30: The Shocking Truth About Bone Loss – How to Rebuild Strength with Kevin Ellis, The Bone Coach

Today we are having a very unique conversation with my friend and colleague, Kevin Ellis, who is better known as the Bone Coach. He is a Forbes Featured Integrative Health Coach podcaster and the founder of bonecoach.com through a unique three step process in a world class coaching program called the Stronger Bone Solution, he and his credentialed team have helped thousands of people with osteopenia and osteoporosis in over 1500 cities around the world get confident in their stronger bones. Bones Plan Today, the Bone Coach community has grown to over 250,000 people focused on osteoporosis reversal and achieving their stronger bone goals. His mission is to help millions of people with osteoporosis build stronger bones and help our children and grandchildren create a strong and healthy foundation so that they can lead long active lives. Y', all, this conversation is going to blow your mind. There are so many parallels between bone health and thyroid health and Kevin has done the deep, deep work to bring us all insightful, unique information that you have not heard before. So I'm excited to dig into this conversation. Welcome to Modern Thyroid and Wellness, the podcast that explores the intricate dance between health, wellness and thyroid, unraveling the threads that weave our vitality together. I'm your host, McCall McPherson, and I'm so thrilled to guide you on this journey to optimal wellness. Kevin, I am so happy that you're here today to chat with my people. I think you are. I don't think I know you are. An absolute wealth of knowledge of incredibly valuable information that people will not find. Other places, especially my people, need to hear this information that you've accumulated over the last several years. So tell me, I'm so curious, how did you end up helping women with osteoporosis and osteopenia?

Yeah, it's actually an interesting journey because when you hear about bone health or you think about osteopenia or osteoporosis, you're not typically thinking about a younger male. You're thinking about the woman, 50 plus. Or maybe your mother or your grandmother or somebody that you saw had a fracture or injury or something later in life that was affected by bone loss. You're not thinking about a younger male. And for me, really, it started with my own health journey. I could take it back even to before I was born. When my mother was five months pregnant with me, my father was told he had cancer. Two months after I was born, he passed away. He was 35 years old at that time. My entire life I had this fear that I Was going to follow down that path to an early grave, not be there for my kids or experience the joys of being a father. Yeah. And he was a Marine, so I went in his footsteps, to follow in his footsteps at about 17. And I signed up, and then I went in the Marines at 18, went through the Marine Corps, got out, was. Had all these different health issues. Chronic digestive distress, low energy, poor sleep. Found out I had celiac disease. And so, you know, your audience, I'm sure, is familiar with celiac disease, but for everybody who's not or is hearing it for the first time, autoimmune condition, where when you ingest gluten, it damages the villi in your small intestine, the tiny little nutrient absorption centers. Then you can't absorb the nutrients from the food you're taking in, and specifically calcium. You're the primary mineral constituent of your bones. So I was working out, doing all these activities, not knowing I wasn't absorbing enough nutrients, and my body was going to my bones and pulling from there, and it led to bone loss at a young age. So even as a tough Marine, I some. It was. It was a physician's assistant at the time. Not even all the doctors I was working with. Yeah, that. That was like, hey, you've had. You have celiac disease. Has anybody done a bone density scan on you? I said, no, they did. It came back, said I had osteoporosis. And I was shocked at that time.

You were how old?

Yeah, right around 30 years old.

Yeah.

And so I was shocked at that time, and I went and I got a second opinion that confirmed it. And then it turned my. My focus turned from, like, me being this tough person who could endure that was part of my identity to this person that was fragile and, you know, was scared and worried and overwhelmed and was going to be dealing with fractures and dependence on medication for the rest of my life. That was what. Where my head was at at that time.

Right.

So I just took the same energy, effort, enthusiasm I had in the Marines, and I applied it to the health space. And I said, I'm going to figure this out for me. I'm going to figure it out so I can be there for my kids and my family. And I did the reading, the research, consulted with everybody, and I grew basically a community after I figured out my own plan from about 200 people to now 275,000 people. And, you know, we have had lots of people come through these Stronger Bounds programs. We got a whole team built around this now, and it's really just a passion of mine to help people build stronger bounds. So. And it usually ends up being 90, 95% women, but we still have men. We help too.

