Overview of Vibration Therapy
Vibration therapy involves using a device that moves up and down at a specific frequency and amplitude to stimulate bone growth.
It provides impact stimulus necessary for bone growth, which can be safer and more controlled than activities like jumping.
Benefits and Uses
Bone Health**: Vibration therapy can improve bone mineral density, strength, endurance, fall risk, joint pain, and swelling.
Other Benefits**: Potential improvements in weight loss and overall physical health.
Contraindications and Risks
**Eye Issues**: Avoid if you have retinal detachment or glaucoma.
**Inner Ear Issues**: Avoid if you have balance problems or inner ear conditions.
**Osteoporosis**: Generally safe, but caution is advised for extremely frail individuals or those recovering from fractures.
Choosing a Device
**Key Factors**: Frequency (30-35 Hz), amplitude (2-3 mm), and type of vibration (vertical vs. teeter-totter).
**Quality**: More expensive devices like Power Plate are more reliable and consistent.
Protocols for Use
**Standard Protocol**: 10 minutes a day, 3-5 days a week.
**Intermittent Exposure**: Recommended 60 seconds on, 60 seconds off for 10 cycles.
**Exercises**: Standing, squats, calf raises, planks, and push-ups can be done on the device.
Investment Considerations
**Cost vs. Benefit**: Comparison between investing in a vibration plate vs. other interventions like OsteoStrong or HRT.
**Personal Preference**: Decision depends on individual circumstances and accessibility.
Questions and Answers
**Tolerance**: Some individuals may need time to build tolerance to vibration therapy.
**Additional Weights**: Not recommended to add weights while using the vibration plate.
**Specific Conditions**: Vibration therapy may help with plantar fasciitis and peripheral neuropathy.
HRT Discussion
**Effectiveness**: HRT is beneficial even after age 60, with lower overall mortality and reduced risks of various conditions.
**Risks of Stopping**: Stopping HRT can lead to menopause-like symptoms again.
Dexa and Rems Imaging
**Understanding Scores**: Importance of looking at grams per centimeter squared rather than just T-scores or Z-scores.
**Comparison**: Dexa and Rems should be compared consistently for accurate tracking.
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Breta Alstrom: Sid with
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Breta Alstrom: today, we're gonna be talking about vibration therapy as like a modality for building bone. So if you guys have questions as always, you can go ahead and drop those into the chat.
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Breta Alstrom: and we'll ask we'll answer some of those things like as they come up, and then this topic will probably only cover or like, take up about 30 min of our time. And so if you guys have other questions that you wanna dive into at the end. Today we'll have some time for you guys to jump on, live if you want to, or submit your questions in the chat on other topics. But just wait until we wrap up on vibration to to start putting those things in the chat
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Breta Alstrom: awesome. So
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Breta Alstrom: let's go ahead and get started. Doug, can you make me a host?
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Dr Doug: I sure can. Maybe
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Dr Doug: there you are.
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Dr Doug: You are a host
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Dr Doug: so.
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Breta Alstrom: Thank you.
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Breta Alstrom: And
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Breta Alstrom: awesome. Okay? So 1st question here. I let's just dive into like, what is vibration therapy like when we're talking about that. What exactly are we talking about? Just to set the stage.
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Dr Doug: Yeah. So there are. I have a number of videos on this on Youtube. And then there's also
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Dr Doug: I, I just did an interview actually with Belinda Beck from
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Dr Doug: She is one of the authors in the Lythmore trial, so I was just chatting with her this morning. We actually talked about vibration for a long time.
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Dr Doug: So it's timely. So vibration essentially is the idea that if you are, if you want to grow bone, you need to provide stimulus couple of different ways to provide stimulus. Some people would say, resistance training. Arguably. That's not really the stimulus we're looking for. We need impact
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Dr Doug: for the bones to want to grow more bone quality, density, etc. So the ways to do impact would be
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Dr Doug: literally impact, like jumping off of stuff like being a gymnast. I think most of us are probably past that in our lives. So then, we need to find a way to do impact safely or to simulate impact. And that's where vibration comes in. So vibration is going to essentially move some device up and down at a a frequency or a speed and then it's going to do it at a certain amplitude and in a certain modality. And those 3 things are the things that you wanna look for.
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Dr Doug: and we'll we can look at like, for example, Cheryl's question around the the Vt 00. 7 vibration plate. We can try to answer those questions around, what is a a good quality plate versus not.
