Healthy Bones with Dr. Joe & Lara Pizzorno: Rational Wellness Podcast 236
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Lara Pizzorno and Dr. Joe Pizzorno discuss how to Promote Bone Health and Reverse Osteoporosis with Dr. Ben Weitz.
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2:31 An acid forming diet like the Standard American Diet (SAD) contributes to bone loss by leaching calcium out of the bones to restore your pH to the right alkaline balance. This concept of an alkaline diet affecting the pH of the body has been criticized by medical researchers because they measured people’s blood pH before and after an alkaline or acid diet, and they found no difference in blood pH, so they criticized this whole idea. But the body works very hard to maintain the blood pH in a very narrow range but that process may involve the kidneys excreting more acid, which increases risk of kidney stones, and it may involve the body taking calcium out of the bones to help alkalinize the blood. If you want to prevent and reverse osteoporosis, the first thing you need to do is to alkalinize the diet by eating fewer animal products and by reducing salt consumption. If people consume too much salt, it puts so much load on the kidneys that the kidneys can’t get rid of acid as well. You need to add more vegetables and fruits, which are generally more alkaline. Even though you may want to reduce animal protein, it is still important to get enough protein, say at least 65-70 mg per day, but you need to balance out this protein with enough calcium, say 1200 mg of calcium per day. Calcium can come from broccoli, spinach, and dairy other than milk, provided that you can tolerate both the lactose and you don’t form antibodies to milk protein.
12:22 The high sugar and carbohydrate content of the Standard American diet (SAD) cause blood sugar and insulin spikes and this creates inflammation.
12:50: Unhealthy fats like saturated and trans fats can negatively impact bone health. The healthiest fats are the Omega 3s, which should be in a proper balance of 4:1 with Omega 6 fats.
13:29 But are saturated fats really unhealthy? If the saturated fat is from grass fed animals, then it is healthier than from animals that are fed corn. Beef that is pastured will have conjugated linoleic acid, CLA, which is anti-inflammatory and beneficial. Also, if animals are fed corn, then their fat will have high levels of arachidonic acid, which may be causing the problems that are being blamed on saturated fat, according to Dr. Pizzorno. The other thing to consider is that animals store toxins, like heavy metals in their bones, so bone broth may not be a good idea.
18:05 Flouride. According to Lara, flouride in small amounts may be beneficial, but in the US excess flouride–flourosis–is very common in younger people, so we are probably best avoiding toothpaste with flouride and avoiding flouride in the water. Flouride replaces the calcium in the bones and the teeth but it makes for a different bone structure, which is not as well connected.
20:53 Heavy metals. Heavy metals can play a negative role in bone health, esp. cadmium, lead, and mercury. Cadmium causes damage to the bones and the kidneys. Our kidneys are really good at scavenging cadmium and clearing it out of the blood, but it can get stuck in the kidneys and poisons the kidneys. The kidneys are responsible for converting 1-hydroxy vitamin D into 2-hydroxy vitamin D, which is the active form. Cadmium also poisons the osteoblasts in the bones, which are responsible for laying down new bone. Studies done in Seattle show that 20% of the osteoporosis of women was coming from cadmium that came from eating soy products. If lead is present in the bones, pregnant women’s bones will release the lead to go into the bones of the baby, unless plenty of calcium is included in the diet.
25:32 Lara found out in her early 40s that she had severe osteopenia after taking a DEXA scan at a trade show. She was shocked. But everybody in her family has had osteoporosis, so she has a genetic tendency. She discovered that her vitamin D level was low and at the time the recommended amount was 400 IU, but she found that she needed 10,000 IU per day to bring her level up. She also started taking vitamin K2 MK7, which is required to activate the Gla proteins (Osteocalcin, which pulls calcium into your bones, and Matrix Gla protein, which prevents calcium from depositing in your soft tissues like your blood vessels, your kidneys, your breasts and your brain). Unfortunately K2 is not present in many foods. It is found in small amounts in certain cheeses but the only good food source is a fermented soybean product called Natto, that smells like dirty socks, so supplementation is necessary. You should get 100-200 mcg of MK7 and you should have equal amounts of vitamin A and D. If you have cardiovascular or kidney damage, then take 360 mcg of MK7. Lara also take B complex. She had a H. pylori infection in her gut, which can decrease hydrochloric acid production and HCL is need for calcium absorption. She took triple antibiotic therapy, which cured her H. pylori. Now at age 73 Lara has healthy bones with no osteopenia.
37:21 Drugs that interfere with bone health. There are a number of prescription drugs that can interfere with bone health, including statins, certain blood pressure medications, and even antidepressants. Statins, esp. at higher dosages are bad for bone by interfering with cholesterol production and we need cholesterol to make our hormones that are good for bone health. Cholesterol is used to make vitamin D and to transport vitamin K. Dr. Pizzorno feels that cholesterol has been overly villified as the use of statin medications has been promoted as the answer for preventing heart disease. Dr. Pizzorno wrote an article, The Vilification of Cholesterol for (Profit ?) about this topic. Some blood pressure medications interfere with bone health. Thiazide diuretics protect bone, while loop diuretics and calcium channel blockers harm bone. SSRIs, which are antidepressants, promote bone loss. They increase the production of serotonin and serotonin binds to a receptor on the surface of newly formed osteoblasts and stops them from developing, so your bone building cells don’t develop.
44:44 Calcium. Some studies that have shown a negative effect on heart health with calcium supplementation did not also give vitamin D and vitamin K. You need all three of these nutrients working together. And magnesium should be taken with calcium in a Calcium: Magnesium ratio of 2:1. With respect to types of calcium, despite a lot of claims, calcium hydroxyapatite is not a more effective form of calcium and it contains phosphorus, which is bad for bones, for cardiovascular disease, and for kidneys. Calcium citrate can be a good choice, since citrate is an alkalinizing agent and it can be absorbed without producing a lot of stomach acid. Lara recommends consuming about 1,200 mg of calcium per day from both diet and supplements with no more than 500 mg at a time. It is best to take calcium supplements with a meal since the hydrochloric acid produced for the meal will make it easier to absorb the calcium. She also recommends taking strontium citrate to promote greater bone density. Strontium has a bad reputation because of a pharmaceutical version of strontium ranelate that was developed that was toxic because of the ranelic acid. Strontium is a natural bisphosphanate. It acts through several different mechanisms both to increase osteoblast activity and to increase calcium absorption. There are also some other trace minerals that are synergistic with calcium, including potassium.
58:11 Boron. Boron is very helpful for bone. It slows down the activation of the 24-hydroxylase enzyme that breaks down estrogen and testosterone. Boron is even used in cancer treatment. Most people should consume 3 mg boron per day and those with with degenerative joint disease like osteoarthritis would benefit from 6 mg per day. Research shows that 6 mg of boron per day prevents bone loss. Here is a paper that Lara wrote about boron, Nothing Boring About Boron.
Lara Pizzorno is the co-author of the newly released book, Healthy Bones, Healthy You!, which she co-wrote with her husband, Dr. Joe Pizzorno. Lara is the best selling author of a previous book on bone, “Your Bones: How you can prevent Osteoporosis and have strong bones for life-naturally” . Lara is also the editor of Longevity Medicine Review and the senior medical editor for SaluGenecists and Integrative Medicine Advisors.
Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.
Dr. Weitz: Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates, and to learn more, check out my website, drweitz.com. Thanks for joining me, and let’s jump into the podcast. Hello, Rational Wellness Podcasters.
I’m very excited today to be getting the opportunity to speak with Lara and Dr. Joe Pizzorno on bone health. Lara Pizzorno is the bestselling author of a previous book on bone health, Your Bones: How You Can Prevent Osteoporosis and Have Strong Bones for Life Naturally, and she is now the co-author of this newly released book, Healthy Bones, Healthy You, which she co-wrote with her husband, Dr. Joe Pizzorno. Lara is also the editor of Longevity Medicine Review and the senior medical editor for SaluGenecists and Integrative Medicine Advisors. Dr. Joe Pizzorno is one of the most important naturopathic doctors, educators, researchers, and one of the founding members of the functional medicine movement. Dr. Pizzorno has written or co-authored more than 12 books, including the Encyclopedia of Natural Medicine, which has now sold over two million copies and pretty much everybody who has an interest in natural medicine has a copy on their bookshelf, the Textbook of Natural Medicine, Natural Medicine for the Prevention and Treatment of Cancer, and The Toxic Solution, among others. Thank you so much for joining us today on the Rational Wellness Podcast.
Dr. Pizzorno: Good to be with you. Thanks for the invitation.
Dr. Weitz: Before we get into the questions, I wanted to tell you that this new Health Bones book is really a great read and it goes into incredible depth about so many aspects of bone health that are often not discussed, such as, how heavy metals negatively impact bone health, how common chronic diseases such as heart disease, kidney disease, IBS and hypothyroid impact bone health and what to do about it. I think both laypersons and practitioners will learn a lot from reading this book, and not just about bone.
Dr. Weitz: You guys did a great job. Lara, let’s start by talking about some of the factors that cause bone loss in our US culture including the standard American diet? How does a diet that’s high in acid-forming foods contribute to osteopenia and osteoporosis?
Lara: Well, when the overall pH of the body is not in good balance, your body will constantly try to reestablish that healthy balance because many cellular activities can’t happen properly, the enzymes won’t activate, unless they’re at a certain pH level, so when you lose that level, your body instantly tries to reestablish it, and the way that it does that is by making you, typically you’re more acidic and so it tries to withdraw alkaline compounds from your bones, namely calcium, to restore the alkaline balance, and if you’re chronically doing that, you just keep pulling calcium out of your bones and eventually that results in bone loss.
Dr. Weitz: Right. Now, I agree with you, but some folks criticize this whole concept of alkaline balance because they say that the blood levels, your pH in your blood, is always going to stay in a very narrow range no matter what, so it’s not really that relevant.
Lara: Okay. I’m going to let Joe do this one because he’s on PubMed with papers on this issue.
Dr. Pizzorno: This is my topic.
Dr. Pizzorno: Dr. Weitz, one of the things I enjoy about my life right now is I get to go back and look at age-old natural medicine concepts from the perspective of modern science. I suspect you’ve had this experience, as well. If you look back and read the writers of 100 years ago, they had some great clinical insights but they were limited by the science and technology of the time, their understanding of medicine at the time. They started to notice that people who ate what they thought was an acid-forming diet seemed to be less healthy than people who ate an alkaline-forming diet. They started advising people to eat a more alkaline-forming diet. What the MDs said was they went through and said, “Oh, well, let’s see what this idea is valid.” They measured people’s blood pH before and after an alkaline or acid diet, and they found no difference in blood pH, so they poo-pooed the whole idea. Okay. Well, there’s two problems with that. Number one, as you well know, since you’re medically trained, the body works really hard to maintain the pH over a very, very, narrow range, because, as Lara said, our enzymes require an exact pH. If you vary on the pH, they don’t work very well, so by making it the very narrow range, so when a person’s eating an acid-forming diet, that means that the foods that are eaten are metabolized to form more acid. Not that the food itself is acid, but it’s how it’s metabolized, the body has to adapt.
The first thing it does is the kidneys start excreting more acid compounds, and which makes you have more kidney stones, by the way, but kidneys adapt. As long as a person has good kidney function and is relatively younger, not too much trouble. But as people get older, their kidneys don’t function as well. They’re now less able to get rid of excess acid. Now the body has to adapt in other ways. What’s it do? It takes calcium out of the bone to normalize the pH, so it looks like the body’s just fine because the blood pH hasn’t changed, but we look at what’s going on in the bone to adapt to the excess acidity, it’s bad. And it turns out that, and the research has been, taking older, post-menopausal women, with osteoporosis, don’t give them vitamin D, don’t give them vitamin C, and calcium. You just alkalize their diet, and they start rebuilding bone. Now, of course, we do way better than just alkalizing, but it’s part of the picture. I think you’ll hear from Lara again and again, you have to deal with the whole picture, not just one piece of it and expect that to fix it.
Dr. Weitz: How do we alkalize their diet? What do we take out? What do we put in?
Dr. Pizzorno: You want to decrease the acid-forming things and increase the alkaline-forming things, so what causes excess acid? Sulfur-containing amino acids account for about one half of the excess acidity in the diet. Okay, so, you have to eat less sulfur-containing amino acids which tend to mean less animal products. The other half is really surprising. It sure surprised me, is excess salt consumption, because when people consume too much salt, it puts so much of a load on the kidneys, the kidneys can’t get rid of the acid, as well. And then in terms of the alkaline side, fruits and vegetables. A plant-based diet is alkaline. Just, once again, a plant-based diet is more alkaline.
Lara: Also calcium. There have been studies done on people with post-menopausal women with bone loss, and the ones who are getting written, because protein is a big issue, and meat is a really good source of protein, and so you don’t want to skimp on your protein, but you have to have the calcium to balance the effects of the protein, and when they looked at people who were consuming at least 1,200 milligrams of calcium daily and 65, 70 grams of protein a day, they did better than the people who were consuming less protein and less calcium, and of course the people who consume a lot of protein and not much calcium really tanked. Not a good outcome.
Dr. Weitz: What are the sources of calcium in the diet? Is dairy a good source?
Lara: Well, of course Dairy’s an excellent source and there are many vegetables that are good sources of calcium. In the book, I have a whole table of the common sources and what a serving provides and so forth. There’s dozens of them. If you like broccoli, broccoli’s a good source, spinach.
Dr. Weitz: Yeah. Now, dairy’s a controversial one, especially in the natural medicine, functional medicine movement. I think a lot of us have sort of soured on dairy in the sense that the dairy proteins are highly allergenic and difficult to digest, and then most of the dairy products are homogenized and pasteurized and there’s problems for a lot of people in breaking down the lactose in dairy, so I think that dairy is not as popular these days among natural doctors and practitioners.
