A (5:08)

But the third question, and I think perhaps the most fundamental question then, is, does mouth taping really mean you're going to get those benefits? And here's where it gets a little tricky. Sorry, Sage, but the answer is not necessarily. First of all, there's just not a lot of studies on this, and the studies that have been done have been limited and inconclusive. But secondly, some experts we talked to said mouth taping is probably pretty useless unless you're utilizing proper breathing technique. Now, what does that mean? Well, think about this. And you can just do this along with Me. As you're listening to the podcast, in order for any of this to work, you have to make sure your tongue is placed properly in your mouth. And that means your tongue is in the up and forward position. Try this right now. So place the tip of your tongue directly behind your teeth, your front teeth. And then relax the tongue along the upper palate of your mouth and keep it there. So feel your tongue just behind your teeth. You shouldn't be able to talk. You shouldn't be able to say the word the. For example, now with your tongue sitting right behind your front teeth, try and breathe in through your mouth. You can't do it. You have to breathe in through your nose. And that is probably a great way to actually nose breathe instead of mouth breathe. Proper placement of the tongue in your mouth. So it's not just as simple as taping your mouth closed. You've got to get the proper position of your mouth in the first place. And before you even go and try that, I do want to stress that mouth taping, perhaps no surprise, can be risky and even dangerous, especially in people who have sleep apnea, which is far more common than you might think. Roughly 30 million Americans are estimated to have it, and a huge chunk of that, about 23 million, are undiagnosed. So, point being, you may have sleep apnea and not know it. If you do have sleep apnea, mouth taping could seriously restrict your airflow, therefore depriving your brain and your body of oxygen, which of course could be hugely problematic. We need to breathe. And even if you don't have sleep apnea, mouth taping can still really be dangerous. A recent analysis found taping or sealing the mouth closed or even strapping the chin to keep the mouth closed could pose a serious risk of asphyxiation in the presence of nasal obstruction. So there's lots of reasons we have trouble breathing through our noses. Deviated septum, nasal polyps, sometimes nasal tumors. Those are things you should get addressed. So before you go out and start taping your mouth, there are some other things you should try first.

A (7:56)

Look, it's great to hear about the trends we're seeing online which could improve your sleeper health. I don't dismiss all of them outright, and. But first and foremost, you need to be educated about what really works, what doesn't work, and what might be dangerous. So keep that all in mind. And thanks to all of you who wrote in asking such a great question and staying curious about these trends. Okay, we're going to take a quick break, but after we come back. We got a great listener question about bone loss and calcium supplements.

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A (9:33)

All right, we're back with paging Dr. Gupta. Jennifer is with us. What's the next question?

B (9:39)

Our next question comes from a listener named Deb. Here's what she had to say.

F (9:46)

Can you revisit the the osteopenia issue and what is being recommended now as far as calcium supplements or not calcium supplements? And I have a neighbor, her doctor is giving her testosterone and said that it will help strengthen her bones, which doesn't sound right to me. I don't know. And I do have osteopenia, and I'm 72 years old, but I still, I'm very active. I have two horses and I ride every day. And I have a farm that I take care of myself. Thank you.

A (10:23)