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Breta Alstrom: Awesome. Yeah, we'll dive into some of the plates that people should be looking at. But this is a good question. Just since you brought up Linda back. Did she?
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Breta Alstrom: talk about the Vladimir study at all? Yeah.
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Dr Doug: Yeah, so so and so. Yes, the vibr study, though, she said, there isn't. There is a preliminary publication. She was. Gonna send me the actual paper. I've heard of it, but I don't know that I've actually read it. I know that it was happening, but I don't know that I actually, I can speak to the results. Yet. Have you seen it, Brett?
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Breta Alstrom: I have not. Cheryl just wanted to know if the results had been published yet, but it doesn't sound like.
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Dr Doug: Yeah, so it it was a little confusing, she said, that they in the clinical, in the Clinical Trials Journal. It's not really a journal. They did publish something, but I don't know that it actually has all their results in it. I can tell you what she told me, cause I don't think there was any secret to that. So what they were. Look, they were looking at. She's friends with Clinton Ruben. So
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Dr Doug: this is an interesting conversation, but so she's friends with Clinton Ruben. She was studying his high, high frequency, low amplitude device with G's less than point 4, which he is deemed to be safe.
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Dr Doug: And looking at that in combination with exercise and what she just this is her to me so secondary information. But what she said, is that in that study there was no benefit. In fact, those the people that were using that device lost bone even in combination with exercise, they still lost bone.
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Breta Alstrom: And can we? Can we name the device? Because I don't know if everyone knows.
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Dr Doug: Yeah, sorry I'm speaking. I'm speaking in code. So Clinton Ruben is the designer and co-founder, I believe, is what he calls himself of the company marredine. So the merodine live. Liv is a one of the companies that sells a a vibration device specifically for osteoprocess. He's authored a number of papers on the topic, but always championing his approach, his technology. And there's quite a bit of debate around
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Dr Doug: his publications and his work
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Dr Doug: here.
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Breta Alstrom: Awesome. Alright. So then, outside of Osteo process, what are the other benefits? And potential uses for vibration therapy? Because sometimes it can be a big investment.
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Dr Doug: Yeah, for sure. So this was a steep learning curve for me. And I was. People asked me the question because there was such.
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Dr Doug: There's so many like conflicting areas in osteoporosis treatment, which is, I think, really interesting. But one of those is the fact that you have these 2 very different groups, the Power Plate Group, which is just one company, and they have a device that's different than the Maradine group, and they will each tell you that the other one is garbage. So in in so many words, so Clint Rubin will go so far as to say that the power plate devices are absolutely dangerous, and nobody should be on one. The power plate guys will just say that
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Dr Doug: Clinton's device just doesn't do anything.
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Dr Doug: So I had to go down and look at a lot of a lot of studies to try to figure out what this meant for myself and my end conclusion is that the the power plate device is probably doing more, and it is probably still safe.
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Dr Doug: There are still some question marks in there. But when you look at those studies around that type of device, and I can explain that more. But around that type of device you see improvements in bone mineral density. In some studies not all studies. You see improvements in strength, you see improvements in endurance. You see improvements in fall, risk
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Dr Doug: or stability, I guess.
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Dr Doug: Joint, pain, and discomfort.
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Dr Doug: What else? Swelling? I think, edema. So there's a lot of weight loss. Maybe it's not really. There are studies, but there are some studies on weight loss.
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Dr Doug: So there's a lot of potential therapeutic benefits of vibration. But there are still some question marks for me.
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Breta Alstrom: Yeah, awesome. So when it comes on the flip side of that, what are the contraindications? When would we probably not recommend it? Or
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Breta Alstrom: just potential risks.
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Dr Doug: Yeah. So this is is challenging cause. Again, you talk to you talk to Dr. Ruben, and he will tell you that if you're standing on a power plate. Your head's gonna fall off. That's sort of like the conclusion which is that they're absolutely dangerous, and nobody should be on one. But when you look at his, his publications, what he says those devices are doing as he's measuring them versus what they say their devices are doing are very, very different
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Dr Doug: Hulseinus publications that you're achieving between 7 and 9 G's, which is acceleration. So, like the number of Gs you would experience like lifting off from the earth in a space shuttle right?
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Dr Doug: So when he measures it, he gets a very different measure than when the company power plate measures it, and they measure their acceleration in 2 to 3 g's
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Dr Doug: when I interviewed, and I can't think of his name off the top of my head. The gentleman I interviewed from Powerplay doesn't work for powerplate, but uses their devices at his clinic.