Lara: I think that’s true. I also think that the key issue with dairy, if someone reacts to casein, to dairy protein, then they need to avoid dairy. It’s going to cause inflammation, and anything that chronically causes inflammation will excessively activate the osteoclasts, which are the cells that break down bone, but if someone is not reactive to dairy, then dairy foods can be very beneficial. The issue with dairy, the one thing that you really have to avoid if you’re going to have dairy is milk. Things that are fermented, the cheeses and so forth, they’re very low lactose content, and even in the quote, unquote, lactose-reduced milk or lactose-free milk, all they do is apply lactase, which is the enzyme that breaks apart lactose, to the milk, so you still have the components of lactose which are glucose and then another sugar called galactose, and galactose is an incredibly inflammatory sugar. It is used in research to prematurely age animals, and the amount that is used in the research to have this effect is comparable to what you would get if you drank two glasses of milk a day. You can get away with one, but more than that, you do not want to have. Outside of that, milk has whey. It’s a very anabolic protein. If you can tolerate milk, I mean, dairy products, fine, just don’t have a lot of milk.
Dr. Pizzorno: Yeah. I think if you can-
Dr. Weitz: What do you think about raw milk versus pasteurized milk, and then, a lot of other people in the natural medicine world have moved away from cow’s milk to sheep’s milk or goat’s milk or camel’s milk.
Lara: I’ve never tried camel’s milk.
Dr. Weitz: According to Dr. Vojdani, it’s the least allergenic of all the animal milks.
Lara: Yeah. I don’t think it’s readily accessible in the US.
Dr. Weitz: There is one company that distributes it.
Lara: Well, if you can get it and you like it, okay, but again, I think it will still have lactose in it. You’d have to check the lactose content of the milk.
Dr. Pizzorno: I think also, Doctor, as long as there’s not an analogy, fermented dairy products, we’re okay with, but the raw dairy products in terms of raw lactose, as Lara said, we see problems with it.
Dr. Weitz: Right, so, essentially, you’re talking about cheeses and yogurt, right?
Lara: Right, and there are some cheeses that have high content of vitamin K2, which is incredibly protective for bone and the cardiovascular system.
Dr. Weitz: Right. Right. Yeah. I definitely want to get into the vitamins in a few minutes. Other aspects of the standard American diet that contribute to bone loss. You talk in your book about a diet that’s high in sugar and refined carbohydrates. Why is this bad?
Lara: Because those cause insulin spikes, and when sugar is in the bloodstream and it’s not absorbed well into the cells, it’s very inflammatory.
Dr. Weitz: Okay, and what is the role of unhealthy fats in bone health and which fats are healthy and which fats are unhealthy?
Lara: Well, the healthiest fats are the Omega-3s, properly balanced with Omega-6s which are also helpful when they’re in no more than 4 to 1 Omega-6 to Omega-3 balance. Both types are healthful. The unhealthy fats are the too much saturated fat, and of course the trans fats are extremely unhealthful in any amount, and those are really in processed foods, primarily, so you want to limit trans fats as much as you can.
Dr. Weitz: Now, I think the trans fat is uncontroversial, but some in the natural medicine movement have come to see saturated fat, in some cases, as not necessarily unhealthy or maybe a healthier source of fat, and as I’m sure you know, a lot of people recommend grass-fed butter and other sources of saturated fats. What do you think about, or coconut oil which also has a fair amount of saturated fat?
Lara: I think it depends on the life of the animal from which the meat or fat or anything else was derived. Animals, beef, that’s pastured, will have, in the fat, is going to have a compound called conjugated linoleic acid, CLA, which is extremely anti-inflammatory and highly beneficial, and then I don’t think it’s as much of a problem. We need fat. Our bodies need fat. 25 to 30% of the diet, at least, should be fat, but the type of fat that’s consumed is what the issue is, I think.
Dr. Pizzorno: I’d like to add a little nuance to this. I wonder if you see this, as well. Whenever a new idea comes out or another new fad comes out, I was try and step back and say, “Okay, now, how does that match up with nature?” Somebody comes out and says, “Well, this food source that people have been eating is a major cause of disease,” well, I look at, first, has something been done to the food to make it bad, or is it a valid concept, and so many of these times, what they’re doing is they’re making a mistake. For example, this whole thing about saturated fat. Now, yes, at high enough dosages, could be a problem, but in most situation, the saturated fat research came from animals fed corn, so that they have high levels of arachidonic acid. There’s a direct correlation between arachidonic acid and saturated fat. It’s not the saturated fats causing the problem, it’s the arachidonic acid. And arachidonic acid is only a problem because, rather than feeding cows grass, getting all this better balance of fats, well, we’re giving them corn. Not only giving them corn, but we’re also giving them medicine chemicals that are poisoning them. It gets in their milk, so we’ve actually gone from a relatively healthy food in a natural environment, particularly fermented, at the milk part, or even as the meat, eating the meat when it’s wild, to now this domesticated thing which has all the wrong fats in it, all these toxins in it, and it’s not healthy food.
Lara: Animals store toxins in fat.
Dr. Pizzorno: Yes. All these toxins are fat soluble.
Lara: Bones and fat. I’m not a big fan of bone broth because toxins get stored, and heavy metals in particular get stored in bone, then you make a nice, big broth of that and drink it all up. Not a good idea.
Dr. Weitz: Right. I guess you’re probably not a fan of liver either, huh?
Lara: Well, if it’s a healthy animal that was pastured and not exposed to a lot of garbage, the liver should be healthful.
Dr. Pizzorno: On the other hand-
Lara: Yeah, Joe?
Dr. Pizzorno: The liver’s where the toxins are detoxified.
Dr. Weitz: Exactly.
Dr. Pizzorno: Think about what that means.
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Dr. Weitz: You mentioned fluoride in the book, and so is fluoride good or bad for bone? I know most dentists are highly tout fluoride as good for your teeth because they do these studies and they see the fluoride gets incorporated into the teeth. What do you think about fluoride?
Lara: In very small amounts, it’s fine. In larger amounts, it’s an oxidant, and it’s a very, very powerful oxidant, and they’ve now shown that in the United States, fluorosis, you know the brown kind of pitting on the teeth, is extremely common now in younger people who’ve been exposed to it and in the water and everything. I think we’re just getting too much, so it’s like many, many things. In smaller amounts, it’s beneficial and useful, but when the intake is excessive, it can be harmful, and so that’s what I think about fluoride.
Dr. Weitz: Yeah. I think the fluoride just replaces the calcium and it’s actually a poorer mineral to be incorporated into the teeth and bones.
Lara: It makes a different bone structure, yes, and it’s not well connected.
Dr. Weitz: The fluoride we’re getting in the water is not even some really clean source of fluoride. It’s coming from the fertilizer industry and it’s this toxic byproduct that they’re throwing in our water, and then, as you say, we’re getting excess fluoride from all these other sources, like people who use these Teflon pans and the PFOAs and the PFOSs that have seeped into the water supply all over the country, so those are also toxic sources of fluoride.
Lara: This is Joe’s area, if you want to elaborate.
Dr. Pizzorno: Yes, of grave concern. I thought the fluoride was coming from, it was aluminum manufacturing, aluminum production-based products.
Dr. Weitz: What kind of manufacturing?
