How This 55-Year-Old Woman Naturally Reversed Osteoporosis | Doctor Explains Complete Routine

0:00All right, welcome back to the Dr. Doug

0:01Show. Today we have another success

0:03story for you. And what I like about

0:05this success story is that it actually

0:07took a little bit longer. This is a

0:09patient who really struggled early on.

0:10I'll talk about why she had some

0:12challenges, but we just continue to kind

0:15of work the program, figure out where

0:17the weaknesses were in the approach, and

0:19you'll see by the end that we were able

0:21to find success. So I look forward to

0:23sharing this with you and I want to

0:25define our structure as we go so that

0:27you can help to do this on your own. So

0:30what I'd like to do first is talk about

0:32how we approach creating a program for

0:34bone health. We use this thing called

0:36the 4R method which is just something

0:38that we created to help us to provide a

0:40framework for our patients but also our

0:43osteoclective members and anybody who's

0:45following us and helping us to kind of

0:48push this forward. We talk about this

0:494hour method a lot. So, let me just

0:51review it with you real quick. So,

0:53number one, the first R is to recognize

0:56why you're losing bone. This is just

0:59root cause medicine at its best. Why are

1:01we losing bone? We don't need to accept

1:03that bone loss is a part of aging. We

1:05prove that in our practice. So, why are

1:07you losing bone? Number one. Number two,

1:09the second R is then reverse those

1:12causes of bone loss. Now, when I talk

1:14about reversing osteoporosis, this is

1:16actually what I'm talking about. Yes,

1:18it's great to see that T-core go above

1:20negative -2.5, but what I'm actually

1:22talking about is reversing those causes

1:23of bone loss, improving your bone

1:25metabolism, and then you see improvement

1:27in your T- scores down the line. So,

1:29that's what I mean when I say reversing

1:31osteoporosis. The third R then is to uh

1:35retest and make sure that you're headed

1:37in the right direction. This is really

1:38really important and this is a good case

1:40example of that where she had a great

1:43program but it wasn't working initially

1:45because there were pieces that were

1:47still missing or weren't being done

1:48adequately. So while we had good initial

1:51labs, we thought we had the right

1:53approach, we ended up, you know,

1:55retesting and seeing, oh, we're not

1:57headed in the right direction. And so

1:59retest, make sure you're heading in the

2:00right direction. Don't just stick your

2:01head in the sand and assume that what

2:03you're doing is working. And then the

2:04fourth R is my favorite one and this is

2:06to revive your life and live without the

2:08fear of fracture. I'm going say it

2:09again. Revive your life and live without

2:12the fear of fracture. So that's the four

2:13R method. Again, easy for anybody to use

2:16this to apply their own uh tools into a

2:19framework to help improve their bone

2:20metabolism. Okay, so let's get back onto

2:22this patient. So uh we're going to call

2:24her Ruth. So Ruth is a 55year-old woman.

2:28She is 5'4 and 116 pounds. And this is

2:31pretty typical of our patient

2:33population. generally tend to be

2:35smallframed, underweight, undermuscled,

2:38and that is a recipe for osteoporosis

2:41eventually for a lot of people. Now,

2:43what made her case interesting out of

2:44the gate is that she also had a very

2:46strong family history. So, this is

2:49really important. If you have parents

2:51that had osteoporosis, if you had

2:53parents that had fractures, it's really

2:55important to understand that you are at

2:57increased risk. In fact, I recently uh

3:00interviewed uh Dr. Stuart Kim who runs

3:02the company Axgen and this is he has a

3:04program that's all about identifying

3:06genetics for osteoporosis. I think

3:08mostly applicable to younger individuals

3:10to see what their risk is but this is

3:12another way to say it. Now in his test

3:15he shows I think it was over 80% of the

3:19uh future of your bone quality and

3:21quantity is based off of your genetics.

