Episode 53 - Osteoporosis

Transcription

Dr. Edwards: This is Dr. Chad Edwards and you are listening to podcast number 53 of Against the Grain.

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Intro: Welcome to Against the Grain podcast with Dr. Chad Edwards where he challenges the status quo when it comes to medicine. We get into hot topics in the medical field with real stories from real patients to help you on your way to a healthy lifestyle. Get ready, because we’re about to go Against the grain.

Marshall Morris: Hello. This is the super tall Marshall Morris, and today I’m joined by Dr. Chad Edwards. Dr. Edwards believes that 80% of medical recommendations are crap – technically speaking here. He served in the US Army. He is an author of Revolutionize Your Health with Customized Supplements. He’s the founder of revolutionhealth.org and the Against the Grain podcast. Dr. Edwards, how are you doing?

Dr. Edwards: I am doing well.

Marshall Morris: You’re doing well?

Dr. Edwards: I am. If I were any better, vitamins would be taking me.

Marshall Morris: Oh my God. That doctor humor is just incredible today. It’s so on point.

Dr. Edwards: [laughs]

Marshall Morris: That’s awesome. Dr. Edwards, we’ve made it well into the second half of the path to one hundred. We’re on 53 now.

Dr. Edwards: That’s right.

Marshall Morris: Okay. And I’m pretty excited. I see the hot topic today but I want to let you introduce it.

Dr. Edwards: Yes. Obviously, I’m having a lot of fun with this. I get great feedback from patients. I’ve got new patients because of the podcast. It’s my chance to air my thoughts and processes. Certainly, we want our patients to be able to get to know me, get to know the clinic better, and the more time they spend with us, the better they know us, the more that they understand where we’re coming from, and how we can help them Tulsa prolotherapy.

This has been a great forum, in order to try to get some of this information out. Why do we do what we do, and how do we do it? What can we do to help optimize health, and all those kinds of things? I love it. I appreciate your help with this. You’ve been amazing with this process. Thanks for all your help.

Marshall Morris: Absolutely. That’s a great segue into our hot topic. I couldn’t have done it better myself. What are we talking about today?

Dr. Edwards: Having the foundation of our clinic and the foundation of what we’re doing with the podcast and all that kind of things, I think it’s good to think about the foundation of our architectural structure Tulsa prolotherapy.

Marshall Morris: Okay.

Dr. Edwards: Basically, we’re going to be talking about bone health and a specific disease of the bones, called osteoporosis.

Marshall Morris: Okay, osteoporosis. Is that mean I’m turning into a dinosaur, or–

Dr. Edwards: No, that’s petrification.

Marshall Morris: Okay. So not a dinosaur?

Dr. Edwards: I guess, technically petrifaction is not you becoming a dinosaur. That would be– I don’t know what that would be.

Marshall Morris: A fossil?

Dr. Edwards: That’d be weird.

Marshall Morris: Okay. I’m with you. What is osteoporosis?

Dr. Edwards: Osteoporosis is basically where your bones are too thin.

Marshall Morris: Okay.

Dr. Edwards: The reason that we care about that is because of the potential for fractures, or pathologic fractures. Pathologic fractures come about because there’s a disease of the bone. The bone breaks with a relatively minor load. I can fall down a step and not break something, but an 80 year old woman may fall down a step and break her hip. That’s bad.

Marshall Morris: A little fun fact. Have you ever broken a bone?

Dr. Edwards: Yes. But it was through stress fractures because of the rug marching I had to do with some of the military stuff I did.

Marshall Morris: I’ve never broken a bone. I don’t know what that is.

Dr. Edwards: Mine was not fall down, go boom, snap, that kind of thing Tulsa prolotherapy.

Marshall Morris: It was just repeated.

Dr. Edwards: Yes. Gradual onset of pain once, an onset of pain another time. But I broke the bone in half was in my foot.

Marshall Morris: Oh my God. Would you say most are one way or another? Most are gradual, or most are “Hey, I fell and broke my arm.”

Dr. Edwards: My experience both in clinical medicine in my clinic, and in the emergency room is there – all of a sudden, boom snap.

Marshall Morris: Okay. Osteoporosis affects bones, in that they’re too frail or they’re too thin.

Dr. Edwards: Correct.

Marshall Morris: Would you say that’s consistent with, “Hey. Fell. Bone was too thin, couldn’t support my weight and it snapped and broke?”

Dr. Edwards: Yes. I would say that the thinner your bones, the higher the risk for developing a fracture.

Marshall Morris: Okay.

Dr. Edwards: It’s important to understand this process. What sets you up for being at increased risk for osteoporosis and fractures? And what can you do about it. That’s what we’re going to talk about.

Marshall Morris: Is osteoporosis a disease that it’s black and white? One day I have it and the next day that I don’t have it, or is it a gradual, I fall within a certain range or– Explain that to me.

