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Dr. Osborne’s Zone
Cure for Osteoporosis? Science Reveals Shocking Truth About Bone Density
01:04:51
Most people think bone loss is caused by low calcium — but that’s only part of the story. In this deep-dive episode, Dr. Peter Osborne breaks down the real root causes of osteoporosis and osteopenia, from chronic inflammation and medication side...
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Hey, osteoporosis is not a calcium deficiency. Let that sink in. Tonight on Dr. Osborne's Zone, we're going
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to be doing a deep dive on
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the nutrition of osteoporosis, the vitamin deficiencies that are linked to it, the mineral deficiencies that are linked to it. Oh, and by the way, we're going to be talking about a long list of medications that are very common to, that can actually drive osteoporosis. So if you want the new science on how to overcome how to heal your osteoporosis with diet and lifestyle, stay tuned. We'll be right back.
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You unlock this door with the key of compassion. Beyond it is another world. A world of science, a world of common sense, a world of sanity. You're moving into a land of both empathy and ethics, of nutritional knowledge and empowerment. You've just crossed over into Dr. Osborne's zone.
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Welcome back.
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Tonight, we're going to be talking about bone loss. If you've been diagnosed with osteoporosis or osteopenia, or if you've been told because you have a family history of bone loss that you should be extra concerned, or if maybe you're taking certain types of medications for other conditions, maybe you have hypothyroidism or blood pressure problems or cardiovascular disease, and your doctors have said you're at increased risk for bone loss. This is a show you're not going to want to miss.
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Now, when we talk about bone loss, there are a lot of factors in
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terms of what causes it, and the factors are not.
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Although calcium plays an important role, most doctors, when they diagnose you with bone
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loss, are going to want to tell you to go take calcium, and that's about the end of the nutritional guidance
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that you're going to get. But in reality, there are a lot of factors that are associated with bone loss, and these are just a handful of some of the more common ones. So you can see here lack of
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physical activity, number one.
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At the top of the list, there
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is a law called Wolf's law. And this basically means that bone grows based on pressure. Pressure is what physical activity is. So if you move your body and you put your muscles and your bones under pressure through exercise and weight bearing is definitely better than non weight bearing,
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then you can actually increase the physiology behind why your body wants to increase your bone density. So lack of physical activity is a big one. Excessive exercise can also be a problem.
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Now, here we are talking about exercise,
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so you have to know where to draw the line.
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For many of you Exercise is done or should be being done to tolerance. And so some of you might be, you know, heavy, heavy exercisers where you get into a situation where you're working out multiple times a week, you're not taking enough time off, you're not getting adequate downtime or rest or sleep. This can actually contribute to chronic inflammation that leads to bone loss. So there's a nice balance, just like everything else in the world. Too much is a bad thing, too
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little is a bad thing. You've got to find that magic spot
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right in the middle.
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Chronic inflammation. Now we're going to go a little bit more in depth about this because I believe that chronic inflammation is the cause of bone loss, period, no matter who you are, no matter what the situation. We also know that being a woman, being a woman, predominantly because women have less muscle mass in general, women are less capable of being physical. Now please don't take offense at that.
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They. There are some of you women out there that are super strong and can exercise and maybe you're crossfitters or maybe you're competitive athletes.
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I'm not saying as a general rule that all women are at risk, but the vast majority of women are. Then we have things like smoking and alcohol use, of course, lifestyle factors that cause what they cause. Chronic inflammation. And then we have a history of bone fractures. Now this is less of a risk factor per se. And if you've had a, like a trauma.
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So if trauma was what you experienced as a fracture, that is not, you
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shouldn't count yourself in that category of risk. We're talking about spontaneous fracture.
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I had a patient not very long ago who had compression fractures in her spine and they were spontaneous, meaning she didn't. There was no car accident, there was no major injury.
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This was just spontaneous. And so if you have ever had a spontaneous fracture, historically speaking, you're definitely at much greater risk of future fractures and of bone loss and the chronic medication use. We're going to talk more in depth about which medicines you want to look out for here in just a minute. Family history of osteoporosis. Now this is less important. Again, there's a caveat to this one.
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So if you have a 90 plus year old grandma who was diagnosed with
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osteoporosis, that's not what we're really talking about. We're talking about you have somebody in
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your family, your immediate family, who maybe they were diagnosed with bone loss in their 40s or 50s or even, maybe even earlier.
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This is kind of more of an early onset.
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Traditionally speaking, osteoporosis true. Osteoporosis is really a disease, progressive disease, of the elderly, of the very elderly,
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not of younger folks. So if you have family history of that older crowd, not so much an issue.
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It's of the younger folks in your family.
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And then frequent pregnancies, again, true of ladies too, being a woman. So these two kind of hand in hand, because men can't be pregnant, despite what many people are trying to say nowadays. But frequent pregnancies, because of the nutrition, right?
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When you have and you're growing a baby inside of you, this requires vast amounts of nutrients, many of these nutrients which help aid bone maintenance.
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And so as you are pregnant multiple times, very important to monitor nutrition, to reverse any kind of malnutrition that might occur during pregnancy or during breastfeeding as well, but also to maintain healthy, healthy bone. And this ties into nutritional deficiencies because, you know, vitamin and mineral deficiencies, not just calcium, Right?
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Calcium is important, but it's not just calcium. Your bone is made by a variety of different nutrients.
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And so this is important, especially if you are worried about bone loss. It's important to have that checked. It's important to have that measured. And then we have lack of sunshine. And this has a lot to do
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with vitamin D. Vitamin D is how we make vitamin D is through sunshine exposure. There's a cholesterol on your skin that gets converted into vitamin D when you're
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exposed to UV light. And so that vitamin D, very, very important. One of the things vitamin D does is it improves or increases the absorption of calcium.
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So if you don't get adequate vitamin D, you'll actually become calcium deficient over time. So these are some of the main
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factors behind why people could potentially develop bone loss.
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But let's go a little bit deeper.
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Let's check out this diagram. So what is a very kind of
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typical scenario in most people's lives, right. Is everything that you see here, which we start with up here with number one, which is poor nutrition. A lot of people don't eat well, okay? Eating out, fast food, junk food, high doses of carbohydrates, especially processed carbs and
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processed seed oils, grains, glutens. This is poor nutrition, right?
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And then we couple that with lack of physical activity. How many of you have a job that's super physical? Now, there may be some of you out there that do, but most people nowadays don't have a physical job. They have a sedentary job.
