January 24, 2024
During the meeting, we discussed various topics related to osteoporosis, pre-diabetes, and dietary considerations for managing these conditions. The key points from the meeting include:
1. Osteoporosis and Pre-diabetes Diet:
- The challenge of managing a diet for osteoporosis and pre-diabetes simultaneously was addressed. It's less challenging than losing weight and building bone at the same time.
- Adequate protein, nutrients, and energy intake are crucial for an osteoporosis diet.
- For pre-diabetes or insulin resistance, carbohydrate content should be limited rather than overall calories.
- Carbohydrate restriction can be adjusted based on severity, potentially under 150, 100, or even 50 grams to lower A1C or fasting insulin levels.
2. Mediterranean Diet and Carbohydrates:
- David mentioned following a Mediterranean diet and consuming a variety of foods but noticed an increase in his A1C due to the carbohydrates in the diet.
- Dr. Doug suggested that individuals who are sensitive to carbohydrates should adjust their intake and consider timing carbohydrate consumption around physical activity for better utilization.
3. Bone Biopsy for Bone Quality:
- Tom inquired about the use of bone biopsy to determine bone quality
- Dr. Doug suggested that blood biomarkers like CTX, can provide information on bone turnover without the need for a biopsy.
4. Alternatives to Multivitamins:
- Don asked for alternatives to a specific multivitamin (Pure Response). Dr. Doug expressed a preference for individual supplements over multivitamins to avoid overlapping and excessive intake of certain nutrients.
5. Idiopathic Hypercalciuria and Bone Loss:
- Tom discussed his condition of idiopathic hypercalciuria and its impact on bone health. Dr. Doug recommended further investigation into the cause of calcium loss.
6. Hormone Replacement Therapy (HRT) and Bone Health:
- Dr. Doug discussed the importance of testing hormone levels and adjusting HRT dosages to achieve optimal ranges for bone health.
7. Exercise and Bone Health:
- Dr. Doug addressed questions about the effectiveness of various exercises for bone health, including isometric exercises, running, and the impact of exercise on nutrient depletion.
- Yoga and Pilates were recognized as beneficial for muscle and core strength but not as significant for building bone density.
8. Vibration Devices for Bone Health:
- Dr. Doug was skeptical about the effectiveness of a vibration device called Osteo Boost for bone health due to a lack of scientific studies supporting its claims.
9. Protein Intake for Muscle Building:
- Dr. Doug agreed with the recommendation to consume 30 to 50 grams of protein in one meal to stimulate muscle building, emphasizing the importance of the first meal of the day.
10. Anti-nutrients and Bone Health:
- Dr. Doug discussed the impact of anti-nutrients like oxalates, phytates, and lectins on bone health, suggesting that some individuals may need to avoid them, while others may not be affected.
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Dr Doug Lucas: nice to see new people.
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Dr Doug Lucas: I don't know if it's the different time different day. Who knows?
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Dr Doug Lucas: Alright, let's see here.
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Dr Doug Lucas: So, David, where's David? There's David, hey, David?
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Dr Doug Lucas: So David asks a question about osteoporosis diet versus pre-diabetic diet. Yes, this is a challenge. It's not. It's not a hard challenge. It's not as bad as trying to lose weight and build bone at the same time, David. So it's not. It's not the most controversial one.
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Dr Doug Lucas: but it is an issue. So we see a fair number of people that come in with elevated what's called we would call insulin resistance, or pre-diabetes, even into diabetes that also have osteoporosis, and it's kind of interesting when they overlap like that.
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Because you think of, you know, the general population of people with osteoporosis are gonna be people that have generally gonna be leaner and more metabolically fit. But we're seeing more and more people that are coming in with metabolic dysfunction. So we deal with this often.
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Dr Doug Lucas: So the the main approach from an osteoprosis diet perspective is to get adequate protein, adequate nutrients, adequate energy. A lot of people are under eating. And so this is something that we're really pushing a lot of people toward is getting enough calories enough protein enough food, enough nutrients, and then supplementing the rest.
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Dr Doug Lucas: The biggest difference between that diet and somebody who has prediabetes or or diabetes, or insulin resistance is just gonna be the carbohydrate content. For the most part, we don't. If we're trying to build bone, we don't wanna under feed. So you know, a chloric restriction for somebody that has prediabetes also works. That's why certain diets like a, you know, a strict Vegan diet or a strict, even carnivore diet. Go on either end of the extremes. They're both
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Dr Doug Lucas: going to end up being calorie reductions. That's why they can both fix pre-diabetes. But we don't wanna be calorie reduced if we're gonna try to build muscle and bone. So we want. We don't want a calorie restrict. We just want to restrict carbohydrates, and so, depending on the severity of it, we could restrict, you know, under 150 under 100, even under 50, if we wanted to get aggressive. But that would drop a one C or or fasting insulin elevation of most people. Does that make sense, David?
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David Callen: Yes, yes. So I've been eating a lot of Mediterranean diet. Eating the rainbow, making sure I protein, you know the collagen with peptides and everything. And so over 6 months ago I was hitting the bullseye at 5. And well, now it's a 5.9, cause the rainbow has carbohydrates in it. As it turns out.
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Dr Doug Lucas: so it just it depends on how carbohydrate sensitive you are. And so I'll I'm I'm actually in a similar boat. So I've been training. If anybody follows me on Instagram, I've been posting videos with me, training really hard working with a new trainer, and she's got me eating more carbohydrates than I've eaten
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in my. I don't know adult life because I'm very carbohydrate intolerant. So. I told her I would try, and it's same thing. So my a Onec went from like 5, 3 to 5. Where am I like? 5, 6,
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Dr Doug Lucas: and some. Some of us just don't tolerate carbohydrates very well, and I don't really understand why I don't know what breaks in the metabolism for some people, but I just can't. I can't eat between 200 grams of carbohydrate. I just can't, even if I'm training hard. So yeah, go ahead.
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David Callen: I was gonna say so then I mean in my research, I found the that the fruit, you know, like blueberries and oranges and tomatoes. All of these things have are good for bones. They're part of it, cause that's what I was like when I got caught being osteoporos. So
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hmm!
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David Callen: So what I'm hearing you saying is, just get a little more critical on the amount of grams on meeting. Exactly. And also
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Dr Doug Lucas: so this is my approach for people that have insulin resistance that want to consume more carbohydrates. So if they're athletes, if they're training hard trying to build muscle mass, etc.,
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Dr Doug Lucas: is just shape your carbohydrate around shape your carbohydrate consumption around activity. So if you're gonna eat before you train, you can consume carbohydrate there, cause you're gonna burn through it right away. And then in that post training sort of like muscle adaptation phase. You're gonna utilize more carbohydrate there as well. If you can package your carbohydrate around your training and then be lower carb elsewhere you'll see your AI
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Dr Doug Lucas: and C drop so you can still consume those things. Just consume them from the right timing perspective. Yeah. And then if it's still high and going higher, then you just need less of them
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David Callen: if
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Dr Doug Lucas: yeah.