Dr. Edwards: Yes. First of all, the diagnosis is black and white. The achieving the diagnosis is gradual. I don’t know of anyone that just went from completely healthy to completely diseased. They may think their bones are healthy because it’s never been looked at, and then they have a test and they determine, “Oh. I have osteoporosis.” One of the things that we do in our clinic is proactive trying to identify things as early as possible, and intervening as quickly as we can, as aggressively as we can, through lifestyle changes. Adding supplements sometimes. Rarely, but sometimes, medications, to try and optimize the health of the bones and everything else as well, so that you can live a normal healthy life until the day the good Lord calls you home Tulsa prolotherapy.

Marshall Morris: Okay. Let’s get into it. What is that test? What is that range?

Dr. Edwards: The gold standard for looking at bone health is called a DEXA scan. And the DEXA scan is looking at the density of — it using an X-ray absorptiometry – and looking at the bone mineral density. And how dense are those bones. How healthy are those bones.

Marshall Morris: My mom’s always told me that I’ve been pretty dense. So–

Dr. Edwards: Yes. This is a little bit different.

Marshall Morris: Okay. Fair enough. Okay. The density, and that’s measured with machines?

Dr. Edwards: Yes.

Marshall Morris: And how does that process to [unintelligible 00:07:04]?

Dr. Edwards: You would go to your doctor and they would say, “Let’s–“. There’s a couple of different ways to do it. The one I recommend is a DEXA scan. It’s almost like getting an X-ray, and they’ll spit out the results. And I’ll talk about the absorption. This DEXA dual-energy, X-ray absorptiometry, or something like that. We look at that and we’ll get an absolute number, but the way will interpret this is what we call the T-score. And osteoporosis is defined as a T-score of less than a -2.5. It’s kind of a double negative and it can be confusing. If the raw number is greater than 2.5, like 3, 3.5, 2.6, something like that, but it’s a negative. And what that means– We’ll talk about that with the T-score, when we talk about what the score is. This T-score less than a -2.5, so more negative. And that is osteoporosis. That’s specifically at the spine, hip, or forearm Tulsa prolotherapy.

There’s another condition. I deal with pre-diabetes and then some pre-conditions. Well, pre-osteoporosis is a condition called osteopenia. That’s just your bones are a little bit thinner, but not quite to the result of osteoporosis. And that is when you have a T-score of -1, -2, – 2.5. That range from -1 to -2.5. You’re not quite to osteoporosis, but we’re on the path. This T-score basically is a statistical average. Actually, this is a standard deviation. Not to get too deep into the woods of what statistics means or what these definitions are. But basically, it’s a statistical analysis of a population. We’ve talked before about labs and what’s a normal result on a lab. If you go back and listen to our second episode, second podcast, we talk about that. How do we achieve normal?

With a T-score, what we’re doing is, we’re comparing the patients’ results to young adult females. We’re looking at young females and we’re looking at their bones, and we do an average, and then two standard deviations. Each standard deviation which, that’s just the statistics– One standard deviation, and then two standard deviations in 2.5 standard deviations. Osteoporosis is when you look at the T-score of the patient that you’re testing and you compare that to the young female, and where is that patient’s labs, in reference to that young female’s labs. And you would look and see, okay; three standard deviations from the mean or the average of this group of people. Does that make sense?

