Bones, Hormones, and Happiness: Rethinking Osteoporosis

Hi and welcome to How Humans Heal. I'm Dr. Donnie Wilson, and in today's episode, I'm really looking forward to introducing you to my friend Margie Bissinger. She is a physical therapist and integrative health coach who specializes in helping women with osteoporosis and osteopenia and to prevent osteoporosis and osteopenia. And she's been doing this for over 30 years. She's the host of the Happy Bones Happy Life podcast and online community, and she's also co-founder of the Bone Health Academy, where she's training practitioners in her approach to preventing bone loss, which is such an important thing. We tend to forget about our bones, don't we? And yet you're here to remind us the bones are important. Thank you so much for joining us today, Margie.

Oh, I'm so happy to be here with you and your community.

Oh my goodness. So tell us more, like just even starting off, like what, what got— how come the bones got your attention? How did you get into this in the first place? And, and And I know you're going to start to show us the energy you have around this conversation that isn't enough talked about.

So true. And it's funny, I just sort of fell into it. I was working as a physical therapist and in an outpatient orthopedic. That's my background. And a group of endocrinologists started asking me if I could see their patients with osteoporosis. Now, this is over, actually over 35 years ago.

Amazing.

And it was early on. It was early on. And I had had the training in women's health. And I, you know, so I had the background to do this. So I said, sure. And it was so upsetting to me because these well-intentioned women didn't— you know, their doctor says do exercise and they just didn't know where to turn. So they were, you know, going to trainers or they were looking— it was even before the internet, you know, and they had no idea what to do. So they unfortunately were doing exercises that increased their risk Oh, no. It was so upsetting that I said, I have to get involved in this area. And so I started— got involved in New Jersey on the state level. We have a whole community where I started overseeing all the osteoporosis initiatives. I wrote a book then, one of the first books on exercise and osteoporosis. And I also got involved nationally. And it just became my mission because I saw that there was so much that could be done, and it wasn't being done, just like you said. Still to this day, but the beautiful part, and this is, I know, so much your philosophy, is when people are empowered with the knowledge and the tools, they turn around and it was actually a blessing in disguise because osteoporosis is scary, but people can feel fine. And then they have this bone density and all of a sudden they're mortified. Oh my gosh. And, you know, so we go from fear, but once they learn the tools, they become strong, they eat better, they reduce their stress. And then life is actually— it was actually a catalyst for good things to happen. So that's my belief in the whole thing. And that's what I've seen all these years. But just like you said, we need to get this out there because it really isn't. And there's just so much that can be done.

Well, and I love the idea of helping women to start thinking about this. I mean, and men, and we can talk about that as well. But before menopause, before the bone loss starts happening. And so I want to be able to like Like, if you and I could write our own guidelines on this, you know, when do you think women should start thinking about their bones? Because in the standard approach, you know, sometimes a doctor might not order a bone density until age 65, which is way too late, I think. I've even— Oh my gosh.

So, I so agree. Yes.

I've even heard the doctors who write the textbooks on osteoporosis say that age 65 is too late, but that's when it's happening. So what do you think? When should women start thinking about this?

I actually think every age, because the truth is that women— that, you know, when we're young, we build most of our bone. And so, you know, women by the 80 to 80— really more like 85 to 90% of their bones by age 18, and then by age 20. So what we do when you're young, it's sort of a bank that you're making deposits. So what we do when you're young really can affect the amount of bone we have later on, even if we do lose some.

Mm-hmm.

So I think, unfortunately, the pediatricians should be a couple of things, the way people eat and exercise. Some people now with all the devices, a lot of people aren't doing the exercises to build their bones. So I think really at all ages, but a lot of times— so again, when we're younger, but really every single age. And then menopause becomes a big opportunity. Yeah. To besides the exercise and nutrition, to also work with the hormones to prevent bone loss. And that's something that you know the good news. I was just at the International Interdisciplinary Symposium on Osteoporosis, and they were saying what's new in 2026. So they did change because really what they recommended was age 65. So now they didn't change that, but they said it used to be you had to have like an actual reason on this FRAX score. But now. Just menopause or just one reason, you can get it earlier. But still, to me, that's the most ridiculous thing. So I think people should be tested at least before menopause, perimenopause, just to see where they're at, or if they have issues earlier than that. But it should be something like we look at all other things. It should be something all through life. Are you doing things that are stimulating your bones? And I think it's It's really a missed opportunity, and so much could be prevented if we took that approach.

And we're going to get into that. I want to ask you all about what you think about diet and exercise and mindset related to this diagnosis. But first, I'm thinking, just based on what you're just describing, I want women to feel empowered to know that you can ask your doctor, say, I would like to have a DEXA scan or bone density scan, even though I'm not yet 65. I, 'cause if you show interest and you ask for it, they have the ability now to order it based on like the guidelines that be out there. And you can also, if your doctor is not willing, you can go to the imaging center yourself, right? You can just go straight to the imaging center and order and pay out of pocket for a bone density if you want.

Exactly, Dr. Doni. That's the thing. And that's my philosophy that unfortunately, We need to take this into our hands. And we're no longer the passive recipients. We have to be active participants. And that's why the knowledge is power. The more people can understand and, yes, ask for it. And if not— because it usually is covered. And now, as I said, they don't have to have these certain restrictions that they did. But yeah, you can get it yourself as well. But usually, if you say, you know, I have a family history, or I had anorexia, or I had all sorts of digestive issues, I had issues when I was young. I would like to see where I'm starting with my bones. There you go. You know, so—

And this is the thing, is that what we're referring to as this, what's often called a DEXA scan or bone scan, is the best way to know because you can't see your bones another way. I mean, and then you and I can talk about different blood tests and urine tests that help us monitor bone loss, but that's basically the way to find out if you have osteopenia or osteoporosis, right, is to just get a DEXA scan. And it's not like, Because some people then worry about, you know, radiation exposure and do I really want to go into this whole world of getting imaging? But from my perspective, just for me to, just to put my 2 cents on this, is to say, to me, I would rather get that information even from a single test so we know where you are starting from, and then we can be proactive. And even if the standard medical, then you start hearing about their, what they want to do or prescribe, you don't always have to—

Right.

