♪ Bob and Brad, ♪
♪ the two most famous ♪
♪ physical therapists ♪
♪ on the internet ♪
- Hi folks, Brad Heineck, physical therapist.
- Hi, I'm Chris the pharmacist.
- Bob unfortunately is not here today.
He's enjoying life somewhere else.
He'll be back.
We're happy to have Chris here today.
He's got plenty of expertise for this title:
Osteopetrosis, osteopenia,
causes, treatment.
And can it be reversed or prevented?
This is highly researched.
You spent many hours on recent research for this.
Lot of good information.
Before we go any farther,
let's introduce our channel again.
- All right. - Chris is going to help here.
We've got, go to www.bobandbrad.com for our giveaway.
We are giving away the Booyah stick.
Wonderful tool for exercise, balance and posture.
Also go to Facebook, bobandbrad.com,
pinned to the top of the page.
You can also get to the giveaway.
As well as Twitter,
Instagram, and don't forget TIKTOK.
Anyways, we're done with that.
Boy, I got problems with that.
I'll keep working on that.
Anyways, let's get to the title,
Osteoporosis, Osteopenia.
Let's clarify that first, Chris.
Osteoporosis, osteopenia, what is it?
And who does it affect?
- Sure, well I guess, well, osteoporosis and osteopenia,
they're both brittle bones, weakening of bones.
And osteopenia generally would come before osteoporosis.
So it's kind of that gradual stage in between.
Normal bone, and you go to osteopenia
and then you go to osteoporosis.
So it's kind of step wise, motion there.
- So if you have osteopenia, it's not so bad,
your bones are stronger than they are
if you have osteoporosis.
And that's measured by what they call a "T-score".
If you go into the doctor, they'll give you some numbers.
And I believe if I have this right,
- 1.0 to a -2.5
is considered osteopenia.
- Correct. - And if it goes worse,
a -2.5 or lower than you're
on the osteoporosis range. - Osteoporosis.
- I think some people hear the name
and they really don't fully understand.
It happens pretty much to everyone as you age,
it's like getting gray hair.
So the big thing is,
is you can treat it, self-treat it to a certain degree.
And you can do that successfully.
So my question is, as a title:
Can it be reversed or prevented, yes or no?
- The answer is yes.
So that's the good news. - All the time?
- I think of most of the time.
And you have to kind of adhere to some rules.
So basically the big thing with osteoporosis and osteopenia
really is to make sure that we're exercising.
Cause you need to have weight-bearing exercise.
And that's going to be one of the key elements of trying to
reverse and also, or slow it down.
Depending upon where you are in the spectrum.
- And so obviously as a therapist,
you know, you're talking my wheel house.
So it's like, yes. - Yes.
- I can, I can get into this.
And what else is there?
- Well besides the exercise, weight-bearing exercise,
then we can look at eating our daily diet.
We got to eat a healthy, balanced diet.
So that's critical folks.
The biggest thing is if you can get
your calcium through foods.
So dairy products, that's kind of the primary one for most.
Listen, some of us are lactose intolerant.
So then we go to nuts, we go to green leafy vegetables.
- Okay, but hold on Chris.
Before we go any farther,
I think we need to talk about what is
the big deal with osteoporosis?
What happens if you get osteoporosis?
What are the dangers?
- Sure, it's brittle bones Brad.
So it means that bones have a higher risk of fracturing.
And so they're most commonly found,
your hip, your spine and your wrist.
So the three most common, but it can be anywhere.
- We do have this.
So with in therapy, it's, you know,
you've heard of compression fractures.
This happens in the vertebra
and these can be very painful.
It's gonna change your life for a number
of months before it heals.
A compression fracture in the spine
is not like your bone that completely fractures.
A vertebra actually crushes, it changes shape.
And your body has to heal and readapt to that,
which is very uncomfortable.
It's not a enjoyable thing at all.
The hip you said, is another thing.
Obviously, I've had people that are,
they're pretty old at this point,
but literally just walking osteoporosis so bad
that the bone broke- - Just snaps.
- without falling. - Yes.
- It's not real common, but it can happen.
So, obviously we want to get after this at an early age.
So that's the biggest part of osteoporosis,
is the bone being brittle.
- The bone is brittle.
Basically, it's poor, I mean basically it's like sandstone.
You can kind of, if you actually,
doctors have certain x-ray techniques that
they use a variety of different ones.
But when they look at it, the bone actually looks porous.
So basically bone is a flexible living material
and it's constantly building up and breaking down
through all of our lives.
