Why Bone Health Matters for All Women with Kevin Ellis

Hi, I'm Dr. Tabitha, the gutsy gynecologist. I'm a triple board certified, OB, GYN and Functional Medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey. And I'm super excited to share my wisdom and unique perspective as it pertains to women's health. After caring for thousands of women, I've come to realize that your gut health determines your gyne health and your overall health. And it's a super gutsy thing for me to go against conventional gynecology practice to bring you the truth. No more band aid medicine, ladies. We're talking root cause resolution on this show. So if you're struggling with hormone imbalance, weight gain period issues, anxiety, insomnia, you name it, then you've come to the right place. And I want to be your gutsy gynecologist. So welcome. Hi ladies. Welcome back to the Gutsy Gynecologist show. Sorry for the scratchy voice I had Covid again. I pretty much recovered except this voice issue. So hopefully it doesn't act up too much today. But I have an awesome episode for you. And this is not just for older ladies. So I know you think osteoporosis, you think, oh, that's not my problem. I don't need to worry about that until later. But my guest today is going to tell you how he. Yes, it's a man was diagnosed with osteoporosis at 30. So it is something you need to think about because there's huge sequelae that are associated with getting osteoporosis. So you're gonna really enjoy this episode. It's super important for all of us to. To know about this and to share this with everybody else that we know too, because so many people are affected and they don't realize and then they go on to have other issues following that diagnosis. So I am here to preach early prevention and intervention so that we don't end up with these disease processes and all their resulting sequelae. So I just want to say thank you so much for all the amazing DMS that I get and the reviews. Like, you guys are so awesome. I appreciate all the love. I. I appreciate that you're following me on Instagram and you are enjoying my posts. Like, I'm really trying to educate and get the word out there about all of the conditions that we're struggling with as women and essentially how conventional medicine is failing us. Right. And we really do need to get to the root cause of these issues. We need to be asking why and figuring that out and really tackling things as opposed to just putting a band aid on them. So today we're going to talk about not only what is osteoporosis but but like, why is this happening? Why do women get it? How do we prevent it, more importantly? So this is a really awesome episode. Let me sing Kevin's praises really quickly. Oh my goodness. So Kevin Ellis, he's better known as the Bone Coach. He's a Forbes featured certified integrative nutrition health coach, podcaster, YouTuber, bone health advocate, and he's the founder of Bone Coach. So after an osteoporosis diagnosis in his 30s, which he's going to tell you about, which is crazy, he realized just how challenging it can be for the average person to make sense of what needs to be done to improve and how to move forward confidently with stronger with a Stronger bones plan. Today, not only has he transformed his own health and made continued progress on his own journey, he's now dedicated his life to helping women with osteopenia and osteoporosis gain clarity and confidence that improving is possible. So I love pain to purpose stories and I just, he is on a mission. He's doing this for all of us, which I just think is incredible. And he's, you know, adorable. So if you want, you don't need to even listen to this episode, you can watch it on my YouTube channel, the gutsy Gynecologist and see Kevin in real life because you're just going to really be drawn in to what a sweet, caring person he is and the fact that he's doing this for us women and he's having incredible results and I'm just really excited to talk to him. So he has this whole unique three step process. He has world class skill coaching programs that he and his team have like put together to help women get stronger bones. So he is actually on a mission. He's not to not just help over 1 million people around the globe build stronger bones, but to help our children and grandchildren have the education, the resources and the nourishment needed to prevent osteoporosis and other diseases in the future so they can lead long active lives. So I love that he's paying it forward. He's thinking about leaving a legacy. I think that's so important, you know, and he and I touch on the effects of birth control pill in this episode and other forms of birth control and how they affect our bone health. And right after this, he interviewed me for his podcast. So go check that out. As well. Well, I'm not sure which episode is airing first, but definitely check out Kevin Ellis, the bone coach. So here we go. Well, welcome, Kevin, to the Gutsy Gynecologist Show.

Tabitha, thanks so much for having me. It's great to be here.

Oh, I'm excited for this conversation because women are so misinformed about osteoporosis, and I don't think a lot of women realize the severe implications it can have on their lives. It's like a silent killer, right?

It's a silent condition. So a lot of times people don't really understand they have it until, you know, a fracture or something like that happens. So it is something that is an important thing and even some of the statistics around it, like, We've got approximately 10 million Americans that have osteoporosis. We have another 44 million people that have low bone density. One in two women and up to one in four men are going to break a bone in their lifetime due to osteoporosis. For women, the incidence is greater than that of heart attack, stroke, and breast cancer combined. That's huge. A lot of times people think about hip fractures, too. Like, they saw their mother or their grandmother or something like that. They had a fracture six months after a hip fracture, only 15% of the patients can walk across a room unaided. And then every year, of nearly 300,000 hip fracture patients, one quarter of them end up in a nursing home, and then up to half of those people never regain previous function. So those are pretty alarming statistics, right?

Yeah, it's very scary. So. But that's not why you went into it, right? Like, tell my listeners, because everybody's like, why is there a man talking about bone health? You know, this is a menopausal women's disease, but it's not, is it?

No, it's not. That's not always the case. And so for me, for my personal journey, and I'll even start, my health journey kind of started when I was a lot younger.

I was.