Okay, Deb, first of all, I gotta say, I love hearing that you're still riding your horses. I have an equestrian in my family, and she's only 16 right now. But I imagine this being a lifelong sport, you're also taking care of your farm. You're staying active. That is awesome. So let's get right into it. First of all, a lot of people have probably heard of osteoporosis, but what is osteopenia? Well, it has to do with your bones and bone loss. And actually, osteopenia is a term that many doctors don't use as much anymore. The preferred term is low bone density. So that's what osteopenia is. It is a form of low bone density. We talked to Dr. Deborah Selmeier, a director of the Metabolic Bone Diseases Program and clinical professor of medicine at Stanford University School of Medicine, and she said that put, put simply, osteopenia is low bone density that is not at the somewhat arbitrary cut point that defines osteoporosis. So it's not as bad necessarily as osteoporosis. So thinner, weaker bones. Yes, but not weak enough to be considered osteoporosis. Somewhere in between. Okay, I wanted to make sure you got that definition. Now, to determine if you have low bone density, you would have to take a test. And that test is called a dual energy X ray absorbitometry, otherwise known as dexa, that measures the mineral content of your bone. This does not hurt. It is not invasive. If you're concerned about bone loss, you should talk to your doctor about getting that test done. That way you're dealing with real information. Now, why should we care about this at all? The real concern here is fracture risk. How likely are your bones to break? And there are a few factors that determine fracture risk. It is a combination of a person's bone density. Yes, but also other factors, such as your age, if you've had a prior fracture, if you drink or smoke, or if you have conditions that might increase your risk, like rheumatoid arthritis. Fracture risk can be calculated using the FRAX Online fracture risk calculator. That. That's F R A X, if you want to look it up online. Now, keep in mind, these are just numbers and no two people are alike. Some people with low bone density will be at higher fracture risk and may need medications. Others will be at lower risk and they're going to need nutrition and lifestyle measures only. So again, have a conversation with your doctor about your personal risk level and determine how you can best improve your bone density.

A (12:59)

Now, Deb, let's get to your specific question around calcium supplements. Calcium is important for bone health throughout your life. It helps build and preserve strong bones and also helps support essential functions of the heart, muscles and nerves. For all people, including those with low bone density, calcium intake should meet the recommended daily allowance, which is 1000 milligrams a day for adults ages 19 to age 50 and 1200 milligrams a day for women over the age of 50 and men over the age of 70. So for you, Deb, that would be 1200 milligrams a day. I should tell you there are great calcium calculators online. You can figure out how much calcium you're likely taking in through your diet. And I think a lot of people are surprised at how little calcium they get, especially if they're not regularly taking dairy products such as milk. A diet with no calcium rich foods will give you about 250 to 300 milligrams of calcium A day only. Okay. So you'll need to identify enough calcium rich foods and or supplements in addition to that to get the recommended intake per day. And just so you know, the good news is the absorption of calcium is the same from food, from fortified foods and from supplements. So you can effectively use any combination of sources. Foods naturally high in calcium, again, no surprise. Milk, yogurt, cheese. But there's also other non dairy foods like canned fish with bones like sardines or salmon, dark green leafy veggies like kale or broccoli. They're also great sources of calcium. And some milk substitutes or tofu juices, cereals, they are fortified with calcium. Now quick caveat, don't go overboard. There is no benefit to mega dosing with calcium. You just want to get the amount that you need. Dr. Salmeyer says a calcium intake over 1500 milligrams a day can actually lead to high urine calcium and increase the risk of kidney stones. Also for your friend who is taking testosterone, Dr. Selmeier told us there are no data on testosterone as a therapy for low bone density in women. In men with low testosterone, testosterone therapy can increase bone density by a small percentage, but it may not reduce fracture risk. That frac score that we were talking about earlier. In fact, some research has shown that testosterone treatment in men may be linked with a higher risk of fracture. So look, don't overdo it. Don't take things that are unnecessary, but certainly take think about bone density, especially as you get older.

A (15:41)

Deb, I'm really happy you asked. When it comes to bone loss and calcium supplements, there is a lot of information out there. There is a lot to unpack. I really hope this helps you. That's a wrap for today's episode. Thanks again to all of you for sending in your health questions. No question is too big or too small. Keep them coming. You might just answer it on our next show. Reach out to us, record a voice memo, email it to asksanjayn.com or give us a call 470-396-0832 and leave a message. Thanks so much for listening.

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Your Ears the podcast I am your host, Michael Ian Black. I like that. I want the United States to state murder is bad unequivocally, but I would like it better if we then followed that up with not murdering people. Once the boat is incapacitated and people are just hanging out in the water a la Jack and Rose from Titanic, trying to find some space on that plank of wood, you don't then circle and assassinate them. Have I Got News for your Ears Releases new episodes every Wednesday. Don't miss an episode. Follow us wherever you get your podcasts.