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Dr Doug: He's authored again. A number of papers. He has worked with thousands of patients. And he's very comfortable using it in areas where I would even recommend potentially. Not so all that to say is, there's some controversy here.
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Dr Doug: But the clear areas where people probably want to be careful are, if you have any kind of eye issue that could be like a loose or displaced like cornea, people would even say potentially, glaucoma. I would just anything anything eyeball related, because the eyeballs are very sensitive, probably want to stay off of any vibration plate.
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Dr Doug: Same thing with inner ear stuff. The inner ear is such a weird organ with the you know the little bones and the crystals and the things. If you've got inner ear stuff balance stuff tentative like ringing all those things, I would probably wanna stay off of it because you just don't know what it's gonna do
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Dr Doug: that said
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Dr Doug: people that use these devices. Those aren't contraindications. Necessarily. They're just probably areas to be careful.
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Dr Doug: Osteoporosis is not a contra indication, and so regardless. I would probably say this with caution, but almost regardless of T score. If you can stand on your under your own power. You could probably stand on these devices safely.
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Dr Doug: That said, if you, if someone is extremely frail, if they have fractures, if they're recovering from fracture, then they wanna steer clear. So it's just it's it's a gray but for people that haven't had fracture for people that have osteoporosis and are trying to improve their bone density, they're able to stand under their own power. They're able to do resistance training. These devices are likely helpful.
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Breta Alstrom: Yeah.
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Breta Alstrom: And when we're looking for a device, I you kind of touched on it with the Maradi versus power plate. But like, what are you looking for in a device that could potentially build bone? Because there's just some questions in the chat, too, that, like
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Breta Alstrom: you know, Belinda Beck spoke at their list. Local Osteo Boston's like support group, and she said, that vibration isn't helpful for bone growth. But you know that.
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Dr Doug: A beautiful
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Dr Doug: I haven't. I haven't looked at their study yet, but I think she was only looking at Clinton's device. I think she was only looking at that high intensity or sorry high frequency, low intensity, which is, they both call both companies, call their devices the same thing which is really confusing. But
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Dr Doug: the Ruben device, the maradine device, which is very low intensity, meaning that it's it's less than one G, so it's point 3 to point 4G's. It moves less than a millimeter, whereas the power plate devices are moving 2 to 3 so there's a very palpable difference between the 2 fair. I've never actually sat on a Maradon to be fair.
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Dr Doug: yeah. And.
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Breta Alstrom: This is in the the like frequency that we're looking for in those recommendations. What would you say.
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Dr Doug: So 30 to 35. The way they measure it is Hertz Hz, so that's the number of times that it vibrates in one second, so it moves up and down 30 to 35 times a second.
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Breta Alstrom: Her.
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Breta Alstrom: Okay. So I think that's just like Co contextually, for everybody here, just knowing that like as the research comes out. And as this is explored more definitely to be looking into the the methods for sure, like what what tools they're using to kind of
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Breta Alstrom: evaluate which devices that you would potentially wanna look into in the future. But we do generally recommend power plate for people and have a discount code which I can share with you guys as well. And we'll talk about a couple of the other suggestions on on potential vibration plates a little bit later. But
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Breta Alstrom: how?
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Breta Alstrom: But let's talk about protocols for a second. And how would you recommend somebody start using a vibration plate for building phone?
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Dr Doug: Yeah. So before we get there, let me just mention one other thing. So we'll we'll look at some specific devices.
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Dr Doug: But there's really 3 things you wanna look at when it comes to protocol, and if there's there's protocol. But then there's what the device is doing. So with a device. Frequency is one. So you need to make sure that it has the right frequency.
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Dr Doug: and then the amount of displacement. And that's the difference between, say, Maradi versus powerplate. So the amount that it's moving up and down. And again, we want that probably to be between 2 and 3 seems like the sweet spot, and then the 3rd one is how that migration is occurring, and this is where, if you're looking at other devices, if you can't tell. Then there's there's a cheap way to make devices, and a more expensive way to make devices. The cheap way is a simple teeter totter, so you have a, but you basically have a motor.