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Dr Doug Lucas: so oh, hi! Don, nice to see him meet you. Thanks for all your comments and
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Dr Doug Lucas: slack. Appreciate that.
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Dr Doug Lucas: All right. So, Tom.
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Dr Doug Lucas: have you ever heard of someone going for a bone biopsy to determine bone quality working with a specialist who wants to have a bone biopsy to evaluate bone quality as they feel. I have low bone bone, turnover and excessive sclerosten levels
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Dr Doug Lucas: be an interesting blood marker. They say a biopsy would confirm this better than blood work. What are your thoughts? I've never heard of that, Tom. I wish that there were a gold standard off of biopsy. Not that I want to biopsy a lot of bones, although I guess I'm trained to do it.
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Dr Doug Lucas: because right now all we have is Dexa and Rems. Right? So so we have. You get a dexa, and you don't really know what it means there's variability like it's not a great test, but there's nothing to compare it to. I've not seen data on bone biopsy that would tell us
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Dr Doug Lucas: anything of quality. I mean, I know from my my surgical experience I can feel it right like you try to drill into osteoporotic bone. It's like drilling into. I don't know pinewood, you know. It's it's super soft
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Tom Gatto: but I don't know what you would compare to, so I'm I'm not familiar with any studies on that. I'd love to see him if they exist. Yeah, sure, yeah, he, he, the specialists I'm working with. He's a anologist, and he does a lot of research and
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Tom Gatto: bone, health and bone markers, and he was trying to explain to me that
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Tom Gatto: he would not be able to really give me a treatment plan unless he knows for sure what's going on inside my my bone, and he feels I would be a good, a good candidate for the Vanity Medication. I told him. I'm really not looking to go that route
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Tom Gatto: right now, so I feel like he's just being really detailed and just trying to figure out what would best match me, cause he told me he wouldn't want to discuss medications until he knows exactly what's going on, he said, with blood work. He can get AI idea. But he wouldn't know for sure.
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Dr Doug Lucas: Yeah. So I think, what's what's interesting about that is, II agree. So I don't. If I'm gonna use a drug which I almost never do. But if I'm gonna use a drug I want to know is somebody rapidly losing bone, or they're having a hard time building bone
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Dr Doug Lucas: right? And that's to 2 totally different scenarios. So the bisphosphonates and prole are used for people that are rapidly losing bone which I would only use in the short term, anyway. But for people that are having a hard time building, bone evinity kind of, but only for the first 6 months does it actually help build bone, and then the anabolics for tail and timlos.
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Dr Doug Lucas: so. But you can get that information off of blood biomarkers. So the and Ctx will give you that information. So that's a lot less painful than a bone. Biopsy.
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Tom Gatto: Gotcha. Okay? Okay?
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Dr Doug Lucas: Yeah, it's interesting. Haven't heard of that.
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Dr Doug Lucas: so
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Don, ask, is there an alternative to the
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Dr Doug Lucas: to recommend pure response, which one's pure response? Oh, the multi.
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Dr Doug Lucas: There's so many Maltese.
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Dr Doug Lucas: Let me actually send a note to my. I don't have the Maltese listed out, cause I actually don't like them. But my! My Rds. Like them. So let me ask my Rds. While we're sitting here, Don, and I'll get you an answer. I don't like them, cause I end up.
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Dr Doug Lucas: I end up overlapping them too much, and so then we end up with too much of some things.
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Dr Doug Lucas: But some of our team really likes it. Hold on! I'm gonna send a slack to my.
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Dr Doug Lucas: where's my coaching team?
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Dr Doug Lucas: Right right here
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Dr Doug Lucas: I'll find an answer for you. Any alternatives to pure response.
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Dr Doug Lucas: Alright.
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Dr Doug Lucas: we will find out soon.
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Dr Doug Lucas: hmm!
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Dr Doug Lucas: So, Tom. Specific question about treating bone loss from idiopathic hypercalia. Such a weird thing. II hear this like
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Dr Doug Lucas: I hear it occasionally. and I feel like it's
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Dr Doug Lucas: I feel like it's sort of a cop out diagnosis like idiopathic. Anything is kind of a cop out diagnosis. The question is like, Why, why are you losing? Why are you losing calcium? Where is it coming from? Is it coming from bone? Or are you just getting too much through diet? So I would wanna dig in into that more to understand why it's being lost. Is it a parathyroid thing. Is it something cause? Usually, unless you have kidney problems, you shouldn't be losing calcium like that.
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Tom Gatto: Yeah, yeah, they they check me for everything. My parathyroid was normal. They did a bunch of testing on that and that's what they think might do, cause I was. I'm 38, and I develop stress fractures in my hips from from running. And that's when they started doing all this testing on me. And you know they realize I have low bone mass.
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Tom Gatto: So, and then they sound. The only thing that came back abnormal was that when I urinate I was just treating way too much calcium. So now I'm on a a thighs eyes. Medication that helps helps with that that helps, you know, control the the calcium better. It kind of it kind of helps with that
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Dr Doug Lucas: I love that I don't love that move, either, to be honest. But
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Dr Doug Lucas: it does. It does work, but it doesn't fix the problem. And this is, what about that about that move? Yeah, so I just shared my screen to go over this supplement. I get asked. This, I get asked this question all the time.
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Dr Doug Lucas: So as far as the hyper calcia area, I would just want to dig deeper, you know, looking at the labs, trying to figure it out and figuring out why you're losing calcium and then following things over time. So that's that's a deep question. But pay attention for other stuff here. I know you're new to this, right? This is challenging for you.
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Dr Doug Lucas: It's a tough early on yeah, early on, it's really tough. So this phone grow product. I've reviewed this lots of times. And so
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when I look at this so out of the gate, I always looked at how much calcium can you guys see this? I know it's it's probably pretty small.
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Dr Doug Lucas: Yeah. So I always look at how much calcium is in it. So you know, you've got 750 mans of calcium coming from Algae, and I've had somebody in the Youtube comments tell me that they use the same supplier as algae, Cal. I don't know that that's true. That's just what I've heard.
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Dr Doug Lucas: So you're getting similar algae as or sorry. Similar calcium from algae as algacal. If it's coming from a whole food source like algae, I'm I'm kind of okay with it. I still don't really, really really know what to think about it. I've sort of changed my mind over the last couple of months over. If it's coming from whole food versus
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Dr Doug Lucas: algae versus bones versus rocks, I think there's probably differences to all of it. So I'm getting, I'm getting more okay with algae. So now I'm going to say, probably okay, same thing with the vitamin c comes from algae, but it's just like a it's a whiff of vitamin C, the d coming. Naturally.
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Dr Doug Lucas: I'd be surprised if you're getting that's interesting. I don't know that you're actually getting 1,600 iu from Algae. That seems like a lot. It's possible, I guess.