Marshall Morris: Yes.
Dr. Edwards: Okay. That’s what the T-score is. If you’re one standard deviation away from the average, then you get a T-score of -1. If you’re 2.5 standard deviations away from below average, then that’s a negative 2.5. The osteopenia is 1-to-2.5 standard deviations below average. Osteoporosis is 2.5 standard deviations or more below average, compared to the young adults.
There’s also what’s called a Z-score, and that’s where you’re doing an age adjusted– I don’t use that one. I don’t know many people that do, but if you have an 80-year old female, the Z-score would be how does she compare to her age, to her peers, not to a young 20-year old female. That’s the difference. That’s what osteoporosis is. It’s basically– This happens when there’s an imbalance between bone formation and bone resorption. We’re always in a constant state of turning our bones over.
We have osteoblasts and osteoclasts. The blasts make new bone, clasts break it down. We’re always in this constant flux and constant balance. We store calcium, we store phosphorus, we store a number of things in bone. Those things get mineralized, and it’s important to understand that the foundation of Bones is actually collagen, type I collagen. We talked about type I collagen a lot when we talked about ligaments and tendons in Tulsa prolotherapy, because that’s type I collagen also. It’s a very strong protein and it forms this mesh-like thing. It’s almost like the rebar and concrete.
Collagen– If you were to make a road and just lay out concrete, it would crack all over the place. It’s very hard, but because of the ground, because of the weight on top of all those things – and it doesn’t have a rigid structure within it to hold that shape – you’ll get a lot of cracking. Bone is the same way. You need that collagen as the rebar in the concrete. The collagen itself gets ossified. We get these calcium hydroxyapatite crystals, and these minerals that go on there and calcify on that thing, and strengthen it, and that’s what makes bone.
It’s not just adding new calcium to bones that makes it better; it’s the collagen as a foundation, and then calcifying it. Then, as far as you’re improving osteoporosis, as the balance between the osteoclasts and osteoblasts building up and breaking down.
Marshall Morris: Okay. We understand the structure of bone a little bit better now. We understand maybe the definition of what osteoporosis is. How do I develop osteoporosis, do I have it now, how do I know I have it, what are symptoms of that or what are some of the leading causes that most people think cause osteoporosis?
Dr. Edwards: Sure. Again, the way to know it is to get tested. You can look at an X-ray and they might say, “All your bones look a little thin”, but it’s a very subjective evaluation. Get tested, DEXA scan probably one of the best ways to do it. About causes of osteoporosis, the absolute bar and none, most common cause of osteoporosis is low estrogen. Now, we’re mainly talking about women here. We are mainly talking about postmenopausal women, but there are a couple of other conditions that play a role in this. One of those is anorexia. When women have anorexia and they quit menstruating, that’s certainly a risk factor to let you know that their estrogen levels are low, and they’re at increased risk of having a bone mineral density problem.
I have some patients that have had anorexia at least in the past, if not currently, that have osteopenia and/or osteoporosis because they had years without sufficient estrogen. This is a major issue. It’s one of the reasons that I am an advocate for bio-identical hormone replacement therapy, postmenopausal, because it can really protect your bones from early resorption and destruction. Another thing that causes low estrogen is postmenopausal, as I alluded to. You stop having periods in your early fifties, late forties, then you are beginning to break your bone down more than you build it up.
We want to make sure we have a good reserve, and that really starts much earlier than most people think. You need to have solid, solid bones in your twenties. In fact, Depo-Medrol as a– I’m sorry, Depo-Provera birth control shot. You get it every three months for birth control. It’s a progestin that counteracts the effects of estrogen, basically. Many of those women become amenorrheic, don’t have a period, but it also can inhibit their bone growth. We don’t like women to be on that too long, because it can negatively affect their bones. I prefer that women not take it at all, because there’s number of potential bad effects but that’s another thing to consider.
Interestingly, as I was reading through the statistics and preparing for this, I saw a statistic that women that have had a bilateral salpingo-oophorectomy, had both ovaries removed, had a 54% increase in the risk of fracture in their hips, spine and their wrists. 54% decrease, interesting study I mean interesting number. I don’t know all the ins and outs of that, but you’re increasing your risk of fracture by removing those. Estrogen is the most common– For men – low testosterone.
Marshall Morris: Okay.
Dr. Edwards: Also a big advocate for testosterone, listen to some of our older podcast on testosterone. Lots of benefit to that, but for men, low testosterone. In fact, women that take testosterone, it’s been shown to increase bone mineral density 8%. Adding testosterone to women, can make a big difference; especially if you’ve got a woman that comes in, she has breast cancer, she can’t take estrogens. Testosterone. Get their testosterone up and many of them feel better, bones are much healthier.
Another one is a condition called hyperparathyroidism. Parathyroid is a gland near the thyroid gland, secretes calcitonin and parathyroid. Hyperparathyroidism causes an increase in calcium excretion in the urine, where you just leaking out calcium. That’s something we can do it. A diet low in calcium, a lack of vitamin D – that can certainly do it. We’re big on that in our clinic, making sure we get good vitamin D levels. Sedentary lifestyle, you don’t shock those bones into growing thicker and stronger. My athletic women, even well into their fifties, sixties and seventies that are like big time athletes, I don’t ever see osteoporosis in them. In fact, I’ve seen some 60-year old women with bones as healthy as the 20-year olds. Absolutely amazing, the effect of exercise.