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Dr Doug: probably on either end. And it's just doing this. So then, the whole plate is doing this. And you can imagine, just from the mechanics of that. If you're standing near the center of that plate, you're not gonna move very much. The displacement is gonna be very small. If you're standing on the outside of that plate, the displacement is gonna be much bigger. So when they start quoting statistics of Oh, it moves 2 to 3. So, millimeters, the question is, where is it on the outside? Is it on the inside? What if I stand like this, you know?
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Dr Doug: So the the teeter, totter devices are less expensive to make. And so those are the ones you're generally going to find that are going to be cheaper. The vertical displacement. Devices like marredine and power plate have to be calibrated. They have to move the whole thing up and down, and then
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Dr Doug: actually, power plate goes a step further. And what they describe basically like a 3D rotation. So the the whole plate is actually moving in kind of a 3D. Pattern. So it is not just straight up and down. It's actually doing more than that.
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Dr Doug: What that does I don't know. But that's what they do.
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Dr Doug: Does that make sense. So then, oh, so second part of that protocol. So how do you use it? Most of the studies will use an exposure of 10 min a day.
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Dr Doug: and they'll do it either 3 days, a week, or 5 days a week. Compliance in most of the studies is between 80 and 90%. So let's say most people are doing it 4 or 5 days a week.
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Dr Doug: The way that we recommend people do it because there's some evidence and some thought behind this, which is
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Dr Doug: the long-term exposure, meaning like 10 min at a time, is going to increase your risk and
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Dr Doug: potentially be less effective than intermittent exposure. So almost like if you were to like, correlate it to like resistance, like cardiovascular trading
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Dr Doug: interval training is more effective than the same amount of time. Just sitting on a bike, going as hard as you can.
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Dr Doug: so interval training same thing with bones. If you do the exposure at intervals, say a 60 second interval, then step off the device for 60 seconds, and then step back on the device for 60 seconds and do that 10 times. It'll be a 20 min exposure, but only 10 min, with 60 second intervals.
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Dr Doug: And when you look at the the way that powerplate has created their devices, there are 2 home devices. One's called the Move, which will go continuously for 10 min, and the other one is called the personal and the personal actually stops at 60 seconds, so you can see there's a very intentional 60 second pause that will, it will remind you. Stop, wait 60 seconds, and then hit, start again and do that 10 times.
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Breta Alstrom: Yeah. And so if somebody has.
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Breta Alstrom: well, are you, are you just standing on it? Because, like, yeah, I, if people are following you on Instagram or Youtube like they'll probably see you doing more than just standing on it.
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Dr Doug: Much do it.
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Breta Alstrom: On the powerplate or migration of any kind.
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Dr Doug: Yeah, so yeah, and so like, clear transparency, I have a power plate. So I talk about it. I use it. I put it on Instagram and and I use that. We'll talk about the different products. But I use it because I'm I'm confident that it is doing what it says it's doing
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Dr Doug: I use it as a way to warm up. So I'm also, you know. I hope to repeat my rems here someday, and hope that I'm improving my Bmd. Too. But really, I'm using it more as a way to warm up my joints, so particularly lower body. I find standing on it, doing some like shallow squats, and then doing deep squats on it. And it really just it makes my hips move better. I feel more mobile. I feel ready to lift.
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Dr Doug: I'll do just sort of like upper body rotations, side bends. I feel just everything's just gliding and moving.
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Dr Doug: and then, when I do upper body I'll do like plank on it or push up on it. And it just feels really good in my shoulders. So I think it's just making. It's sort of doing these like very minimal translations that are very foreign to our joints, but it it provokes them to warm up. The muscles are firing, and different ways to warm up gets blood flowing, gets limp flowing. So I use it for a number of things. And hopefully it'll be helping with my bone. Marrow density, too.
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Breta Alstrom: Yeah, do you guys have? Oh, actually, I wanted to ask about investment when it comes to investing in vibration therapy compared to other
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Breta Alstrom: interventions or so it could be like one question, was osteo strong versus getting a vibration plate?
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Breta Alstrom: How would you spend your investment?
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Dr Doug: 7 min tough. So I guess the one thing to say about osteostrong versus say a power plate is that osteoastron? You have to be near. So there are lots of them, but they're still not globally available. Power plate you can have in your house. So for people that are in remote areas or can't get out as much. Then it's probably having a device at home is gonna trump going anywhere. If you can't get there.
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Dr Doug: If you had a power, if you had a if you had the option of going to osteoastron, and it was next door versus a power plate at home. That's really hard to know. Obviously the Osteoastral guys would say, Go to Osteoastro.