I love that. And what an incredible pain to purpose story. There's so many parallels between our stories. I mean, mine started with celiac too, and ended up a thyroid problem as opposed to a bone density problem. But I love so much that now you're taking all the information that you've harnessed that, you know, listeners will find out very soon is very, very, very unique and just intricate and sharing that with the world. So thanks. Lay some foundational pieces for us. Tell us about what osteopenia is. What is osteoporosis? How common is it? What are. How do we know if we even have it?

Okay. Osteoporosis literally means porous bone. And it's a condition that's characterized by either not enough bone formation, excessive bone loss, or a combination of the two of those things. And with osteoporosis, both your bone density and your bone quality are reduced. And that's going to increase your risk of fracture. Fractures. Of course, for anybody who's, who has had one or has seen someone have one, those are the things that can put your future in question. All the things that you want for your future, you know, they can become painful and debilitating. So if we want, if we, if we can, we want to prevent them. I think it was Benjamin Franklin who said, an ounce of prevention is worth a pound of cure. And you know, he, when he said it, he talked about fire safety. But it applies so much to our health and to our bones especially, because it is a lot easier to prevent bone loss and fractures from happening to start than to try to reverse the course once it's already down that path. So I always encourage people be on the side of prevention if you can. The first place you have to start is getting some objective data points to know the status of your bone health. So the first data point that you would look at would be a bone density scan. You can get bone density from either a REMS test or an actual bone density scan like a DEXA scan. And what these are going to look at is the actual mineral content of your bone. And there's also something called bone quality that we want to look at too. Bone quality can be done through either a tbs, which is like an add on software to the bone density scan, or it can also be done through a REM scan. So now we can get a picture of bone density. We can get a picture of bone quality and those two things to combine to create bone strength. Okay. The challenge is, most people at the time they're diagnosed, they only have the bone density part of the picture. So they have this score that says either plus one or minus one is considered normal and healthy. Minus one to minus 2.5, it's considered osteopenia, which is. We would call it low bone mass, but it's like a precursor to osteoporosis. Minus 2.5 or lower with this score is minus 2.6, minus 2.7, so on and so forth. That's considered osteoporosis. And the greater the negative number becomes, the more severe the osteoporosis. Most people only have the bone density part of that picture.

Got it.

You want to have bone density, bone quality, and the third pillar of bone strength, which is bone turnover. And this is what most physicians don't look at is bone turnover. So. And I. I actually consider this a major flaw in the medical system, is that we only look at things like bone density, which tell us the thing, what we've done for the past two years or so. We need to know what's going on in our bones right now, and. And look at the activity level of cells that are breaking down and building up bone. Bone turnover helps you do that. There are specific tests with that, and we can get into those in just a minute, too.

Yeah, no, I would love that. So basically, what you're saying, is it similar to thyroid? Right. If people just go to their doctor and they say, hey, we're gonna do. Let. Let's do a checkup on your bones to find out if you have osteoporosis or osteopenia. The likelihood that someone's going to get a full, true picture of what's happening is close to zero percent. Is that right?

Yeah, that's. That's pretty accurate. Yeah.

Yeah.

Usually only getting part of the picture. And look, if you get a diagnosis of osteoporosis and you have a bone density score of negative 2.8 or negative 3 or negative 3.5 or negative fours, you want to do something, right? But what I'm saying is that there's still other parts of the picture you don't have that you need that objective data to make good, solid decisions. Because what's often going to happen is you get told you have osteoporosis, and in that conversation, 15 minutes worth of time, you get the scan results. You get told, take calcium. Here's a list of dairy Foods that you should eat and, you know, then don't lift anything heavy. Take your vitamin D. We'll see you in two years for your next bone density scan. That's what 95% of people get told. And there's just so much more to do than that. And so you can, as the educated, empowered patient, you can say, hey, I'm not saying no to the medication. I'm just saying help me get a little more information first.

Right. And then also, in addition, it's kind of like the people who are diabetic or pre diabetic. Right. Like, we'd love to intervene before someone is pre diabetic or before they're diabetic. So are there markers that we can look at leading up to. Oh, yes, now you meet the diagnostic criteria for osteoporosis and let's treat you. Are there tests that we can run to know where our future bone health is headed now that maybe hasn't reached osteoporosis or osteopenia?