When my mother was five months pregnant with me. My father, he was told he had cancer. And two months after I was born, he passed away. And he was 35 years old at that point in time. He was a marine in Vietnam. He did 22 months in Vietnam, survived combat. He came back home and he got cancer from Agent Orange, and he passed away. So as I was growing up, I mean, I always knew I was going to be a Marine. But then I also had in the back of my head that, you know, my fate could Be the same as his. That I could pass away at a really young age and I might not have as much control over it as I thought I did. So I. After I got out of the Marine Corps, I went and I started having these different health issues. I had poor sleep, high stress. Some days I could barely get out of bed. I didn't have that energy. It was affecting all aspects of my life, my relationships, everything like that. And then I got to the point where I was diagnosed with celiac disease. So this is a condition where it's an autoimmune condition where when you ingest gluten, it damages the villi, your tiny little absorption centers in your small intestine to where they can't do their job, they can't absorb your nutrients. And that was happening to me. So I was going about my daily activities. I wasn't taking in the nutrients I needed. And then my body was going to the bones, its greatest mineral reserves to pull those nutrients. And then I was subsequently diagnosed with osteoporosis. And that's how this became a very real thing for me as a young male. I was shocked. I actually, I got a letter in the mail. It wasn't even an in person visit. It was a letter in the mail that said, you have osteoporosis, go on a gluten free diet. And that was it.

Oh, my gosh.

And I was like, I was like, this can't even be real, right? Like, I knew something was wrong, but I was like, I can't even believe this is real. I have to go get a second opinion. So I went, I got a second opinion and I went. And they actually confirmed I, in fact had osteoporosis.

And how old were you, Kevin?

About 30 years old at that point in time. Wow.

So.

And at that point in time, I felt like I was living the nightmare I always feared I was going to live, which was passing away at an early age, like my father had. And I had kids on the way, young kids on the way. And I was just really worried that I wasn't going to be there to be the father. Mine didn't get the chance to be for me. So I had a really strong reason to go and start reading and researching and consulting with different people and spending a lot of money on different foods and supplements and all this. So I went that path and I started finally making progress. I was improving my health. I felt better, I had more energy, and I was getting to the point where I was actually improving my bones too. And it was through this whole process, in this journey, I realized it is not the average 30 year old male that is dealing with this. It is the woman, just like you started out talking about. It is the woman, 40s, 50s, 60 plus, that gets told they have osteopenia or osteoporosis. And they're presented with four, four different options, calcium, vitamin D, go for a walk and take a bone drug. And that is woefully inadequate.

Right.

That's just. There's so much more to that picture. And that's really the reason why I started Bone Coach and founded bonecoach.com oh my gosh.

So it's so important for women to realize that they are not getting adequate care. So there's so many ways that we're dropping the ball. In conventional medicine, we're not addressing the issue until it's diagnosed. Right. And Medicare doesn't even pay for a bone density scan until the age of 65. And so you wait until you have osteoporosis to do anything or ever think about it. And then like you said, you're given these four treatment options and they're grossly inadequate. And most women go on to have a fracture and hospitalization and possibly death. So let's unpack all of this. It's so important. So I would say, you know, the vast majority of women listening are probably in their 40s. And so should they start thinking about health, their bone health now, or should they wait until they have a bone scan done?

There's never an early enough time to think about your bone health. Right. So I think what would be helpful is I'll just walk you through what, what, let's talk about what osteoporosis is, how you understand if you actually have it and what that looks like, and then how to know what you could have done differently or you know, how that could have impacted you at a younger age and then also through your current age right now. So osteoporosis literally means porous bone. And it's a condition that's characterized by either not enough bone formation, excessive bone loss, or it's a combination of the two of those things. And in osteoporosis, what happens is both your bone density and your bone quality are reduced and that is what increases your risk of fracture. So the way you find out you have osteoporosis is through what's called a DEXA scan. That's dual energy X ray absorptiometry. It's a painless test, kind of like an x Ray, but very low levels of radiation. So you lay down on this machine, it does a scan and it tells you the actual mineral content of your bone, your bone mineral density. And then what it does is it generates a score. And that score is called a T score. And the T score is telling you how much your bone mass differs from the bone mass of a healthy, approximately 30 year old adult. Right. If you have a score of plus one or minus one, you're going to be told that's normal. If you have a score of minus 1 to minus 2.5, that's going to be considered osteopenia or low bone mass. And if you have a score of negative 2.5 or lower, so you have 2.5, negative 2.6, negative 2.7, so on and so forth, that's considered osteoporosis. And the greater that negative number becomes, the more severe the osteoporosis. So most people are not getting these scans like you and I just talked about. They're not getting these scans until their 50s or 60s or later. But that's too late in my opinion. Right. They're getting them as a check in the box. But if we're listening to this now and you haven't had a bone density scan, you don't know just what a baseline is. We need a baseline measurement. Let's get one. Let's get the objective information because you want to know, you know the information so you can monitor future changes. That's, that's going to be really important. And the other part of this is that we don't want to avoid getting something just because we're not happy with what, or we think the answer could be something that we don't want to actually deal with or face or that we're not going to be happy with. So you always want to have that information with you. So that's really important.