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Dr Doug Lucas: And I actually like that. My amount of vitamin DK. 2 is m mics. I'd love to see more of that strontium. I don't think most people need just depends on your starting point. Boron. 3 milligrams is great. Silica is great vanadium plus or minus.
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Dr Doug Lucas: And then you have all these like sort of
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Dr Doug Lucas: the proprietary fruits and vegetable things.
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Dr Doug Lucas: and then the probiotic and enzyme blend. I don't know that everybody needs this, and I think for some people it could actually be harmful. So I'm I don't like giving enzymes to everybody. I think that there's potential danger there, especially for younger people, Tom, if this is coming from you or for you generally. Younger guys and and gals don't have enzyme issues, but older do.
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Dr Doug Lucas: And then the growth factors again, strontium. I don't think we for the most part need and then, of course, the proprietary stuff. So II think it's okay. I think you're gonna get all of these things. This is basically Aljakala with other fruits and vegetables in it. I would just use alga Cal, because it has. I think it has all the same things. I would use.
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Dr Doug Lucas: I'll tell you exactly what we're doing
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Dr Doug Lucas: to play around on.
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Dr Doug Lucas: and don't buy like a year's supply or anything, because we're going to have probably a relationship with Al Jako in the future.
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Dr Doug Lucas: But here's what I would do you ready?
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Dr Doug Lucas: So Aljacau, plus by itself gets you? Yeah, don't buy a 12 month supply.
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Dr Doug Lucas: Stop it. I don't want a 12 month supply
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Dr Doug Lucas: their website. Here we go. So similar calcium mag, even though not from a great source, with mag oxide, but a fair amount of mag same amount of d same amount of k, same amount of boron, same amount of C's, and then trace elements.
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Dr Doug Lucas: So you get all the same things, and then I would pair that. Then with
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Dr Doug Lucas: d. 3 complete and d 3 complete is gonna give you more d so, but not a ton a thousand. And then you're gonna get retinol palmitate. So the active form of vitamin, a complex of vitamin, e, another, another 50 mics of mk. 7,
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Dr Doug Lucas: and then almost 5 grams of K. 2 is MK. 4 and 1,000 mikes of K. One. So you get full spectrum KEA. And D in that product. So I would add both of those together, for really, I think what is a pretty complete
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stack? Just not everything. But it's a really good starting point
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Dr Doug Lucas: that make sense. Yeah, thank you.
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Dr Doug Lucas: Yeah, of course.
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Dr Doug Lucas: so dawn. Quick question about hormones
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Dr Doug Lucas: can't find any recommendations for dosing or blood levels.
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Dr Doug Lucas: What are the tests used to track? Can I point to a resource for optimal ranges would you give me?
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Dr Doug Lucas: Are these your labs done?
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Dr Doug Lucas: Thanks for sharing?
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Dr Doug Lucas: Yeah. So let's let's do this. Let's see. Can I?
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Dr Doug Lucas: I wonder if I can share it. Don, do you mind if I share this.
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Dr Doug Lucas: you sure? Okay, I'll see if I can share it. Actually, let me see.
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Dr Doug Lucas: Share a screen. Oh, totally.
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Dr Doug Lucas: Look at that! Alright, Don. Your labs are front and center. Hey? Thanks for being so open and honest. Okay, so we have. Looks like testosterone. We've got total and free, which is great. Estrogen. We're measuring Estrada, and then Fs and Lh, which are the 2 hormones from the pituitary, telling the ovaries what to do. And then you have serum progesterone. And so for for post menopausal women.
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Dr Doug Lucas: we expect that they're not going to have any estradiol, and they're not going to have any progesterone, because those are made primarily in the ovaries. And so once you have ovarian failure. You don't have estrogen or or progesterone testosterone, though not always true. Testosterone is made in both the ovaries and the adrenal glands. The adrenal glands can make about half so for some postmenopausal women, they actually have adequate testosterone. I don't see it that often, but it exists.
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So if we're talking about Don, specifically.
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Dr Doug Lucas: These reference ranges.
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Dr Doug Lucas: Are these my reference ranges done? Yes.
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FNSA President: thank you. From the tracker. You know that lab tracker that you I put myself in. I'm like, well, there's lots of holes in here that. The one the column on the left, the Estrada 5.6.
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Dr Doug Lucas: Ssh, that's this year. That was just done. Beginning of January. And the others are other years. So it's like this spattering of data that doesn't. Yes, that happens. Yeah. So we're gonna update the tracker. I just updated this, the hormone video. So we have a new hormone video that should be out. Brett would know. But it should be out soon.
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Dr Doug Lucas: but It'll have updated ranges, too, but these are all still pretty accurate. So
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if we look at.
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Dr Doug Lucas: if we just start with total testosterone. These are the units are different between estrogen and testosterone. They'll be added to the new tracker. But the this is what they come in in lab core, and I can tell them to you if you need me to. But basically we're trying to get women to symptom relief. And but this is the challenge is that a lot of women don't consider the symptoms of testosterone deficiency. So that'd be the same as we see in men. So that's lack of energy, change in body composition, visceral fat, loss of muscle, mass.
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Dr Doug Lucas: energy, vitality, libido, sexual function, etc. All the same, both men and women. About 80% of the symptoms of menopause are coming from testosterone deficiency, not estrogen deficiency. And so this range is, we're finding probably just almost irrelevant like we almost don't even need to have a range, because we're really basing off of symptoms. I still wanna know, cause I don't wanna drive it too high, but we see some women feel great with the total testosterone of 40. Some women need over a hundred. It just depends on
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Dr Doug Lucas: their ability to utilize it, what the receptors are doing, but then also the free T. So if we look at your levels here, Don, you have essentially no free testosterone. But you have essentially no testosterone, because you have no total. You have no testosterone
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Dr Doug Lucas: getting to 10, though we're finding is probably too much, because this would require a total testosterone of, you know, more than we need. So probably we're gonna adjust this reference range. Call it like, yeah, 3 to 6. Something like that.
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Dr Doug Lucas: Okay. Estrogen, though, is much more well studied estrogen. In order to have an impact on bone, we need a minimum of 40,
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Dr Doug Lucas: preferably closer to 60 or 80, but that requires replacement.
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Dr Doug Lucas: That's not going to happen naturally, for a postmenopausal woman. I can't tell how. I can't tell your age range. Don't
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Dr Doug Lucas: I'm 58 post menopause. There we go. Okay, you didn't have to share that. But thank you. So I can tell you're in menopause based on these laps
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Dr Doug Lucas: so that that requires replacement. There's no other way to get there.
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Dr Doug Lucas: And then, Progesterone, same thing. You don't have any. If you want to get the benefit of Progesterone for both osteoblasts, which is building bone, but also sleep. Then you have to take it, and if you're taking estrogen and you have a uterus. You also have to take it to protect your uterus from hypertrophy.
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Dr Doug Lucas: Does that all make sense?