You get to choose what you're going to do about it, but at least you have the information. If you don't know and you assume, then you might end up finding out the worst way, which is with a fracture. I can't tell you— I have patients who they ended up only finding out they had osteoporosis after having a hip fracture, and I would rather know sooner than that.

Absolutely. The thing is, it's so much easier To prevent bone loss, you can. I mean, the good news is there are things we can do now that actually increase your bone density and increase. However, it's so much easier, and what we want to do is prevent it. So the earlier we know, you know, just like you said, at 65, you could have had all these years from perimenopause. If you see that there's already bone loss, there's so much that could have been done. And so I agree. The thing about the testing, right? The DEXA is the gold standard. It's still the best we have. There is. You know, depending. But there is an imaging test called the trabecular bone score that I like people to have because that also— because the DEXA will just show bone quantity, doesn't show quality. So 2 people with the same number, one could have really healthy bones, and if they fall, they wouldn't fracture. But yet one could have very poor bone quality. So the TBS will show the bone quality of the spine, and it really does give us good information. So if it's your very first time, I would look, and you can just Google what places have trabecular bone score. And more and more places are getting it. And so that's something that if there's that possibility, but if not, just see where you're at. And just so you know, you have a baseline because, you know, and as I said, through menopause now, you don't have to lose bone, you know, like people just assumed they did in the past.

Well, and this is such an important topic. I talk a lot about helping women to understand menopause hormone therapy and the latest research on this. Because of course, for decades, the message in the media was to be afraid of estrogen. And, and now the latest research is, oh, that was wrong. And now actually estrogen has been shown to prevent bone loss. But the key is, right, if our— if we're going along with this estrogen before menopause, and then as we start to go through perimenopause, the estrogen starts dropping, all along with that, the bones are Loss is happening, right? So it's way back at the beginning of perimenopause when the estrogen starts dropping, so does your bone start dropping. And so by the time you get to the point where your period stops, it's already— you've already had some bone loss going on, right? So don't wait that long is what— why you're saying that.

That's the beautiful thing. And as I said, I was at this conference with conventional doctors and they made a big deal. What's new? The black box warning is gone. So everybody is now realizing that we missed the boat. We really led women down the wrong path for many, many years. And the funny thing is, my husband is an OB-GYN.

Oh, yes, that's right. I remember.

But the problem is now, because of that, you can't get bioidentical estradiol. It's so hard to get because everybody is ordering it like crazy. It's really interesting, but it's a whole different mindset now, which is so good for people that people don't have to suffer. And you know, prior to this, because my husband had been doing this way before that happened, and people weren't getting the osteoporosis because they were all on estrogen. But then the study came out that stopped. So there was a so it's a very good preventative thing. There's many other things to do, but it's something that I. I think, you know, it used to be you wouldn't go, you know, you wouldn't go on hormones just for bone loss if you felt fine. It was only if you had symptoms. But that's not the case anymore. They're seeing so many benefits and prevention.

Yes. And just women to know that even now the studies are recommending starting even estrogen therapy and potentially progesterone therapy with it before the official menopause, which is when— 1 year after your last period. So you might be starting Estrodiol and you still have your period happening in order to help prevent bone loss very early. And definitely if you've already had your period stop happening and you're not— you haven't already thought about and talked with your doctor about and started systemic estrogen, it's time to think about it based on this because we want to be protecting your bones. But yes, let's get into all the other things, Marjorie, because this is where you really specialize in saying it's Yes, estradiol is— we got to think about that. We got to, you know, see if that's the right choice for you and get you with a practitioner. And this is something I do in my practice, is help women get on the right doses of menopause hormone therapy. But we don't just stop there, right? There's, as you've been insinuating, there's so much more we need to do for our bones and that we can do for our bones. But these things we can do for our bones ends up helping our whole health.

Yes, that's the beautiful thing about this. Yes, that's what I love so much. And it's just been so rewarding because people do turn around and they're like, wow, you know, they're doing so many good things and they wouldn't have— the problem is this diagnosis is so scary that it really propels people into action. So, you know, no one wants to be afraid, but yet—

Sometimes we don't want to change our diet or start exercising, but then we find out our bones are Breaking down and we're like, oh my gosh, I better do something, right? Exactly.

Yes, exactly. So that's, that's the good part. Yeah.

So what is your, like, because I know you have these 4 pillars, what, tell us more about that. Like, what is, is that what that is, is talking about diet and exercise?