Yeah, I think that's a really important point. And you mentioned for you it was celiac disease and you had to avoid gluten because that was triggering the celiac. The celiac was triggering the malabsorption. So you were stealing the minerals from your bones. And some people are like, well, I don't want to know all that. Right. But it saves your life and it saves so much heartache and pain for your future. I mean, it really saves your future. So what are the major causes? Because celiac is kind of an uncommon cause. What are the major causes of osteoporosis?

Yeah, so there's actually a couple of different types of osteoporosis. So there's primary osteoporosis, and that occurs as a result of the decreased in estrogen and hormones in postmenopausal women. Right. Estrogen has a protective effect on bone. As estrogen levels decrease, as they do during menopause, that's going to cause an increase in the activity level of cells that are breaking down bone. But then there's a whole nother cause of osteoporosis, and that's called secondary osteoporosis. And this is the category I fell into. And a lot of people that are in their 30s or 40s or 50s, even their 60s, too, have or had a secondary cause. Secondary cause or secondary osteoporosis is the result of behaviors, conditions, disorders, diseases, and medications. All of those things can contribute to bone loss and eventually lead to osteoporosis. And what is really important to understand is just because you're a postmenopausal woman does not mean that is the sole cause of your bone loss. Right. There could be more than just hormones, and it could be another cause. So we have to make sure we objectively address all of these things and some of the more common causes. I would say, you know, medications can be a big contributor to bone loss and osteoporosis. One of the first ones that always comes to mind when we're talking about medications are prednisone and cortisone. Right. Glucocorticoid steroid medications are designed to suppress inflammation. They mimic natural steroid hormones in your body, and they're often used to treat conditions like asthma and autoimmune conditions like rheumatoid arthritis. Those. And two of the more common ones are prednisone and cortisone. Now, if you are taking this medication or you're considering it, just know going into it, it will contribute to bone loss. Okay? And the reason for that is that it. It's going to reduce the GI absorption of calcium. It's going to increase your urinary excretion of calcium. So you're going to have a calcium deficit. And then the glucocorticoids themselves are acting directly on osteoclasts, your bone resorption, bone breakdown cells, to increase their lifespan, which is going to reduce your bone density. Okay? So know that going in, or if you're using those medications, just know this is. This is something that's important. Another medication that a lot of people aren't aware of that contributes to bone loss. Selective serotonin, reuptake inhibitors, ssri. This is a class of drugs that typically uses antidepressants. Right. And there was one review of 19 studies on the effect of SSRIs on bone that indicated they have a negative effect on bone mineral density and they increase the risk of fracture. And then the last medication, I mean, there are other ones too, but I think probably the next biggest bucket that a lot of people use antacids. A lot of people take these medications. I'm sure you've seen this. A lot is a lot of people take these medications because they think they have too much stomach acid. A lot of times when we think we have too much stomach acid, we actually have too little. And then we go and suppress what little stomach acid we do have with Proton pump inhibitors, PPIs, omeprazole Nexium, Prevacid, H2 receptor antagonist drugs like Ranitidine and Zantac. And, you know, Tums. A lot of people think TUMS is a good source of calcium. It's. It has calcium in it, but it's calcium carbonate. It's not even a good form of calcium too. So the reason that's a problem when we're suppressing that stomach acid is you need stomach acid to properly break down and extract nutrients from your food. Right. Like amino acids, the building blocks of protein. Your bones are 50% protein by volume. So you need amino acids, magnesium, iron, calcium, B12, all these ones. If you have low stomach acid, you're going to have a challenge getting those nutrients. So those are just some medications that can be contributors to bone loss. There are other contributors too, for sure, but those are some of the big ones too.

Yeah, I think that list is so important. Oh, my gosh, you're speaking my language. And I will tell you, the majority of women that come to see me are on those medications. It is now standard of care for OB GYNs to prescribe antidepressants for menopausal symptoms. So here you have a woman who is going into a hormone deficit. Her hormone levels are going low, she's gaining weight because of it. She's turning over her bones more often and losing her bone density. And then you put them on this antidepressant, they gain more weight, they lose more bone. Like what a setup for a disaster. I just, we're failing women, you know, so I'm really glad you brought that up. And the proton pump inhibitor, so many women are on these. And when those were first created, it says clearly, like, this is for a four to six week use of acute symptoms. And women are on these for years.

I've seen 10 to 20 years. Sometimes we've been on these medications.

It's heartbreaking. It's just, it's not okay. You have to wean off of it. And just a side note, like that isn't something that you can just stop taking. If you've been on for 10 or 20 years, you usually have to wean off of it with a functional doctor who knows how to actually support your digestion and get that stomach acid back to where it needs to be. Because like you said, it's necessary to digest your food. The other big medication I think of is like medoxy, progesterone acetate, Depo Provera shots, the nexplanon rod in your arm. We now know that women as early as their 20s, when they're on this birth control, they have significant bone loss and they poo poo it. They say, oh, it's reversible, it'll come back. I'm sorry, but most of these women are on these birth control for 20, 30 years until they go into menopause. There's no reversing that bone loss at that point. Right. So women need to start thinking about this. And I love the idea of getting your bone scan, have a baseline, see what your bone health does look like at this point, I think it's so important. So they're going to do that test, say it comes back with osteopenia. What do we do? Tell me what conventional medicine does and then tell me what the bone coach does.