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Dr Doug Lucas: Yeah. And as far as reference range for Progesterone, there isn't one we just, we basically again, we treat to symptom relief. Or if somebody has breakthrough bleeding because of estrogen, progesterone and balance, then we add, more
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Dr Doug Lucas: call
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Dr Doug Lucas: okay, great questions. Alright. So let me pull up the
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Dr Doug Lucas: questions. I had him.
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I had them, and I closed them. That's all right. I know where they are.
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Sheryl: I have something.
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Dr Doug Lucas: Who's that? Oh, Hi! Cheryl!
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Sheryl: Hi! So
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Sheryl: I have a low T scores.
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Sheryl: that
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Sheryl: that the people want to give me. Remote is a map with, and I would prefer not. But I was wondering what would you automatically do? An anabolic with like a
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Sheryl: spine T score of like negative, 4 negative, 4.1, and like hip set negative, 3
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Sheryl: even though they've stayed stable since
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Sheryl: I had my first, Dexa 2019, and the second 1, 2023.
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Sheryl: And they're similar to each other.
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Dr Doug Lucas: Yeah, I mean, it's good that you're not continuing to lose bone. And and this is where you know, having that same question from Tom earlier, which is, if
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Dr Doug Lucas: if you're not rapidly losing bone, using a drug that slows down. Bone. Loss isn't going to be helpful now. That's not what they're recommending. They're recommending affinity.
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Which is a little bit of both, but has such a short lifespan. You can only use it for 12 months.
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Dr Doug Lucas: So for you. If if it were that low
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Dr Doug Lucas: and I would wanna know kind of some other factors, but I would be worried about it. Yeah, that's really low. I would love to know about bone quality if it's possible to get a rams to see what kind of bone quality you have to see how deep the hole is that we're digging out of. But if it's a deep hole and we're really worried about fracture, or you've had previous fractures. Then adding, an anabolic would be something I would consider.
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Sheryl: Yeah, I don't. I don't feel fragile, and I am active. I have good balance. And I did fracture my wrists in 2015. But what was the mechanism? Though?
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Sheryl: I fell, and my hand got sort of trapped while my body fell to the side. So
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Sheryl: it wasn't like fall like like you just fall and roll over. Kind of thing. It was like my hand got stuck, and with my
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Dr Doug Lucas: my forearm sticking up. But the rest of my body went off to the side.
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Sheryl: That sounds terrible. Yeah, so so I think it was a. It was a small fracture. And I hear.
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Sheryl: So I don't know if that counts. Yeah, yeah, it's hard to know. It's a weird mechanism. So
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Dr Doug Lucas: I would. Still, if it's possible to get a rems to learn about bone quality that would be wonderful. But it's still, if you're negative. Four's, that's it's pretty light, right? There's there's probably a strength issue there. I've never seen somebody that had a t-score of negative 4 that had good bone quality. I've also I don't know that I've ever seen a rems on somebody that has a T score of negative 4, though, so I'd I'd love. I'd love for you to do that for all of us.
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Dr Doug Lucas: but I would still consider it that low.
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Dr Doug Lucas: It's gonna be a a trip to get there cause I'm in the West Coast, and I just talked to a new clinic in Florida in Naples. They're opening in April with the rams.
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Dr Doug Lucas: So anyway, yeah, they're all they're all East for now.
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Sheryl: Thanks.
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Dr Doug Lucas: You're welcome, all right. I'm I think it's James Bondi. Right? So James is having a technical issue and can't
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Dr Doug Lucas: unmute or turn on the camera. But he has a question.
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Dr Doug Lucas: and if it's not James, I apologize, so. Is there an association between osteoporosis and diabetes? Is the question in the chat, and I think the answer is.
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I've never seen hard data on this.
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Dr Doug Lucas: You would think the answer would be in general, no, but diabetes is an inflammatory condition, so I think it's possible that there certainly could be some overlap, probably a subset of people, but diabetes is also associated with obesity, which in for some, in some studies, protects against osteoporosis, and some not again, I think, cause it's an inflammatory condition. So I think that they're they're probably loosely associated. But I've never seen a a true statistical analysis on that
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S Jaye: question. 125,
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S Jaye: yeah, it's it's okay. I mean some. I think it's
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Dr Doug Lucas: I'm just gonna turn that one off
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Dr Doug Lucas: alright. So I've got questions, questions.
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Dr Doug Lucas: all right. What do you guys want to start with? We did a lot of hormones last time I've got supplement questions, exercise questions, nutrition, questions.
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Dr Doug Lucas: fasting questions, holiday reset, question, lab questions.
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Dr Doug Lucas: so many things. Where do you guys want to start?
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Dr Doug Lucas: You're here. You get to choose.
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Dr Doug Lucas: Cheryl says, exercise alright. You were the first one. Cheryl. Good job.
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Dr Doug Lucas: Somebody posted my own video in here. What did I say?
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Dr Doug Lucas: we'll come back to that
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Dr Doug Lucas: exercise. Okay, exercise.
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Dr Doug Lucas: So first question is, 2 questions from Kathy.
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Would isometric exercises, such as pulling, pushing, as hard as you can do the same thing as Osteostrong. That's a great question, Kathy, and I've heard that before, and the answer is, no.
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Dr Doug Lucas: but I can't explain why I would need I would need Jake wish to help me to understand that there's something about the way that the osteostrong equipment pushes back that allows you to generate so much force. I don't know how they do it, but osteostrong and biodensity together both have equipment that can generate even in people that aren't athletes. 9 multiples of body weight. So I don't know how they do that, but it is unique, and it's not just an isometric exercise, although I agree, it sure looks like one
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Dr Doug Lucas: and then Kathy also wrote in, I've heard that exercise could actually deplete bone nutrients. Should you eat protein before and after workouts? Kind of a controversial question, even in like the the training space, right like pre workouts. Do you eat before? Do you eat after? Do you train fasted? I think, for us in the osteoprocess space.
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Dr Doug Lucas: We want to build muscle and bone. So I would. I would lean on the the evidence from the people that are building the most muscle, which would be the bodybuilders, the strength trainers, you know, the guys that are putting on a tremendous amount of muscle mass and and power
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Dr Doug Lucas: powerlifters, so they generally will eat before. Not a lot, but they'll eat before, but mostly to fuel, right? So a higher carbohydrate meal that we're talking about earlier with David. A higher carbohydrate, you know, smaller meal like a snack, but having some some food on board when you come in, so that you don't get glucose lows, and you don't get, you know, get fatigued as easily.
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Dr Doug Lucas: Not a big meal, though, and then eating afterwards. There is a metabolic window more true in non-trainers. So people that aren't really well adapted to exercising. But you have about an hour to 2 h afterwards, where, if you consume protein within that window. You're gonna get more protein synthesis in your muscles. So I would recommend eating a protein meal afterwards, and that can be a good sized meal.