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And that leads to, we said a minute ago, Wolff's law, which is the
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law of Pressure on bone. And when you're sitting all day in a chair, there's no pressure on your
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bones or joints, that lack of physical activity is going to lead to deterioration in your overall bone and your muscle. And then we have unhealthy eating habits. So this kind of ties into poor nutrition. Nutrition, but poor. Let me back up a minute, because I mentioned fast food and junk food here. But poor nutrition could also be that you're eating wrong for who you are.
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In other words, you could be eating what you think is a good diet, but not getting adequate nutrients from the diet that you're eating or the diet that you're eating might not be right for you.
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And an example of this would be gluten.
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There are a lot of people with gluten sensitivity.
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And as I'll show you here in a moment, gluten is a major contributor or can be to bone loss. And another example of this might be somebody who's following a vegan diet and they're doing it for health purposes. But that vegan diet, because of the low quality of protein typically found in a vegan diet, there's a poor nutrition outcome in that regard. Now, again, there are a number of different examples as far as, like, poor nutrition, not getting adequate quantities of nutrients from the diet that you're eating, or maybe eating the wrong diet.
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It's not right for you as a unique person. These are all things that can be identified, by the way, with the right kinds of doctors and testing and also
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paying attention and listening to yourself and
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listening to your body and just being
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tuned in to how you feel when you eat. All important.
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Then we have things like alcohol, right? So we got. Let's move down the list here. So, you know, a lot of people will gravitate to alcohol. Of course, alcohol is a driving force behind nutrition deficiency. So alcohol can cause vitamin B deficiency.
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Alcohol can also contribute to things like magnesium and zinc deficiency. Alcohol is a poison in a sense. And so if you're doing this on the regular, if you're drinking on a regular basis, this is going to be a problem for you.
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When you add up the years we
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mentioned before, sedentary job, and then, you know, kind of the combination. One of the things that happens, you
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know, if we follow this through all the way, right?
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So we've got poor nutrition, lack of physical activity, unhealthy eating habits. We throw in a little alcohol and stress.
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We have a sedentary type of job now because of all these things, we hurt. We hurt.
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We have chronic inflammation.
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And generally where does pain show up first? Usually it shows up in things like muscles or joints. We get a little bit of joint ache or joint pain, a little stiffness,
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that type of thing.
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And then a lot of us gravitate toward pain medicines. And of course, pain medicines can also cause deficiencies of things like vitamin C and B vitamins and iron.
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And so now we're multiplying, potentially the problem, because these nutrient deficiencies can also cause pain.
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Right. And so now through all this, we also start seeing bone loss. Why? Because nutritional deficit leads to bone loss. And then what does the doctor do for bone loss?
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Generally they want to give more meds. Right.
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So at the end of the day,
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depending on which meds you get, these
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meds cause additional nutritional deficiencies. So we go back to poor nutrition here. Right.
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So this just becomes a cycle that becomes self feeding. So how do we intercept? Right.
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We evaluate ourselves, we answer ourselves honestly and say, am I doing my part to improve bone health or am I
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wrecking myself by having all of these
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factors working against me?
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And only you can answer that question.
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You just have to be honest with yourself about it.
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Now I mentioned before about gluten and
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I posed the question about gluten.
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Gluten, can it cause bone loss? And I think it's important to show you a little bit of information.
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Being the guy who knows a lot about gluten and being relatively, I'll say, famous for gluten sensitivity, I want you
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to look at this study published here recently. Osteoporosis can be the sole presentation in
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celiac disease, meaning you could be celiac, have no gut symptoms, have no diarrhea, no intestinal pain or discomfort. But osteoporosis or bone loss might be the way your celiac manifests.
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That's what this is discussing and referring to. So you can see here. Celiac disease, an autoimmune condition causing gluten intolerance and disrupted absorption of nutrients predisposes to osteoporosis. The release of pro inflammatory cytokines, calcium malabsorption and the activation of osteoclasts. Osteoclasts are cells that break bone down, represent the main mechanisms responsible for bone derangement. Hence, it's important for physicians to consider screening for celiac disease panels in patients representing with osteoporotic features with no clear etiolog.
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So if you go to your doctor and there's no reason why you should be osteoporotic, you're generally relatively healthy, your doctor should consider measuring you for a gluten issue.
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That's what this, these researchers are saying
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about gluten and osteoporosis. Now, beyond that, we know gluten causes vitamin and mineral deficiencies, many of which contribute to bone health. Right? So when you're lacking nutrients that are necessary for your bone to remodel and
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your bone to grow and maintain itself,
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you're going to end up with poor quality bone over time.
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So it's very important to understand gluten induced malnutrition is a major driver of this. Then there's also gluten induced inflammation.
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And I want to introduce you maybe to a new topic.
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There's a term in science that has
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been introduced more recently, and that is a term called osteoarthritis immunology. And what does that mean? This is a new field of science where you have bone.
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Osteo means bone, and immunology means immune system, where you have the discovery that
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bone is broken down as a result of chronic inflammation. Right.
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So when we think about gluten, gluten causes chronic inflammation. So you can see your bone loss triggered by the cytokine network of inflammatory autoimmune diseases.
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What autoimmune diseases are linked to bone loss? Well, celiac disease, rheumatoid arthritis, lupus, Hashimoto's thyroiditis, ankylosing spondylitis, psoriatic arthritis.
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There's a host of pre existing autoimmune conditions that we know. The inflammation that's driving those diseases is also driving and osteoimmunological bone loss. And so what I'm showing you here, there's just that correlation in the research, right? These researchers are saying that, look, chronic inflammation leads to a host of different cytokine releases, okay, that increase bone erosion
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and decrease bone formation. That's what this fancy diagram is basically
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saying with all these complex terms.
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Right.
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We don't have to get into that, but it's important for you to understand that chronic inflammation increases bone erosion and reduces bone formation.
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Thus, net bone loss over time, leading
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to disease like osteoporosis. And this is inflammatory.
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Now, how do you know whether you have the inflammation? One of the really great tests that you can ask your doctor to run
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and insurance covers it, is high sensitivity C reactive protein.
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This is a protein released by your liver that's a good indicator of whether or not you have chronic systemic inflammation.
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So if you go in and you have a positive CRP, what's positive is
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anything higher than 0.9. Okay.
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Anything higher than 0.9 is going to
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Be considered too much, too high. It's a marker for systemic inflammation that's
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going to increase the potential risk for you to develop bone loss through that inflammatory pathway.
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What can you do about it? Figure out what's causing the inflammation in the first place.