Dr. Pizzorno: I thought the fluoride came as a waste product in aluminum manufacturing production.
Dr. Weitz: Is that right?
Dr. Pizzorno: That’s my understanding.
Dr. Weitz: I thought it was coming from fertilizer manufacturers or something.
Dr. Pizzorno: You may be correct. I don’t know. I’m aware that-
Dr. Weitz: Anyway, we know it’s a toxic form of fluoride that’s being dumped into the water.
Dr. Pizzorno: Yeah. This is a great example of a small amount of a naturally occurring element has been negatively associated with cavities, which is great. Doesn’t mean we put in a bunch of a different form of fluoride into our water supply and saturate people with the water supply, with toothpaste, with getting their mouth washed by dentists. Now, we’re way overloading our systems for fluoride, and there’s some pretty worrisome research on fluoride. I don’t want to get into that, because we’re getting beyond the scope of this book, but people need to-
Dr. Weitz: That’s one of the great things about this book, is you mentioned some of the concepts like heavy metals that most people don’t think of as being associated with poor bone health, but you got to take all those into consideration if you’re really going to take a functional medicine approach to bone health, and those can be some of the keys, and just taking vitamin D and calcium’s not enough. You mentioned other heavy metals that play a potentially negative role on bone health. You mentioned, in specific, lead, cadmium, and mercury.
Dr. Pizzorno: Right. Well, this is the area of the book that I had the most involvement with, so [inaudible 00:21:33] why I’m missing so much. Let me give you kind of a big statement first, then I’ll get into specifics. As Lara’s writing this book, and the previous one, she would comment to me about what she’s working on or ask me questions with my medical background. Now she’s getting her master’s degree in nutrition, which is exciting, so she won’t have to ask me as many questions, I guess.
Lara: No. He’s teaching me chemistry now. We’re doing organic chemistry together. It’s very entertaining.
Dr. Pizzorno: Not that that’s going to be important to bone health, I think, oh, wow, that’s interesting for heart health. Then she’d talk about something else, and I’d say, “Well, that’s important for the kidneys.” Then she’d talk about something else, I said, “That’s important for the brain.” I started to realize that all this physiology she’s trying to normalize in the bones was the same physiology everywhere in the body, so when we’re writing this new book, the people who are helping us try to figure out what name to give it, when they say, “Healthy bones, healthy you,” when they first said that to me, I said, “Wow. What a great idea,” because the things we do to make the bones healthier make everything else in the body work better, as well.
Cadmium is an example. Cadmium causes a lot of damage, and a lot of that damage is in the bones and the kidneys, so our kidneys are really good at scavenging the cadmium. It gets all the cadmium out of the blood within a day or two. It’s really good at it. The problem is, it gets stuck in the kidneys and it basically poisons the kidneys. Why is that important for bone health? Well, the kidneys are responsible for converting 1-hydroxy vitamin D into 2-hydroxy vitamin D, and that 2-hydroxy vitamin D is the most active form. Happens in the kidneys. The kidneys are poisoned by cadmium, the cadmium conversion, and then directly in the bones themselves, well, it turns out the osteoblasts are responsible for laying down new bones after the osteoclasts have taken them out.
Well, cadmium poisons the osteoblasts, so it can’t form new bone as well, so cadmium is really bad on bone. There were studies done here in Seattle where they determined that 20% of osteoporosis in women in Seattle was due to cadmium and the cadmium was coming from eating soy products that were conventionally grown, because conventionally grown soybeans with high phosphate fertilizers, they’re often contaminated with cadmium. Cadmium goes right into the soybeans, you eat the soybeans, it goes right into our bodies, poison the kidneys, poison the bones.
Lara: It’s not just soybeans that are soaking up cadmium from the high phosphate fertilizers. it’s conventionally grown foods. They all have more cadmium in them now. Another thing with cadmium and the other nutrients is that when there’s a heavy metal around and there’s also a nutrient, like a mineral that you want to absorb in the soil, you’re going to absorb more of the heavy metal if you don’t have enough of the nutrient around. They compete, and so, one example is lead and calcium. They’ve done studies where they’ve given young pregnant women extra calcium because that way they’re releasing less lead from their bones as their pregnant, because, you know, you’re withdrawing calcium from your bones to help form the bones of the baby, and so if you have lead in your body, that lead is coming out, and it can get into the child, so they’ve done studies where they’ve looked at making sure that young pregnant women have plenty of calcium because it will interfere with that release from the bone, so there is a balance. People take vitamin D, and as you know, vitamin D helps us absorb calcium. If calcium isn’t around, vitamin D is going to help you absorb cadmium and lead and mercury from the food that’s conventionally grown.
Dr. Weitz: Well, maybe we should segue into your story, which I know involved finding out that you needed a lot more vitamin D, maybe you can tell us about your story about bone health.
Lara: Sure. Well, I was in my early ’40s. I’m now 73 and I have really great bones, but when I was in my early ’40s, we were at a medical conference and we went to the exhibit hall and they were showing a new piece of equipment that doctors could have in their office that was reasonably inexpensive for clinicians, and it would check your bone mineral density in your ankle. This was, what, like, 30 years ago now, and so, DEXAs were being used, but they weren’t as frequently being used and there was less awareness. The machine for the doctor’s offices were so much less expensive, they were selling it to say, “Get this in your office, and then if someone tests badly on this, then you make sure you get them into the big DEXA X-ray, so we went over, and I got checked, and I just, I’m healthy.
I follow everything that this man tells me to do, and I’ve been very healthy and even though everybody in my family had osteoporosis, I thought, “Oh, no, not me. I eat right. I exercise, et cetera.” I already had severe osteopenia. I was about 45, so this was well before menopause, so that’s what started our little adventure into trying to figure out what on earth was causing this, and for me it turned out to be genetic, which actually isn’t surprising. I mean, if some disease runs in a person’s family, chances are they have a genetic susceptibility that increases their risk for developing that condition. For me, it turned out to be vitamin D. At that time, I think the recommendation for vitamin D was, like, 400 IU a day. It turned out that for me to get my vitamin D levels up into anywhere resembling normality, I needed over 10,000 IU every day.
Dr. Weitz: Yeah. I remember, at the time they would tell us how dangerous the fat-soluble vitamins were and could be really toxic if you take too much vitamin D or vitamin A.
Lara: Yeah. Our friends thought I was going to turn into a pillar of calcium, like Lot’s wife, with a vitamin D genetic susceptibility, but I didn’t and I started to rebuild bone, finally. Also, we live in Seattle, so it rains here all year long. The sun comes out for a couple months a year and you just can’t make a lot of vitamin D here. It’s not easy, so the combination of my genetic susceptibility plus living in Seattle really was causing my bone loss, and that was the start. Then, after we identified that, I started to very slowly regain some bone, and then I was the editor of a medical journal called Longevity Medicine Review, which I think is still up, some of the issues are still up online, and i was asked to write a paper on vitamin K, and so I started reading all the research on vitamin K and I thought, wow, this is really important, especially vitamin K2 which pretty much no one knew about. I started taking vitamin K2 and that helped. Do you want me to talk about why that helped?