Yeah, great question. Those would be bone turnover markers. That's what they're called. And one of them is called an active bone loss test, called the CTX, CT Low Peptide Test. The other is called a bone builder test, the P1NP. And these tests look at the activity level of cells that are breaking down and building up your bone right now, present day. So DEXA scan looks at, did you do the right things for the past year and a half or two years? And it's going to give you a snapshot and tell you that. But you have to have at least two of those objective data points, two years apart, to know that's too long to implement a protocol hoping that you're doing the right things. This is the major flaw in the medical system. What we want to do is if you look at bone turnover markers, you can see changes in these markers in weeks to months and not years. So you can see your ctx, if it's really high or elevated, you can see that come down in weeks to months, you can see that bone formation come up. And when you look at it this way, now you have these leading indicators that you can improve and target to make sure the lagging indicator, the bone density, is where it needs to be two years down the road. So you get a baseline of the markers, you give an intervention, then you look and retest again to see what the impact of that intervention was. And if it's improved, if it's brought the bone loss down, boosted it up, and if it didn't, now we go in, we make adjustments until it does.

So you're saying there's a way, there's more of a preventative approach as opposed to a treatment after it's already occurred approach, which definitely, as a person who practices regular medicine, is not available as a resource to us as a clinician.

And these tests are not new. Also, they've been around for a long time. It's just they're not part of the standard protocol. You know, when somebody is told they have osteoporosis, partially because it creates even more time that the person has to go get another lab and get additional results. And then now that patient has more data to use, and they may not decide to take the pharmaceutical based on that. But I think all physicians, all practitioners should be doing this. It's just challenging for them to get that within the regular system. Like, I'll see people try to get these from their GPS and primary cares, and they have a hard time even getting them once a year through their doctors. So what'll happen is they'll get referred out to endocrinology or rheumatology. Those are more specialized areas that help with bones. But even those specialists might not actually order the markers or they're not going to order them as frequently as you would need to see them to see those meaningful changes for it to be useful. So we. Sometimes you have to go outside of that system to get what you need.

My people are very familiar with that idea. Yeah, because it's the same. I mean, there's two things that happen in that realm. One is physicians. Clinicians do not like to order tests. They do not know how to interpret. So if you hand them a list of paper that says, hey, will you order these tests for me? If they don't know how to interpret them, they feel uncomfortable. And then secondary to that is when they start ordering a lot of tests. Insurance companies don't like that. And then they get feedback from that insurance company of like, hey, you're really charging a lot of money when we could simply be doing a bone density scan. If you keep doing this, we're going to pull coverage and we are no longer going to be one of our in network providers. That's what, that's what I figured out over the years with thyroid. And there, again, there are so many similarities with bone coach support. Is there a way that people can access some of these tests through you and your program without having to rely if they hit a dead end with their clinician?

Yeah, you can. I mean, sometimes people try to go directly to the labs. But the labs can charge a really high amount for the individual trying to get the test done. So in those situations they would come to like Bone Coach, which has hundreds of thousands of people in it. And we have, you know, this is kind of the back end side of things for people to understand how this works. We can go to some of these bigger lab organizations with greater purchasing power because we have more people and say, hey, we've got a lot of people that are coming to get these tests. Can we make it more affordable for them? And then we just pass those savings on to the end people. So we do that all the time and we can bring Those costs down 40, 45% sometimes for the end consumer who's trying to come in and get these tests done. And it's. We can also do it in a way that we can track their data over time. So, and that's what's most important is like, if we're helping you achieve an outcome, we should be able to track some of that data along the way. And that's really important part of our process.

So, again, so similar like with Hashimoto's and antibodies, make an intervention retest. Right. Make a different intervention retest. But without data, we're all just throwing darts at a dartboard blindfolded, hoping to hit a bullseye. And the likelihood that someone's going to, in an intentional way, be able to influence their bone density. Checking it every year or two with a bone density scan is, you know, it's difficult. It's the same with thyroid. You need that data.