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We don't take any inflammatories. A lot of doctors want to just put people on any inflammatories, you know,
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and damn the cost of the anti inflammatory.
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But what I will show you in just a minute is if you do
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that, you're going to end up in worse shape. And let's just talk about why that is. Okay, so what are some of the common anti inflammatories?
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Well, right here. Steroids. Steroids are one of the most commonly prescribed medications to treat inflammation in patients.
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But one of the side effects of steroids is bone loss.
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Now how, why do steroids cause bone loss?
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Because steroids reduce calcium, magnesium, vitamin C, vitamin D and zinc, just as for starters, right?
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And these critical five nutrients play a
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major, major role in how your body
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repairs bone and how your body maintains bone. So steroids also work catabolically.
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Catabolically means they break down tissue. So steroids are catabolic in nature.
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That means your tissue gets broken down.
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This includes bone, but it also includes muscle. That's why people that go on long term steroids end up getting super swollen. They retain a lot of water, but their muscles just waste away and they lose most of their strength. And the longer they're on those steroids, the greater the risk for the development
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of that bone loss. And this is also true, it's not just true. People that take oral steroids for pain.
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It's also true of those of you
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with asthma and you're trying to reduce
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your asthma inflammation as a result of
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that inhaler, that steroid inhaler.
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So be aware that that correlation exists. Okay, so let's talk about nutrients. I said earlier that you know, bone
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loss is not a calcium deficiency. So ca. This is calcium. Okay? This is an example of some of
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the most common and important nutrients that play a role in building and maintaining your bone. Now this is not a comprehensive list. This class is not designed to go into the hours and hours and hours of conversation that we would have to have about how all of the nutrients play a role in bone health. So please, you may have a nutrient in mind. It's not on this list. I just want you to know this is not intended to be the most comprehensive list. There are other nutrients as well.
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That being said, these are some of the most critical and some of the most important. So calcium, magnesium, vitamins B9 and B12.
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Okay, why? B9 and B12 deficiency lead to an increased homocysteine level. So this is another test you can ask your doctor to run. Increased homocysteine has been linked to bone loss. And how can we lower homocysteine? Well, predominantly B12, but also folate, which is vitamin B9.
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And so that's where that connection exists. We also have drugs, or not drugs, but nutrients like vitamin K. Vitamin K helps to push calcium into your bone cells.
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So think of vitamin K as the air traffic controller for calcium. It makes sure that calcium makes it
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into the bone matrix. And then we have nutrients like vitamin D. As I mentioned earlier, vitamin D
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tells your intestinal cells to absorb calcium. And so if you don't have adequate vitamin D, your intestinal cells will not absorb calcium super efficiently and you can become calcium deficient.
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So vitamin D, very important along that line, we also have vitamin C. Now,
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vitamin C very important for forming the collagen. Your bone is made out of a few different things. It's made out of an organic latticed
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network of collagen and protein, and it's
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made out of a network of minerals. So you have this basis backbone of protein. And then minerals come in and harden it and mineralize it.
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And so vitamin C is very, very important for the formation and the strength
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and the integrity of the collagen in your bone.
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Then we have protein, protein, very critical protein forms that backbone matrix of the bone itself. We'll talk more about that in a minute. And you've got iron and zinc and then there's potassium. So again, you've got vitamin K here,
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and here we got potassium is represented
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by a K. And then boron, selenium and strontium being minerals. Now I want to show you
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just little bit of the research on nutrition and bone. So let's take a look first here at magnesium. Okay, so this is just a review
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on the importance of magnesium in bone health. And so review of multiple studies. You can see here lower values of magnesium are related to the presence of osteoporosis. And that about 30 to 40% of the subjects analyzed, mainly menopausal women, have hypomagnesiumemia. Considering the intervention studies published to date on supplementation with magnesium, most have used this mineral in the form of citrate, carbonate or oxide with a dosage varying between 250 and 1800 milligrams. In all studies there was a benefit in Both terms of bone mineral density and fracture risk.
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So improvements both in the bone itself,
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but also reduction in the risk.
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Fracture magnesium, super important. And research confirms that in a big way. Then we have, let's see here, let's, let's pull this one up. This one's on the role of zinc in bone health.
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And I think important understand a number of studies have been done on zinc, but this one, this was a paper that was published kind of analyzing all of them and the functions of zinc and bone health. And so you can see here in this diagram, you know, on the left hand side you've got insufficient zinc and
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then on the right hand side you've got adequate zinc.
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And what happens is the lower your
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zinc goes, the poorer your bone quality gets, the slower your bone regeneration gets and the slower your bone growth get.
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So we have three different parameters being affected as a result of not having adequate zinc. So we know zinc plays a major
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role in all three of these areas and going to be a very important nutrient for bone health. Now so many individuals are low in
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zinc because they're taking medications that deplete zinc. Probably arguably one of the, one of the biggest ones are your blood pressure medications. So a lot of folks out there
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with high blood pressure issues taking these types of medications really, really struggling.
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Now this next one on protein, and I mentioned this earlier, but again, there's
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this major attack on protein. Right now we are being told that eating animal protein causes all kinds of nefarious health problems and diseases. We're being told that it destroys the planet. And yet out of the same, the other side, we're being told to eat all these processed junk foods that are full of very harmful ingredients and untested ingredients, like a lot of these plant based meat substitutes that are coming out
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that have become more and more popular. But the reality is most people are protein deficient and most people eat way
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too many carbohydrates and don't eat anywhere near enough protein.
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And all the research has been coming
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out here recently saying this, this is especially true of people as they get older. Women especially over the age of 60, should be eating 1.2 to 1.5 grams of protein per kilogram of body weight.
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Okay?
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So if you want to get your
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kilograms, you just divide pounds or you
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take your weight in pounds and you divide that by 2.2 and that should
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give you your weight in kilograms. So you can do the math or you can go to Google and you can search and do a calculator, but 1.2 to 1.5 grams of protein per kilogram of body weight.
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And most people and most Doctors are recommending 0.6 to 0.8 grams of protein
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per kilogram of body weight. It was not even, in some cases, not even half of what you need, right? So protein becomes very, very important nutrient. And, and if we're talking about the research on protein, and this is, again, this is a major summary, a systematic review and meta analysis of protein intake and bone density, you can see that
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dietary protein, adequate dietary protein, leads to
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improvements in hip and femoral neck bone density.
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Inadequate protein increases the risk for hip
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fracture and reduces bone density by as much as 11%.
