Detect Osteoporosis & Osteopenia Early, with Kevin Ellis

We can't make an assumption that just because you're a post menopausal woman that hormones are the only cause of your bone loss. We want to know, is there something else contributing? It's just understanding where you're at, what's your current picture, and how do you make adjustments from there.

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Hello and welcome to this episode of the Feel Freaking Amazing five Journeys podcast. I'm Wendy Trubo. Ed's with me today. He's not always with me, so savor the moment, folks. And guess what? We have Kevin Ellis on our show today. He's one of my favorite, favorite people. He is better known as the Bone Coach. He's a Forbes featured Integrative health coach, podcaster, YouTuber, and he's also the founder of bonecoach.com, which he founded us after an osteoporosis diagnosis in his 30s, which, by the way, men don't get osteoporosis in their 30s. Just. Just for the listeners.

They don't get osteoporosis very often.

And. And that was really the impetus for understanding how challenging it is for the average human to get the ways towards stronger bones and prevention and resolution of osteoporosis. So I'm going to skip to the punchline and let you all know that he reverses osteoporosis and has subsequently done it with thousands of people. So, Kevin, welcome. What a pleasure to have you here.

Thanks so much for having me here. This is. This is going to be great. I'm looking forward to it.

All right, so what is osteoporosis?

Well, osteoporosis, I mean, it's something that not too many people know that much about, especially if you're a male or a younger male. But you're probably going to learn more about it if you're in your 50s, your 60s, your 70s, and you're a female. And 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 both of those things. And in osteoporosis, both your bone density and Your bone quality are reduced, and that increases your risk of fracture. And that is, you know, as people age, I think that's one of the biggest concerns most people have is their aging is they may have seen like their mother or their grandmother or some kind of progression or they had a fracture and that significantly altered the course of their life from, from there forward. So preventing fractures, understanding your, your bone density, where it's at, and maybe some proactive and preventative things you could do now is just really, really important.

But let's make sure, just for our listeners, what is osteopenia, then? Osteoporosis is porous bones. What's osteopenia?

Osteopenia is like a precursor to osteoporosis. It would also be called low bone mass, is what I would prefer to call it, but you might get a diagnosis from a physician of osteopenia. The way that is going to be determined is through what's called a bone density scan. Somebody goes and gets this scan, and you may have to request this scan because it's probably not going to be done until you're 65 unless you request it. But it's very low levels of radiation. You lay down on the machine, it does a scan, it tells you your bone mineral density, which is the actual mineral content of your bone, and then it generates a score. A score of plus 1 or minus 1 is considered normal and healthy. Minus 1 to minus 2.5 is considered osteopenia, which is a precursor to osteoporosis. Minus 2.5 and lower, minus 2.6, minus 2.7, so on and so forth. That's considered osteoporosis. And the greater that negative number becomes, the more severe the osteoporosis. And I, I always encourage people get a baseline earlier, right? Get a baseline earlier in life, see where you're at. Because you, it could be that you also didn't build up enough bone in your younger years. You may not have reached peak bone mass.

So I don't know about you, but I usually recommend women do it at least 50 years old. That's, that's generally, I'm like, are you female?

Do you breathe? Do you have any risk for bone loss?

Let's do a bone density at least at 50. I like the bone.

Yeah. But even if it's not like, I think it would be good just for general, even men, men or women, 30s or 40s, to get a baseline, understand where you're at. So that way, later on in life, it's not necessarily Just this surprise, right, that oh my gosh, osteoporosis, it must mean that I'm losing bone right now like this. Something is right now contributing to that. That's not always the case. Right, because when you get a bone density scan, it's a snapshot in time. This is your bone density right now. What it's not telling you is it's usually not telling you your bone quality, which is the structural integrity, the micro architecture, how that bone is organized. Those two things combine, they create bone strength. A lot of times people only have part of the picture. There is an add on software that you can get called TBS Trabecular Bone Score that can help fill in that quality part of the picture. There's also technology called rems, a newer technology called REMS that is radio frequency echo graphic multispectometry technology. And that looks at your, it's like an ultrasound technology. It looks at your bone density, your bone quality and gives you a five year major risk for osteoporotic fracture. Like a fragility score. Basically. There are those tools to look at your bone quality.

Is that in addition to.