Yeah. And I want to touch on a few things too. I want to actually explain bone turnover a little bit more, please. And why people, when you look at a bone density scan, it's really just showing you the past bone turnover is showing you the future bone turnover. You're also going to hear it called bone remodeling. And it's basically this process that happens throughout our lives. It's norma, you want it to happen. It's why you get a new skeleton every seven to 10 years. You have a couple different cells involved in this process of bone remodeling. You have these cells called osteoclasts that are doing up this damaged, weakened bone. And it's a coupled process. Then you have these cells called osteoblasts that are coming in and building stronger, healthier new bone. This is normal. So it's not to say that all bone breakdown or all bone resorption, that's another way to say that is Bad. It's it. And you need it for this healthy remodeling process of cleaning out the damaged bone. Because what happens is, as we're all going about our daily lives, doing our daily activities, doing your chores around the house, or doing an intense workout at the gym, you get these tiny little micro cracks and micro fractures in your bones. That's normal for every single person. And then you have cells within the bone, they're called osteocytes, sense that damage, and they send out a signal to these other cells. They're like orchestrators of this whole remodeling process. And then these osteoclasts come and scoop out that damaged bone, and the blast come build stronger, healthier new bones. So we want this to happen, but. And you would use these, this active bone loss test, the CTX, and the bone builder test, the P1MP, you would use these tests to look at that process. There are different types of bone turnover, though. And when we actually get the diagnostic information, we can see, like, what's a person's test result. We can understand if they have high bone turnover or if they have low bone turnover, and if that's leading them down a path of more bone loss and leading them down a path of osteoporosis. So we can absolutely be on the preventative side here. So if somebody has really high bone turnover, they might have a high CTX and a high or normal P1NP. And what that tells us is that bone is breaking down faster than it can rebuild, and that can lead to weaker bones and a higher fracture risk because the bone loss is just happening too quickly. We see this a lot in postmenopausal women, especially if they're not on bioidentical hormone replacement therapy. There's also low bone turnover, and this is where we have bone breakdown that is slow. But because, remember, I said it's a coupled process, that bone formation is also slow. So what happens is that the bones are going to remain weak and fragile because they aren't clearing out that damaged, weakened bone that you're getting every day of your life. Right. They're not renewing properly. So in this situation, we would look at the CTX, the P1NP, your active bone loss test, your bone builder test, we would say CTX is lower, normal, and the P1NP is also low. Okay. So that's how you can get really specific. And the ratio between the two of these tests can also become a target, too. So it is good to get both at the same time so much deeper.

Than just Looking at your bone density. Fascinating.

Yeah.

I want to switch a little bit and talk about treatment, like standard treatment versus the reality of what's available and what all we can do. But is there anything else that you want to touch on about the lab component before we shift gears a little bit?

No, I think that's. I think that's great. I think we kind of nailed the bone Turnover piece, the CTX, the P1NP, those, how important those tests are. You know, you want to get both of them. And we can help you with that at Bone Coach too, if you need to get. Need to get the help for that.

I definitely, like I told you this last time we spoke and hung out in real life, I want to do this myself. So this is still on my to do. I haven't pulled the trigger yet.

I just thought we should, we should totally run. Run you through this too.

We should. And then do a followup of how, how it looks. Because that was one of the things on my pernuo scan that I think wasn't the best, was how my bones are looking over the last few years. So I would love to find ways to intervene and this is such a powerful way to do that.

Yeah, let's do it.

Yeah. Okay. Tell me a little bit about the contrast of standard treatment. It's very similar to thyroid. You go and there's one basic treatment, a couple treatments, not really deep. It's just a pill for an ill sort of situation and you're sent on your way. So paint the picture for us for that.