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I mean, these are huge changes. So think about this.
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How many of you have gone to
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your doctor and you've been diagnosed with osteoporosis from a bone scan and instead
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of saying, hey, I need you to be here, we need you to be here.
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1.2 to 1.5 grams of protein because your bone is made of a base of protein. But how many of them instead pull out the prescription pad and write you a prescription for something like Prolia or Fosamax, right? These very, very potentially dangerous drugs.
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We'll talk about that shortly. Stay with me. But protein, so important and so easy to eat, so easy to add to the diet.
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But so many have been misled by so many. We'll just say untrained or uneducated doctors as it relates to nutrition, they're following
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along the same lines of rhetoric that
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the media is pumping out to make everybody protein malnourished. It's, in my opinion, it's a little ridiculous. Okay, so that's protein. Let's talk about strontium. Strontium is interesting. So it's a mineral and it's actually in Europe it's used, there's a certain
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kind of prescription, strontium used as a drug treatment. But you can take natural strontium. You don't have to use a medication. Those of you listening from Europe, you can take, instead of the medicine, you can take strontium citrate, which is a natural supplement. But one of the things I want to point out here is that commercial foods grown on fields, using synthetic fertilizers, pesticides and herbicides have appreciable lower levels of strontium than organic food counterparts. Now, you always hear me say, eat well, eat organic.
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There are reasons why we want to choose organic. One of the biggest is that it's
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more nutritionally dense than non organic foods. So you get these minerals and good organic food choices. You can See here. Thus, the restoration of adequate strontium levels to individuals may simply represent the normal homeostatic requirements for strontium. And normal healthy bone may require some levels of strontium to prevent calcium loss
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if strontium helps your bone preserve calcium.
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Most importantly, treatment to elevated strontium levels
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has repeatedly been shown to demonstrate safe and remarkable efficacy at diminishing fractures in hip vertebral as well as peripheral sites.
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Srontium, which is one you very rarely
- [28:21]
B
hear anything about at all, is very critical as a trace mineral to improve and to support bone health. Okay, let's talk next about iron, because this is a really common one. I've talked about this a lot in context of celiac disease, meaning this is iron deficiency is number one deficiency in people with celiac and gluten sensitivity. And this is, you know, this is
- [28:50]
C
not just me saying this, this is my experience clinically. But it's also what you'll see if you do a literature search on nutritional deficiencies and gluten sensitivity as iron is a super common deficiency. Now, there's a, there's a kind of a balance with iron. And this, again, this is a, this is a review of that balance where too little iron can contribute to poor bone formation, but too much iron can also create to poor bone formation. So you can see your iron overload leads to an increased breakdown of bone. Okay?
- [29:25]
B
But adequate iron also leads to improvement in bone quality. So it's, it's just like anything else. Too much, not a good thing. Too little, not a good thing.
- [29:34]
C
We have to hit that right amount. So if you've been diagnosed with bone loss and your doctor's not measuring your iron, he should be.
- [29:41]
B
And a lot of doctors will not do an iron panel. But you ask for an iron panel as a starting place, right? An iron panel is at least more accurate or at least more representative of iron than just running, because a lot of times they'll do a CBC and they'll give you hemoglobin and hematocrit. These are two markers that can mean you have an iron deficiency, but you
- [30:04]
C
want an iron panel.
- [30:05]
B
You also would ask your doctor to measure ferritin, which is stored iron.
- [30:10]
C
Those are kind of bare bones testing just to look at iron status. And so again, if you're low, which
- [30:17]
B
is super common in those with gluten
- [30:19]
C
issues, we see ferritin very commonly below 10 in folks, we see iron stripped to the floor.
- [30:25]
B
We see chronic recurring anemias, people that, no matter how much infusion they do, no matter how much Iron they try
- [30:33]
C
to take, their iron levels keep dropping repetitively. And this is going to impact and affect the bones.
- [30:39]
B
So just be aware of that and get it measured. Look, these are all things that can be measured. And if your doctor wants to put you on a very powerful drug, they
- [30:48]
C
should be measuring your nutrition first. Always measure nutrition first because the answer
- [30:53]
B
to your problem might be in nutritional supplementation and not necessarily in chemical manipulation with medication. Okay, so let's rearrange this because these
- [31:07]
C
are both coming from the same research study. And I just want to give you
- [31:10]
B
a couple of summaries on it. So if you look here at.
- [31:18]
C
This was actually a study published a number of years ago called the COMBS study. COMB stands for. It's an acronym. Doctors love acronyms. A combination of micronutrients for bone. Okay, so a combination of micronutrients for bone. In this particular study, you can see your patients who declined using pharmacotherapy, meaning patients that did not want to take bone drugs or who previously experienced failure of drug treatment, meaning they took the drugs but the drugs didn't work, were offered other options, including supplemental micronutrients identified in the medical literature as sometimes having a positive impact on, on bone mineral density after. So 12 months. This was a 12 month study. After 12 months of consecutive supplementation, micronutrient therapy with a combination that included. These were the things that were included.
- [32:04]
B
Vitamin D, vitamin K2, strontium, which we just talked about, magnesium and DHA. Docosahexaenoic acid, by the way, docosahexaenoic acid, this is a type of. Write that a little neater. This is a type of omega 3 fatty acid.
- [32:24]
C
So if you're eating cold water fish, that's a good source of dha. But in this, again, in this study, vitamin D, vitamin K, strontium, magnesium and dha. And then they repeated their bone scans. The results were analyzed in a group of compliant patients and demonstrate improved bone mineral density in patients classified with normal osteopenic bone. Osteoporotic bone density. According to the results, this combined micronutrient supplementation regimen appears to be at least as effective as bisphosphonates. That's drugs like Fosamax or strontium ranelate, which is the prescription strontium used in Europe in raising bone mineral density levels in the hip, spine and femoral neck sites. No fractures occurred in the group taking the micronutrient protocol. This micronutrient regimen also appears to show efficacy in individuals where bisphosphonate therapy was previously unsuccessful in maintaining or raising bone mineral density. Again, this just is a reiteration that nutrition is far more important than chemical manipulation. This study shows it. Now we look at the mechanism of action of micronutrients. You can see micronutrient strategies do not work by altering physiological parameters such as the function of osteoclasts. Osteoclast remembers a cell that breaks bone down. That's how bone drugs work. So micronutrients don't work that way.
- [33:49]
B
Right.