Yeah. How do you order that? Is that, is that something we can order?

There are only certain clinics in the country right now, so Europe, it's already more widely adopted. The REMS technology is already more widely adopted in Europe. Not surprising. And it's been a slower adoption here in the us but there are some clinics out there that have this newer technology. And then in terms of the TBS trabecular bone score, you just have to ask ahead of time, call the facility ahead of time. Hey, do you have this add on software to DEXA called tbs? If they say yes, then you just want to confirm with the technician when you get there that that facility actually has it and that they're going to do it, do that with your scan. But the other thing that it doesn't, a bone density scan is not telling you, is not telling you if you're still actively losing bone right now, present day. So that is where bone turnover markers come in. And that is where you can look at the activity level of cells that are breaking down and building up your bones. So one of them, the most sensitive marker for bone resorption, resorption is just another word for bone breakdown, is, is the ctx, serum ctx. It's a blood test, the CT low peptide test. And that test looks at the activity level of cells that are breaking down your bone. And if that activity level is elevated or even really high, that can be an Indicator of active bone loss and a root cause issue that needs to be addressed.

So I order ntelopeptide in the urine.

Yep. You do urine or blood?

Do both usually, yeah.

So there's the blood NTX also. Right. But then urine would be the preferred for the NTX too. So an ntx, if you do the ntx, getting it as the first catch of the day, it would be the best in terms of the urine first thing in the morning. And you're getting these labs fasted too, because especially with the bone turnover markers, they can be influenced by diet, by time of day, things like that.

So what is the difference between the CTX and the ntx?

Ntx, they're both bone bone resorption markers. So they're looking at the activity level of cells that are breaking down bone. The biggest differences between the two are that NTX is still. It's just you're doing it in a different form. Right. So CTX is one, NTX is the other. I would say the preferred forms of the CTX would be the blood. Preferred form for the NTX would be the urine. Then the other thing too is that that looks at the bone resorption or breakdown side of the picture. But what it's not looking at is the other side of the picture, which is formation. So if you're looking at one side, you want to look at the other side. So the most sensitive marker for bone formation is P1NP Pro collagen type 1N terminal propeptide. Sometimes it shows up a little bit differently depending on which labs you're looking at. But that's the other part of the picture. It's a blood test. And that test is directly looking at the activity of the osteoblast, the cells that are building your bone.

I love that. This. I mean, I'm assuming this is a standard LabCorp quest lab that you don't have to see a functional medicine doctor to say to your doctor, could you please order these tests on me? It's. This does not necessarily. I mean, of course you should see a functional medicine doctor, but you don't need to for this.

So there are a couple for bone formation. Right. So P1NP Pro collagen type 1N terminal propeptide. That's a mouthful, by the way. That's the most sensitive marker for bone formation. That's directly reflecting the activity of the osteoblast, the cells that build bone. There's another one called osteocalcin, which a lot more people are familiar with. Osteocalcin this is a protein that's produced by the osteoblast that's important for activating bone mineralization and binding calcium to the bone matrix. So osteocalcin is also another one that we can look at in the blood. But then there's also bone specific alkaline phosphatase. So when you go get a comprehensive metabolic panel, the cmp, and in that you have your alkaline phosphatase, there are different fractions within that. So there's, you know, you can tell if that is elevated, what the elevation is coming from. You can explore that further. And there is bone specific alkaline phosphatase, and that is detecting early signs of osteoblast activity. And this would be an important one to have if a person also has high or elevated serum calcium too. Because you're looking at like bone cancer or something like that potentially. But that can be another indicator of what's going on in your bones. And then outside of just bone turnover markers, there's another one you could look at. You look at 24 hour urine calcium, right. And this is, it's not a bone turnover marker test and it's not looking at the activity level of those cells that are building up and breaking down bone, but it is looking at calcium. And the primary mineral constituent of your bones is calcium. So if you are losing a lot of calcium through your urine, that could also be an indicator of active bone loss. So there, there are lots of tests that you can do to look at what's going on inside your body. Those are some helpful ones.

So just to be clear, for the primary ones, the C peptide, the P1NP, are you using the standard levels or you have a much shorter range? Because a lot of times in functional medicine we don't like, we don't like the average. We like optimal.