Yeah, standard treatment. Calcium, vitamin D. Go for a walk. Don't lift anything heavy. We'll see you in two years for your next bone density scan. And oh, by the way, here's this thing you're going to go pick up at the pharmacy that may or may not actually work for you. Thing you're going to go pick up at the pharmacy is an osteoporosis drug or medication. I will say people come to us because they want a natural approach to building stronger bones. And we teach that at the same time. I can't be anti medication, even though we teach a holistic approach. I can't be anti medication because I've seen where it's necessary and lifesaving for some people. I've seen people that come to us that have really poor bone quality, that have 10, 15 more fractures and they need an immediate intervention. Now, that's not the time to go. Try to go the. The natural approach. Right. We need something at that point. But for the majority of people, especially the majority of people listening here too, there's so much more you can do than just blindly following a standard treatment protocol. We need more information. So again, I always tell people in those situations, you're usually going to be presented with different types of medications, different categories of drugs, either an antiresorptive medication or an anabolic medication. Antiresorptive medications are designed to slow down the activity level of those cells, the osteoclast, that are breaking down the bone. Can they do that? They sure do. There are two different category types to those drugs. There's bisphosphonates and rank ligand inhibitors. Bisphosphonates, you probably heard some of these before. Phospamax, Reclast, Actonel, Boniva. The safety and efficacy of bisphosphonates is not really well known beyond five years. Just kind of like I was talking about. As we're going about our daily lives, doing our daily activities, you're getting these little micro cracks and micro fractures in your bones and you want that remodeling to happen. But if you're on these drugs for especially extended periods of time, multiple, multiple years, you can actually slow down this remodeling process too much, where you start to accumulate the old worn, damage, weakened bone. So even if your bone density scan, remember, density is only part of the picture, even if your bone density scan is showing as stable or slightly improved the quality, the structural integrity of the bone may actually be compromised. And so you may actually have weaker total, total bone health versus what your DEXA scan alone is just showing. So you have to keep that in mind. The other anti resortive medication is called Prolia, and this is a rank ligand inhibitor. And Prolia just has some important considerations for people. You know, if you go on that for one or two rounds, you're getting this every six months or so. And you want to try to come off that medication, you can't just stop at cold turkey. You have to relay with another medication like a bisphosphonate to not increase your risk of vertebral fractures. And if you've taken that medication three times or more, you would have to use Reclast, which is the strongest medication to shut down this rebound effect. This is not me telling you to come off of medication on this podcast. Can't do that. But it's me educating you that at the time that you make the decision to take the medication, you're probably not understanding that you're either committing to it for multiple years or you're committing to multiple medications. You Just don't know it yet. Okay, so this is what I'm giving you up front is like there are important considerations. These have a dramatic effect on bone physiology. It is not like taking an aspirin. So that's, that's probably the first one. The other category of medications that are going to be recommended are called anabolics. Usually these medications are recommended for people that have already had fractures or they have poor quality bone. And the, the drugs, forteo venity, Timolos, they're designed to build bone, build better quality bone and build it faster. Can they do that? Of course they can. There are risks and side effects that come with it. And then you can't just stop that drug cold turkey when you're done. You have to then follow it with an anti resorptive just to not lose the bone you just gained. So remember, you're not just committing to one drug, you are likely committing to multiple drugs. If not for a couple of years, possibly a lifetime.

And what about the people who, I mean very commonly just are non compliant, they fall off the radar of the clinician. So now they're in really bad shape without ever knowing. The clinician doesn't even know because they haven't been there to follow up, to transition appropriately off or to another medication. Yeah, that's a big deal.

Yeah. And, and by the way, this whole, this whole conversation around medication too, it should stem or at least begin with monitoring the CTX, the P1NP, the bone turnover markers. Because what can happen is you might have a person that comes in for their first bone density scan and it shows that that person has osteoporosis on dexa we only have one data point. We don't have two data points showing a downward trend. We have one data point. And so that doctor may come in and say, oh, let's put this person on pro Leah or let's put this person on an anti resorptive. How do we know that person is actually losing bone right now? Present day we don't unless we do a CTX and those bone turnover markers. So what could happen is, and I see this all the time, the person could be prescribed the medication. And now we over suppress a process, a natural bone remodeling process that doesn't need to be suppressed and that can just, that cannot be a good situation for people with their bone health. So again that makes the case for why we need these bone turnover markers too. Especially if you are starting a medication or even if you're, even if you're going to do bioidentical hormone replacement therapy. Right. And you want to see the status of. Is it actually bringing my bone loss down? Is it helping boost that bone formation up? Get the baseline first and then monitor future changes three months in and see if it's making the change. Because if not, maybe the dosing needs to be adjusted potentially too.

Right. I love that. And it's about every 90 days that we should be monitoring those, at least till we're stable.