First thing is that people have to figure out what are their root causes. And this is what's missing. This is what's really missing in conventional medicine. It is not a one-size-fits-all approach. Each person is very different. If someone has digestive issues and they're not absorbing their nutrients, that needs to be dealt with. Inflammation, whatever it may be, if there's any kind of systemic inflammation, and it could be food, it could be food sensitivities, gluten's a very big deal in this community, but if there's inflammation, that's going to affect the osteoclasts, which break down bone. So any kind of inflammation is going to affect your bones. So we need to figure out what could that be. And so, you know, or if you're on certain medications, a lot of people are on proton pump inhibitors, you know, certain things really will affect your bones. So we need to figure out, are there any root causes? The other thing, and I'll just say this because I see this too often, is parathyroid, hyperparathyroidism, which your parathyroid— because what happens for some reason, Dr. Doni, I don't know the reason for this, however, In medical school, they're told if some— so I tell everyone, look at your blood calcium. If their blood calcium is over 10 and you're over 40, you really need to get that evaluated. It's more of an involved conversation, but you should check that because I've seen this missed. And what happens if the parathyroid glands are overactive? They're going to be taking more calcium out of your bones than necessary. And the only treatment for that is surgery. And the good news is it's benign. It's not a tumor. That, you know, there's no problem. But once you have the surgery, it's unbelievable. On each summit, you won't believe this, each summit I had 20 people just from listening to a parathyroid surgeon. Anyway, so we need to see—

It is. It's— I see it too, more people than you would realize. And so definitely, because I'm glad you're pointing out the blood calcium, because sometimes people see their blood work and they think that the blood calcium has to do with what you're swallowing in your diet. But it's not, it's about this gland, which we hardly ever hear about, which is the parathyroid gland. And its job is to manage the calcium from your bones into your blood. And so it has nothing to do with your swallowing. It has to do with the hormone function, the gland that's in your neck by your thyroid gland, but it's not to do with the thyroid. It's to do with the calcium management from your bones. And, and so what Marjorie's saying is if that, if those little glands, the parathyroid gland is over-functioning, it could be pulling calcium from your bones without you realizing it, and it's showing up as a little— it could even be a little bit high calcium in your blood.

Yeah. So look at your blood work because a lot of doctors miss this. There was recently a patient who came from an endocrinologist that my husband saw, and she had like 10.4. And anyway, she had to have parathyroid surgery, but this was crazy. And she also— he put her on estrogen and had this— and she had the surgery. In one year, are you ready for this? 14. This is unheard of, though, but it's true. 14% increase in her spine bone density. Can you imagine? But anyway, just look at that. But that's and there's a Dr. Diva Boone I was so lucky to meet, and I've had her on the podcast, and she's a parathyroid surgeon, and she has a free calculator on her site, so you can go and you can put your values and your parathyroid hormone as well. But anyway, the point is. It's something that's missed too often. And I guess for some reason in medical school, they learn, just watch it. But you don't want to watch it because you're losing calcium. You want to get it evaluated and make sure. Sometimes there are other reasons, but it's just something to check out. But anyway, so that's the first thing. Look at root causes. Just see what your root causes could be. Nutrition is key. We want to make sure we're getting and absorbing Calcium, magnesium, vitamin D, K2, those are the main ones. But, in general, protein is so essential. We really need these nutrients for strong, healthy bones and the matrix around the bones. The third one is my favorite, which I think moves the needle, and that's exercise. And, it is so exciting what the research has shown You know, I'd say over the past 10 years in terms of strength training and how women— how they used to say, you know, scare people, oh, don't lift too much, you'll fall apart. But now it's just the opposite that, you know, the bones respond to the forces placed upon it. So it's amazing what has been shown. And I see this every day where people are really gaining bone at all ages. And they keep gaining bone just from the exercise. So not that that's the only thing I would do, but it's been so empowering to see people get, you know, and when you're strong, oh my gosh, you feel so good. So we can go into that in more detail, like exactly what exercises, but the exercise and balance exercises too, because we want to prevent the biggest thing. It's not what our DEXA shows. The biggest thing is to prevent falls and fractures. So that we can live a healthy life. So all those— there's so many exercises that people can do to improve their balance.

And is there some that we shouldn't be doing?

Yes. The exercises, if you have osteoporosis or even osteopenia, what we should not be doing is forward flexion and rounding. So I don't know if you can see this, but it's the front of the vertebrae. So if you look at this, for those who can see this on video, the front of the vertebrae here, This is showing someone with osteoporosis. And they have— and so where the fractures occur, it's not in the back. This is the front.

Mm.

It's not the back of the spine. It's the front of the spine. So there's wedge fractures, and then there's compression. But if you took this— this one doesn't move— and you bent it forward, all the force is on the front of the vertebrae. So all of that rounding out exercises, those are in— and they've done— they did a study at Mayo Clinic They'll never repeat this. This is quite a while ago, but they won't repeat it because of what happened. And they showed that people only doing round— they looked at people over a 6-year period of time for fractures, and they wanted to see doing different exercises. So people doing backward extension had a 16% fracture rate. People who were only doing rounding, ready for this? 89% fracture rate.

Wow!

Yeah. So they'll never repeat this. But it makes sense if we're constantly putting forces on the front of the vertebrae that's already weakened. So not that you can't do everything, but when you're doing yoga and Pilates, you do things with a neutral spine. You don't do the rounding. You learn to do hip hinge, bend from the hips, not the waist. And so there's a lot of modifications. But that's the one thing that— and excessive twisting, not gentle twisting, but you're not going to do excessive torsion and twisting to the end because that's just putting too much torque. And it's not to do no— they used to say absolutely no forward bending. Well, that's not realistic. So the Canadian guidelines came out and they're not repetitive. You know, it's not— you want to try to avoid it, but you're not going to fall apart if you do that. But it's just not repetitive, not with weight, not sustained.

So you want to— Be mindful, like be more mindful of that. And that's such a good point to be aware of, like, because I don't think we would normally think of that. Like, Oh my gosh, who would have thought that it was, it was moving forward that would be more stressful on this, on those bones in the spine? So that— thank you for sharing that. And I think you have one more pillar you wanted to point out before we go into more detail.