3:24That's a big number. So if you have a

3:26strong family history like this patient

3:28had both mother and father something you

3:30really need to pay attention to. Now

3:32before starting the program she had

3:34started doing a walking routine. She was

3:36walking three to four times a week but

3:38she had actually had a fracture right

3:40before this. So would that really

3:41changed the way that she exercised.

3:43Before that fracture though she was

3:45actually much more aggressive with

3:47running. So she was actually a runner.

3:49She would run four to five miles 5 days

3:52a week. That's a lot of running. And we

3:54know that running is associated with

3:56bone loss in a lot of people. So this

3:59may have been part of her cause right

4:01now. She was also at that time lifting

4:03three days a week and that's great. I

4:05don't have a lot of details of what that

4:06lifting included. So it's at least good

4:08that she was doing some resistance

4:10training at the same time. Now she also

4:11followed a vegan diet for many years

4:14through her adult life. And she actually

4:16said it really well in her own

4:17paperwork. She said, "I tried to eat a

4:20whole foods plant exclusive diet.

4:23However, I often times just ate more

4:25highly processed food and ate a quote

4:28glorified vegan diet. And that's what I

4:30see unfortunately a lot of people do

4:32because it's hard to eat a whole food

4:34plant exclusive diet. So, she was eating

4:37quite a bit of processed food and I

4:39think that was also probably playing a

4:41role in her bone health. Now, if we look

4:43at her DEXA scores, we actually have

4:45data going back four years. I don't have

4:46the official report going back, but if

4:49we go all the way back, her uh if you

4:51look back in

4:522022, her spine started at a T-core of

4:57-3.5. 2023 it was -4.1. So this is where

5:01she actually started having fractures.

5:02She's had multiple fractures. Um so this

5:05is a really bad starting point. Right

5:07now her hips were a little bit better,

5:08T-core of -2.6 and they stayed at -2.6

5:12as she went from 2022 to 2023. So, her

5:15spine was her biggest concern. So, I

5:17have her entire list of supplements when

5:19she started the program with me, and I'm

5:21not going to list them out because it's

5:23a really, really long list. And what I

5:24want to point out here is that she was

5:27doing what she thought were all the

5:29right things. Now, she was doing weight

5:30bearing exercise. She was walking 3 days

5:32a week. She wasn't doing any any

5:34resistance training yet because she was

5:36she was recovering from a spine

5:37fracture. Um, but this list of

5:39supplements is massive. So, I'm just

5:40going to list off a couple things. I'm

5:41not going to go through all of it here,

5:43but she was on D3 K2, she was on an

5:46omega-3, she was on a mag glycinate, she

5:49was on methylated B12, she was on a

5:51probiotic, she was on a osteo combo

5:55product, she was on estragalus,

5:58iraflavon, she was on a couple of kidney

6:01things, she was on a couple of metabolic

6:03things, she was using borage oil, some

6:05vitamin E, some other minerals. Um, just

6:09looking at this list, it's massive. Uh,

6:13amazing grass green blend, melatonin,

6:16torine, and on and on and on. Collagen.

6:19So, she had this really massive

6:21supplement list, and we see this pretty

6:23frequently. She was doing weight bearing

6:25exercise, but she was still losing bone.

6:27Now, she was also in a bad starting

6:29point because she has now had multiple

6:31fractures. She's had multiple rib

6:33fractures, which are not technically

6:34fragility fractures, but one was from

6:36her husband hugging her.

6:38H that's a low mechanism force right

6:41there. Um the other one was from a dance

6:43partner picking her up on her ribs,

6:45right? And caused a rib fracture. Now

6:47she had some spine fractures from

6:48falling down the stairs. That's

6:51potentially real trauma, but actually a

6:53fragility fracture depending on the

6:55mechanism. And then she also had the

6:57most recent fracture in 2022 uh from

6:59riding a horse. So she's had multiple

7:01fractures. She has low bone density.