- [33:49]
C
They rather work by function, by remediating underlying nutritional deficiencies which then permit restoration of inherent physiological processes. It is increasingly documented that nutritional deficiency continues to be an unrecognized and under treated process problem in clinical practice.
- [34:08]
B
In my opinion, it is the number one problem in our health care society today is nutrition is totally ignored by most doctors. And not only is it ignored, it's, you know, it's, it's ridiculed in many cases and patients are gaslighted and told it has nothing to do with fill in the blank condition.
- [34:26]
C
And that's true of bone loss. Investigations and management of malnutrition, often found in those with chronic disease, should become standard practice in clinical medicine. So in essence, the authors of this study feel like malnutrition and correcting nutritional deficiencies should be the standard of care,
- [34:45]
B
not the other way around. Not using drugs first and then come around to nutrition if drugs fail.
- [34:50]
C
Now if you look at the relative cost, this is where it gets really interesting. So if you look at the current comb protocol, which is the combination of those different Nutrients, cost about $2.26 a day. Okay. You know, amounting to $67 or so a month, or $824 a year.
- [35:10]
B
Now I would argue that if you ate well, you would get a lot of these nutrients that you're supplementing with eating organic, eating real food. Right.
- [35:25]
C
As opposed to junk food that's high
- [35:27]
B
in calories and low in nutrients.
- [35:29]
C
And so it wouldn't really cost you any more.
- [35:31]
B
It would just cost you the cost of the food that you're already buying. But you may spend a little bit more on buying high quality food, but the quality of life that you'll have as a result of it, in my
- [35:40]
C
opinion is worth the cost. Now then we get, you know, if you're using bone drugs, so bisphosphonates, this is again they range, there's a range
- [35:47]
B
in cost, okay, from 90 cents a
- [35:50]
C
day, that's the least generic preparation to up to $12.96 cents per day. For the brand name versions.
- [35:59]
B
Now, you know, they mention this, this generic preparation. Let's, let's just make a note about generic preparations. It's a really good book. I recommend that you all check out.
- [36:12]
C
You can, you can listen to it
- [36:14]
B
on, on Audible, if you do audiobooks, you can buy it and read it if you prefer to read. But it's called Bottle of Lies. And what this book is about is, it's about generic drugs. A lot of our generic drugs today are produced in India and China.
- [36:33]
C
And the oversight, the FDA oversight on these particular medications is horrific.
- [36:39]
B
There are FDA inspectors that go over to these factories that are producing these generic brands and they're coming back to the FDA and saying these guys are doing a terrible job. Their facilities aren't clean, they don't have
- [36:54]
C
any standards, and the FDA is turning a blind eye to it. And that's what this book is about. It's about exposing that. And so if you're on a generic preparation, look, I think it was Mayo Clinic a number of years ago quit
- [37:06]
B
using generics because they were getting such
- [37:09]
C
inconsistent results and trying to manage their patients health. And so they've gone predominantly to brand name drugs. So now again, if generic is not all that trustworthy here we have, then we have to go to the brand name. And so now you're talking about $2 a day versus $12 or almost $13 a day in terms of cost difference. But the impact or effect is no
- [37:32]
B
different, meaning the nutrients work better without
- [37:35]
C
the side effects according to research.
- [37:38]
B
And then you can get other, there
- [37:39]
C
are of course other ones that you can go down to $5.58 per day for alendronate, which is again is another type of bisphosphonate. But again, it's still not cheaper than that. $2.26 a day of nutrients. So very important that you consider nutrition
- [37:58]
B
if you've been diagnosed with bone loss. And because otherwise, what's the alternative?
- [38:08]
C
The alternative is to use bone medications that cost more and not just financially. And let's talk about that for just a second here.
- [38:22]
B
Okay, so this diagram here is a list of some of the most commonly
- [38:27]
C
used medicines for treatment of osteoporosis. Okay, so you see here the category on the far left and then the names of the different types of medicines here. And then we get how they actually
- [38:40]
B
work and then their side effects. And this is really what I want to pay attention to.
- [38:47]
C
Bisphosphonates, again, common examples. One of the major side effects that
- [38:52]
B
I have seen very frequently is esophageal erosion, meaning people get on these drugs and it just tears up their esophagus and their stomach. Now the problem with that is it causes malnutrition when you can't eat. It hurts to eat. And you're destroying the lining of your
- [39:07]
C
stomach and your esophagus, you're going to cause malnutrition. But we also know that the side effects of these medicines can cause bone, joint and muscle pain, intense muscle pain. Look, the number one thing you can
- [39:22]
B
do to prevent bone loss is exercise. Now what you're not going to be able to do
- [39:29]
C
if you're taking a medicine that causes you to have a lot of pain is exercise.
- [39:34]
B
So by default, the side effect profile
- [39:38]
C
can contribute to the bone loss that you're trying to treat. Now we also know one of the other major side effects is bone death.
- [39:44]
B
That's what osteocorosis means. It means bone death
- [39:51]
C
in this case of the jaw. And this is a manifestation of long term use of this type of medication that this is a lot of dentists will pick up on this because you
- [40:00]
B
know they'll have patients that come in with a lot of bone pain and
- [40:03]
C
jaw pain and dental problems and then additionally atrial fibrillation. So if you're going to your heart doctor after you've started a bone medication, know that this class of medicines can do that and just be aware of it. Now you can also know that, so
- [40:16]
B
these are side effects, but then these are problems exposed long term use. So if you're on them for any
- [40:21]
C
great length of time, we know these drugs increase the risk of cancer of the esophagus. They also increase bone brittleness and increase the risk of certain types of femur fractures.
- [40:31]
B
So the whole goal here is to
- [40:33]
C
reduce the risk of bone loss. But these particular medicines can increase brittleness of the bone. And this, this happens to do with what these drugs do is they force
- [40:47]
B
calcium into the bone in an overabundant way.
- [40:53]
C
And so your bone needs a little,
- [40:55]
B
just like anything else, your bone needs a little calcium, but it doesn't need more than what it needs. And if you put too much mineral in the bone, then the bone becomes too brittle. Remember, bone is supposed to be pliable. It's supposed to have really great tensile strength. It's not, not supposed to be hard like steel, it's supposed to be more like bamboo where if you were to bend it, it bounces back and it
- [41:16]
C
doesn't snap, it doesn't crack. You bend steel hard enough and it snaps. We don't want your bone to do that. And that's what these drugs can do long term. Then we have other drugs a little less commonly used, but Avista Raloxifen, which is a selective estrogen drug. This particular class of medications can cause blood clots in the veins, in the eyes and the lungs. We got a typo here. Lungs, strokes, hot flashes in the legs or leg cramps, rather leg swelling, shortness of breath and vision changes. And in long term increases the risk of thromboembolism and fatal stroke. So, you know, risk, benefit, guys and gals, that's what taking medicine is all about. Is the risk of the side effect of that medication worth the benefit that the medicine might provide? And that's the only question that you can answer. Don't let anybody force your mind on any of this. And then there are the biologics. This is, these are kind of relatively newer, but forteo and prolia, these are common biologics now being used. These are more of the injectable types where you got to go to your doctor and they inject you with these drugs and they're parathyroid mimicking type hormones basically.