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Dr Doug Lucas: and then adding, carbohydrate to that, too, will help to increase the glycogen stores helps you to recover faster. If you have issues with metabolic disease, then that's where I would put the walls around carbohydrates and then stay lower carb the rest of the day depending on when you're training
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Dr Doug Lucas: as far as does exercise actually deplete nutrients, though from the bones. I would say only chronic cardio, like running long distances, unfueled, so like fasted running for long distances.
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Dr Doug Lucas: swimming has a propensity to do it. And again, I think, just because it's a sort of a moderate to high level cardio state that you hang on to for a long time. Right? So people that swim tend to swim for a long time. People that run tend to run for a long time, and your body does want to deplete bone density in those scenarios. They're also potentially inflammatory.
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Dr Doug Lucas: Another reason why hope that answers that question.
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Dr Doug Lucas: del l del l
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Dr Doug Lucas: so Dell says, seems to be settled that running, that normal running alone does not stimulate significant bone growth. True, however, presumably runners in relevant studies have worn standard cushion shoes. Are you ever any studies looking at barefoot running and bone, metabolism or heel drop
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Dr Doug Lucas: or barefoot heel drops?
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Dr Doug Lucas: Oh, sorry if barefoot heel drops can stimulate bone growth. I would think that barefoot running might as well. I think it's compelling. I've never seen a study on it, but I would also be afraid in an older population to recommend barefoot running, or even like 0 heel drop shoes for people that have been wearing traditional sneakers.
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Dr Doug Lucas: I found when I was in my foot and ankle practice cause Footnanka was my sub specialty in orthopedics. People that went to to 0 drop or kind of the flat shoes or minimal issues. They really had Achilles problems. So it'd be an interesting transition to make. I'd love to see a study on it. But I don't know how well it would be tolerated. And you're right. Heel drops probably part of an impact program.
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Dr Doug Lucas: that it is one that we're doing for sure.
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Dr Doug Lucas: Mmm. Jackie asked about Yoga. And is there any value in doing yoga
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Dr Doug Lucas: same with Pilates? So I think Yoga and Pilates are great. There's there are studies out there on Yoga and Pilates, and some do. Some do show some improvement in bone mineral density. But I think we have to take those studies a little bit with a grain of salt because they're they're kind of multi-modal, like people are doing other stuff, too.
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Dr Doug Lucas: So I think they're going to be beneficial from a muscle perspective, from a agility, from a core probably mindset to mindfulness. Like, I love Yoga and Pilates. I think they're great. You have to be careful. Don't put yourself in a dangerous position, but
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Dr Doug Lucas: they're not going to help build that much bone. So I think they're an adjunct for sure. Let's hear I got a couple
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in the chat.
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Dr Doug Lucas: Hmm.
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David asks. Example of changing Ctx and and P. Scores as person's bones are being strengthened. Let me give you an example, David, of some numbers.
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Dr Doug Lucas: I'll let him answer that. Oh, Hi! There you are! Yeah, let me pull up. I had a patient yesterday that just knocked my socks off. Let me see.
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Dr Doug Lucas: this was great, so this was, I'll give you a little background. This is a patient who was in New Hampshire, and our licensing in New Hampshire was wonky because I was licensed as a kind of like a telehealth thing that was available during the pandemic, and then it went away. But my real license wasn't there yet, so she had to be on hold. So she did a bunch of lifestyle stuff in between
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Dr Doug Lucas: being able to work with me. Where are you?
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Dr Doug Lucas: Oh, here it is! Alright. I don't think I can show you this without showing your name, which I shouldn't do. But let me just give you her numbers.
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Dr Doug Lucas: Okay? So she went from.
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Dr Doug Lucas: oh, they're not in here. Ok? Well, I'll give you the ballpark. So, for example, her starting numbers were
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something like.
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Dr Doug Lucas: let's hear, I think her starting. Ctx, so ctx is the the bone breakdown marker. Right? So her starting Ctx was somewhere around, like, let's call it 500.
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Dr Doug Lucas: Her.
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P. One. And P.
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Dr Doug Lucas: Which is the bone building biomarker. Let's call it. We'll just actually use round numbers to make it easy, so we'll call it 50. So you have to adjust for units when you do this. So the way that you do it is you would do 50 for and P divided by basically point 5 or whatever it is point 5 0 0. Right? So you do that 50 divided by point 5, and you get a hundred. What we're finding in our patients is, people are kind of generally between like 50 and call it 2 50.
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Dr Doug Lucas: So let me tell you her number. So then this is cool. So she's not on hormone replacement. She did a lot of work on her diet. She's got some gut dysfunction, but she's feeling better. She did a fob map diet for a while. We're gonna treat that. But she was being very cognizant about physical training. She was doing more resistance training than she's ever done nailing her diet. She had already started on some of the supplements, and then so her repeat labs were her, and P. Was 102.9,
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Dr Doug Lucas: which is really hard to do. Naturally, to get over 100, and then her Ctx. Dropped from in the 500 s. To 3 28. So her ratio is 313. That's the highest I've ever seen. Naturally. So that's kind of cool.
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Dr Doug Lucas: was excited. So now she's starting on hormones. Yeah. Now she's starting on progesterone and testosterone. She's 20 years out.
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Dr Doug Lucas: So we're not gonna do estrogen, but starting on testosterone and progesterone
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Dr Doug Lucas: and a few other things, oxytocin immun optimized her supplement stack and gave her a big kudos. She's really excited.
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Dr Doug Lucas: and so SSJ.
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Dr Doug Lucas: Ask, is it possible to send weekly notifications of upcoming Zoom Webinar with meeting link in subject line. I'm happy to pass that along to our tech team. I think Brett has already left, but I'll copy this, and I will send it to her
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Dr Doug Lucas: right now.
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Dr Doug Lucas: done.
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Dr Doug Lucas: we'll see. The answer is, yes, it's possible they just need to do it.
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Dr Doug Lucas: See here? Diane asked in last week's Q. And a. I believe you mentioned that low dose estrogen is not necessarily effective.
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Dr Doug Lucas: You're on the climber 25 weekly Patch. I thinking this might not be enough. She has quote unquote, serious osteoporosis, 62 years old, no strong family history of cancer, although sister was diagnosed with estrogen, dominant breast cancer in 2020. She's in Canada. We're way behind here relying on a natural path to support bone. I'm actually, I might be getting licensed in Canada, which would be a lot of fun. Working on that. It's not easy to do.
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Dr Doug Lucas: yeah. So b hr, T. Is is new for him. So the question, then, Diane, is, what are your serum bubbles? And so he's just gotta check. He's got to check your serum bubbles and see it's possible to get there on a patch. It's just not all patches will get to there. So you wanna aim for that 40 to 60 and I can get you. Let me get you the units on that cause. It's gonna be different in Canada. So hold on. Just 1 s.
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Dr Doug Lucas: It bothers me. It's Diane.
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Diane’s iPad: Hi, I've had a lot of requesting estrogen test.