Oh, and this one you'll love because this is totally up your alley and mine as well. This is something I think is the foundation, and that is reducing stress and increasing happiness. And people don't They— I'm telling you, people in my community, yeah, they'll exercise, they'll eat, but they don't appreciate how big a role this plays. But cortisol, the stress hormone, has been shown to increase cortisol. Chronic stress increases activity of the cells that break down bone, the osteoclasts, and reduces activity of the bone-building cells. And there's been studies on this. And happiness— happier people have increased bone density. So it's all about—

Isn't that something? That's so interesting.

Yes, but to me, it's the foundation because I have seen if someone isn't happy and they're stressed, they're not even going to have the incentive to get better. So when you can add this piece in, to me, it's miracles. I used to work with chronic— that's when I saw how this piece was so important, working with chronic pain patients. One of my first jobs was chronic pain, neck, back, all sorts of things, and people were miserable. You know, they were so unhappy. And I had just gone through a bad period in my life, and everyone's like, you're so happy. I'm thinking, gosh, if they knew what I'd gone through, they wouldn't have said that. But I realized I sort of was, despite my circumstances. Like, I actually was, that it wasn't based on my circumstances. So I started teaching them now what I call happiness habits, and miracles started happening. I mean—

Wow.

Neck pain, back pain got better so much faster, and people started Enjoying life. So I realized very, very early on, I was in my early 20s, I mean, very early on in my career, wow, this is really powerful. And so that's part of it.

I've done a lot of detoxes over the years, and many of them made me feel a lot worse. Not only that, but I've had a lot of patients come in and tell me how after doing a detox, they have a stomachache and headache And they can't sleep, and they're feeling anxious. And I'm like, I can't just recommend that my patients do a program that's going to make them feel worse. So I finally decided to design my own detox program. It's a 14-day detox program that's not like other detox programs out there in several ways. One is that I'm focused on helping. You to get the toxins out in a safe and effective way using nutrients, antioxidants, and supporting our natural detoxification pathways in the body. Also, I'm helping you to decrease your exposure to toxins by learning the ways that you've been exposed to toxins and how to change your day-to-day lifestyle to decrease your toxins Over time. And I'm helping you to look not just at chemical environmental toxins, but also emotional and energetic toxicity. And yes, it's possible to accomplish all of this in 14 days. I have so many patients who have done the 14-day detox and report back to me how much better they feel. And I think it's also because I help you to know what to eat. You are getting adequate food that tastes good, plus protein shakes that I developed that are good for your body, that your body knows how to use these nutrients and take them in and use them to help you safely detoxify without feeling worse. Also, I help you to balance your blood sugar levels, get better sleep, and introduce things like meditation, biofeedback, and other types of stress recovery into your day-to-day routine. So I just am so excited about it. I want to make sure you know about this 14-day detox. I'm going to put the link. You can find it at drdoni.com/detox-program, but I'll also put the link below so you can find The 14-day detox program at DrDoni.com. I look forward to guiding you through this detox so that you can actually feel better on your way to better health.

There's not one program I teach or any—that's why I call it Happy Bones Happy Life because I think this piece, as you can attest to, you are the queen of this.

Yes, helping ourselves to like process stress and recover from all that cortisol because cortisol. Not only does it disrupt the digestion, and you were talking earlier, like if we don't digest our food and get our nutrients, how's it gonna get to our bones? And if we, if we have imbalanced gut bacteria, that influences the bone health too. And so then, and then, then the stress disrupts our hormones, like our blood sugar and, and our potentially thyroid and estrogen, and that bothers our bones too. And then the stress, you know, it just piles up, right? This cortisol, either too high or too low.

Yeah.

is gonna make us more susceptible to all different health issues, including bone loss. So, like, if we go, wait a minute, actually healing the bones has to do with healing the whole rest of your body. And you're reminding us that it has to do with healing your mind and your mindset too.

Yeah. You know, that's why I love what you do because you integrate it all. You know, you look at the whole person and you figure out the underlying root causes and also deal— it's not one and the other. Do it all at the same time. Slowly though. I'm such a big believer. Do one thing. You know, start slow and don't freak yourself out. You know, people get stressed because, oh gosh, I have to do deep breathing. I have to do that. No, no, no. You see what you like and you know how good it is. And people sometimes think, you know, it's just the most selfish thing I can do to work on my own happiness. And it's just the opposite because it's contagious. And when you're happier, everyone around you is happier. The world certainly needs more happier people now. So it's probably the best thing you can do for yourself and everybody else.

What do you— if you could, you know, give us a little taste of your happiness habits and where people could start. Is there something they could start doing already just listening today to give it? And then I'm gonna definitely be sharing where they can get in contact with you and learn more from you. But maybe you can get us started today.

I think a couple of things. I think the first place is to not— to be a victor in life and not a victim. And you can tell if you're in victimhood. That's like, oh, poor me. And victimhood is, are you blaming, shaming, or complaining? And sometimes we don't realize— and shame is just self-blame. And the point is, if you're in that mentality, like, oh, poor me, I have osteoporosis, I'm going to fall and break my bone. And On and on and on. Nothing can heal. People do not heal. Their sympathetic nervous system gets activated. They don't heal. So it's a simple solution. It's, first of all, catch yourself, you know, catch yourself. Oh gosh. And sometimes I've had people do games where they put like a jar and they'll, you know, put money in like, oh, you know, because you don't think you do it. But sometimes—

Mm-hmm.