Yeah, so. So in terms of conventional medicine is usually, usually going to propose a medication. Right? And a medication. When we're talking about osteoporosis, bone medications and bone drugs, these are not like taking an aspirin. Right. These have a dramatic effect on bone physiology. And there are two different categories of these drugs. There are antiresorptive drugs and anabolic drugs. Antiresorptives are designed and anti resorptives would be your bisphosphonates, like Fosamax, Boniva, you know, some of those other ones reclassed. And then you've got rank ligand inhibitors, which are Prolia. Okay. Those are the big ones. You've probably heard these if you've had this conversation with your physician. These drugs are designed to slow down the activity level of cells that break down bone. Okay. What's important about bisphosphonates is that the safety and efficacy of these drugs is not really known beyond five years. And then what also happens is as you and I are going about as everyone, everyone. Regardless whether you have osteopenia, osteoporosis or not, as you're going about your daily life and you're doing activities and you're exercising, you're starting to get these little micro cracks and fractures in your bone. They're tiny, tiny, tiny, tiny. But what happens is you have these cells within the bone that start to send out signals and they start to say and communicate to other cells in the bone that say, hey, we've got some damage here, it needs to be repaired. So what happens is these cells called the osteoclast, they come in, they scoop out that old, worn, damaged, weakened bone and right behind it we've got these osteoblasts that come in and build stronger, healthier bone. But it's a coupled process. So when we slow down the activity level of those cells that break down bone, we're not going to have that new, new bone that's going to become and filled in. So what can happen over time is you can start to accumulate that old, worn, damaged, weakened bone and that can lead to bones that are not as healthy and not as strong long term. So that's really important. From an anti resorptive medication perspective then the other category of medication that's going to be proposed is an anabolic medication. This would be your forteo, your avenity, your tymlos. Those names will probably sound familiar if you've had this conversation. Usually that medication is recommended to people when they've had low trauma fragility fractures, or they've had multiple fractures, or they have really poor quality bone. What a lot of people don't understand about those medications is that when you take one of these medications, these are designed to build bone, build it faster. What happens is you can only take these drugs in most cases for a certain period of time and then you have to follow it with another medication. And a lot of people don't know these things before they start and they end up getting into the cycle of just multiple medications. So really, really important to understand that.

And once you stop these medications, like those benefits, all that support that you had for your bone is gone. Right. And sometimes you end up in a worse state than you began. Right.

As an example, you know, those anabolic medications, what happens is, remember I just said it's a coupled process when we have to clean out the damaged bone, you know, break down the health, the bone to build healthier, stronger bone. When you take an anabolic medication, you're not just speeding up the activity level of cells that build bone. You're speeding up the activity level of cells to break down bone too. And what happens is you've got the bone building cells are going to build bone and build it faster, but eventually those bone breakdown cells will outpace and if you don't follow it with another medication, you will lose all of the gains that you just had. So yeah, you just have to understand there are short and long term implications and important considerations before you start a medication. So if you're in that office, it's a 15 minute visit, you get handed a DEXA scan. Hey, you have osteopenia or osteoporosis, I would encourage you to pause, take a deep breath and let's get some more objective information before you jump into a decision. What does some of that other objective information look like? Well, number one is that just because you have a bone density scan does not mean right now, present day, you are still actively losing bone. Okay. One of the ways you can tell that is there is there are these tests called bone turnover markers. And these tests look at the activity level of cells that build up and break down bone. So there's one test that looks at serum CTX or a CT low peptide test. And this test is the most sensitive marker for bone resorption for bone breakdown. And if that activity level is elevated, that can be an indicator of active bone loss. Okay, so that's a blood test. There's also another test that's a blood and a urine test. I prefer the urine second catch of the day. It's called a urine NTX or NT low peptide test. And that test again looks at the activity level of cells that are breaking down bone. So when you get that side of the picture, you also want to get the other side of the picture too, which is bone formation. And then these bone formation markers is one that's called P1NP Pro collagen type 1N terminal propeptide. That is the most sensitive marker for bone formation. So now we're starting to get the other side of the picture too, of what's going on inside your bones. And there are two other bone formation markers that we can look at. Osteocalcin is one, and there's also one called bone specific alkaline phosphatase activity. And now if you have ever gotten a any kind of blood work, there is a good chance your physician ran a comprehensive metabolic panel, a cmp. You will most likely see that it's got a lot of different markers on there that assess different function and minerals and electrolytes and things like that. One of the things it looks at is alkaline phosphatase. And if there's an elevation in alkaline phosphatase, that could come from a couple different areas, could be the gut, could be the liver, but it also could be the bone. And that can be helpful also when we're looking at bone specific alkaline phosphatase. Because if you have something like elevated calcium and elevated bone specific alkaline phosphatase, we need to be looking into, you know, possible malignancy or something like that too. So, I mean, there's a lot of stuff that you can use when you have this objective information. You get such a better picture of what's going on inside your bones.