7:04This is a bad starting point. Now, when

7:06we first met and we talked about all of

7:08the different approaches, for us always

7:10hormone optimization comes up. Now, she

7:13has an interesting family history that I

7:14want to talk about because for her, this

7:16was really the biggest driver of her not

7:18using hormones. So, her mother died at

7:21the age of 70 of a recurrent metastic

7:24breast cancer that was initially

7:25diagnosed at the age of 47. Now, you can

7:27imagine this impacted her significantly

7:29as she went through menopause and had a

7:31conversation around hormones. her

7:33doctors, as she told me, told her that

7:35she had a strong family history and that

7:36it was too dangerous to use HRT. Now,

7:39here's what's frustrating about that.

7:40So, number one, they didn't take into

7:42account that she already had low bone

7:44density and osteoporosis. So, she

7:46literally was in a position of increased

7:48risk of another disease that was going

7:50to get worse with estrogen deficiency.

7:54Secondly, the risk of cancer,

7:58specifically breast cancer that comes

8:00from having a family member with an

8:02increased risk or with a history of

8:04breast cancer is already present. So

8:07that risk doesn't change whether or not

8:10she uses HRT or not. And this is

8:12misunderstood. So I'm going to say that

8:13another way. If you had a family member,

8:16immediate family member, sister, mother

8:19that had an early cancer, it puts you at

8:22increased risk of developing cancer.

8:24That's true. That's the genetic side of

8:26it, even if there were lifestyle factors

8:29involved. But that risk already exists

8:33prior to the decision to start HRT. And

8:36the risk doesn't change when you start

8:38HRT. This is what's misunderstood about

8:41family history. Now, that does mean that

8:43we do need to be more cognizant of

8:44screening. We need to be more aware that

8:46you are at higher risk and hit

8:48potentially, especially if not done

8:50right, could make a cancer grow faster.

8:52So, I'm not saying it's not relevant,

8:53but it's not a reason in my opinion not

8:56to start, especially like in this case

8:58where some of the, you know, more common

9:00cancer genes had actually already been

9:01ruled out. Sorry to pause this success

9:04story, but if you are struggling to find

9:07your own success story, you're looking

9:08for more information, please consider

9:10coming to our free master class. The

9:11master class we do about every other

9:13week. I run it myself and we talk about

9:16the top uh I think it's three or maybe

9:18five at this point um mistakes that we

9:21see people making as they are creating

9:22their bone health journey. It's very

9:24very consistent. We see people make

9:25these same mistakes all the time and I

9:27don't want you to do that. So come join

9:29us. We'll talk about the things that

9:30we've seen and then we also leave about

9:3220 minutes for Q&A. We talk about some

9:34resources on where to potentially go

9:36from there. It's totally free. Look for

9:37the link in the description on YouTube

9:39or you can head to our website

9:41optimalhumalth.com and you can find it

9:42there as well. Okay. So, how do we do

9:44this? Well, we want to start with the

9:46four Rs, right? So, what is the reason

9:49why she's losing bone? Let's recognize

9:50why she's losing bone. Well, we already

9:52said some of it. She had a sedentary

9:54lifestyle because of a fracture. She was

9:56eating a vegan diet. When we started

9:57tracking her protein, she was getting

9:59nowhere near ideal protein. We're

10:01talking 30 to 40 grams a day. So, that's

10:04a clear reason. She also had some gut

10:05dysfunction, which I haven't talked

10:07about yet. Um, she wasn't on hormones

10:09and she was early in menopause, right?

10:11So, she's 55 years old. I think she went

10:13through menopause in the her early 50s.

10:16So, we're talking like within the first

10:17two to three years. And we know that

10:19you're going to rapidly lose bone during

10:21that time frame. Okay. So, then what do

10:22we do with the second R? How do we

10:24reverse then those causes of bone loss?

10:26Well, we had a conversation around HRT,

10:29right? So, this is one of the biggest

10:30tools you can use. So, we started her on

10:33HRT. We educated her on the risk and we

10:35educated her on the best ways to do

10:37screening. And she was very comfortable

10:39with that. And she feels great on HRT.