Or just even tap your wrist, catch yourself. And then what you want to do instead of focusing on the problem, You focus on solutions. Okay, you know what? I'm going to exercise. I'm going to reduce my sugar, and I'm going to start doing some deep breathing or whatever. But the point is, so that's one. And I think the second thing is the thoughts. I think we can get so consumed by negativity. And so if we can just— there's a couple of things to just increase the positivity in your life. So it's like waking up in the morning. What good is here? I know I don't currently see. Like, just start magnifying the good in your life. So, you know, looking for the good, number one. When something happens, savor it for at least 20 seconds. That's what they found. You can increase new neural pathways. So if someone says, you know, oh, Dr. Doni, I love your book, it's amazing. Ah, it was nothing. Thank you. You know, I really enjoyed writing it. Like, absorb it. You see a sunset, don't just walk by. Absorb it because that, you know, you just want to get more. And then if you do have a negative thought, there are ways to deal with that. But, you know, okay, you don't throw it in the closet because that's not effective. But, you know, you can question it. That's one of the things. But the other thing is, okay, so then you can counteract it by, you know, if something like by 3 positive thoughts. So yes, that's true. And this is true. So those are just some easy things To get started, but I—

Love those. I love those. And it's all about increasing the awareness about the thoughts we're having, because otherwise we're just consumed by these thoughts and we think we don't have control. But actually what you're teaching is like, hey, we can— we're not the thought. We can actually observe the thought, and then we can put it out in front and be like, okay, I see that thought, and is it really true? And Not that I am going to just push it away, but I am going to acknowledge it and accept it. And then I am going to look at other possible thoughts I could have, right? Like, oh, what could I be grateful for? Or what can I acknowledge? And then, then it— you become more empowered because you are actually getting to have some autonomy over your experience and your environment.

That is so true. Yeah. The thing with the thoughts is, is that your body does not know the difference if it is real or perceived. That is the problem. So, so often we are so worried and we're so worked up and we're causing all sorts of havoc over something that's not even true. So there's— I love the work by Byron Katie where you like look at a thought. Is this true? Number one, you know, you may say, oh yeah, is this absolutely 100% true? You know, and then you think, where would I be? It's called The Work for anyone that wants to look it up. Very powerful. Yes. You know, where would I be? How am I when I think this thought? And where would I be if I had a different thought? And then you make a new thought because it is so true. I mean, there have been times where you are giving a talk and someone leaves and you are like, oh my gosh. But then you realize that it was not. They had a phone they had to deal with. It is so common. So I think the thoughts are something that really makes such a big difference.

That's interesting.

There's many other habits, but— and your social life. I mean, they've done major, major resources on the environment and who you surround yourself with in community and how that's such an important part of being happy. But there's so many things. And the good news is it doesn't matter where you start. Everybody has certainly a happiness set point, but it doesn't matter if you're the biggest Negative Nelly. Everybody can raise that. That's what they found. It's exciting and it's so nice. Who doesn't want to be happier tomorrow than they were today?

You know, it is not about because of what other people want you to be. It's because it feels good within you and you're teaching us it actually helps your bones. So it's like, yes, of course. And everything else, even if you do it just for your bones, then it's like, tell me.

The thing is on happiness, they've actually— there was a nun study that showed people live 9, an average of 9 years longer. Your immune system's better. There's so much actual research besides the bones on what, you know, all these things. So—

Mindset. And we use this as well. I use this and teach this with HPV, you know, because it's another scary diagnosis, right? We get diagnosed with HPV and we're like, oh my gosh, and all the fear, and it's paralyzing. I think that same thing can happen with osteoporosis, right? It's paralyzing and you just think, oh, I'm going to have to put on bubble wrap and do nothing. And actually, That's the worst thing you could do. We actually need to take it as an opportunity to say, hey, what can I do? Even in little small steps with support, with guidance to actually help your body heal. The bones are— it's not that it's just set because sometimes there's this perception that there's— once you've lost bone, there's nothing you can do. But you're not saying that. You're saying even if you've already lost bone, there's still hope.

Yeah. You know, that's what's so fascinating. Yes. And the interesting thing is, so yes, we can increase bone with exercise. We can. But I have to say that, you know, because I remember after my very first summit was Natural Approaches to Osteoporosis, and I didn't bring up medication at all because I wanted people to see the other part of it. But the truth is nobody wants to fracture. And the good news is that For people who really are at high risk, the medications now are very different than they used to be. So you— I still— it's critical. It's not like some people think, okay, I'll either go on medication or I'll do the natural approach. It's not like that. You can use medication for a short time to get you over the hump. The new medications build bone. And so there are plenty of people that are on it for a short period of time. They build the bone while they're— excuse me— while they're working on all their root causes. So it is an option. And if somebody— if you've already had a fracture, if you're— there's different situations where it is appropriate. And it, you know, so, but the new medications build bone. So there's so many things, there's so many ways when you get rid of root causes, you can improve your bones. So there's just so much that can be done. And that you know that you can live a vibrant, healthy, and you're stronger. I personally do the Onero program, which was which was based on the research out of Australia. So I see I've gotten really really strong. But I see all the other women, people in their sixties, seventies, getting so strong. They are changing tires. They're lifting their suitcase. You know, it's just so wonderful to see and. It's, you know, and eating better. So every— you know, that's the other thing, because you're dealing with root causes. Someone's had constipation or GI issues forever, and, you know, a lot of times we just sort of poo-poo things like, oh, everybody has these issues, no big deal. But when you want to start working on the root causes, then all of a sudden I'm like, oh, wow, that feels better, and my eczema's gone. Yeah, it's good.

Yes. Well, tell us more about the exercise part. I mean, you're talking about getting stronger. So, and, and yeah, what is Because I know you also have, and I'm going to have a link for everyone to see if you want to get access to your— first of all, you have a free exercise series, but then you also have an exercise bundle. Is that where people can learn more about what do you suggest for exercise?