I love that. I think that's really important for women to take a step back and not jump into the quick fix band aid approach. You know, as a functional medicine physician, I'm just thinking all those medicines are just trying to prolong the inevitable. It's just a band aid. You're not actually fixing the problem. You know, I take care of a lot of women in menopause, and like you said, the primary cause of osteoporosis for these women is their low estrogen. And so for. For so long, we used estrogen replacement for bone health. And then we all freaked out in 2002 from the WHI study and took everybody off of it and did them huge disservice. But now we're coming back around and we're realizing women do need their hormones, they do need estrogen to keep them healthy and prevent aging and disease. And so I would encourage women to ask their doctors, you know, why is this happening? Is it menopause or is it a secondary cause like you mentioned? And I'm guessing that's where you really focus and shine, you know, helping women is handling those root cause issues. So, like, let's talk about that. Tell me what it looks like when I come to you with my osteoporosis diagnosis. Are we talking about diet, lifestyle changes? Are you helping them look at those markers that you just talked about so awesomely.

Yeah. So a lot of times, what happens, like, when someone comes to us that we have them watch, and you know what I'll do for your audience, too, that we can do at the end of this, this episode is we'll give them free access to My Stronger Bones masterclass. Maybe we can link that in the show notes or something.

Yeah, for sure. That would be awesome.

And what this is going to do is that is going to walk through the three step process that we use to help people go from that place of fear and uncertainty and overwhelm and not knowing how to handle all this stuff to being confident and empowered and knowing what they need to do to build stronger bones. But at a high level, what that process looks like is the first thing anyone has to do is you have to identify and address root cause issues of bone loss. Right. You have to know what tests are most important. I just shared a couple of them, but there are a lot of other ones that are really important too. And then when you get those results back, you have to understand what the results mean and then what do you do with those results and then how do you move forward confidently to the next step, which is nourish. You have to restore the raw materials and nutrients that you need for stronger, healthier bones through diet, through digestion, through absorption. You have to make sure you're taking in the right inputs so you can produce stronger outputs. Because you can't possibly expect to rebuild something that's not there. Right?

Right.

It happens on three layers. The first layer is, are you taking in the right nutrients in the right amounts? The second layer is that's through diet, through supplementation. The second layer is, are you actually absorbing those nutrients if you have overt digestive issues? A lot of times I hear people saying that they've had IBS for 10, 20. I had one woman talk about how she had had IBS. She was 7 years old, she had IBS and she was like younger than 10. That's a lifetime of having those digestive issues. When you have those kind of issues, absorption is almost always going to be a problem. But even if you don't, I mentioned celiac disease. You could be a celiac but not have the classic GI symptoms.

Yeah, you could have no GI symptoms.

Exactly. You could have neuropathy or fatigue or brittle fingernails or brittle hair, dry skin or something like that. Those other things could be indicators. But you may not have the digestive symptoms. So absorption can still be an issue in those situations. And if you do have digestive issues, digestive issues can actually be a source of inflammation that contributes to and fuels bone breakdown in the body. Yeah, important point there. So resolving those digestive issues is super important. And then the third layer is, are those nutrients making it to the cell level. And a lot of times, even if someone is eating healthy on layer one, like I'm eating, you know, I'm eating a protein and I'm eating whatever, you still Might not be hitting the nutrients at layer one, right? So it's a lot. It's really hard for the rest of those things to line up. So those are the, those are really important things. And then the last part of what we're doing is it's building, right? We have to build strength, the body, strength of mind, strength, the bone in a way that prevents fracture and injury. You have to reduce your stress. That's. Stress is a contributor to bone loss, right? Just like we were talking about glucocorticoids, natural steroid hormones, the body, you know, cortisol. Cortisol is if that you're flooding your body with cortisol. And it doesn't have to be these crazy physical stressors. It can be psychological stress too. It could be fear, family conflict, financial challenges, trying to keep up with the perfect lives of the Joneses on social media, right? All these things fuel and contribute to and drive that stress response. So you have to get that in check. You have to improve your sleep. It is pretty well documented. Poor sleep will reduce your bone quality. Then also you have to make sure you got the right exercise plan in place. And you're providing the stimulus that your muscles and your bones need to become stronger. Because you need a couple different types of stimuli to support healthy bones. You need muscle pulling on bone and you need impact. And the most effective interventions use one or both of those in combination. You always get told, hey, go for a walk, do some walking. I can tell you right now, walking is not going to be enough. It's still good, right? If you're doing a daily walk, keep doing it, but don't count that as your only form of exercise. You do need that weight bearing exercise and place that healthy stress on the bones. But you also need to incorporate some muscle, some strength training, some resistance training. So you can use resistance bands, right? Variable resistance bands, that's great. You could use barbells and free weights. But if you're not familiar with how to work out properly, you want to make sure you're progressing slowly and getting up to the point where you're actually at an intensity that's going to help support healthier bones. The 5 to 10 rep range is what studies show has been most helpful. But if you don't have good form and body mechanics, you don't want to just go watch a video on YouTube and dive right into some deadlifts at that intensity with that kind of weight. So you got to make sure you just do things right from the beginning. And when you do that, all that stuff put together is going to help you get the right plan in place for your bones too. And I do one other thing with exercise that I'll point out is that there is also non weight bearing exercise. And this would be your cycling, your swimming, your kayaking, those kinds of things. Just like I said, don't just count walking as your only form of exercise every day. Don't just count those as your only form of exercise. Because when you have non weight bearing exercise, you're not placing that healthy stress on the bones. Especially with swimming too, because your, your, your body doesn't have to work against gravity. That's a problem that astronauts have in space is their body's not working against gravity, they don't have that stress on the bones. So they, they, you know it's going to reduce your bone density. So place that stress on those bones.