Dr. Weitz: Sure.
Lara: Vitamin K2 is required to activate what are called the Gla proteins. I call them the glamorous proteins, because they really make you glamorous in terms of not having cardiovascular disease and not having bone loss, because these proteins, one of them is called osteocalcin and it pulls calcium into your bones, and the other one is called Matrix Gla protein, and it prevents calcium from depositing in your soft tissues like your blood vessels and your kidneys and your breasts and your brain, so vitamin K2 is really important. It’s not present in … Blue cheese has a fair amount of it, but outside of that, in the western diet, there are a few cheeses that supply a little. It’s very, very tiny amounts of vitamin K2 are available, and you really have to eat a Japanese fermented soybean product called Nattō. Yeah. It’s slimy, gross. Smells like dirty gym socks.
Dr. Weitz: [crosstalk 00:30:03]. Yep.
Lara: Yeah. It’s bad, so basically people need to take vitamin K2 to get enough, and I started doing that. That made a big difference. Do you want me to go along the odyssey of some of the other things? There have been a number of them.
Dr. Weitz: Absolutely. Yeah. No. [crosstalk 00:30:19].
Lara: I am truly the poster person for osteoporosis.
Dr. Weitz: Because, I’ve talked to a number of people who said, “Well, I did all the natural stuff. I took my vitamin D and the calcium and so therefore there’s nothing you can do,” and it’s like …
Lara: No. Vitamin D helps us absorb calcium. That’s it. It does nothing to determine what happens to the calcium once it’s in your bloodstream. That’s the job of vitamin K2, and if you don’t have it around, chances are your calcium’s going to go into your blood vessels.
Dr. Weitz: By the way, what about MK4 versus MK7, since we’re on the topic?
Lara: Yeah. MK7 is far more potent and the reason why is that, in your liver, the MK7 is put into cholesterol, and cholesterol travels around the system for three or four days before it’s eliminated, broken down. The MK4 version goes into triglycerides which are cleared within six to eight hours, so when you take MK7 you can take a really small amount. Typically 100 micrograms or between 1 and 200 micrograms is enough for most people because it’s building up in your system, in your cholesterol, and so it’s always available for you to use, whereas the MK4 version, you have to take 15,000 micrograms every six hours to have that stay available for you, so it’s a difference of 45,000 micrograms a day versus about 180 micrograms a day, so I think MK7 is a better choice for most people. There are a few genetic polymorphisms that make some people very, very effective at using vitamin K, and they’re recycling it more quickly and so on, and so for those people, there are some people who do fine on MK4, but it’s a very small number of the population, and you can have that checked, easily.
Dr. Weitz: The dosage of MK7 that you recommend for most people?
Lara: Well, it’s 100 to 200 micrograms is enough for most people but it really depends on, there’s a balance that you want to achieve between vitamin K, vitamin D and vitamin A. They all work together. Your intake of vitamin D and vitamin A should be pretty comparable. They balance each other, and then vitamin D actually increases your production of the proteins osteocalcin and Matrix Gla protein that you need to have vitamin K2 around to activate, and so if you’re taking more vitamin D, you need a little more vitamin K. There’s a chart in the book where I say, “If you need this much of vitamin D, you need this much vitamin A and you need this much vitamin K,” but typically it’s 100 to 180 micrograms for vitamin K2 in the MK form. If you already have chronic kidney disease or cardiovascular disease, then in the research they’re using dosages of 360 micrograms per day. It’s extremely safe. There’s not even a tolerable upper limit set for vitamin K2. It’s so safe.
Dr. Weitz: Good. Yeah, so let’s hear the rest of your story. What were some of the other key factors in helping you overcome your bone issue?
Lara: Okay, so there was K2, and then, I grew up in Florida and I’ve developed lots of pre-cancerous skin problems, basil squamous skin cancers, and I finally realized that I wasn’t getting enough vitamin A. You need the comparable amount of vitamin … The vitamin A and vitamin D balance each other’s activities, and you really need both of them. We don’t eat meat, so that liver you were talking about, we don’t do that. There aren’t a lot of other really good sources of vitamin A, and beta carotene is not vitamin A. About over 80% of people do a lousy job of getting beta carotene into vitamin A, which I also hadn’t known about.
I wrote a couple of review articles on vitamin A and I learned all this stuff, then I started taking vitamin A. That was another thing that I learned. I try to take as much, comparable amount of vitamin A to vitamin D, and because we do not eat meat, I need to take it as a supplement, and then, the vitamin K. You want that to be in balance, as well, so that was kind of the next thing. Then, I discovered that magnesium is a really important mineral for bone, and if you do not activate vitamin B6 into its form of P5P, pyridoxal-5-phosphate, you have a lot of difficulty getting magnesium into yourself, because that’s the job of P5P, so that’s another snip I have. I don’t do that very well, so I take a little of that. Actually, I take a B complex, because all the B vitamins work together, and just taking one can kind of mess up the pachinko game that goes on among them all. I think those are kind of the biggest ones, the B vitamins, but, yeah.
Dr. Weitz: I think you mentioned having a H. pylori infection, as well.
Lara: Oh, yes. Yes. Sometimes, I think that I have experienced many things so that I would know what to do about them. H. pylori was certainly one. For years, I never knew when I would be six. Joe is the president of Bastyr University. We had many formal evenings and dinners and things and I never knew when I would be so six to my stomach I couldn’t stand up from the dining table and leave, so that was an adventure, and I’m old, so this was back when Barry Sears discovered helicobacter pylori. Before this, I had gone to doctors who had told me, “You just need to breathe deeply. You’re not relaxed and that’s what’s causing all of this,” at which point I had control myself from ripping out their throat. I did refuse to pay for the consult, but, yeah, so, we discovered that.
Dr. Weitz: How did you the H. pylori?
Lara: We did triple antibiotic therapy. Oh, yeah.
Dr. Weitz: Triple antibiotic therapy.
Lara: Yeah, and I remember, shortly after that, Joe was invited to China to set up reciprocal programs with some Chinese medical schools for students to come here and our students to go there, and here we are in China where conditions aren’t particularly sanitary, and everybody else in our group got sick except for me. I was the only one whose digestion was fine after getting rid of my H. pylori. Many, many older adults have h. pylori. It’s extremely common and it disrupts your ability to digest your food properly because it interferes with stomach acid production, and then you lose bone, and that’s a very, very easy thing to check, and it can make a huge difference for someone.
Dr. Weitz: Now, one of the things you mention in your book is how a number of conventional drugs interfere with bone health, and you mentioned high dose statins, certain blood pressure medications and even antidepressants. Perhaps you can talk about those a little bit.
Dr. Pizzorno: Wait for a second. Dr. Weitz, thank you for reading our book. I’ve written a lot of books, and so many times I’ll be interviewed very politely by somebody who didn’t bother to read my book, so I appreciate the invitation, but it would be nice if they read it. You clearly read it.
Dr. Weitz: Absolutely. I consider that my obligation for having the opportunity to getting to speak with you.
Dr. Pizzorno: Okay.
Dr. Weitz: Yeah. Let’s start with high dose statins are bad for bone-
Lara: High doses, quite a bit more than, what is it, milligrams a day.