Or it just depends. Like, I have different frequencies that I recommend for, depending on where people are at. So somebody comes to me, they get their first baseline. Everybody should have a baseline of these results. Especially after about 30 years old, everybody should just get a baseline from which to monitor future changes. Then if you get your baseline and your results come back and they're really high, like, you get a high result of 800, 900, over a thousand. Sometimes I see people, their results are like this. There could be multiple contributors to bone loss, not just a hormonal issue. Mm. So the primary causes of bone loss are hormonal. Specifically in postmenopausal women. Estrogen has a protective effect on bone. When those levels decrease, as they do during menopause, it's going to increase the activity level of cells that break down bone. But there are a lot of other causes, secondary causes of bone loss. And when we. Behaviors, disorders, conditions, diseases, medications. So when somebody has a really high result, they could have a hormonal issue, but they could also have lots of different secondary issues that need to be addressed, too. So what we would do is we would say, okay, if you got a high result, let's go to work figuring out what's causing the high result. Focus on addressing the root issue, not just covering it up with a medication. Focus on addressing the root issue and then going back and retesting, sometimes eight weeks to. To three months, just that frequency, if it's really high and seeing, have we made any improvement? Have you brought it down even a little bit? And if we have, we can stay on that path. And then when you get down to a little bit, maybe a moderate bone loss, maybe you drop the frequency to every three months when you start to stabilize. Maybe it's every six months. Right. Or if you. I had somebody show up on a call. This very rarely happens at this point, but I had somebody show up on a call who had multiple stable DEXA scans. She had great bone turnover markers. The ratio between the two was great. And I just said, look, you could probably just monitor them once a year at this Point because she'd already made so many good changes. So that there's different frequency based on where you're at. Basically. Yeah. Same.

Same with thyroid hormones. Absolutely. And the better you're doing, the longer you can wait between. I see the same.

Yeah.

So contrast a little bit of the standard approach, which is obviously largely oversimplified and reactive. What can we do to be empowered? Obviously, monitoring labs is a really big deal. And then talk to me about interventions like lifestyle, diet, exercise. What can we do to participate in protecting our bone health as we age?

Yeah, great question. Some of the. Some of the most impactful interventions are number one for. For reducing bone loss and boosting bone strength. Some of the most impactful interventions are number one, bioidentical hormone replacement therapy. If it makes sense for you, it's not right. Not right for every single person. And there are some nuances with that. So you want to consult with somebody before you jump into that. But that can be one of the most impactful things on bringing that bone loss down and boosting that bone formation up.

Yeah.

The second one would be getting the right nutrients. Your bones are not just these static structures that hold you up. Right. And carry you through life. They do that. They do a really good job of it. But they are also living tissue and they need specific nutrients. Your bones are actually a pretty good amount of protein, and it's this collagen protein matrix with minerals laced in there. So even just to maintain that foundational bone structure, you have to have adequate amino acid intake. So you can get this by using essential amino acids adding in collagen. So one of the collagens that is my favorite includes fortobone. Fortabone is the only collagen peptide that actually has the randomized control trials behind it, showing its benefits for bone. So I always encourage people incorporate something like that into your plan. And then you can incorporate regular meals that include protein. 30, 40, 50 grams. You know, adjust based on your situation, but try to hit a minimum of something like that. And you can have, you can have your fish, you can have your meat, you can have animal based proteins and those kinds of things in your plan. And if you feel like sometimes I'll have people come to me and they'll say, I'm really busy. This, you know, it's not practical for me to sit down and eat three meals with chicken and fish and beef and, you know, other things. And probably a lot of people listening to this too. They have busy lives. You might be busy working in business. You might have your own business, you might be taking care of kids. So it's like, how do we make that practical? So you can also incorporate some whey protein isolate potentially where you get some additional benefit for bone, some additional nutrients for bone, or a beef protein isolate. If you are, you got an autoimmune condition, you're trying to put in a remission, you don't tolerate dairy. Well, you know, you could add a scoop of that in there and get an extra 20 gram boost to a smoothie or something like that. So that's more of a way to make it practical to get enough protein throughout your day. But then we also got to get enough minerals and vitamins. Some of the most important ones that I like to see people incorporate. Calcium obviously is the primary mineral constituent of your bones. So you want to be getting enough of that. If you don't feel like you can get enough through your diet. Nutrition, especially if you are again following something like an autoimmune protocol and you're not incorporating dairy and even cultured and fermented dairy, right. That can have some benefits for some people. You then have to find non dairy sources of calcium. Two of my favorites, arugula is a plant based source of calcium bioavailable. It is low oxalate grain, so that can be a great addition. So you can saute that, you know, lightly with some extra virgin olive oil, or you could use it as a side salad and again get some additional benefit from that. You can also incorporate sardines and mackerel and these smaller fish that don't have, you know, the heavy metal load that some of the bigger fish do that also have the bones in them too. And these can be great additions because you can get bone in sardines. In a can get a punch of 300 milligrams of calcium, get a serving of 20 grams of protein and some omega 3s that can dampen your inflammation all in one go. Right? So I love those as a good autoimmune addition for those who can't tolerate dairy. And then magnesium is important. You know, if you're not getting enough, most people aren't getting enough. You can supplement with that. I like the chelated forms of magnesium just from an absorbability perspective. So like a bis glycinate, chelate or maybe McCall, you have some other recommendations that you have around that. But getting enough magnesium is important. Part of the reason is it helps activate vitamin D. And also if you're trying to rebuild anything within your body so you take in all these proteins broken down to an amino acids, and then you're trying to rebuild that inside your body and your muscles and your bones. Magnesium helps with that process. Right. So you need it to be present for that process to take place. So getting enough of that is important. And then I'll touch on three of the other bigger ones. Vitamin D we all know is important for bones. So your doctor's not wrong when they tell you to take vitamin D and get enough calcium. There is. There's great research behind that. Kind of like we talk about with thyroid. McCall talks about thyroid, and I talk about with bone health. Vitamin D is a hormone, though. So you want to test your level, take a specific supplement, retest your level in three months, especially if the target is to raise the level. Right. Make the intervention, take the supplement, get a little more sun, you know, during the day or something like that, and then retest in two or three months and see did the intervention make the intended impact? If it did, great, keep on that path or hold steady if it didn't, what do we need to adjust? Is it a new supplement? Is it making some other change? So vitamin D is super important. And then vitamin C is key for maintaining and developing a healthy skeleton. And it is actually a. Your, your bones are a collagen protein matrix structure. Vitamin C helps stimulate pro collagen and enhance collagen synthesis. So it's great addition. And the last one is vitamin E. Delta and gamma tocotrienols are great because there's actually some studies behind those that show benefit for bones, specifically in terms of improving bone turnover. So what I like to do is like, we test the markers, but then also incorporate things that have studies showing improvement in those markers, too. And delta and gamma tocotrienols have that.