Oh, that's a great point. And there's so many reasons that women, you know, north of 40 need to transition from cardio to weight bearing exercise. And this is a huge part of that. It's, you have to strain those bones a little bit. I always think of like the palm trees, like they were created to bend and sway. You know, an oak tree would never survive in the tropics. They would go through one storm and they would, you know, snap and break because they're not pliable, they're not bendable. But the palm tree was made for those storms. They're made to take those stressors. And they actually studied palm trees and they are stronger after a storm, after they've bent all the way down and popped back up. So I thought that's pretty amazing. That is totally what bone does. You know, it's like the same thing. You put the strain and that makes it stronger. So thank you for pointing that out. So women get, when they work with you, they're like learning about exercise, they're learning about diet, all of sleep, all stress, all of that stuff, right?

Yeah. And it's basically, it's walking them through. So I mean, we have an application process and things like that. So a lot of times what people do is they watch, you know, some of our trainings or something like that and they say, you know what, this might actually be really helpful for me. I've got osteopenia, I've got osteoporosis in those situations. We've got different programs. We have a program that's been featured in Forbes and has some highly credentialed experts that have contributed to it. And it's a Three to six month program that walks you through, step by step, how to build stronger bones. And we've helped a lot of people at this point either prevent more bone loss, stabilize their bone loss, or actually get to the point where a year and a half, two years later, they've come back to us and have improved their bone density and their bone strength, which is awesome. I love seeing that. But it all starts with, you got to get the objective information. You got to take steps in the right direction.

Yeah. You got to see where you're at. So I can already hear women saying, okay, do I have to give up gluten? Are there food restrictions? Because women get a little bit particular when it comes to, you know, having to give up food. So is there one specific diet that works for everybody? Are there things that you're like, eh, this is, you gotta go, okay, so this is one.

And I bet, I bet you've talked about this before, but I'm gonna put one more nail in this coffin. Sugar.

Oh, my gosh, yes. Sugar and alcohol.

Let's just talk about sugar and bone health for a second. So sugar damages bone by triggering an inflammatory response. It lowers your vitamin D levels, which are really, it's really important for bone. It depletes your bone, healthy minerals, your calcium, your magnesium, your chromium, your copper. It inhibits the intestinal absorption of calcium. And then this is a big one. It blocks the absorption of vitamin C. And vitamin C is key for maintaining a healthy skeleton. So when I'm talking about sugar, obviously I'm not just talking about the white domino sugar, you know, I saw when we were a kid. I'm talking about your breads, your cakes, your cookies, your crackers, your pizzas, your pastas, all that stuff that breaks down into sugar. So keep those in mind. And if you do consume, if you are consuming sugar right now and you're like, oh, my gosh, I can't just eliminate all of that right at once. You don't have to, right? Yeah, you can try. If you can go cold turkey, great, do it. But if not, as long as you can do things 1% better today than you did yesterday, think about what's going to happen at the end of the year. How many percentage points have you moved in the right direction? And over time, if you think about your health like the length of your life, how many improvements will you have made if you just do things 1% better every single day? Try it.

Yeah, I think that's an amazing point. So important. I just think of, like all the Starbucks, Frappuccinos, and just the drinks and the smoothies and all the stuff that women consume every single day. Like, you have no idea how much sugar you're consuming, ladies. You really, really, really, really are. You have to break up with sugar. That was the game changer for me. That and getting sleep. Like that restored my entire life, breaking up with sugar and getting sleep. So Kevin obviously knows what he's talking about.

And then so some other things from a diet perspective. So a lot of times people ask me, like, okay, is there a perfect diet for osteoporosis? They hate my responses because I say it depends, right? We are all biochemically and genetically unique individuals, so we're going to respond to different foods and supplements and dietary approaches differently. Which is why I don't like saying there's one single blanket, you know, rigid framework for. With zero flexibility for every single person. Because let's say you do have digestive issues. You have small intestinal bacterial overgrowth, you have Candida, you have parasites, you have some other health issue that has to be addressed, or you have an autoimmune condition that you're trying to put into remission. Your dietary approach is going to look differently in some cases than those who are not. Right. There are going to be differences there. So just be kind to yourself as you're navigating this process. But here are some foods that I think are. Are important that I've seen work, generally speaking, for most people. The first one that I really like is I love sardines and mackerel and salmon. And if you're listening to this and you're like, gosh, that doesn't sound appetizing at all. Well, we've had a dietitian on our team who's. She's worked with our people for a long time. We had her put together some recipe videos. So we've got recipe videos on how to make sardines and mackerel taste good. But. But the reason why I love these, especially if you get them in the can, is that they've got the bones in them. And these aren't hard, pokey bones that are going to hurt your mouth. They actually almost melt in your mouth, right? And the reason why I like these bones is because it's not like you're just taking calcium. You're actually taking everything that your bones need to become stronger, right? All the minerals, the right ratios, the proteins. And then you've got protein from the fish, too. Your bones need that protein and amino acids. And then the other, the Other power punch there is Omega 3s. Anything that contributes to inflammation in the body is going to fuel bone loss. So Omega 3s are the dampeners of inflammation. So that's one reason why I really like those different types of fish with the bones in another. One of my favorite foods is arugula. Arugula is a great same cruciferous family of vegetables as broccoli and kale. It's rich in, you know, vitamin C, calcium, bioavailable calcium, up to. If you go look and I don't like plastic clamshells in the grocery store, but if you were to look and see those plastic clamshells in the grocery store and you were to go saute some of that arugula down, it's going to saute into a smaller portion and that's going to have about 200 milligrams of bioavailable calcium, which is great.