- [42:28]
B
But what they do is they inhibit
- [42:29]
C
maturation of the cells that break bone down.
- [42:32]
B
So they basically they stump or stop
- [42:35]
C
the maturation of the specialized bone breaking cells. Now side effects, nausea, vomiting, constipation, low
- [42:43]
B
energy, muscle weakness, again, muscle weakness, talking about exercise.
- [42:48]
C
Okay. And then we come over here to joint aches, leg cramps, dizziness and increased blood calcium. So they increase the quantity of calcium in the blood and that can increase
- [42:59]
B
the risk for cardiovascular events.
- [43:03]
C
Low blood calcium levels as well can sometimes happen. So serious urinary and respiratory tract infection, skin rashes, or inflammation of joint pain and osteonecrosis of the jaw. And then we have long term risks,
- [43:16]
B
osteosarcoma, and that's cancer of the bone.
- [43:21]
C
So you know, these are the risk benefit ratios that you're, you know, that you're embarking on if you take this direction first. Now look, it's maybe one thing if
- [43:33]
B
you have spontaneous fractures of your bones because they're so brittle and weak.
- [43:36]
C
And maybe you need something like this
- [43:38]
B
initially so that you don't fracture out. But most people with bone loss issues
- [43:42]
C
do not have anywhere near that level of bone loss.
- [43:46]
B
And so we're talking about people that really should be focusing on good quality nutrition and good quality diet and lifestyle
- [43:52]
C
factors as a standard. So let's talk a little bit more about diet and how diet impacts your bone. Okay. We've Got, we talked about gluten already, prevention. And this is just what did we say earlier?
- [44:07]
B
It's eating well, eating organic, reality food, not fake food, okay? Not what I call fruit, Frankenfood.
- [44:20]
C
Real food, no grain, no processed food. This, you know, hand in hand. And then no excessive sugar. And sugar, remember, sugar is one of the problems with sugar is very acidic. So when you have a hyperacidity, you actually can increase the ability for bone to break down.
- [44:40]
B
Now, on the diet front, I wanted to talk a little bit about some diets that are now again being promoted in our society, predominantly the vegetarian vegan diets.
- [44:52]
C
And so this is a review of the literature on the effect of vegetarian diets on bone health. Because many people are trying to go in this direction because they believe it's the right thing to do. And again, maybe you're a vegetarian.
- [45:05]
B
I'm not trying to pick on vegetarians here, just trying to give you the data so you can make intelligent decisions.
- [45:10]
C
But this is what this literature review found, and this was just recently published in 2022. Okay? So there are different kinds of vegetarianism, and I'm just pointing out a few of those here in this table too. You can see there's lacto ovo vegetarian, which basically means someone who eats plants, but they also will do dairy and they will do eggs. Okay? And then in the middle here, you have lacto vegetarian. So this is somebody who will only do dairy, but no eggs. And then you have vegan, which is someone who will not do any eggs or any dairy or any animal products whatsoever. And so you can see this is the difference in these key nutrients. Calcium, protein, vitamin D, iron and zinc and B12. So you can see in the lacto ovo vegetarian group, there was a mild deficiency of vitamin D, there was a mild deficiency of vitamin B12, but no difference in these other minerals and nutrients. In a lack the vegetarian group, there was a mild deficiency in vitamin D and a mild deficiency of vitamin B12. Again, very similar in terms of the two partial vegetarian groups. But in the vegan group, we have severe deficiency of calcium, severe deficiency of
- [46:20]
B
vitamin D and a severe deficiency of vitamin B12.
- [46:25]
C
And so why do I share that with you?
- [46:27]
B
Because if you're following a vegan diet,
- [46:29]
C
it would go to say, if this is something you believe in and you
- [46:32]
B
want to continue to do, you might want to consider some supplementation, you might
- [46:38]
C
want to consider some testing to make sure that you're not ending up with a problem.
- [46:43]
B
Because this is part two to that study, to that Literature review.
- [46:49]
C
You can see here again, vegetarian diets. The star represents vegan diets. So again, these are nutrients that are lower, generally speaking, in vegetarian diets. But where you see the, the star, those are definites as far as research is concerned.
- [47:05]
B
And that refers to vegan diets, especially vegan diets.
- [47:09]
C
Right. So again, low vitamin D and low calcium cause an increase in parathyroid hormone. An increase in parathyroid hormone causes an
- [47:18]
B
increase in bone resorption. So you're breaking down your bone faster and then subsequently you go to your doctor and you get bone mineral density
- [47:27]
C
scores that are lower. Then we have reduction of protein.
- [47:31]
B
This leads to a reduction of strength, which leads to sarcopenia and frailty, which, sarcopenia is just a fancy way of saying muscle loss.
- [47:39]
C
Okay?
- [47:40]
B
We get a reduction of iron, which equates to a reduction in pro collagen
- [47:46]
C
synthesis because iron is necessary for collagen production. But you also get anemia and hypoxia,
- [47:51]
B
which is low oxygen. So this has to refers to oxygen.
- [47:55]
C
And then that in turn leads to reduction in vitamin D, which increases bone resorption and reduces bone mineral density. And then you get zinc, where you
- [48:05]
B
get stunted bone growth and reduction in bone mineral density.
- [48:11]
C
And then you get vitamin B12, which leads to a reduction in insulin, like
- [48:15]
B
growth factor 1, which reduces the synthesis of bone.
- [48:18]
C
And you also get an elevation in homocysteine. And homo homocysteine has been linked to osteopenia and osteoporosis, so leads to reduction of blood flow to the bone, leads to actually reduction of the ability to produce that bone. So again, if you're on a vegan diet, you really want to take note, if you're on a modified vegetarian diet, it's still a good idea to get tested. And look, hey, maybe you're eating meat
- [48:44]
B
and vegetables, maybe you're on a heavier diet in that direction. And it's still a good idea to
- [48:50]
C
get nutritionally tested because lots of people have nutritional deficiencies despite the type of diet they eat because of the way
- [48:56]
B
that things are grown and farmed in industrialized farming practices.