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Dr Doug: They've never been studied head to head. Had some really interesting conversations with Belinda back around about Osteostrom and osteogenic loading. I'm not going to share that until I can
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Dr Doug: validate some of her thoughts.
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Dr Doug: let's just say she's not a fan.
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Dr Doug: but it.
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Dr Doug: from what I've seen, I would say that they're both ways to simulate impact. And it just depends on which one you're more comfortable doing.
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Dr Doug: At this point.
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Breta Alstrom: And what about I? I think I know the answer to this one. But what about Hrt. Versus a vibration plate?
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Dr Doug: Hmm, well, yeah.
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Dr Doug: Hrt, hands down because it's it is impacting your bones. But it's impacting every tissue in your body.
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Dr Doug: Yeah.
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Breta Alstrom: Yeah. And I think that's like the important thing to to like zoom out like, I know everybody's here because we're trying to build bone right. But there's so many other benefits to clinical interventions for Osteo process that it's not just about giving you back to your baseline of where you maybe had healthy bones, but it's about improving your life overall, and all of like the health benefits that come along with living a lifestyle that you know, reverses osteoporosis. So keep that in mind. Would you recommend? Or
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Breta Alstrom: I Helen, I might have you clarify your question here that heel drops our
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Breta Alstrom: safer than vibration. Or can you do heel drops with vibration? I'm not sure. So, Helen, if you need to.
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Dr Doug: I can answer that either way. So
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Dr Doug: heel, if you look at the research on heel drops and the research on vibration, the the benefit is probably about similar, but heel drops and vibration also. Both are gonna carry the challenge that they can.
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Dr Doug: They can be done in in extremely different ways, even a simple heel drop, if you're doing it, you know, by not releasing your weight all at one time. If you're not really free falling, if you're wearing shoes, if you're on carpet, if you're on asphalt, if you have your knees bent or straight, you can change the the heel drop from what could be pretty substantial impact. We're talking like 4 to 5 multiples of body weight versus probably no more impact than walking.
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Dr Doug: So a heel drop is not just a heel drop same thing with vibration, though. So for those of you that have a device, if you've stood on a device, you know that if you shift your weight back over your heels, it's like, Oh, wow! That's a lot of vibration, you know, versus if you're flat footed your weight slightly forward, it almost feels like nothing. And then, if you lean over the front of your foot, it really feels like nothing's happening.
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Dr Doug: So it's these things are really hard to study, as far as which one's safer. You probably have more control over a heel drop.
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Dr Doug: but at the same time you can still generate 5 multiples evaluate. If you just let it go, you sort of get you get real all excited, and you just let it go, and you slam into the ground, and you could certainly get hurt. So vibration is gonna be more consistent from that perspective.
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Breta Alstrom: Yeah, we'll circle back to some of the other devices in just a second here. But the on the protocols.
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Breta Alstrom: So we always have questions about the benefit of like, okay, so there's like the 60 seconds on 60 seconds off. If somebody's in a hurry, can they do 60 seconds on 30 seconds off, or can they just keep going? What are? What are your thoughts.
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Dr Doug: Yeah. So I'll tell you. Most of the study protocols were 10 min straight. And I think they were doing that because they wanted it probably wanted to increase compliance. I know, even for me, like when I'm doing intervals on something I always kinda like, forget I'm like, Wait was that 7, 6, I forget. Let's go with 6.
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Dr Doug: So I think it's going to be easier for people if you just stand on it for 10 min. You have a timer in front of it, and you go.
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Dr Doug: Probably there's benefit of doing
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Dr Doug: the interval exposure. But there's not enough research to say that one is better than the other, or that changes in the intervals like 30 seconds off 60 seconds on, switch it around. Do 2 min, whatever. Not enough research to know.
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Breta Alstrom: So then, when it comes to like somebody, I I think there's also right like maybe we would call this like vibration intolerance, and some people who don't tolerate it, can they work on it? And what would you suggest? There.
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Dr Doug: Yeah. So this is what? And again, I'm sorry. I wish I could remember his name. The gentleman I interviewed from power Plate.
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Dr Doug: He wouldn't like me saying it that way. The gentleman I interviewed who uses the power plate devices in his.
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Breta Alstrom: See you in.
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Dr Doug: There we go. That's that's more accurate.
