm not sure. I think that I was told awhile ago. I have a post nasal drip.
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Susan Jaye: and I don't know if that's irritating my thyroid. When I took the supplement that I got from this place called the Bio Station. I wasn't tired anymore. I was really great when I went to a doctor he wanted to give me that desiccated armor
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Susan Jaye: armor.
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Susan Jaye: and I took. I took that. I think it was 30 mg, and one morning I woke up and I thought I was gonna have a heart attack or stroke my! My! My heart was beating so fast.
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Susan Jaye: and II didn't know what to do. So I wondered if you could just
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Susan Jaye: sort of if there's a
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Susan Jaye: you know, a work around for something like that, because this nodule doesn't seem to be
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Susan Jaye: slowing down
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Susan Jaye: year after year when I have the ultrasounds.
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Susan Jaye: Yeah, so have they talked about. I'd be curious to see what your labs look like. But have they talked about removing the nodules surgically? No, in fact, I don't have in front of me. But I did go to a guy who said he was a bone metabolism, Guy, and he did run a bunch of tests, and he he did the the the free. Everything he didn't do antibodies, and and he told me I was fine. He told me I was fine
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Susan Jaye: I didn't. I didn't. I haven't gone in yet to see him to look at. You know. Look at the fem. If I'm low, normal, you know, mid normal. I'm waiting for a blood test from this bio station, because that doctor looked at his and she said, No, no, he, you know, she's testing the antibody. So I'm waiting to hear back.
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Dr Doug: Yeah, then that's that's one thing that I would if you don't know that answer. Look and see, are you? Is this, you know, kind of like an inflammatory hashimoto's thing.
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Dr Doug: The thyroid is really interesting, and I've been humbled by the thyroid more times than I can count.
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Dr Doug: because the labs don't necessarily show the picture. So I've had patients go on a desiccated product like what you did. And actually, I experienced this myself. So I know exactly what you were feeling and because thyroid function fluctuates
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Dr Doug: if you give somebody treatment which is a static dose.
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Dr Doug: but then based off of numbers that you see one time you could certainly be fooled, and I experience that again myself where I felt that feeling of being hyperthyroid, and it doesn't feel very good. I felt like the same thing like my heart was going to explode.
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Dr Doug: So It's it's a toughie. But figuring out why you have that is important. So is it autoimmune? Is it like a structural thing? Is it a little tumor that needs to come out surgically? But then you would likely see hyperthyroid numbers?
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Dr Doug: And if that were the case, they wouldn't have put you on, desiccated thyroid. So again, that's something that probably takes a little work up over time, and then
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Susan Jaye: manipulating it a little bit, and then just seeing you know, what? What do we need to do? So it's a complex answer. Sorry, that's okay. But the reason I brought it up was because when you sent that the Youtube, it you know, we're you're tying it into the hormones and everything works and everything. And so could it be that if you have nodules or things like this, that if you're on Hrt, can that like
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Susan Jaye: not not absorb properly in your body because you have the
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Susan Jaye: the nodules.
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Dr Doug: Not necessarily, and is. If your thyroid function is
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Dr Doug: is somewhere near normal, then it should be fine. If it were high, then it would metabolize it faster, because it metabolizes everything faster. And similarly, if it were low, you might have to adjust. But that's why we always test dosing to.
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Dr Doug: because everybody seems to do we? We don't. There's no one dose for everybody for HRT.
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Dr Doug: And that's why we we test and we retest, and we test if you have symptoms, etc. So it's thyroid. But a lot of other factors as well.
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Susan Jaye: Right? Thank you.
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Dr Doug: This question was from, and I know I'm gonna say this wrong Auranka is how that it's spelled, anyway.
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Dr Doug: And she's asking about a professor, Tony Wei weiss Corey work on brain aging. So I have not heard of that. But I put it on my list of things to look at, so more to learn, always more to learn.
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Dr Doug: I love what I do.