Dr. Weitz: Milligrams of Lipitor, or, yeah.
Lara: Yeah, so, at that level, it actually seems to be protective for bone, but when you start going to the higher levels, it can help promote bone loss, and part of the reason why is that statins interfere with cholesterol production, and if you’re really excessively producing cholesterol, that’s a good thing, but if you take so much that you’re significantly suppressing your ability to produce any cholesterol, you know, we use cholesterol. We use it to do things like make hormones like estrogen and testosterone and so forth, and we need those hormones for our bones.
Dr. Weitz: They make vitamin D and transport our vitamin K2.
Lara: Exactly. Yeah, so, again, it’s one of those balance things. A little bit might be helpful, but if you have to take a really high dose, you need to make sure you’re getting checked and do everything you can to mitigate against the adverse effects of it.
Dr. Pizzorno: This is one of my pet peeves. I wrote a [inaudible 00:39:23] paper about three years ago now, and you can go to PubMed and read it if you want, entitled Vilification of Cholesterol for Profit. You may recall a newscast came out that basically said, “50% of people over the age of 40 should be on a statin drug because they’re so safe and they’re only beneficial,” and they quoted a very large study, 10,000 person double blind, consumer controlled study. Well, that’s pretty impressive, and here’s where there’s a problem when you look at the abstract versus reading the study. You look at the abstract, wow. That’s pretty impressive. I guess statin drugs are safe and they have benefit, but when we actually look at the data, the way they did it was this 10,000 person trial started with an open label trial. What that means is everybody got the statin drug, then anybody who had an adverse reaction was removed from the trial and then those where left over, half got statin drug, half got placebo, and they found 1% adverse drug reaction to the statin drug. Well, that sounds pretty good, but you need to ask yourself, “Now, how many people did they remove from the study?” Out of that 10,000, they removed 3,000, so 30,000 of people had a reaction. Now, of course, some of those could be placebo and not real, but then when you do the post-marketing surveillance on what percent of people have an adverse reaction to statin drugs, guess what? It’s 25 to 30%, so they basically, from my perspective, created a study designed to produce the result they wanted, rather than valid information.
Dr. Weitz: Those of us in the natural world here seeing patients have known this. We see so many patients who complain about the muscle aches and the brain fog and all the other side effects they get from statins, and meanwhile they’re publishing these results, as you said, showing 2% of the people have these side effects.
Dr. Pizzorno: [inaudible 00:41:22] it’s not true, but they make money, so they keep doing it.
Dr. Weitz: Absolutely, absolutely, and they even talked about the poly pill which was going to be given to every single person for prevention, and it would contain a low dose statin, as well as, I think it was going to have a blood pressure medication and maybe metformin or something.
Dr. Pizzorno: Yes. That was exact. That’s what they were doing. Metformin, statin, and a blood pressure [inaudible 00:41:47].
Dr. Weitz: Certain blood pressure medications actually can interfere with bone. Can you talk about which ones?
Lara: If I can remember which ones off the top of my head.
Dr. Weitz: Yeah. I took-
Lara: Well, they use [crosstalk 00:42:02] to help lower blood pressure.
Dr. Weitz: This is how you can tell that this was such a good book. I’ve got this pad of notes I took while I was reading it, sitting on my back porch drinking a glass of organic red wine. I’m glad that you said small amounts of alcohol are good for bone.
Lara: Small amounts of alcohol are really good for you. Yeah.
Dr. Weitz: You said that Thiazide diuretics protect bone, while-
Lara: Right. Loop diuretics cause bone loss.
Dr. Weitz: Calcium channel blockers harm bone.
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Dr. Weitz: You also mentioned that SSRIs, antidepressants, promote bone loss.
Lara: Yeah. It’s interesting how they do that. That one, I do remember. What happens is they-
Dr. Weitz: Those are so commonly prescribed.
Lara: Very commonly prescribed, and they increase the gut production of serotonin and then that serotonin binds to a receptor on the surface of newly forming osteoblasts, and stops them from developing, and so, your bone building cells don’t develop, and that’s a problem.
Dr. Weitz: Yeah. I certainly understand. Let’s talk about calcium supplements, and we’ve known for a long time that calcium is beneficial, but of course, when a few of these studies came out showing that calcium increased risks for heart attack, everybody freaked out and now it was like, no, no, you can’t take calcium. Just take vitamin D. If you’re going to take calcium, just take a little bit, because if you take a lot it’s going to calcify your arteries, so what do we know about the truth about calcium? How much should we be taking? How much is it safe? What form? I noticed you talked about some of the forms that we’ve been told for years, like hydroxyapatite are the best forms of calcium, actually not as beneficial as we thought they were, or maybe not beneficial at all, so tell us about calcium supplements.
Lara: Okay, so, the first thing is the papers that came out, they were primarily written by a group headed by Boland and his team in Australia, and they looked at studies where only calcium was given or calcium and vitamin D were given, and no vitamin K, okay? As I mentioned before, vitamin D helps us absorb calcium. It does nothing to control what happens to that, and if you don’t have vitamin K available, you’re not going to activate the proteins that pull that calcium into your bones where you want it and prevent it from depositing in your arteries where you don’t, so that is essentially the answer to that issue. You’ve just got to have … The nutrients work together, and you need the team, not just one or two of them.
Dr. Weitz: By the way, one of the reasons why they did some of these studies is because earlier studies had shown that people who consumed more calcium had a lower risk of heart problems.
Lara: That’s interesting.
Dr. Pizzorno: [inaudible 00:46:36] calcium, magnesium.
Lara: Yeah. Maybe it was magnesium, as well, because those two have to be in balance, too, and that’s another big problem in the modern world.
Dr. Weitz: Let’s finish with the calcium first.
Lara: Okay. Okay. On types of calcium, the reason the hydroxyapatite is not more effective, two reasons that I really don’t like hydroxyapatite. One, it’s hyped. It’s really expensive. It’s overpriced calcium, and when you consume it, in your stomach, your body is going to break it apart, okay? The calcium ions, if you produce any stomach acid, the calcium ions are going to be released from whatever their partner is, and then you’ll absorb the calcium ions. You do not absorb it as a blob. You absorb calcium ions and then the apatite is very, very high in phosphate, phosphorous, and high phosphate levels are one of the problems with the American diet, largely because of phosphate additives in all the processed foods. I wrote a review paper on this, and it’s on PubMed, entitled Canaries in the Phosphate Toxicity Coalmines, which is what we are. The latest research has shown that they’ve known about this for people with kidney disease for a long time, but now they’ve discovered that high phosphate intake is causing cardiovascular disease in everybody, not just people whose kidney function is impaired.
Dr. Pizzorno: It increases the rate at which the kidneys degenerate.