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Dr Doug: What he says is that oftentimes, when he gets especially older people, more comorbidities, ear stuff, eye stuff. They don't tolerate it out of the gate. I think. Sometimes 2 women with pelvic floor stuff can also not tolerate the vibration.
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Dr Doug: There is a a tolerance that builds up over time. So I think it's maybe it's more comfort. I don't really know what it is that changes but he does find that people do start to tolerate it over time, and that is one of the risks that I fear. If people are gonna spend a couple of $1,000 on a device is like, if you've never stood on one. How do you know, I think, though, Brett, do you know, is there like a 30 day like money back guarantee on on power plate. I wanna say there is. But I don't
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Dr Doug: right. Yeah.
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Breta Alstrom: I would have to double check on that. But I think we could find that out. Yeah.
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Breta Alstrom: Yeah.
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Breta Alstrom: And sorry I was gonna pull up
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Breta Alstrom: his name. But I'm searching our Youtube for.
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Dr Doug: I just ran through this came to me. His name's Jason Convisor, Dr. Convisor.
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Breta Alstrom: Okay, cool. And so from there, on the the tolerance. So there's some ways right to like build up. But are you gonna get any benefit from that. And like, specifically one of the questions. And this isn't really related to tolerance, but, like the merits of doing like squats, calf raises adduction, hip flexors, planks, pelvic bridges like. If you're and push ups, if you're off the machine for part of that, are you? Gonna keep the bone health benefits.
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Breta Alstrom: And then how could you put together like a comprehensive protocol?
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Dr Doug: I would I would keep them separate. So I would do like a bone health protocol on the device. And then if you wanna train on the device, too. You absolutely can. And that's the way that honestly, if you go to the power play website and you look at their exercise library. They're not just standing there. They're doing exercises on the device.
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Dr Doug: Are you going to get as much of a bone benefit? Probably not. Cause your knees are bent. You're in different positions, right? So you're not getting that vibration through your spine when you're doing squats on the device. But I will say that if you look at the research on the improvements that people see, especially this anabolic, resistant group, people that have osteoporosis fall in that they're going to see better gains on the device than they are off the device. So there you may want to train on the device, I would say, like, have a handrail available, because I've almost fallen off to.
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Breta Alstrom: Yeah. And then what about like adding ankle weights, or like a rock, or like a weighted vest, or something like that, while training.
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Dr Doug: Not studied for sure. I'm thinking, in my own experience, you know. Okay, I will do like, say squats with a Kettlebell.
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Dr Doug: It's a lot of force if you think about what you're doing. If you if think about the physics behind it, you know, imagine that just like strapping 30 pounds to your body, and then standing on something that's hammering you with a couple of G's of force. I don't know that that's a good idea.
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Dr Doug: That sounds questionable.
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Breta Alstrom: And on something where, which I I feel like we would need more data on this. But this is one of the questions. If you can decrease the amplitude, or if you're on a device that has just like a lower amplitude, then the power plate
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Breta Alstrom: would would that maybe be a way to increase.
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Dr Doug: Yeah, I don't. I don't think so. Cause you're it's it's the wrong variable. So if you'd imagine, if you were to compare again like Maradine to power plate, and you were to say, Well, I'll just. I'll put 30 pounds of weighted vest on and stand on a maradine. It's still only hitting you with 2 to 3 g's, it's just 2 to 3 g's of what.
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Dr Doug: So I don't think you're going to compensate for one with the other.
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Dr Doug: yeah, no.
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Breta Alstrom: Okay, great got the questions answered. And then what about someone with Planar fasciitis struggling with heel drops? Would vibration plate be a better option for them?
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Dr Doug: Probably it would. Actually, I mean again, I don't. I haven't seen a study on this, but just because I used to live in the world of plant infectious. My guess is that it would probably be therapeutic and potentially hasten recovery. Because if you think about Planar fasciitis is like a slow or non healing tissue. The more you vibrate the more you get blood flow around there, the faster that's gonna heal so I would even consider like
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Dr Doug: standing on something on the device and letting it, like.
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Dr Doug: you know, vibrate into your like. Like. This device would like vibrate into your player of fascia.
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Breta Alstrom: And then on the flip. Well, not the flip side. Slightly different. What about with peripheral peripheral, my God, I, got I'm not gonna be able to say it today? Neuropathy in your feet to argue against against vibration? Or could it actually help.
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Dr Doug: Yeah, no, I would argue for vibration as long as you had enough sensation to actually like, stand on the device and know what's happening to your like protective sensation.