Yeah, nice.

And the reason I like arugula is that it's also low in oxalates too.

Right. As opposed to spinach.

Yeah, it's just really high. So, you know, if you go to the grocery store and you're trying to figure out what green you're going to eat today, and I don't like vilifying any specific, specific food like that. Like especially, you know, but when you look at the back of a label and you see that spinach has a lot of calcium, that calcium is not bioavailable because it's bound up with oxalate. And oxalates are an anti nutrient that can prevent, you know, you from absorbing those, those nutrients, those bone healthy nutrients. And if you have these are just some indicators, some joint pain or digestive issues, kidney stones even, those could be indicators that you have a hard time breaking down and degrading that oxalate so you can swap that spinach for the arugula. And the last thing I like about arugula is that it's bitter. It's one of the last foods that are bitter in our diet today. Why are bitters important? Bitters stimulate bile. Your liver produces bile. The bile is stored in the gallbladder. And when you eat your foods, that gallbladder squeezes that bile and helps emulsify fats and break down your food and kill off some of those bad bugs if you've got them there. Right. So that, that can be another great addition to your plan.

Oh, my gosh. Yeah. Like just take some arugula, put some beets on there with a little balsamic vinaigrette and goat cheese. Oh, my gosh. You're good to go. Like, it's amazing.

Yeah, no, arugula is a great. That's a great addition for sure.

So good. Oh, my gosh. You're just a wealth of knowledge. Like, you literally had this problem and you're like, I'm going to learn every freaking thing I can about every day.

Every day. Still learning.

It's incredible. I'm just so impressed. I love pain to purpose stories. Like, it's the best. And that's who you want helping you as someone who's lived it, walked in the shoes, who figured it all out, you know, trial, error, whatever, and knows how best to handle it. So I'm so impressed and excited that you are helping millions of women because this is going to be game changing. I mean, it's really giving women their lives back and their futures back. So bravo to you, Kevin. This is awesome.

Thanks so much. And I love your work. I love what you do. I know you've helped so many, so many women. And you're like, I'm just honored to be on your podcast and be able to share this with, with the people that are listening. And the last thing I would say, too, is that I know a lot of your audience probably has kids too, right?

Oh, yeah, let's mention that.

Let's just touch on that. Because I love working with the people we work with. I work mostly with women 40 to 65 plus, you know, right. In that area. That's usually who we're working with. But I know from the conversations I have with them, they're always talking about, I want to learn so I can prevent it in my kids and my grandkids. And that's where my real passion is, is prevention. So what we have to understand is that up to 90% of our bone mass is put on by the time we turn age 18.

Yeah.

And the remaining 10% approximately fills in by the time you turn 30. So by the time you turn 30, your bucket, what I call it, is about as full as it's going to be. So if when you're younger or your kids are younger, they've got poor diet and nutrition, they lead a sedentary lifestyle, they smoke or drink excessively, you know, they have an eating disorder or they're on birth control. Yeah. You know, I was just gonna say they take certain medications, even those can prevent you from achieving peak bone mass. And that's going to make sure that's going to. You're going to have a lower starting point in the future. So we need to be doing things actively now with our kids, with our grandkids. You know, from an exercise perspective, if you've got young kids, get them in gymnastics.

Yeah.

Gymnasts have great bone density because you're doing all these dynamic movements. You're moving in different directions, not just in the same, you know, running pattern over and over and over again. Same thing with soccer. Right. Bone density in the legs of soccer players are going to be stronger because they've got these multidirectional impacts and forces and quick bursts that they're doing. So how can we get our kids engaged in these activities that are putting that healthy impact and healthy stress on those bones? And then how can we give them good diet, good nutrition? I know, because I'm a parent, right. I understand this firsthand. It's like we want to lean toward what's convenient. How can we get things to be healthy? But a lot of times it falls back to convenience. Right. So we need to make sure that sometimes it does take doing a little bit of research first. Right. Maybe spend a little bit of time figuring out what are some of the brands and some of the things that you can already have stocked in your house or even just some of the foods you can already have cut up up in your house on a Sunday. And how can we distribute that to those kids throughout, you know, the beginning of the week? One of my favorites for kids is because kids like the crunch, right? They see their friends eating the chips and the crackers and all this stuff. Get them some plantain chips. Plantain chips can be a great substitute. They'll use sustainable palm oil with some sea salt. It's an anti inflammatory. Like it's, it's, it's a food that's not going to contribute to inflammation, which is going to be good. But then you could also make them some kale chips too, as a substitute. So you put your oven on 300 degrees, you cut up, I like the dino kale. It's called Dino or lacinato kale. You cut it off the stem, you rinse it off, you pat it dry and you lay it on a sheet in the oven. And then you get these little olive oil misters and you mist these kale leaves, these dino kale leaves, and you sprinkle it with sea salt, put it in the oven for 10 to 12 minutes. They come out, they're crispy, the kids love them, everybody's happy. They're gonna get some.