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Dr Doug: So then, Lois, are you here, Lois? I don't see a Lois. So Lois was asking about Osteo strong. And basically, do I need to be lifting on other days? I think we covered that.
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Dr Doug: And enough
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Dr Doug: detail. Short answer is, Yes, probably
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Dr Doug: Bev.
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Dr Doug: Alright. So Bev asked 2 questions here she asked, what disorders primarily affect the quality of trabecular bone.
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Dr Doug: That is, why would the quality of bone in the spine be far less than that of the hips? And then, when taking hormone replacement, how long does it take to see improvements in trabecular bone? So the short answer is, it really depends.
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Dr Doug: And for those that don't know what she's talking about. the one reason why you might see like was mentioned earlier. By Janina. Some people will see improvements in spine, and not in
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Dr Doug: the femoral Mac, or the hip, and vice versa.
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Dr Doug: and the reason for that is that there are the bone in each of those 2 areas is very different. So bone in the spine
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Dr Doug: his much more spongy bone or trabecular bone in a very thin rim of cortical bone, or the kind of it was. What is in the hip is the thick
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Dr Doug: you know. Kind of what you think of as bone, as like the thick part of the bone on the outside, but the spine has very little cortical bone and a lot of trabecular bone, and then the femoral neck is the opposite. The femoral neck is a lot of cortical bone, and almost no trabecular bone.
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Dr Doug: The metabolism of those 2 types of bone is different. And typically we see that the trabecular bone is going to respond faster.
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Dr Doug: However, I will tell you. My experience is that
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Dr Doug: we still see it what seems random that some people will see improvements in hip and not spine, and some people will see the opposite. And so, like I just a patient that I talk about a lot. Robin, who is a patient of ours, who freely tells me I should talk about her all day long every day and use her name. So IOI do. But Robin, in her first year with us, had over 10% improvement in her femoral Mac
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Dr Doug: Dexa, but she went down by, I think, 2 or 3% in her spine. And so for her, we were asking the question, because she's doing all the things. Well, not all the things. Now. She's doing all the things. But in that first year what was different between those 2 areas. And the biggest thing was she wasn't loading her spine. She had a history of low back pain, so she was protecting her spine. But she was loading the heck out of her hips.
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Dr Doug: And so I think it had. It just shows that she had all of the the right milieu of hormones and supplements and all the things.
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Dr Doug: but she wasn't loading it, therefore there was no stimulus.
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Dr Doug: So I think that's one thing. We still have to provide the stimulus, and it's harder to load the spine than it is to load the hips, because any any weight bearing activity is gonna load the hips, but to load the spine. You really have to do something with your upper body.
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Dr Doug: So that's one thing. And the other thing is, if you look at the drug studies
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Dr Doug: drugs like estrogen drugs like relaxophen, will have a bigger impact on spine fracture prevention than do the other drugs like Forteo and forteoivinity and and the Bisphosphonates, and I think that has to do with the metabolism of the cortical versus the trabecular bone. So there is different metabolism. I don't think that we understand
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Dr Doug: all of it, or that we can drive it one direction or another. Our goal is to fix them both.
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Dr Doug: But I think for people where we see tremendous benefit in one and not the other. I say we're doing the right thing. Let's just continue to provide the stimulus for the other, and it should follow.
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Dr Doug: We don't have enough data since we've been doing this for 3 years. I can't tell you that we have enough data to say that we've had somebody that was slow in one, and we've seen improvement after making that shift in the other. We should probably have that in
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Dr Doug: 9 months or so, because we'll but get people with 2 plus years of data.
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Dr Doug: Alright, I think that's it. Debbie Klein mentioned in the chat of those who haven't seen it, that Ucla health has guided meditations on an app. That's true. I've actually downloaded that and looked at that
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Dr Doug: Beth Sayer had some recommendations in there for recovery. International self-help, mental health support groups, recoveryinnational.org. I don't know if that's what she's looking for, but it certainly doesn't hurt to look