I would start with the free exercise, the things you can do safely. So I really believe, I mean, the best thing if you can is to really see a physical therapist. I mean, that's the absolutely best thing who who specializes in osteoporosis. But regardless, you need to do things safely. So what I put together was like a starter thing because posture is so important. You know, just like we talked about that rounding, so many people during their posture. So there's certain really easy exercises that you can do throughout the day. So in that handout, and that's free, it's in videos. I think it's over 9 videos. So I show people how to sit. It's a good exercise. For the neck to put that in the shoulders, and there's a little tai chi qigong exercise. So easy things that you can do that make such a big difference in your posture because you can't tell someone, "Oh, keep your head here." It doesn't work. But what I found as a physical therapist teaching posture for forty years is quite honestly is that if you do these simple exercises, like super simple three to five times a day, it reminds your body and it. We've been doing this in the state of New Jersey. There's a couple programs that I'm involved with, and it's amazing how people have improved. It's so wonderful. So there's posture exercises in that. There's a video on with six balance exercises we talked about because you want static balance, like lifting one foot up, but then you want to move. You know, you want to have your feet, but you want to be able to move. So I showed two qigong things where you're going back and tai chi where you're going back and forth. And that's been so helpful because if you practice that and then you're walking and you hit a rock or something, you've got this. And so many people didn't fall because of that. So, anyway, so there's some easy balance and then 2 weight-bearing exercises that are easy to do during the day because, you know, it's good to do the impact also, you know, like jumping and things, but you don't want to start there. So these are just gentle stomps and I demonstrate how to do that. So that's all in That hands out, but then I have a community, and every month we have different classes. And I've had so many different physical therapists and people come and show different types of exercise programs. So in that bundle, there's—I'm very big into qigong. So we created something called Bone Strong Qigong with another—with a qigong master—and because we want to prevent falls, but it's so good. It's stress reduction and balance. So there's. That's in there. There's different—

Oh, wonderful!

Yeah, so lots of things. People can look into that. So, the key things you want in your program, you want to do the strength training twice a week. You want to make sure that you're doing strength training. And it's not just 5 pounds. It's more like the study— not to do this on your own, but the study that really moved the needle, that study from Australia, it was called the Lismore Study. What did they do? They did squats, but weighted squats. They did— what is it called?

A shoulder press?

Shoulder press. Yeah, you know, when you lift shoulder press. And deadlifts. And then you're lifting up and coming down on the feet. So the impact— not— but there's— but you need to learn how to stabilize. You need— but the point is, it's the resistance that's very important. So you want that to be part of it twice a week. You also want the posture. You want the balance. And then aerobic also. You want to be able to have that aerobic capacity. So all those components, you know, really make a comprehensive exercise program. But yeah, so I have all sorts of resources to help teach people. And in that program, in the program, the exercise bundle, the first class is teaching you how to stabilize. You know, how do you breathe? So you're making like a corset, so you're stabilizing and helping your pelvic floor. So, so yeah, lots of good stuff. And you—

I love it. Oh my, that's so helpful. Thank you for creating that because people can access it from anywhere. It's an online resource.

Oh yeah, everything I do is, is, is online. And not that I always— as I said, I think it's great if you can work one-on-one with a physical therapist, but You know, I, I just find it important to bring the best people who are really the experts in the field, bring them to people all over, all over the world actually. They come. So it's— we have fun too. I have also live classes that every month people can come to. So lots of good stuff.

I love it. And I'm definitely gonna— I'll have you— anyone who's interested, we'll put a link here so you can go check it out some more and, and, um, and join in there. And as well as you have your Happy Bones Roadmap. How is that different?

Oh, the Happy Bones Roadmap I created after the summit, Doni, when— Dr. Doni, where there was so much information. I had a lot of information. And people were a bit overwhelmed. And overwhelm is really our enemy. And so what I wanted to do, I wanted to make it simple. So there's 4 classes. And the first class is on evaluation. Like, what are the key tests you need to get done? And I explain that. The second class is on exercise. You know, what are the concepts so that they understand? Oh, and that's also in that handout, you know, exercise concepts, but this way in much more detail and to exercise really what you need to know. So, because you, as I said, you need to be the person who understands it. It's not like, oh, Margie said do this. Well, why? If you don't understand the why behind it, So that's the exercise class. The third class is on nutrition. You know, what do we need? What are the supplements in detail? And the last class is stress and happiness and more more tips and things. But then I have in that in that program, I also have different things. I also have a pelvic floor class with a pelvic floor physical therapist. I have qigong class. I have a strength training class. So I have I have, um, and it— I have like 6 or 7 classes in there. So yeah, so there's some other exercise classes that I also added to give people resources for that too.

So it sounds like it's like, wow, you can just go really in depth on all of these topics and be able to get like the full instructions. This is what Margie says, just do this, this, this, this. And then, and then what kind of transformations do you see in the— in your community, people following this approach?