I love it. Fascinating. Some new ones that I never would have expected. Right.

Which is so cool just from an antioxidant perspective, too. I mean, that's what really. It's bringing down those inflammatory markers also. And inflammation, you know, as we all know, is just one of the biggest contributors to a lot of different issues people are facing. So vitamin E having that antioxidant role helping bring those inflammatory markers down, I'm sure is part of that process too. So huge, huge exercise.

Yeah.

So we can. You can get all the vitamin E you want, or the right vitamin E anyway. You can get all the calcium, the D, all that stuff. You can provide the inputs, but if you don't have the stimulus, you can't. You're going to have a really hard time not just building bone, but Also maintaining. The other thing is that before you even get to exercise, I have a lot of people come to me and they're like, I'm doing so much, I'm exercising all the time I'm spending. Sometimes they're doing too way too much, they're overdoing it, which can actually not be a good thing. But they might be focused so much on the stimulus side that they're not actually addressing the prevention of loss side too. So remember, yes, exercise is important. It's one of the most important things, but you have to prevent the loss too. So as we get into exercise, you need different types of stimuli for your bone. You need muscle pulling on bone, you need impact. The most effective interventions use one or both of those things in combination. You also need to incorporate weight bearing exercise and muscle strengthening and resistance training exercise. So walking is just not enough. Weight bearing includes walking. So you can do walking, jogging, hiking, gardening, playing with the kids, the grandkids out in the yard, pickleball, yoga, pilates, tai chi, qigong, all that stuff can be part of your plan. As long as you're doing it safely with good form, that's great. That's all weight bearing and it's putting good, healthy stress on your bones. There's also non weight bearing. So if, if you're only swimming laps every day of the week and considering that your exercise and getting out of the pool, it's not enough. It's not to say you shouldn't do it, but you don't have the stimulus being put on your bones. It's the same thing as astronauts going into space. You're not using it, you're losing it. Okay, so we need that, we need that stimulus on the bone. So that's weight bearing. That's one thing you have to incorporate. The other is muscle strengthening and resistance training exercise. So this is where you're bringing in the barbells, the dumbbells, the resistance bands, the machines at the gym. If that's where your comfort level's at, maybe it's kettlebells. For functional movements, all those things can be a part of the plan. The bigger movements are the ones that have kind of the greatest return on movement for bone. So squats, deadlifts, overhead presses, those are some fantastic movements. As long as you do them with good form. Yeah, because the range, the rep range you need to be in, or that's really most beneficial, is in that 5 to 10 repetition range. And when you're in that range, doing it at that intensity, you want to make sure you've got good form. So if you're listening to this and you're like, gosh, I've heard of squats, I've heard of deadlifts. Maybe you're familiar and you're already doing them, great, make sure you're doing them with good form. If this is your first time considering deadlifts, don't just go online and look at videos because you're going to see somebody lifting some really heavy weight and you could, you could injure yourself. So you just want to make sure you've got good form before you apply the stimulus. And if you can't have good form with, without, don't apply the stimulus at all because it can lead to injury. So those are some of the most impactful exercises. There are other ones that you can incorporate, but that's probably your best starting point, at least.