10:41Now, the other big player for her is

10:43going to be diet. So, we dug into the

10:45reasons. Why are you eating a plant

10:48exclusive diet? Why are you avoiding

10:50animal products? And it turned out there

10:51were some animal products that she was

10:53actually willing to consume. and there

10:55were some animal products that she

10:56wanted to avoid. So, we found a way to

10:58get more protein for her in a way that

11:01she was comfortable with that aligned

11:02with her morals, her values, and um her

11:06views on animal husbandry. So, we were

11:08able to start getting her more protein.

11:09She's tracking. She's getting over 100

11:11grams of protein a day. That was a

11:13massive change for her diet. The

11:15exercise part is an area where we really

11:17struggled because she was recovering

11:19from this vertebral fracture. She was

11:21walking. She wasn't doing any resistance

11:23training. She had a history of it but

11:25was afraid of it and rightfully so. So

11:28we started her with some light

11:29resistance training. We have a

11:30four-phase program. She was in phase

11:32one. It's a lot of body weight movement

11:34getting used to uh technique again. She

11:37did some of this with a weighted vest.

11:39She was able to wear that with her spine

11:40once it was healed. And then she also

11:42did osteogenic loading through a

11:44biodensity power plate like device. We

11:46went through a gut health program with

11:48her as well. Uh but those were probably

11:50the biggest factors that we put into

11:51play. I wanted to mention a little bit

11:53too about her HRT because I know there's

11:55lots of questions around how, you know,

11:56how do we do it? What's the best way to

11:58do it? And I can tell you that the best

11:59way is going to be individualized. Um,

12:02this particular patient, by the time she

12:04was done with us, she was on a 4

12:06milligram per ml estradile cream twice a

12:08day. She was using DHEA as well as some

12:12testosterone. Uh, of course,

12:14testosterone is off label uh for any

12:17woman. And then she was on progesterone

12:19and we were able to titrate her up to

12:20300 milligrams at night. So this helped

12:23her with her sleep. She felt great. She

12:25had better energy. I mean she was just

12:28raving about how she felt on her

12:30hormones. Now what's interesting we'll

12:31talk about at the end is that we are

12:33still not actually to goal if you look

12:35at her serum levels. But that's okay

12:37because I'll show you all the other

12:39things and it's everything's definitely

12:40headed in the right direction. So we

12:42changed up her supplement stack. And in

12:44fact, for her, and this is actually not

12:46not that uncommon for her, we actually

12:48reduced the number of supplements that

12:50she was on. So, we put her on a couple

12:52of things for detox. She's on a specific

12:54K2. She's on something for um estrogen

12:57metabolism. We did some some urat

12:59metabolite testing on her. She's on

13:01Tongad Ali to help to with conversion of

13:04the testosterone that she's getting into

13:05free testosterone. That was an upgrade

13:07we have to make. Over time, she's on

13:09some additional magnesium. She's using a

13:12product for thyroid support. She using a

13:15product for cortisol support. She's on

13:17lactoerin, lipidrol ox, which is a a

13:20great product that helps with both

13:21oxidized LDL as well as um uh bone

13:25health. She's on a a B complex uh

13:28continued on a fish oil and then algical

13:31plus and this product cardio NAD. Uh she

13:34has a lot of concern around

13:35cardiovascular risk. So still a

13:37substantial list, right? Uh but we're

13:40hitting a lot of things. There's a lot

13:41of cardiovascular, there's a lot of

13:42detox. There's actually not that many

13:44things in there that are specific for

13:45her bone

13:46health. Okay, so how do we do? Let's

13:50fast forward two years. Now, I said

13:52early on we had struggles, and we did

13:53because it was a struggle to get the

13:55right food. We had to do some gut work

13:57to be able to get all that protein in

13:59because her gut just wasn't used to it.

14:00It wasn't used to eating animal products

14:02at all. Right? So, we had to do some gut

14:04work. She worked with our dietitians.