It's so exciting. That's been the best part because I've been doing this for so many years. And so what I see is that people are empowered. They become much stronger. They also, you know, they're eating better. So they come back and they really say— because I always say, to me, the diagnosis of osteoporosis is an opportunity. It's an opportunity to look at your life, see what areas may be missing, and then And then make the changes. So when people do, honestly, they'd say this was a blessing because the majority of people really don't fracture because they're doing things. Now, again, there are people who have horrible bone density and they say, under no circumstances will I do medicine. You have to be— or they've had already numerous fractures. So you have to look where you're at. But I think that regardless of what they've done, there are people who Even, I mean, people who go on medication and they do all these other things and they're good. You know, people have really been able to, you know, enjoy life and be active and not let this bring them down. If anything, they've made changes that have benefited their life. So that's what I see. I see it all. I see people's bone density increasing. So it's possible. And, you know, as I said, I see this in my exercise class. It's quite— the program is called Onero, by the way. Oh, how do you spell that? O-N-E-R-O. Okay. And have it now. It's so funny because I interviewed Dr. Belinda Beck for my summit, and she was the person in Australia who did the research on this. And I asked, I said, because there were clinics all over. So then they took the— because they had such good research and they wanted to see, does this work in the clinical setting? You know, and it did. And so, and so I asked her, is there anyone in the United States doing this. And this is a couple of years ago. Now there's a lot of people. She said, there's one person. I said, oh, you know, where is this person? Somerset, New Jersey, 25 minutes from me. So I immediately, I said to her, you know what? So I interviewed that woman. I met her. Her name is Dr. Claudia Tomas. And I said, you know what? I'm gonna come myself. Even though I do strength training, it wasn't this level. And so I am— took me a couple months to clear my schedule. I go there and And everyone was there because they heard her on the podcast. Can you imagine? It was like so exciting to me that people took action. And so, yeah, so I see people transforming every day. Their posture is better, their bones, their numbers are better. It's just so exciting. So now it's all over the United States. Now there are people doing this. And not that that's the only program, but that's a very good program.

Well, it makes me curious because you before mentioned in the Lifemore study what they were doing. What is the difference with Open Access?

It's a study. It's a LIVEMORE study. So that's the main exercise.

Oh, okay.

Not everybody can do everything, and you can't just go into doing that. You have to learn how to stabilize. So there's, in each person, the beautiful thing about the Onero, because physical therapists, you know, you can't just be any old exercise instructor. You have to be a physical therapist, and I think exercise physiologist in as well.

She would teach it. Okay. Amazing.

They're always qualified people who are going to evaluate you first and meet you where you're at. So a lot of people aren't ready to do that, but they can do a smaller thing. And then there's other things that they put in, too. But that's the basic program that showed these increases in bone density, which is so exciting.

Well, do you mind if I ask, like, because I know, like, I mean, I'm a Pilates lover. What do you think of Pilates and some of the other—

I love those. I absolutely love Pilates. And yoga. I think they're fantastic. And it's interesting because when I was working one-on-one with people, there were people who didn't want to do any exercise. And I knew a good Pilates instructor near me who understood osteoporosis. And so, you know, and they gave them resistance and they increased their bone density as well. The thing with— there's very— if you go to the Bone Health and Osteoporosis Foundation, there's a very good friend of mine, Dr. Sherri Betz, created these 2 handouts. And you can just go under safe exercises. I'm trying to think what I'd say. I made a tiny URL. I'm pretty sure it's tinyurl.com/safemovement or movements, but you can just go to their site under safe movements. And they have the yoga flyer. They have the Pilates flyer. And she made like what's safe and what isn't safe. The best handouts are very good. Yeah, so no, I love those. But you just take certain precautions and there are just certain things you don't do. But I'm a huge fan. Love, love, love all that stuff. Yeah.

I love it. And what is your perspective on some of these devices that are coming out? You know, we're hearing a lot about Osteoboost lately and vibration plates. And what do you think?

Okay, so I will give you my honest opinion. I happen to really like the Maradyn low-intensity vibration unit. That's the one I've been using for like I think it's like 8 years.

Maradine. Okay.

Because it's low intensity. I am not a fan of the high intensity vibration because they found you just need a certain stimulus to stimulate the mesenchymal stem cells in the bone marrow to turn into bone and not fat. And they found that with it, you know, there's certain parameters, so it doesn't have to be that high intensity. So it's low intensity at a certain frequency. So I love the Maradine. Low-intensity vibration unit. I'm not a fan because there have been people, you know, they tell you to bend your knees, not shake your heads. You can get retinal detachments. It's not common, but I, I just always believe in not putting yourself at risk. So I'm a bit— I mean, there'll be other people who will speak differently than I do.

And some people are sensitive to those high vibration places, can trigger, yeah, even, even like histamine reactions. So I love that. To know.

The other thing that I think with is that they— there's something called ISO. I think it's 26. But they do— they look at people in the workplace, and they look at vibration in the workplace. And those levels that they shake you at are not safe for even a couple minutes. So people, you know, if you— if you look at it in that perspective, I've interviewed Dr. Clint Rubin, who— who does— who did the research at NASA on everything. So Mm-hmm. You know, he's very against those. I mean, he's also involved with the low-intensity vibration, but there's, there's data. So, so I don't believe in that. Now, I'll be very honest about the OsteoBoost. Okay. So it's been sensationalized all over. Right. And, you know, it's the same. They use the same research on vibration. But when you look at— you have to be really careful when you look at the research. So the goal was for osteopenia. It was never for osteoporosis. And when you look at the research, you know, their goal was, does it increase bone density or does it prevent bone loss? And that didn't show. That didn't show. It didn't show that. What it showed— so they didn't achieve what they wanted. So then they go back and they say, is there any possibility? So at one vertebrae, L1, it was a little less That was all they could find? All they could find, but it was sensationalized where this, it's so simple. And the other thing they didn't say is during the study, there were people who had to get out because they had low back pain. So, you know, so to me, do the exercise, go, you know, work with someone if you have issues, and that we know increases bone density. You know, to me, I just don't see, I don't see the need and it's one hip. There's so many things you can do to put forces on the hip that we know work. So, anyway, so, yeah, the research and they published something saying, you know, I don't think this is good research. So, yeah, so it's surprising to me.