Yeah, yeah. Because the ranges, especially, let's say even on ctx, right. The range is pretty wide. I don't know, from a couple hundred to like eleven hundred or something is like the standard range. It's pretty, it's pretty significant. If somebody's up at like a 700, 800, 900, 1100 CTX. And it's not an error on the test. There can be errors.

Right.

And it's not an error on the test. That could be an indicator that there's something contributing to bone loss. Right. Then. But if it's on the lower end, you know, and you've got like a 200 or 300 CTX or something like that that's probably an indicator that there's not, or that there's, there's lower bone turnover, not a lot of bone loss that's happening, or that, that you would have a stable result. But then you would also look at, you would also look at bone formation too, and what those numbers are telling you also. But that's like, that's a very general example when you look at everybody's picture. There is some nuance there too, which would be really hard to kind of get into just in this discussion, of course.

What are some top things that you're recommending people. People engage in to reverse and slow the decline?

The fir. One of the first ones and is I wouldn't even focus on reversal, right? A lot of times that, like when people come to me, that's what they say, I want to reverse osteoporosis or I want to reverse osteopenia. And I'm like, it's great to have the goal, but we need to focus on, you're not going to see results in your bone density scan for a year, year and a half, two years. It's not a quick fix. There are no magic cures. It takes time to do these things. So we have to look at leading indicators and start doing the things in your life to get you moving in the right direction. So the biggest kind of areas that we need to affect are figuring out if you have any kind of root causes that are still contributing to bone loss. So getting the root cause, working with functional medicine practitioners, naturopathic doctors, you know, your medical team also, and knowing how to have those conversations, knowing what your lab results mean when they get back, knowing how to spot those patterns, that is so important to all of this. Because if you are still losing, you know, you can't start going up and improving if you're still going down and losing. So addressing the root cause, that's like, that's a big part of this. And usually what we can't do is we can't make an assumption that just because you're a postmenopausal woman that hormones are the only cause of your bone loss. That we want, we want to know, is there something else contributing? So, and then if you are not a post menopausal woman and you're a 30, 40 year old male or 34 year old woman or at any age range, really, it's just understanding where you're at, what's your current picture and how do you make adjustments from there? That's kind of the first part I.

Want to put a plug in here, Kevin, for ensuring that you're working with a functional medicine doctor to do provoked testing for heavy metals because they love the bones and they'll hang out in your bones and put you at risk for osteoporosis. So lead, mercury, particularly lead, really huge plug provoked. Not just a hair test or a baseline urine, but provoking it.

Yeah, absolutely. And a lot of times when, if, if somebody has already had that heavy metal exposure and it's stored in their bones, if they're a postmenopausal woman, right. And they're having that bone loss, a lot of times that with that bone could those heavy metals can come back out into circulation too. So you have this auto intoxication that's taking place.

I think we need to put a plug in that. If you have osteoporosis you want, and it's in an earlier age, you want to get checked for celiac and if you have celiac you want to get checked for osteoporosis. It's a bi directional straight. I feel like we're scratching the surface here, but I've deliberately asked you fewer questions because it's such a big topic. So I think what we should pivot to, A, for the listeners, thanks for listening and B, how can people find you? Because this is, this is the, the start of the conversation at the end of it. So how do people find you and follow you? And we'll put everything in the show notes for sure.

Yeah, so you can always find me@bonecoach.com we've got stronger Bones coaching programs. I mean we've got over, over 5,000 people have come through these programs. It's focused on helping you slow, stop, prevent bone loss, build bone stre strength, prevent fracture and injury and just enjoy your later years. That's the whole focus of this. So that's, those programs are all@bonecoach.com and then you can find us on all the social channels, Instagram, at Bonecoach, Kevin, YouTube, Facebook, Pinterest, those are all at Bone Coach. So you can find us there. And then if we could put my free Stronger Bones masterclass in the show notes, maybe and that, that's a great three step process for them to walk through. And I'll give them a free Bone Healthy recipes guide just for signing up. So if that's in the show notes, I would check that out too.

We'll get that in there. All right, listeners, this is Kevin Ellis. Thank you for joining us. Kevin, thank you for being here for this episode of the Five Journeys Feel freaking amazing podcast. We're so psyched you were here. Everything will be in the show notes. You'll be able to find him. And thanks for being here today.

Thanks for having me.

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