♪ 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.