Be mindful when you— it's a good reminder whenever we see these products that are being marketed, you got to dig deeper and say, was this actually based on research that was showing that it was effective? Because otherwise, you're going to buy a bunch of different things that may or may not help when you could just come back to the basics that do help. I love that message that you're giving.

Oh, it's true. And I get so upset when I see things, you know, they sensationalize. They'll take one piece of something out. Weighted vests, another thing, Dr. Donni. Everybody's wearing weighted vests. So, the truth is they have not shown that they're good for walking around the house or anything like that. Yes, if you use them in an exercise program to add more resistance, but that's the only way. They have not shown people wear them all day or they're walking and it tightens their walk. You know, I've seen people injure their shoulders or their knees are sore. That's not— it's not enough weight to increase bone density. So to wear it and make yourself tight, and it's not shown in the research, but yet you see people wearing them all over. Again, I'm not against it as part of an exercise program, but not the way that people are using it.

Oh my gosh, thank you. Thank you though for sharing this because otherwise you, you know, you might hear these trendy things and then think it's gonna help, but it's— and you've been researching this and really helping.

I research everything because I don't want people spending money. I don't want— you know, you want to do what works. You have limited time, limited resources. You want to put your efforts on what, what you know can help.

Absolutely.

And so I'm doing the research and, you know, yeah, and it works. That's the good news. Yeah.

Oh my gosh, I'm so glad. And thank you so much for sharing. And one more thing I wanted to ask you about, because I know you and I've talked about this before, is about some of the blood tests that we can use for monitoring. Because a lot of times in the doctor's office, they don't know about these tests. And I found them to be very helpful. Blood and urine tests, but I mean there's there's several of them that you could do. But what I end up finding a lot of times as a practitioner, like when when say a person starts in with some exercise and some diet changes, and we get some get the supplements going to support on that level as well, and addressing nutrient deficiencies and all those root causes you were talking about. But you you can't you're not going to redo another dexa for at least two years. But it's nice to know in the meantime. That it's working, that something's happening. And so that's where as a practitioner I find it's helpful. Like, I'll one of the easiest ones that's most helpful I find is to run the CTX, the C-tilopeptides. And now if you ask an internist or GP, I tried this on recently with and they they may not know the test and they may not order it for you. But it's worth asking because I always feel like it raises their awareness that this test even exists. It should be ordered and it should get covered by insurance. But if not, it is a test you can order out of pocket, right? The C-telepeptide at least give you a sense. But tell us your thoughts on CTX and any other tests you think are worthwhile.

I think everybody should get the CTX. The good news at this meeting I was at, conventional doctors, they were saying that, you know what? It's very valuable. So I think—

It's coming. It's going to become more awareness about it.

So, I love the CTX. I think get that right away because you don't know. You get a DEXA, are you actively losing bone? It shows you bone breakdown. And I also get the P1NP. And I like the P1NP to be at least— that's the bone-building one, the propeptide of type 1 collagen. It's a long word, P1NP.

Yes.

And we like it to be around 1/10, at least 1/10 of the CTX. So, you get to see What's going on? But I think it's incredibly valuable, and if you're going to go on something, you know you need to know. Is it working? Is it not? You're not going to wait till the dexa. So I have everybody get that. I think it's super important, and it's so helpful.

I couldn't agree more. I'm glad to hear. Yeah, so you can. So yeah, right. We'll put it in the notes. If you're missing any of these letters, don't worry. We'll have it down below: CTX and P1NP. So you can be like, okay, we need to know. Are you? Because this is a good point. Women will say to me, well, well, isn't the dexa enough? But the dexa is kind of showing you. What's— what, from your whole history of your life up to this point, where's your bone density? But what we want to know—

We don't know if you had anorexia as a kid. You know, you don't know, are you actively losing bone? So yeah, I couldn't agree more with that, Dr. Doni. Absolutely.

The CTX can tell us in this moment, based on what you're currently— your activity, your nutrients, are you losing bone? And then the P1NP, are you gaining bone? So, you can start to see if it's working, if what you're doing is helping.

Yeah, that's the most important one. I mean, there's other things I like— homocysteine to see about inflammation. I also like blood sugar matters with bones. But I think if you're going to go, start with your doctor. Get the CTX. I think that's just super helpful and it'll really give you so much more information.

And then you can— you want to get it under 500 or what do you aim Oh, you know what we do with—

I work with Dr. Kim Millman and Dr. Keith McCormick. What we've found, actually, the values, we like it to be under really 350. We find—

Ah, so under 500 is kind of like at least, but if you can get it under 350, it's even better.

We like that. And we like between 350 and 400 is questionable. But we've found, and these are Dr. Keith McCormick, has done this for so many years. And Dr. Millman—

I'm familiar with him, too. Yeah.

So he's been really looking at this, like, where are you really losing bone? So he has found really above 400, most people are losing bone.

Still, okay.

But when people have like 850, and, you know, that's something serious. We really— that's like a red flag, something serious.

Let's get it down at least under 500, and then your goal becomes under 350. I love that. I love that. Thank you so much, Marjorie. This is like This is going to be such a good resource for the How Humans Heal audience. I really appreciate it. And everyone, please know Margie's there for you. She, she's got all these resources just waiting for you to discover. So thank you again. So it's such a joy to get to talk this through with you. Thank you for joining us today.

Doni, it's always such a pleasure to be with you, and thank you for inviting me.

Of course. And thank you all for joining. If you're new to this How Humans Heal audience and community, then I welcome you to join us. You can, you can subscribe to my newsletter so you don't miss the next episode, or subscribe on YouTube. And I look forward to connecting with all of you again very soon. Thanks again, Margie. Thanks for listening to How Humans Heal. If you liked this episode, leave a rating and a review. And for more resources, visit drdoni.com.