- [49:00]
C
But I just want to make you guys aware so that you don't end
- [49:04]
B
up thinking that that diet is somehow more nutritionally advantageous for you. And then you end up with some fractures or some major bone problems.
- [49:13]
C
Now, there's also medicines that contribute to bone loss, mentioned steroids earlier here, and the effect on calcium, magnesium, C, zinc and vitamin D. But there are some others that I want you to be aware of. And one of Them are statins. Statin medications. Statin medications can impact vitamin D as
- [49:31]
B
well as CoQ10 and. Both of which are necessary for the
- [49:40]
C
energetics and bone production. And you have blood pressure medications which
- [49:43]
B
deplete calcium, magnesium, potassium and zinc and B vitamins and CoQ10. Long list of those.
- [49:58]
C
If you missed my last few shows on blood pressure medications and nutrition deficiency side effects, you might go back and check those out. And then antacids. Antacids cause protein loss, so deplete protein
- [50:13]
B
and B12 and calcium and magnesium. Diabetes medications deplete folate and B12 and CoQ10. And then blood thinners, vitamin K, which is an important aspect of calcium metabolism. Seizure medications cause B vitamin deficiencies. Progestin for birth control reduces. It interferes with estrogen's function, so reduces bone formation. Remember, estrogen, progesterone balances are very important.
- [50:53]
C
So when you interfere with estrogen, you
- [50:55]
B
interfere with bone maintenance. Thyroid medications. Thyroid medications. A lot of folks that are on thyroid medications in my experience are over medicated. The dose is too high. And you know, thyroid hormone is great,
- [51:12]
C
but if you take too much, it's going to deplete bone. And then SSRIs. And these are for depression. So many folks out there taking antidepressants, these have been linked to bone loss as well. So think of kind of the average
- [51:29]
B
person in an industrialized country. They're overweight, maybe they have a little high blood pressure, their blood sugar is running too high. What does their doctor do? Right?
- [51:37]
C
Their doctor says, let's get you on a blood pressure drug. Might as well just hit you up with cholesterol drugs too. And you know, diabetes medicine, now they're
- [51:46]
B
doing that for a little while. And because they're overweight and they sit too much, don't exercise enough, they're hurting, they got a lot of muscle pain, muscle stiffness, then they get a major flare. Maybe they have an injury, they pop
- [51:55]
C
a disc or they have muscle injury. Now they're getting put on steroids, right? And you know, you can just see how this can snowball like this medication as an answer.
- [52:07]
B
Especially multi poly pharmacy cases where people are on more than one kind of medication to treat all of their different things.
- [52:15]
C
And usually what it is is it's not one doctor prescribing five or 10 or 15 different medicines. They're seeing specialists.
- [52:23]
B
So they're going from, from one specialist to the next. And so what ends up happening is because they have a cardiologist, they have an endocrinologist, they have a GP they have a rheumatologist, all the ists, right? You have poor management. Of the potential for side effects of these medications. And so now these polypharmacy cases become massively malnourished. These people now become so malnourished. And so the consequences, yeah, their symptoms
- [53:02]
C
are controlled artificially through chemical manipulation, but now they're malnourished.
- [53:07]
B
And the longer you're malnourished, the further your health deteriorates.
- [53:10]
C
And so the long term solution for this is to recognize it.
- [53:15]
B
There is no way out.
- [53:16]
C
I mean, unless you just want to basically have a quality of life that's
- [53:19]
B
horrific as you get older. Most of us spend the first half of our life working our tails off
- [53:26]
C
trying to accumulate wealth. And we spend the second half of
- [53:30]
B
our life trying to spend that accumulation in wealth on fixing our health because we've abused ourselves so aggressively in the first half of our life by ignoring the things we know that we should be doing. Exercise, sunshine, sleep, clean air, clean water and good, healthy, real food.
- [53:51]
C
Now let's talk a little bit about the analysis. Let's end this with how osteoporosis and osteopenia are diagnosed. And I'm going to point this out. I want to just circle it.
- [54:06]
B
I don't rely on solely on bone scans.
- [54:09]
C
Many of you will go to a doctor.
- [54:11]
B
That's what they do, especially at a certain age. They'll do a bone scan and then the only, only assessment they're making of your bone is strictly a bone scan. Right?
- [54:20]
C
So this is the only thing that they're relying on to say you either
- [54:24]
B
are osteoporotic or you're not.
- [54:26]
C
And this is a mistake because what does a bone scan do? A bone scan shows you how
- [54:35]
B
well your bone absorbs X rays. Right? That's what a bone DEXA is, dual
- [54:39]
C
X ray energy absorb atometry.
- [54:41]
B
So it's measuring absorption of X ray and then it's comparing your ability to absorb those X rays, their T's and
- [54:52]
C
Z scores is what a bone scan
- [54:54]
B
will give you back. And so it's comparing you to 35 year old young people, but there's also
- [55:04]
C
a score that compares you to other people your age.
- [55:06]
B
So there's an age association as well.
- [55:09]
C
But the problem with that is, well, one, you're not 35 if you're 60 in a doctor's office. And the other problem with that is
- [55:17]
B
if you're getting your Z score, which
- [55:22]
C
is an age appropriate comparison is that
- [55:24]
B
you're not those other people. And there are massive Differences between bone density between, between, let's say African American and Caucasian. There are huge differences in bone density between somebody who's overweight versus somebody who's underweight. So there, I mean, because remember, bone grows based on pressure. So if you're, you know, 50 pounds overweight, you're going to have more bone density. That doesn't mean you have healthier bone.
- [55:47]
C
That just means we've tricked the doctor into thinking that your bone is of, somehow is of less quality because we're comparing you potentially to other people who may be obese. And that's not a fair comparison either. So there are tremendous differences between DEXA numbers.
- [56:03]
B
And so if we're just solely relying
- [56:05]
C
on this, we're going to be very misled. So what are some things that you can also measure if you're really trying to assess bone health?
- [56:13]
B
One is something called ntelopeptides. These are tests that your doctor can order. There's nothing I'm going to write down here that your doctor can't order until we get to nutrition. You can have them measure your osteocalcin and you can have them measure something called the oxy. Pyridenoline.
- [56:40]
C
And these are great markers to help you understand how fast your bone is
- [56:46]
B
breaking down versus how fast you're building new bone.