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Diane’s iPad: and it doesn't give it doesn't tell you what it is. It just tells you what you're below.
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Diane’s iPad: and that I'm below 40. So I don't know. I don't even know what that means. Yeah. So if if it's the same unit. So the units in the Us. Are in picograms per milliliter. So pg, ml.
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Dr Doug Lucas: and your your goal is to be between 40 and 60. So if you can, if it tells you that you're below 40, then you you probably need more and I'm not familiar with that particular patch in the dosing of it.
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Dr Doug Lucas: It is possible, with some patches, but I don't know what you have access to. Are there compounding pharmacies in Canada.
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Diane’s iPad: I'm not sure how hard it would be for me to find one, and I'm in DC. British Columbia, and we're even way behind Ontario and Alberta. I'm not really sure what's going on here, but it's it's extremely tough. I can't even get it. We don't. BC. Doesn't even offer a Np.
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Diane’s iPad: And I'm I'm paying for my Ctx
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Diane’s iPad: blood test right? And and and specialists aren't recognizing. So so yeah, I'm kind of now. And and thank God you're here to help me out.
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Dr Doug Lucas: Thank you. Yeah. Well, there's a lot of things we can do. So we can. We can help you kind of dial it in. How far are you from the US. How long of a drive would it be? Oh, not very far at all. I'm close to Vancouver, BC,
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Dr Doug Lucas: yeah. So you could come to the Us and order some of the cash pay labs. So P. Onemp and ctx, you can do through life, life, life, life
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Diane’s iPad: extension. There we go, life extension. You could order that, and I don't know if they would ship it to Canada to ask them how to do it. But if you're in the Us. I know you could get it some way and get it sent back to them. Get it drawn and get it sent back. There's a way to. I have been considering doing that, taking a trip down, figuring out where, and then just taking a trip down and and doing these things so that I have some information.
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Dr Doug Lucas: You also?
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Dr Doug Lucas: yeah, I don't know if you're interested in working with us, but that's also how people in other countries work with us, too. You just have to be across the border.
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Dr Doug Lucas: which is silly. But we have people that we have international people that'll fly into anywhere in the Us. And see us in a virtual visit, and as long as they have an address, then we can arrange to ship things. It's it's quirky, international medical licensing is weird.
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Diane’s iPad: Understood? II appreciate you letting me know that I did not know that.
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Dr Doug Lucas: Yeah, we don't really say that out loud, because it would. I guess we're being recorded now. But we don't really say that out loud, because it's just a. It's a gray area. It's not illegal. It's not an ethical. It's just funky.
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Diane’s iPad: Right? Understood? Should I talk to my nature path about? Well, what about a 50 instead of a 25. I'm just dial. Right?
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Diane’s iPad: Yeah. Test her dial. And then I'm on that. Progesterone cannot get a testosterone test will not even write me the requisition. Nobody will
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Diane’s iPad: like he can't, and my Gp. Won't.
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Dr Doug Lucas: so I can't get testosterone test, which you're saying I could get if I went to the State. So yeah, you could definitely get testosterone checked. Although you would have to in order to get it prescribed. We would. We can prescribe it. If you're in the Us. You just have to have an address to that we can send it to in a state that I'm licensing, which is which
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Dr Doug Lucas: all of them soon.
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Dr Doug Lucas: What's the closest thing to you
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Diane’s iPad: for the Washington
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Dr Doug Lucas: I have to check on Washington? I know it's it was pending. I don't. I don't know if it's gone through or not.
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Dr Doug Lucas: but we can find out. So yeah, you're welcome.
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Diane’s iPad: 25 gonna make. I mean, I'm done improving, I am IIII the person. Last week you talked about John Strontium, and being on it, you said to be headed in the right direction. But I'm just not so sure that this is
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Diane’s iPad: e enough, because I have apparently 6 vertebral fractures, and negative 3.9 and negative 3.1. Although I'm improving. So
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Dr Doug Lucas: improving is good. It just depends on the yeah, the trajectory. If the trajectory is slow and you have a really low starting point. That's a that's a tough conversation.
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Dr Doug Lucas: But at least you're improving right.
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Dr Doug Lucas: And again, that's that same scenario we talked about earlier, where, depending on the scenario adding estrogen. I think that's what this question is about, too, is bone drugs with hormones.
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Dr Doug Lucas: Is adding an anabolic in that situation. Do you have access to Forteo and temlos in Canada?
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Diane’s iPad: All of em. And they've all been recommended to me.
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Dr Doug Lucas: Okay? So because in that scenario I'd I'd love to see the labs, the and the Ctx. But in that scenario, using them as a jump, start to get pushed in the right direction with a faster curve. Because if you're starting at negative 4, your risk of fracture and you've had fractures is really high.
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Dr Doug Lucas: Right? So that's a scenario where I don't mind using anabolics. I don't mind not using them as well. It's just a matter of, you know. I want to prevent that hip fracture. because that's a game changer. Big time
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Diane’s iPad: UN understood. I wish I could get around. There's a part of me that thinks
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Diane’s iPad: I've got better phone. Honestly, I mean, I think intuition around that is
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Dr Doug Lucas: usually pretty good.
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Dr Doug Lucas: So I don't. I don't want to consider that ahead in the sand, move but it might just take it might take some travel
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Diane’s iPad: right? And I'm I'm doing the lift more pieces, but no jumping, of course, with the fractures, and I'm 120 pounds and doing 100 pound deadlines. So I mean, I'm I'm doing all I'm doing all right. I've been a gym rat my whole life. So you know, I kind of yeah, I'm scared of drugs. I've had a I don't do well with them in my gut at all.
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Dr Doug Lucas: Yeah.
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understood. I'm scared of them, too. That's why I don't like to prescribe them.
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Dr Doug Lucas: Thank you for this. I appreciate it, of course. So this next question is, I'm on Hrt, and may have to go on a bisphosphate. Can I do both with bone meds? The answer is, yes, you can do Hr and bone Meds together. There's no contraindication there.
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Dr Doug Lucas: The next part of that is, bones are in bad shape, 19% fracture rate. I'm assuming that's on frax, which is, that's pretty high went off prole
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Dr Doug Lucas: it need to bring. I'm assuming C. Tx. Down from 5, 55 bones have gotten worse by not taking anything after Pearlia beside supplements.
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Dr Doug Lucas: Yeah. So this is that
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Dr Doug Lucas: looks like on way to another fracture. I hate hearing that.
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Dr Doug Lucas: So this is this is the prolia challenge. Right? So you go on, prolia. You're on it for well, however long, 5 years, 10 years, and then you have to come off of it at some point, because it's it's a bone. Metabolism, suppressive drug. You can't stay on drugs that suppress bone metabolism forever. That's why they they
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Dr Doug Lucas: they shouldn't be given to younger people unless there's a clear reason. So now, so this person is off off of Perlia is losing bone. Ctx has gone back up, and the doctor's recommending bisphosphonates, which is
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Dr Doug Lucas: common.