And so what happens is over time
and you know by 30,
that's kind of when it really kind of stops for-
- Age 30? - About age 30.
- Okay that's pretty young, yet.
- It's pretty young and that's kind of one of the keys.
That's when we really want to start to pay attention.
- So that's across the board, male, female, age 30.
- Male, female, doesn't matter.
And it's a little bit later for males,
but I think 30 is reasonable.
Because a lot of times,
a lot of the hormones that govern this
are what kind of drives the bone, the bone formation,
and at least the bone loss
and reformation and everything else.
So when it gets worse for women, menopause,
so about 50 is when it really gets bad.
For men our testosterone levels drop off at about 65.
So that's when that osteoporosis, that's that window there.
So what do you do between 30 and 50?
What we do between 30 and 50 is-
- Well, and again, at that rate, it started,
but it's typically very low.
- Very, very low.
- You're not even into osteopenia yet.
- No, no, not even at all. - But just-
- But this where we can start to pay some dividends.
It's kind of like having a bank and you put money in every
week to keep saving it for your retirement.
Oh well you can think of using calcium the same way.
- Ah that's a good, good analogy, I like that.
- So if we go with that,
we're going to try and put calcium in our bank, so to speak.
And what do we do?
Well we're going to do it through diet and exercise
are really kind of the primary-
- S drink a bunch of milk.
- Well, yep you can,
as long as you're not lactose intolerant.
So I mean, there's other things that we can use.
So I mean, there's supplements that we can use
and the most common one is going to be calcium carbonate.
So that's the, you know that's-
- So that's a pill form?
- Pill form, tablet form.
So, and then the other one that's-
- Is that prescription?
Or is that something you can get-
- All, we're going to talk about
all over the counter products. - Okay.
- So yeah, so basically the calcium carbonate
it would be in a, I guess,
sort of a think of it as an antacid, like Tums,
that's its primary driving force.
But you can find it in certain vitamin supplements too.
And one of the keys with making calcium to absorb the best
is to make sure it's coupled with vitamin D.
And so you're gonna want to probably add
a thousand IUs of vitamin D, so.
- So you know, I'm not an expert at this, I'm thinking,
"Well vitamin D, calcium isn't both of that
in a good, healthy milk?".
- Sure can be.
Now food is fortified with D and a lot of cases.
Cause D is hard to extract out of the diet.
So it's very challenging.
Actually the most D that we get
is standing right outside in the sunshine.
So in about 10 to 15 minutes of controlled exposure,
and we have to be careful with skin cancer risk.
But 10 to 15 minutes without sunscreen,
your body generates about 20,000 IUs of vitamin D
or 500 micrograms.
- So that's quite a bit?
- It's a lot, it's actually enough-
- You're not going to drink that much milk.
- You will never ever, you'll, your stomach will explode.
(Brad laughing)
So I mean, which is a bad day.
So from that standpoint,
you going have some serious gastrointestinal stuff.
- So for people who don't want to take the pills,
even though the pills are across the counter
and they're made of sometimes,
are they made out of natural ingredients you said?
- Yep there is a lot of different ingredients.
And when you think of calcium carbonate,
it's basically limestone.
So I mean rock.
And it can come from crab shells.
I mean, there's a lot of different sources of it.
So, and people are very, very finicky
on what they get for their calcium.
- So the pills oftentimes are basically natural ingredients
or they can be?
- Yep, they come from the earth, I mean so-
- Sure, sure.
Okay, I've kind of got off track there.
But anyways, are there, is there other diet
supplements or vitamins that are gonna help
the bone density?
- Yeah, absolutely.
So we talked about calcium and D.
There's different forms of calcium.
So that again, you've got a calcium citrate.
So sometimes calcium carbonate,
which is the most common one,
can upset your stomach a little bit.
So it can cause things like gas, constipation.
So it can be rough on you.
- So that's the pill form. - That's the pill form,
- It's calcium carbonate.
- Yeah, so then we want to go to something
more like calcium citrate.
And that doesn't really require,
and I should probably backtrack on calcium carbonate.
It's the hardest one to break down, also.
It requires stomach acid.
So you want to make sure you take that with food.
So when you start to eat, it turns up more stomach acid.
So by turning up more stomach acid,
what it does, it breaks down that calcium.
So it absorbs in your intestines better,
so it gets into your system better.
But, some people that bothers their stomachs.
So calcium citrate is a lot gentler.
But the knock on calcium citrate
is you don't get quite as much calcium.
So you'll have to take a little bit more
to get that thousand milligram dose.