I love that. I wanted to put a pin in one thing that is that we've talked about before that I want to highlight for listeners, which is there is all this hype around weighted vests. And not to say that they're bad. Right. But there's all of this hype about weighted vests and walking and how good it is for your bones. And I've heard you weigh in on this before, but I'd love for you to kind of compare and contrast and just share a little bit about your experience in the reality. Is that really enough or not?

Yeah, I think there are better ways to apply, like to give your bones the stimulus that they need and even some more practical ways too. Right. Are you really going to be walking around all day long with a weighted vest on if you're still working in the office or, you know, also, I see a very wide spectrum of people. Some people come to me, they have a diagnosis of osteopenia. They have pretty good quality bone. Not just density, but quality too. In those situations. I'm sure, you know, a weighted vest can be okay, but sometimes I see people come to me that they've got osteoporosis, they've had a vertebral fracture, they've got poor quality bone. And then they go online and they see, use this weighted vest now we're applying this compressive force all day long. We're walking, we're bouncing up and down and it's. It's different. There is some nuance with that in my position with it. So I don't say. I would say if you're somebody who has good quality bone, you've already got the measurements, you've Got maybe a lower score on osteopenia or even on the lower end of osteoporosis. And you've got good quality bone. That can be okay. But I think there are better ways to apply that stimulus. Get the foundational exercise stuff down right. Those movements down right first before you go add in these complimentary things that may or may not actually have the greatest possible return.

Yeah. And I love that you described it as complementary, because I think that's probably really what it is. Right. It's not going to solve the problem. It's not necessarily going to truly prevent the problem on a large scale. You're not building a lot of muscle mass, but it is complimentary. I love it.

And the same thing goes with vibration plates and rebounders and, you know, you name it. You know, usually people show up on calls with me, and they're. They're holding the thing or they're asking about the thing, and the thing is usually focused on the stimulus.

Yeah.

But they're usually not. But then we go look at their results, and it's like they got high levels of bone loss. They haven't looked at their markers, you know, up until that point. And now we got to go to work figuring out why all the stuff that they've done, all the things they invested, and why aren't those things working? Because we didn't address the root causes of the bone loss in the first place. So it all comes back to that.

I love it. Tell us where people can find out more about you and your work and just the resources that. That so many of us need in this journey.

Thanks so much, McCall. Well, you can always find me@bonecoach.com that's the best place to find me is bonecoach.com if you're listening to this and you yourself are like, wow, I need to build stronger bones. Or maybe you got osteopenia, osteoporosis. You have the diagnosis and. Or maybe you want to prevent it from happening. You can go to bonecoach.com there's tons of free resources there. We even have. We've got a free osteoporosis kickstart guide that tells you everything you're supposed to be doing. You can get that on our main part of our website. You can also apply for our programs. There's an application process. We have a whole team of people that are experts just focused on osteoporosis prevention and reversal. You can actually work with the team. There is an investment, obviously, that comes with that. So you go on that, you make you do the application again. That's@bonecoach.com and then you can find me on all the social channels too. And then the last part would be, if you know you need these bone turnover marker tests, the CTX, the P1NP, there is a test called the Active monitoring Test. Osteo IQ Active Monitoring test. You can go get that test@osteoiq.com and what that does is it cuts out. It basically takes away from how hard it would be from you as an individual to go try to get those tests. And it just streamlines it and simplifies it. So osteoiq.com is where you can get that.

I'll put all of that in the show notes too, and I'll be heading there myself. So maybe we'll do a follow up on all of this and see how my bone markers are progressing over time. So thank you so much, Kevin, for being here today and for your work, like, for your investment in the lives and the health of. Of women. And men, too, but a lot of women. So we need more. We need more of that. So thank you for, for creating this and making this available to us.

Thanks so much, Bacall. Thanks for having me. Absolutely.