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Dr Doug Lucas: but I think an error because you were on a bone. Suppressive drug. A bisphosphate is another bone suppressive drug. I think that's an error, because now I think you're gonna see people that are at higher risk for not the rebound vertebral fracture from coming off of prolea, but the atypical framer fractures from being on bisphosphonates.
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Dr Doug Lucas: So I think it's a it's a bad combo. We have seen people come off of prolia if they have the capacity to do all the things that we recommend. It just depends on age and and functional capacity.
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Dr Doug Lucas: But we've seen people come off a prilla and not lose bone. So it is possible. But it takes that like comprehensive program. You gotta do all the things
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S Jaye: Doctor Lucas. I ask you. I only took the prolia for 2 shots. I was limping, holding on to things. I had terrible gird. For an entire year I had terrible heart palpitations, and the CTX. Went to 7, 55, and I was offered reclass. But my thinking at that time, because
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S Jaye: the doctors don't really explain it. They didn't tell me that it bypasses your stomach or something, and it would hold in the gains.
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S Jaye: And now I recently had an MRI, and it looks like I'm gonna fracture again.
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S Jaye: I've been taken KD. At everything under the sun, but I don't know what to do, and when I go see a endocrinologist, they all tell me. Go on event, and I'm thinking, well, that's another ost a steel class bump, you know, Bumper Upper, if you can't tolerate it.
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S Jaye: and I don't know what to do, cause I feel like the problem in my back. I've been complaining about my hip for a very long time, and I had an MRI. There, and the doctor told me it's persitis.
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S Jaye: so
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S Jaye: I think that the upper back that has the bone that's ready to fracture is causing some kind of pressure on the hip
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S Jaye: and I don't know. I have to do something. I'm on the HRT. But I'm not getting anywhere.
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S Jaye: Yeah, so this is these, these challenges like this is why you have to have a a, a big picture. This is why we do all the labs, you know, to sit down and look and see. Use that framework, you know. Why are you losing bone? You know. What? What is it? If you're on? Hrt, it's not an estrogen deficiency. Hopefully, if you're if you're on good. Hrt
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Dr Doug Lucas: estrogen, it's high. Yeah. So it's not an estrogen deficiency. So then, what is it? Is it a gut thing, is it, you know, not nailing the right diet? Take a looking at the supplement stack and see, you know, what are you potentially missing?
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Dr Doug Lucas: There's there are a lot of avenues. But without seeing all those data, I can't tell you specifically what you need to do
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Dr Doug Lucas: tough part. You're in a tough spot. How? What's what's your first name? What can I call you? Susan? Okay, so, Susan, yeah, this is one of those challenging scenarios where we just need we need more information because you're slipping and
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Dr Doug Lucas: you gotta stop. You gotta halt that bone loss.
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S Jaye: Yeah, all my labs are good. I had everything tested. And I'm okay. I don't have thyroid issues. But II have no idea what's happening. And it's really frustrating, cause I feel like I'm going down a slippery slope, and it's not good. Yeah, for sure. I wish I could look at them, do you have your labs available? Yeah, yeah, I have all brand new labs. Yeah. And I even took a saliva test.
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S Jaye: But I don't know what's going on, and the DH saliva I mean, I'm sorry the I don't know the Hrt person put me on. It made me take a saliva test
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S Jaye: and compared it to a very extensive blood test.
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S Jaye: And just I don't know when I mentioned that I might have to go on a bone drug. They said, No, we don't like that. And then they showed me a book that said, You know I would. I said, Well, am I gonna maintain the bones I have on the Hrt. Or am I actually gonna improve my bones?
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S Jaye: And they said, Improve your bones? But I don't know if that's really true.
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Dr Doug Lucas: Yeah. Hr, hrt, Hrt can improve bone density alone, as a single intervention. We do see that both estrogen and testosterone. So that is, that is possible. But to tell you exactly what to do, I'd have to see all those labs. I don't think there's a way for us to do that. If you wanna send them in, you could send them in as a question, and I could. Next week I could review them. I think that'd be a fun exercise for people to to watch me review the labs.
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Dr Doug Lucas: so send send everything you have in, and a question. I think that would be a fun. A fun exercise. I still can't tell you exactly what to do, because I'm not.
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S Jaye: but I think, and it'll also be a good test for everyone to see, because it's very extensive. II went to a bone metabolism, doctor, and then I called life extension with his bone results, and they told me you're missing this, and you're missing that. And then I sent in the more extensive one to life extension. And the woman said, Oh, this is much better. The senior wellness person
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Dr Doug Lucas: much better.
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S Jaye: So, okay, I appreciate that. Thank you. Yeah, that'd be a fun exercise.
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Dr Doug Lucas: So Karen asks, what was the what? What vitamin was this gal on with the awesome change in Ctx. And P. What was she? She was on?
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Dr Doug Lucas: aljacale products.
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Dr Doug Lucas: No, that's not true.
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Dr Doug Lucas: She was on
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Dr Doug Lucas: just a trace mineral product, vitamin d
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Dr Doug Lucas: a vitamin. K.
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Dr Doug Lucas: Remember what else she had started. Basic stuff.
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Dr Doug Lucas: Simple stuff, nothing. Fancy.
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I think, for her it was the change in diet and change in activity.
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Dr Doug Lucas: Think Susan asked about coffee? I'm just going to. I answer this this way all the time, which is.
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I don't wanna look and see if coffee is bad for bones, cause I love coffee. I don't want to know the answer.
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Dr Doug Lucas: I should probably answer that question someday. Alright.
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Dr Doug Lucas: I don't want to know.
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Dr Doug Lucas: Let's see here to go
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Dr Doug Lucas: here. It is okay. Well, we almost got through one topic. Vibration. Is it worthwhile for someone with osteopenia to use Osteo boost? I don't know about the different. I don't know about any products other than
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Dr Doug Lucas: Oh, wait! Let me see this one. Hold on, Osteo boost! I did see this the other day. Alright
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Dr Doug Lucas: checks. Check this out as a yeah. They claim the for the bone is what's building the bone.
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Dr Doug Lucas: the supplement for the bone.
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S Jaye: Yeah, it's in the in the Osteo boost.
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S Jaye: I believe
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I got it.
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Dr Doug Lucas: What did I just share? Oh, I didn't share. Here we go.
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Dr Doug Lucas: So Ford a bone is the milk. Basic proteins right? Mvp.
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S Jaye: I don't know.
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Dr Doug Lucas: We'll find out. Let's find out the other.
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Dr Doug Lucas: Just going to research as a team here.
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Dr Doug Lucas: Nope, wrong one
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Dr Doug Lucas: for thebound for the bone.
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Dr Doug Lucas: There it is. Yeah, yeah. Yeah. So this is a collagen product from
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Dr Doug Lucas: from Jilita. Whatever their they're
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Dr Doug Lucas: there's a parent company, anyway. I've reviewed this before the Ford bone. The research is proprietary.