Lara: Right, so I don’t think adding more phosphorous phosphate to your, taking that as a supplement, is really a good idea, so I don’t suggest taking that. If you do not produce any stomach acid, then calcium citrate is going to disassociate, even without any stomach acid present, but it has a lot less calcium ion in it than calcium carbonate, and they’ve done many studies showing that people who produce stomach acid, calcium carbonate is fine. In fact, the research that they used to initially show that calcium carbonate was a problem and that calcium citrate was so much better, they took a group of older people who were hypochlorhydric, meaning they did not produce much stomach acid, and they tested them before breakfast, when they were fasting. They gave them a supplement. They didn’t produce stomach acid in response to the supplement. They didn’t absorb any calcium. They took the same group of people, and they didn’t report this part of the study, and they gave them breakfast, and guess what, they absorbed their calcium just fine. I think there’s a lot of misinformation. Studies have been used to promote various products in a not very truthful way.
Dr. Weitz: [inaudible 00:49:30], you know calcium citrate probably has the added benefit of citrate being sort of an alkalizing-
Dr. Pizzorno: Alkalizing agent.
Dr. Pizzorno: [crosstalk 00:49:38]. Yes.
Dr. Weitz: But how much calcium in supplements is it safe to take? At one time we were doing 1,500, even 2,000 milligrams, and then after those studies, everybody pulled way back. Now people say just 500, 800. What do you think is for, if you’re working with a woman with osteoporosis, how much is safe, and then how important is it to take it at certain times of the day, to split it up, et cetera?
Lara: You want to be getting about 1,200 milligrams of calcium per day. In some of the research on post-menopausal women, some people have benefited from as much as 1,500 milligrams per day, but that’s total. It’s not just from a pill that you’re taking. You’re supposed to be eating real food that has calcium in it, and you’re supposed to look at what you’re getting from your diet and then supplement the additional, so the company that I work with, am I allowed to mention a company name or anything?
Dr. Weitz: Of course. Yeah. [crosstalk 00:50:41].
Lara: I work with a company called AlgaeCal. In their product, it provides 720 milligrams of calcium. Because the research shows that the majority of people in the US are consuming between 450 to 600 milligrams of calcium daily from their diet, which is way less than you actually need, so if you take the supplement, which is 720 milligrams over the course of the day, you divide it into 2 servings of 350 milligrams each, and the total from your diet and the supplement comes out to between 12 and 1,500 milligrams daily. The fractional calcium absorption, which is how much of the mineral you’re actually going to absorb from what you swallowed, tops out at 500 milligrams. After you have consumed 500 milligrams of calcium, the transport mechanisms, the compounds in your gut that help you absorb the calcium, will be maxed out. They can’t carry anymore.
Dr. Weitz: Don’t consume more than 500 milligrams of calcium-
Lara: … at a time. At one time, yeah, and then you need three or four hours for things to reestablish themselves and for those transporters to be available.
Dr. Weitz: Better with a meal? Better in the evening? What do you think?
Lara: Definitely better with a meal. You cannot release the calcium ions from the food matrix or from their stabilizing partners, like calcium bound to carbonate. It won’t release without the presence of stomach acid, and we produce stomach acid in response to a food intake, so definitely with a meal. Whenever you eat.
Dr. Weitz: Now, the reason for taking it at night is because some of the studies seem to indicate you lose bone while you sleep.
Lara: Well, that’s why I suggest that people take strontium at night. Bone renewal is a housekeeping function, right? Just like all the repair functions, and those ramp up at night when we’re not busy doing a lot of other things, so it’s best to, I suggest that people, if they take strontium, they should take it at night. They’ll get the most benefit from it at night.
Dr. Weitz: Okay, so, calcium with meals, maybe split it up. No more than 500 milligrams at a meal, and then, let’s get into strontium because that’s a controversial compound and I’ve talked to other bone experts who were very negative on strontium and you write in your book that that’s partially because some of the studies of this prescription form of strontium, strontium [inaudible 00:53:24], or strontium ranelate were-
Lara: Ranelate, right.
Dr. Weitz: … were potentially harmful.
Lara: Right. When Servier, the company that created strontium ranelate, developed it, they did so because they look at over 100 years of research showing that many, many different natural forms of strontium were beneficial and caused no adverse effects. Then, for some reason that I wish I-
Dr. Pizzorno: … to make it [inaudible 00:53:52].
Lara: … to make it … Well, yeah, but why they picked ranelic acid, which is a toxin, to combine it with, God only knows. I so wish they’d put it with something that wasn’t toxic, because it would have been a fabulous drug and a lot of people would’ve benefited, but they combined it with this toxin, and when you consume that, just like for calcium, the strontium ions disassociate from the toxin, and the claim was that ranelic acid wasn’t going to be absorbed and it wasn’t going to do anything. Well, that wasn’t true, and there’s now been research that shows that it’s absorbed and it has adverse effects, and it’s part of the group of aromatic compounds that cause things like rashes, DRESS syndrome, blood clots and all that, all those things that are the adverse effects of strontium ranelate, but in the research on natural forms of strontium, there have never been, in more than 100 years, none of these forms of strontium have caused any of these adverse effects, and strontium is so beneficial for bone. It acts through so many different mechanisms, both to increase osteoblast activity, increase calcium absorption. There’s even a special calcium receptor that only responds to strontium. It’s activated by strontium and helps you absorb more calcium, and then strontium also helps lessen osteoclast activation, those cells that break down bone, so it’s a really incredible-
Dr. Weitz: It’s a natural bisphosphonate.
Lara: Well, bisphosphonates only poison osteoclasts. That’s all they do.
Dr. Weitz: Right. Okay.
Dr. Pizzorno: That’s a good point. [inaudible 00:55:47].
Dr. Weitz: Strontium citrate is the form you like, right?
Lara: Right, and again, the citrate is alkalizing, so that’s helpful-
Dr. Weitz: What’s the ideal dosage?
Lara: Well, it depends, just like everything else. If someone has frank osteoporosis, then they would probably benefit from the typical dose, which is 680 milligrams per day, but if someone’s bones are in good shape or they only have osteopenia, they can do a half a dose and they’ll still get benefit from it. There have been studies showing benefits from that. Once my bones were in good shape, I stopped taking strontium. Until I wrote the big review on strontium and I learned all the ways that it supports healthy bone renewal, so I started taking a half a dose, and that’s what I do. Also, strontium also helps you sleep better. It helps tune down some brain activity that would keep you awake, and I find it really helpful for that.
Dr. Weitz: Okay, and now we should have magnesium in a two to one ratio, calcium to magnesium. You recommend that in the book?
Lara: Yes, and that is a big problem because everybody’s taking calcium and vitamin D with nothing else. The standard American diet is really depleted of magnesium because of the way food is grown. You want to talk about that? Then, that balance is off, and when it’s off, it promotes lots of bad things, like cancer as well as bone loss, so it’s really [crosstalk 00:57:26]-
Dr. Weitz: I talked to one doctor who’s an expert at bone, and he said that he looked through all the literature and he couldn’t find any literature that substantiated this two to one calcium, magnesium ratio.
Lara: If you send me his email I’ll send him a bunch of papers.
Dr. Weitz: Okay.
Lara: I mean, it’s there, for sure.
Dr. Pizzorno: Yeah. Actually, I was [inaudible 00:57:48] about that, as Lara’s digging into it, that I’d always heard two to one, but I actually had never saw any research. When Lara actually dug up some research on it, I was quite intrigued. Now, I’m surprised, it was actually two to one.