14:05Uh, so that took some time. exercise was

14:08really slow to get going because she had

14:10that fracture and she had a lot of fear

14:12around lifting. So we started at a

14:14pretty low level and we progressively

14:16overloaded and that takes time if you

14:18have a very uh low starting point. So we

14:22have now DEXA so actually two years

14:24later. So we started her DEXA journey in

14:272022 and now we have data for the

14:29subsequent four years. I told you her

14:31spine went from 35 to 41 before she

14:33started working with us. uh within her

14:35first year she went from 41 to 37

14:38negative uh 37 as a t-core which is a

14:41good improvement but the next year she

14:43went from -37 to -31 and so now she went

14:47from -41 to -31 I only have the bone

14:50mineral density numbers for the last

14:53that jump from 37 to 31 and that's a

14:569.8% an 8% improvement in 1 year. Now,

14:58obviously, it's bigger if you go from

15:004.1 to 3.1, but when you're doing

15:03percentage change, this is really

15:04important. When you're doing percentage

15:06change, you have to use the bone mineral

15:07density, grams per centimeter squared,

15:10versus the um uh t-core. So, if you do

15:13the math on the t-core, you'll get these

15:15kind of big wonky numbers. And remember,

15:16that t-cores change even if your bow

15:19density stays the same, which is a

15:21confusing topic. So, anyway, over that

15:23last year, around 10%. Now her hips just

15:25a little bit slower. Again, I only have

15:27the last year and that was a 7.4%

15:30improvement. She went from 26 to 25 and

15:32then -25 to -22. So she's actually out

15:35of the osteoporosis range uh for her

15:37hips and I think she will be with her

15:38spine probably over the course of the

15:40next year. All right. So then how did we

15:42do that? Well, let's think about it

15:44again. So we used the 4R method. We

15:47identified that she had genetics working

15:49against her. She had her diet working

15:50against her. She had her exercise

15:53working against her. her hormones

15:54working against her, her gut, and her

15:56stress, which I didn't talk that much

15:57about. So, if we're talking about the

15:59first are recognize why you're losing

16:02bone, that's the lowhanging fruit.

16:04That's what we aimed for. And then we

16:06created a program to address as many of

16:08those as we can. But here's what I want

16:10to point out about this case. You know,

16:12if we look at what we did with her, we I

16:15don't want to say we struggled, but it

16:17took us a lot of time to get things

16:19moving in the right direction. That's

16:20why she was with us for two years. But

16:22even if I look at where she is at the

16:24end of two years, it's still not perfect

16:26by any means, right? There's still room

16:28for improvement. Her hormone levels

16:30aren't that high. Her FSH is still 70.

16:32It was 100, so it's better. Um, but her

16:36hormone levels still aren't ideal when

16:38it comes to her labs. Now, she feels

16:40great, but we know that we need to look

16:43at other things, too. Her bone turnover

16:45markers did continue to improve. They

16:47were kind of went up and down throughout

16:48the program, and at the end, they were

16:50still over 150. Clearly, she's building

16:52bone. I'm happy with that. We wouldn't

16:54necessarily have to change anything, but

16:56I still think she could be more

16:57optimized. I think she could be doing

16:59more with her exercise, too. So, there's

17:01still room for improvement. And the

17:02reason why I bring this up is because it

17:05doesn't have to be perfect. You just

17:08have to find the lowhanging fruit, the

17:09things that are going to give you the

17:10biggest impact. Address those things as

17:13well as you can, and then retest and see

17:15if it's enough. And if it's not, then

17:17you need to recalibrate. And if it is,

17:19keep going. and then keep retesting and

17:22make sure that it's still working. It

17:24doesn't have to be perfect. And that's

17:25the takeaway from today. So that's it.

17:27Remember that a diagnosis of

17:28osteoporosis isn't the end, but deciding

17:30to reverse it is the beginning. I'll see

17:32you in the next video.