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Dr Doug Lucas: And I definitely question the results. They have one study that they paid for. So it's never been reproduced, and they're used up a proprietary form of collagen. So then nobody else has ever studied it. So I think it's I mean, it might be good. I don't know. I have a hard time with that one
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Dr Doug Lucas: and then so this thing somebody put a link to this. And I actually just saw I had another Doc, send me this yesterday. So this thing is like a vibration device that sits on your sits on your sacrum.
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Dr Doug Lucas: You're blowback. and I love it that they put in here
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Dr Doug Lucas: the science. And then they put in here the patents
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Dr Doug Lucas: that doesn't actually tell me anything about the science.
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So no studies behind this. I don't believe that this does anything. I can't believe that this does anything.
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Dr Doug Lucas: So I wouldn't recommend that
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Dr Doug Lucas: until I see a study that shows that it does.
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Dr Doug Lucas: All right.
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Dr Doug Lucas: We have 5 min. Let's talk about. Can we talk about protein.
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Dr Doug Lucas: Helen. Hi, Helen! I know you're not here, but
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Dr Doug Lucas: Helen, a friend of mine patient of mine, she said. I heard Dr. Gabriel Lyon interviewed, and she shared that. If you don't have 30 to 50 grams of protein at once, then it's not enough to stimulate muscle building. This was new to me, and will shift. How I tried to get my daily 100 to 120 grams per day target. Do I agree with this? Is this too much.
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Dr Doug Lucas: and also how much is too much protein from powder drinks per day versus whole foods. Great questions. So
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Dr Doug Lucas: I do agree with that. I think. I was actually at at Dr. Lyons, forever strong summit, her first, ever forever strong summit. A couple of weeks ago it was in Austin, and it was super fun. She had a panel with Don Lehman. If you ever wanna look up protein research, Don Lehman is the the godfather of proteins and amino acids. So they were actually talking about this exact thing. So all the studies are. I shouldn't say that most of the studies are done on the first meal of the day.
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Dr Doug Lucas: So this is going to be totally counterintuitive to most people. But most of the studies are done in the first meal of the day. Protein synthesis is most impacted by the protein intake of that first meal.
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Dr Doug Lucas: Getting 30 to 50 grams of protein in that first meal is critical to put yourself in like a muscle building
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Dr Doug Lucas: and a buck
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state for the rest of the day.
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Dr Doug Lucas: So that's one the second part of that is.
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Dr Doug Lucas: if you if you graze on protein, if you eat like a little bit of, you know, like an ounce of this, or an ounce of that throughout the day. It won't trip the wire of creating protein synthesis. It'll be used as energy, and you don't wanna use that really critical nutrient as energy. You need to consume enough of it to flip into the the muscle kind of biosynthesis pathway, and that takes about 30 grams.
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Dr Doug Lucas: So you gotta try to get all 30 grams in at one time. I just posted
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Dr Doug Lucas: just by reposted from somebody meals with 30 grams of protein in it. It's not that hard to do. It's not insignificant, but it's not that hard to do.
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Dr Doug Lucas: if that makes sense. And then, I think, was that was that. Oh, yeah, powders. Man, I wish everybody just got all their protein from whole foods, but I know that's not always possible. So if you have to get some from protein powders. That's fine. I do occasionally, too, but I really try to get it from whole foods, because your body is always gonna absorb it better
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Dr Doug Lucas: that make sense.
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So
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Dr Doug Lucas: Don, you're laughing at me.
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Dr Doug Lucas: I see you you're in my top left box let's, see here
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Dr Doug Lucas: with some anti-nutrient questions. Sure. Cindy asks, how important is it to maintain a low oxalate, phytate, lectin, diet for bone, density.
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Dr Doug Lucas: limiting spinach, kale, wheat.
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Dr Doug Lucas: etc., etc., etc. So here's where I struggle with the anti-nutrients, which is, they bother some people. They don't bother all people but it's sometimes hard to know if they bother you, and that's sort of the catch. So that's why I recommend not consuming things that have have high components of oxalates and phytates and lectins. But some people can tolerate, you know, Rockale salad and eat beans, and it's then they're fine.
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Dr Doug Lucas: But you kinda have to test, or you have to be looking for inflammation. So for people that have a potential chronic, inflammatory condition like osteoporosis can be, then I would avoid them. But it's it's kinda hard to know it is testable. You can do a lectin zoomer from vibrant America, and it'll it'll tell you what you're sensitive to.
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Dr Doug Lucas: But the oxalate you can't test for phytates you can't test for.
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Dr Doug Lucas: And then last question about anti-nutrients. This question is about phytates and oxalates understand that they bind to calcium can negatively impact bone health. She tries soaking nuts and other things, but it's not realistic, sustainable or tasty. True, if I eat phytates or oxalates 2 h away from foods containing calcium or calcium supplement. Will they still bind to calcium? Naturally, I need to know that my calcium intake is going to my bones.
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Dr Doug Lucas: How about magnesium? Another great question. So, yeah, this is the problem with oxalates and phytates. Well, part of the problem is that they can bind nutrients. If you think you're getting calcium and other things through plants, and you're eating those things that are high in phytates and oxalates, you might not be getting it absorbed. It's just really hard to know. So again, my preference is just avoid it. Then you don't have to ask, and you don't. It doesn't matter so that's that's my preference in general.
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Dr Doug Lucas: Maybe eat them away from calcium sources.
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Dr Doug Lucas: I just don't think we need them and then the last part about that from Dan is, she says I have, I like to have a cup of almond milk with her healthy protein packed breakfast. But now I'm not so sure. That's a good idea as almonds are high and oxalates. It's true I don't know how many of those oxalates carry over, though, after the processing of almonds and almond milk. So I actually don't know what the oxalate content of almond milk is
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Dr Doug Lucas: the problem I see with almond milk is 2 things. One is the calcium that's in almond milk. A lot of it's added so essentially like taking a calcium supplement. Right? So it's like usually calcium carbonate. It's a calcium supplement. You should consider it as such. It's not coming from a whole food source.
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And then the second part for me is the environmental part.
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Dr Doug Lucas: which is funny, cause I talk a lot about animal agriculture and sustainable regenerative agriculture, almond farming is terribly water intensive, and it's done generally in deserts, and it sacrifices water to surrounding communities. So we should probably be eating less almonds. Is my preference on almonds. Now that, said I, do use almond milk for smoothies if I don't have raw milk. I just don't use very much of it.
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Dr Doug Lucas: Alright 2 30. We did it. Thanks everybody. Thanks. Don. Nice to see you and thanks everybody. If we didn't get your question answered. Go ahead and post your question in the slack room. I've been seeing more action in there. I've been seeing some good back and forth so definitely do that. And Don again. Thank you for your input. I appreciate everybody who's spending some time answering questions in there. It's really helpful. I want this community to really support each other.