- [56:49]
C
So understanding these markers and combining that
- [56:52]
B
with this information is far more valuable
- [56:55]
C
than just trying to make all the
- [56:57]
B
decisions based on a bone scan I mentioned earlier. There are some other markers, like your homocysteine, because high homocysteine increases the risk for bone fracture. There's CRP C reactive protein, which is
- [57:11]
C
a systemic marker for inflammation.
- [57:13]
B
There's another marker for systemic inflammation that
- [57:16]
C
insurance will cover called esr, erythrocyte sedimentation rate. These are all great tests to help you understand. These first three help you understand how fast bone is breaking down versus how fast it's building.
- [57:27]
B
These are markers of inflammation, these two on the bottom.
- [57:31]
C
So those are good assessments.
- [57:32]
B
You can also have your doctor run a cbc. A CBC stands for complete blood count. Okay. Where on that CBC you'll get hemoglobin, nematocrit, which give you an idea of iron. But then you can ask for an iron panel. We talked about iron earlier. And then from that iron panel, you can also ask for ferritin.
- [58:00]
C
And then in addition to that, in addition to that, you can ask your
- [58:03]
B
doctor to measure your red blood cell levels of dha. We mentioned DHA earlier, but DHA is
- [58:14]
C
again, this is one your insurance will cover.
- [58:16]
B
And this is A red blood cell omega fatty acid analysis. Now be careful on this one.
- [58:30]
C
This one's been tricky. They've changed the reference range recently.
- [58:33]
B
You really want your DHA to be free. 4 or higher. And this 4 is representative of a percentage. So it's a percentage number.
- [58:43]
C
It's a percentage content of fat in the membrane of your red blood cells. But dha, very, very important marker for its role, of course, in bone integrity and bone health.
- [58:53]
B
So look, any of you can go
- [58:55]
C
to a doctor and order any of these tests or have them, or ask them to order any of these tests, and your insurance will cover it and it will give you a far greater
- [59:04]
B
idea of the quality of your bone. Don't rely on a bone scan, because if you rely on a bone scan, you're going to be misled right into the medications.
- [59:14]
C
And that's, to me, the bone scans were a tool that were created to sell more drugs.
- [59:19]
B
The way they're being used, that is absolutely true in today's world.
- [59:24]
C
Now, beyond that, obviously, what else do we want to measure?
- [59:28]
B
So those are all things. Again, those are things your doctor, who
- [59:32]
C
has no nutritional understanding, can order. Actually, let's add one more.
- [59:36]
B
Let's add 25oHD to that list.
- [59:41]
C
Vitamin D. This is the type of vitamin D that can be measured. Again, insurance will cover it. Those all very simple tests that can
- [59:47]
B
be measured by your doctor who knows nothing about nutrition. Then you can do nutritional cellular analysis. But for this one, your doctor's probably not going to know what this is. We look at nutritional cellular analysis, oftentimes referred to as intracellular. But what we're actually doing is looking inside of white blood cells and measuring
- [60:13]
C
growth rate of cells based on their nutritional storage.
- [60:16]
B
So this type of analysis is very accurate. It gives you six months average nutritional status of an individual. So it's a, it's a good marker because it represents a long period of time.
- [60:29]
C
A lot of the nutrition testing that doctors will run in the, in just in the serum, in the blood. It's like a snapshot of the day,
- [60:39]
B
okay, which is not very helpful. Whereas this is like instead of a snapshot, a still frame. It's like watching the whole movie. It's like seeing all two hours of the movie so you can know who the bad guy is, who the good guy is and what happened in between.
- [60:53]
C
Whereas the snapshot is like taking one still frame of a movie and then trying to parse what happened during the
- [60:58]
B
content and context of that movie.
- [61:00]
C
It's very hard to do. So nutritional analysis not done well, with
- [61:04]
B
serum tests, not a recommendation. Now if you have no option, you
- [61:09]
C
know, it's better to get that than get, than have nothing. But just not a great way to go about assessing new nutrition status versus intracellular.
- [61:16]
B
But get intracellular nutrition done if you can. Look, if your doctor won't order it, you can visit Gluten Free Society. We offer nutritional analysis without a doctor's order with this type of technology. And I'll put a link in the
- [61:29]
C
show notes for those of you who
- [61:31]
B
might be interested in getting that done. But you can have all of your B vitamins measured. You can measure things like strontium and calcium and magnesium and zinc and selenium and chromosomes and copper, all the nutrients and minerals necessary for your body to
- [61:43]
C
perform at its best and necessary for bone health. So measuring these things becomes important if
- [61:51]
B
you're trying to ascertain the why as to why you're having problems with maintaining bone status. Now, other things that you want to pay attention to are, are you doing things that cause chronic inflammation? Because if you are, your bone growth
- [62:09]
C
is going to suffer as a result, result of it.
- [62:11]
B
And there are four primary categories of problems associated with driving inflammation.
- [62:18]
C
And we'll end it here.
- [62:21]
B
Number one is eating the wrong food. And this is food sensitivity, food allergy.
- [62:25]
C
These are again, food can drive inflammation.
- [62:28]
B
Number two, being exposed to the wrong types of chemicals. And these can be chemicals in food, food dyes, preservatives, added pesticides, etc.
- [62:38]
C
But also chemicals found in soaps, lotions, shampoos, detergents that you may be reacting to. These are things again that drive inflammation.
- [62:48]
B
Number three is microbial imbalance. There are microbes that can inhabit your GI tract that can create major shifts in balance and rip holes in your gut lining.
- [63:04]
C
And when that happens, it can lead to systemic inflammation, causing a more of a challenge for bone to stay mineralized
- [63:11]
B
and to stay healthy. And then number four in this equation happens to be nutrients, specifically nutrient deficiencies. So low levels of nutrients, which I've already talked about.
- [63:26]
C
So these four things should be measured if you're really trying to truly assess
- [63:32]
B
your bone health and what you can do to improve it. And so I would encourage any of you watching this show to take this information directly to your doctor.
- [63:42]
A
Hey, thanks for sticking with me to the very end. For those of you who watch the entire video, we've got a great bonus for you. A couple of links down below this screen, we're going to have discount codes for our bone box, our premium nutritional supplement designed to help support you and your bone. Additionally, if you'd like to get custom nutrition recommendations, we're also offering a bonus discount on our Intracellular Nutritional Analysis testing link below. You can click that for a great discount today. Thanks for sticking with me through the episode. I hope you have a fantastic day.