- So, and these are, you can just go into a-
- You can go to any pharmacy.
You can go to the web.
I mean like Amazon or whatever source
that you want to buy a vitamin supplement from.
And you can look for calcium supplements.
And there are a variety of different ones.
And so calcium carbonate, calcium citrate
are probably two of the more common sources.
But then they have some of the more exotic things
where they actually make it out of algae's
and plant sources as well.
So for vegan people or vegetarian people
or people that just don't,
they have maybe stomach troubles with calcium carbonate.
So there's options for everybody.
But the best is through the diet.
- So if we have viewers are interested in,
you know, they want to drink their milk,
and maybe do a supplement and they go online,
can they just see how many stars,
they have for a good option?
- I think that's one way of looking at it.
I would tend to be a little bit more critical.
I mean, I look for USP ratings because that stands for
United States Pharmacopeia.
And so that guarantees,
and it's independently lab tested
that what's in that bottle, is in that bottle.
Sometimes again, and I've used that phrase before,
it's kind of the wild, wild west
and people mix and match whatever they can
and give good advertising.
But sometimes it's maybe not the best supplement.
So that USP kind of guarantees-
- So USP, if that's on there,
that's kind of a quality control-
- You're very, high quality. - Okay.
- And that's what you really want to strive for
in just about any vitamin or supplement you're taking.
- Okay, great.
I want to go back and touch on exercise a little bit.
Cause that's that's, you know, that's-
- That's your wheelhouse.
- Yeah, so exercise, Chris and I both swim.
I'm a big advocate for swimming in general for exercise.
But for this bone density thing,
it's not really going to help so much.
- No, it's good for the heart, which is excellent.
It's good for the muscles, which is excellent.
But the problem is, it doesn't put that stress
or force on the bones.
And the bone needs gravity
to try and help to stimulate bone formation.
So whether it's weightlifting,
walking is great.
People like dancing, jumping around, playing some tennis.
- And actually some impact is helpful.
The biggest thing I'm concerned about is
when we talk about impact is
there's a balance issue then,
potential for fall risk.
I did hear of one therapist who did classes
strictly for bone density with elderly people.
And she'd have them hold onto a rail
and actually do some gentle bouncing to get that impact.
So that stimulation for the bone growth would occur.
So walking, you know, jogging or running is great.
But a lot of people do not want to do that.
Particularly in their older years.
It's, you know, they're concerned about
their joint integrity, et cetera.
So I think just plain walking is a very-
- Plain walking is excellent.
- Right, and it's good for so many other things as well.
Is there anything else we need to cover?
Now, if this doesn't work,
let's say someone's in the osteoporosis
and their numbers are low.
Is it going, are they going to have to go
to the doctor and get some-
- Yes. And that's not a big deal.
It's used commonly to- - Correct.
I mean, you know, it's kind of like
osteoporosis is a silent disease.
So, a lot of times we can be walking around
and we just don't even know it,
and all sudden you had a bad fall
or you came into your doctor appointment,
and all of a sudden you're shorter.
"Chris, I see you came here, you know,
"you're an in shorter this year, what's up?"
Well, at that point, it's going to create your clinician
to have a mindset that they've got to treat you.
And so they're going to probably do some X-rays
and see where it's at.
They'll look at your spine specifically,
see if you're just a little slouched over.
So these kinds of things.
So if also you're having some back pain you didn't know why.
So yeah, you show a little bit shorter.
And so it's one of those things where they'll examine that.
They'll do the X rays, the special testing.
And then from that standpoint,
the mainstay of treatment is going to still be exercise
and certainly supplementation.
But they're gonna use pharmaceuticals.
So there's a variety of different medications
that they will use to treat osteoporosis.
And at that point, depending upon
the treatment course and things.
And they've variety from course to course,
treatment to treatment.
So it can get pretty complex and pretty expensive.
So you always want to check with your insurance company.
But it's one of those things that will be a necessary evil
to make sure that these people can stay healthy and active
as long as we possibly can.
- Sure, absolutely.
Wow, we're going to talk about some specific vitamins and
calcium on another video in about a week or so.
And so we're going to cover that
well in just a few minutes between you and I both.
You'll see that video coming up in a week or so,
we'll have that one as well.
So again, Chris, Bob and I, our goal has always been,
you know, keep people healthy, fit, and active.
And possibly fix everything except for-
- A broken heart.
- I don't know if this osteoporosis diet
and regimen is going to be helpful with that.
But we'll see how, we'll give it a go.
- We'll do our best.
- Cheers. - Thank you.