Yeah. I will tell you, my, my 13 year old and 11 year old will eat kale chips, and they will not eat, like, Brussels sprouts or regular cooked vegetables, but they eat up the kale chips. I'm like, here, it's got. It's kind of like a roasted marshmallow. It's got that flavor. But, no, it's worth trying. And I would say, like, I try not to have let my kids have pop because I just find that will kill your bones straight away. Right.

It will. Not only the sugar that we just talked about, and there's plenty of reasons why, obviously not to do that, but phosphoric acid, that's going to pull those minerals right out of the bone. So, yeah, soda in any form, any capacity, get rid of it. Not even something you want to have. I would find a better swap. Like, if you're looking for that fizzy, you know, maybe find a carbonated water or something.

I know. There's so many options nowadays. There's really no reason to drink that pop or soda or whatever you call it in your part of the country.

I know, right? Yeah. And, like, you don't always have to go to the extreme of eliminating it from day one. If, you know that's not sustainable for you. If you know you're gonna, you know, maybe it's one or two days later. It's just you're binging to make up, you know, what you cut out. Maybe it's just a slow and steady taper where you've just found a better alternative and now you're just slowly crowding that out.

Yeah, I love that. I think that's a great point. Like, just have so many other good options that it's no longer needed in your life.

Exactly.

That's great with kids, too, because I think they want something that's quick and easy. Like you said, if you have it readily available, you give them the options. They'll probably just grab it. They just want to eat and go play. Right? Right. Yeah. Oh, my gosh. You're just full of amazing wealth and knowledge. So watch the webinar. You know, I think it's going to be a game changer. And then if they want to work with you, they'll get information from that webinar, right?

Yeah. So free Stronger Bones Masterclass, we're going to give to your audience. We'll link that in the show notes and we'll make sure they have that. Yet there's instructions on if you think it makes sense. I mean, you can easily. There's an application process that we have. We don't work with Everybody. But we do. We go through and we help people understand if it might be a good fit for them. But you can also find me. You can always find me over@phonecoach.com too, and on all those big social channels also.

So the YouTube and you have a podcast.

Yeah, the YouTube, the podcast. You're going to be on my podcast, you know, Facebook. And actually, you know what's interesting? I'm starting a TikTok.

Yay. I'm gonna look for you. I started one and then I kind of fell off the wagon, but I'm getting back on. You know, you have to, like, nurture that stuff, but it's fun.

I love TikTok at bone coach, so. All right. You want to watch me fumble around for a second?

That's awesome. Well, thank you, Kevin. We'll have to have you back again sometime.

Well, thanks for having me. I appreciate this is fun.

All right. I know you got something out of that episode. There were so many amazing golden nuggets in there. A lot of great information. If nothing else, start eating arugula. It's so yummy. Right? But let me know what your golden nugget was. But you're going to start to incorporate and add to everything else that you've been switching up in your life to be your best self. And I would love to know, like, how knowledgeable is the average woman when it comes to bone health? Was this stuff you guys already knew or was all of this like, oh, my gosh, I had no idea. So I would really love to get your feedback on this because I'm trying to gauge the level of understanding of my audience so that I can give you the information that you need, not stuff that you've already heard ten hundred times. Right. So I love your feedback. I appreciate it. I adjust my discussions and my guests and all of that based on your feedback. So I. Oh my gosh, I appreciate it so much. So speaking of that, let me just read this five star review because it just warmed my heart. It says, let's see, it's from Jaybird 10. It says, Dr. Tabitha really touches upon and pinpoints the subjects that I often think about in my journey to maintain my health as I age. No one talks about women's physical and mental health the way she does in honest, layman's terms, terms, which makes it easy to follow along and become informed. I always enjoy listening to her podcast with her knowledgeable guests. I feel as if I'm in a community of seekers and less alone in my curiosity and quest for the best health advice I can find. Dr. Tabitha's podcast often satisfies this for me. I appreciate what you do. Please keep talking about perimenopause, menopause, hormone stability, medication alternatives, bioidentical treatments, any innovative solutions you come across. Your audience is listening. Thank you. Well, thank you Jaybird10. Like that just made my week right there. I love it so much. I really appreciate hearing that because I'm out here just, you know, doing this by myself, basing it off the patients that I see. I'll all day long what you want to hear about. But I really appreciate that feedback because it reinforces some things I need to focus on and not some others. So I would love for you to shoot me a five star review. Let me know what you're thinking. That way Apple itunes knows what you're thinking as well so you can get more of it. So go have an amazing kick ass week for ladies. You deserve it. You're capable of it. You need to tell yourself that every day. Step into the greatness. And if you don't believe it, you need to change your mantra every morning when you wake up. I am strong. I'm capable. I'm beautiful. I am enough. I'm a child of God. I'm enough. So go out. Have a kick ass week ladies. Bye Sam.