Thyroid. There’s this misconception, or incomplete information about; if you have too much thyroid, that it has a negative effect on your bones. We’re aggressive with thyroid my clinic, patients do better when they have a good healthy levels of thyroid, but you have to be careful about their bones. We check those things, but there are studies showing that there is no decrease in the health of your bones on higher levels of thyroid. That’s an important piece.
Smoking and alcohol. If you smoke, just quit. It’s one of the worst things you can do. It screws up your lungs, increases risk of cardiovascular disease, increases all kinds of problems and it screws up your bones. So, quit. Too much alcohol also has an effect and can decrease your bones. Certain drugs, and I’m talking about medications, can increase your risk of osteoporosis. The two biggest ones are anti-seizure medications and the one we all know about it, in medical anyway, is steroids. If you’re on steroids, you go to be vigilant for bone issues. There are some medical conditions; a good example would be multiple myeloma. It’s a cancerous condition, and that can increase your risk of osteoporosis as well.
Marshall Morris: These are a number of different causes or things that contribute to osteoporosis, or the weakening of the bone. We’re going to take a quick break and when we come back we’re going to talk about maybe how to mitigate against that-
Dr. Edwards: You got it.
Marshall Morris: -and how we can strengthen, fortify these bones.
Dr. Edwards: You got it.
Marshall Morris: Boom!
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Marshall Morris: We are back. Dr. Edwards here, joining me today, and we’re talking about osteoporosis and just really the strength of the bones in the body. We want to build up the foundation of the body. The architecture, the backbone– You see what I did there?
Dr. Edwards: I do.
Marshall Morris Okay.
Dr. Edwards: That’s like a dad joke.
Marshall Morris: Yes. That’s a dad joke but– We talked about the causes before the break, so Dr. Edwards, what can we do to be more preventative, and increase the strengthen of these bones?
Dr. Edwards: Obviously, the first thing you want to do is, in young adulthood you want to do everything you can to make sure that you’ve got as much bone, because as we age, we’re not going to deposit as much bone as we did in young adulthood. So, starting early. I’m just going to rehash the causes, and how do you fix that. So, you got low estrogen, low testosterone, you‘re on hormone replacement. If your hormones are low, hormone replacement. We do a great job of that in our clinic, we follow our patients closely, our patients report excellent success, feel great and it really can make a big dramatic difference on their bone health. You got one of those issues like Anorexia, post menopausal, we can fix those things as well.
Screening for hypothyroidism, if that’s an issue, then we screen for that. Make sure that your diet has good calcium, good vitamin D. Most of the times in my experience, biggest thing that I see is low vitamin D. Vitamin D helps to regulate calcium, and we‘ve got podcasts on vitamin D, make sure you go back and listen to those. Vitamin D helps to regulate calcium – vitamin D is actually a hormone, not a vitamin, – and that can really help balance the calcium levels. And if we’re still not getting good results, we may supplement with a calcium hydroxyzine appetite supplement.
Sedentary lifesyle – go exercise, move. We’re talking about weight baring exercise. And like I said before the break, my patients that are big time athletes, they don’t have osteoporosis, I just don’t see it. Watch thyroid, and we’re just gonna be aggressive, and watch those things. Quit smoking, avoid things like steroids medications, if at all possible, and then obviously these medical conditions that can lead to it. That’s certainly something that you need to watch out for and make sure you got good screening and things like that in place.
Then, the last thing that I would recommend is, there are couple of supplements that can make a dramatic difference and there is actually a study, and I don’t know the reference for it, was done by one of my colleges in Harrah, Oklahoma. And they studied one particular supplement, and it had phenomenal results. Basically it has vitamin D, and it has a colonnaded silicon, which helps to enhance type I collagen. Type I collagen helps with skin, fine lines and wrinkles, helps with the strength of your hair and nails. But it got a study on this one particular substance that had a 2% increase in bone mineral density. And I don’t mean that our bones get thinner as we age and it slowed it down by 2%, I’m talking that it went backwards, went better. Got better by 2%, and that’s dramatic. 2% in this kind of stuff is a dramatic number.
So, we want to be aggressive with vitamin D, make sure we’ve got plenty of that, plenty of calcium, add the supplementation as needed, and we’ve just seen some really good results. This is something that you should not have to deal with.
Marshall Morris: Okay, so osteoporosis, something that before today I thought was just out of your hands. Some people get it, some people don’t, it’s just kind of a variable and roll of the dice. But you’re saying that you can actually take control and prevent the development, resulting beyond those 2.5 standard deviations to develop osteoporosis. You can take control of that.
Dr. Edwards: Yes, some people are at higher risk, but there’s a lot of things that we can do to mitigate those risks.
Marshall Morris: Okay. So, osteoporosis affects everybody, everybody’s potential to get it.
Dr. Edwards: That’s correct.
Marshall Morris: So you, as a listener, right now have to figure out which of these things can you improve a little bit on. I would challenge everybody listening that they can get better in at least one of these areas.
Dr. Edwards: Without question.
Marshall Morris: For all the listeners that want to learn some more information about you, or osteoporosis, or the clinic Revolutionhealth, what would you suggest that they do?
Dr. Edwards: Go to our website, revolutionhealth.org, certainly continue to listen to our podcast, and I think if you give good feedback for the podcast, I think your bone mineral density actually increases a little bit.
Marshall Morris: Shameless plug right there.
Dr. Edwards: [laughs]
Marshall Morris: Dr. Edwards, thank you so much for joining us today.
Dr. Edwards: Thanks, Marshall.
Outro: Thanks for listening to todays podcast with Dr. Chad Edwards. Tune in next week, when we’ll be going Against the grain.
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