Dr. Weitz: Two to one calcium and magnesium, and then what other nutrients are synergistic?
Lara: Well, a lot of trace minerals. If you skim the book, you saw a whole list of them.
Dr. Weitz: You mentioned boron. How important is boron?
Lara: Oh, boron is my favorite trace mineral. I actually wrote a paper on that, too. It’s on PubMed. It’s called Nothing Boring about Boron.
Dr. Pizzorno: Mention how many citations, how many research [crosstalk 00:58:25]-
Lara: Yeah. I’m on ResearchGate, and every week they send me, “You had X number of people read this article that you wrote.” Over 3,000 doctors have read boron now.
Dr. Weitz: Wow.
Lara: Yeah. A lot.
Dr. Pizzorno: Nothing Boring about Boron.
Lara: Yeah. There’s nothing about it.
Dr. Pizzorno: [inaudible 00:58:42].
Lara: It’s so helpful in so many ways. After I read all the research on boron, I started on boron. One of the things it does is it slows down the activation of the enzyme called 24-hydroxylase enzyme, that breaks down estrogen, testosterone, so you keep it around longer, but it’s not harmful. It doesn’t make you keep around so much that it would increase cancer risk. In fact, they use boron in cancer treatment, it’s so beneficial, but that’s one of the things it does, and so you get more benefit.
Dr. Weitz: What’s the dosage you like of boron?
Lara: You need at least three milligrams, but then there’s a bunch of research showing that six milligrams, particularly for people who have osteoarthritis or degenerative osteo, what?
Dr. Pizzorno: Yeah. Degenerative [inaudible 00:59:38].
Lara: Yeah, degenerative joint disease of any kind. They’ve done a number of studies using six milligrams of boron. They’ve had a lot of success with it, and there have been several studies just on bone loss and it helped to prevent bone loss.
Dr. Weitz: Now, you also wrote that phytate-rich foods are actually protective of bone.
Dr. Pizzorno: Not what we were taught 50 years ago.
Lara: Yeah, well, phytates bind things in the colon that you really want to have leave, and if they don’t leave and they get re-absorbed, they’re inflammatory, and again, anything that promotes-
Dr. Weitz: Dr. Gundry’s not going to agree with you on this.
Lara: That’s okay. I’m happy to disagree with him.
Dr. Weitz: Let’s hit one final topic, which is exercise. What is the most effective form of exercise to improve bone density? I’ve looked into some of the data on the type of exercise that’s beneficial, and most people recommend some form of resistance training or weight lifting, and yet, a number of the studies really didn’t show much benefit and some of the studies have shown that ballistic or high impact loading is necessary to really turn around bone and stimulate bone building. I know that this is controversial. Do you really want to take somebody who’s older with osteoporosis and have them do ballistic training and suffer compression fractures? This has also led Dr. John Jaquish, who I interviewed previously, to create his OsteoStrong centers where he has these machines that load your bones to supposedly four times your body weight. I know there’s a lot of controversy. What do you think is the best way for us to exercise to strengthen our bones, and what’s safe for osteoporotic patients?
Lara: Well, I think the most important thing is weight bearing exercise every day for an hour. This stuff of, come into my facility and in 20 minutes once a week, you’re going to rebuild your bones. Uh-uh (negative). Not happening.
Dr. Weitz: [crosstalk 01:02:12] 10 minutes.
Lara: Yeah. Bones need stimulation. When the muscles are stressed and the torque is applied to bone, the type of cell and bone, which is actually the most prevalent type of cell and bone, they’re called osteocytes, and they’re machanosensors, and they start the bone renewal process, and they don’t start it until they’re activated, and they’re activated by weight bearing exercise, so exercise is just critical. Really, the best type of exercise is something you’re actually going to do every day for an hour, and there are several types. The having somebody to do the things where they did the pull ups and then people dropped to the floor-
Dr. Weitz: That was the LIFTMOR trial.
Lara: I don’t think so. The people survived it and they didn’t get any broken bones, but I wouldn’t want to chance it with patients that I try to help. I think some of these people are very fragile, and you don’t want to do things that is possibly going to cause a fracture, so there are three types of exercise that I really like that people can do in their own home, easily, with very little equipment. Yoga for osteoporosis, I think is an excellent one. It was a protocol created by a doctor, by Dr. Loren Fishman. He’s an MD at Columbia and he teaches a course for, people can be trained to become certified, and I have done his course. People who do a lot of yoga, I know, take the training, so that’s an excellent one.
It’s a series of 12 poses. They can be done at home. You can access the videos for them online for free. There’s books out, and he has proven in peer reviewed, published research, that it is effective, and what happens is you do these poses and they put torque on certain areas and you hold the pose and it’s isometric, and it really puts torque on the muscle and it signals those osteocytes and they build bone. I’m also a Stott Pilates instructor. I love pilates. It’s very safe form of exercise, can easily be adapted so that you don’t do any of the C curve type things that could cause compression, but you can get really good core strength and it helps people stand up more erect and carry their body properly. It can really work the muscles, and then my favorite is Bar 3, which is a combination of pilates, bar, and yoga. You get all three types of exercises. It’s an hour a day. There are 40 minute classes or 30 minute classes. It’s very accessible online. All you need is a mat, and you can do it in your own home, so I think people need to find something that they enjoy enough that they’ll do it.
Dr. Weitz: If they’re willing to do anything, ideally, would it be better to do an hour of weight training?
Lara: Well, if they’re doing it with someone who’s watching them at least until they really understand how to move the weights, and all, I think an hour of weight training will be helpful, but part of it is when you’re, and Dr. Fishman talks about this, say you’re on a machine and you’re doing a leg press and you kind of lie back on the machine and you do the leg press. That’s not functional movement. That’s not how we live in our life, and I think the exercises that allow us to do the type of functional movements that puts stress on the muscles and the ligaments and activate the osteocytes in the bone that we actually do in our life, is probably the best approach.
Dr. Weitz: Squats and dead lifts more so than leg press.
Dr. Pizzorno: Exactly.
Lara: Yeah. In Bar 3, I probably did 50 squats today with weights, as part of Bar 3, to music. It was fun, sort of.
Dr. Weitz: Great. Thank you for spending some time with us and giving us some great information. Any final thoughts for listeners and viewers?
Lara: You’re a terrific interviewer. I’m astounded at the great questions and how you really looked at the book, and I think you pulled many of the most important things out of it, and I greatly appreciate your help in doing that. I hope it will be helpful for people to hear this interview, and thank you.
Dr. Weitz: Get this book. The name of the book again is Healthy Bones, Healthy You, and it’s available, Amazon, Barnes and Noble and everywhere else, right?
Lara: I think so.
Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast, and if you enjoyed this podcast, please go to Apple Podcasts and give us a five star ratings and review. That way more people will be able to find this Rational Wellness Podcast when they’re searching for health podcasts, and I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica weight, sports, chiropractic and nutrition clinic, so if you’re interested, please call my office. (310)395-3111, and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz. Thank you, and see you next week.
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