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Dr Doug: But for people that are struggling with neuropathy, especially if it's like idiopathic neuropathy, that's usually a blood flow thing.
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Dr Doug: And
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Dr Doug: if you can improve blood flow, which power, plate, or vibration.
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Dr Doug: excuse me, would do
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Dr Doug: then I would expect for that to see potentially some improvement. I don't. I'd be surprised if they haven't studied that. My guess is that there are probably studies on that. I just haven't looked at them.
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Breta Alstrom: Sure awesome. And what? Let's switch gears into different devices. One really popular one that comes up in slack a lot is the Vt. I think it's 700 or 7.
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Dr Doug: I got it I got it pulled up right here.
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Breta Alstrom: Or oh, it's 00 7! It's vt 00 7.
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Dr Doug: The Vc. 00, 7.
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Breta Alstrom: There's a 7 in there. What are your thoughts on that.
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Dr Doug: Would you let me screen share, and it will just like review it together.
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Breta Alstrom: Got it.
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Dr Doug: There we go! Alright.
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Dr Doug: I don't think there's anything you shouldn't see on my my oh, Amazon business account.
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Dr Doug: Alright! So this is an example again, like a very popular one, because obviously this is a great price point compared, to say, a power plate which is a 2, 3,000 or more dollar device.
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Dr Doug: So if we look at this, the the 1st 3 things again you wanna look at is what's the frequency? What's the displacement? And what's the mode? How does it make vibration happen?
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Dr Doug: And so you can see out of the gate they're hitting. They? They obviously know this. So they're already saying high frequency, low amplitude, that's what you want. But then, what are the actual details of that? So how do we find it? It is in here, but I'll show you sort of how I go through this. So something to pick up here. You say, man, 10 year warranty. That's good cause one of the things I worry about with the less expensive devices is, how long are they gonna last?
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Dr Doug: not. Let's say, there.
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Dr Doug: it looks like it has probably some little straps on the side that's not a handle. That's a strap that you're holding onto. It can kinda help you stay on. Power plate has that, too. I don't find them to be particularly helpful personally.
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Dr Doug: I would say overall, that's a pretty small platform, so you could argue. Maybe that's a good thing from a footprint perspective. It's not gonna take up a lot of space, but it's also not very big to stand on for me. I wouldn't be able to do us a a deep squat on that width of a platform. I need a bigger platform for that.
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Dr Doug: Who should not use it all those things
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Dr Doug: retinal detachment for sure.
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Dr Doug: Then some videos. We won't watch those. So then we still haven't answered our question. So if you go down here.
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Dr Doug: They talk about the company. That's fine.
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Dr Doug: Here's the motor, it it it does. Kinda tell you here what it's doing, which is kinda cool, so you can see the motor in the middle. This is the platform this whole thing is screwed to, and the whole thing is is probably gonna move up and down still actually verify that. So it's probably vertical displacement. You can also tell that because of the little bumpers on the side, these little rubber bumpers probably are gonna all move up and down at the same time, which is good. But I wanna verify that.
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Dr Doug: And then it is in here somewhere. So they talk about frequency here, and they will say it's adjustable. Frequency goes from 15 to 40, which is a little unnecessary, because all we really need is this tiny range 30 to 35. I don't know a lot of reason to go outside of that for anything.
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Dr Doug: what else is in here.
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Dr Doug: Here we go.
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Dr Doug: So you have that session timer 1 min to 20 min. Here's your amplitude setting great. So 2 settings low and high, and if you wanted to match power plate, the high setting here would be between around 2 to 3 so that's that's good.
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Dr Doug: So we have right frequency, right amplitude, and what we still don't really know for sure. Is is it all vertical, or does it move
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Dr Doug: side to side? And if anybody knows, raise your hand, because I know a lot of people looked at this
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Dr Doug: alright to know.
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Breta Alstrom: And while we're while Dr. Dogs finishing looking at this, if you guys have any final questions about vibration therapy, you can either put them in the chat, or if you want to go ahead and start to you can put your camera on. If you want to ask your questions. Live about vibration therapy that is totally fine.
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Dr Doug: Yeah, so I can't tell.
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Dr Doug: screen reviews. I can't tell if it's
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Dr Doug: truly vertical or not. You could probably learn some in these reviews, too. So that's the one. The one thing I'd want to know about this. And then the second part I'll say about the cheaper devices is
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Dr Doug: when I talked. And when I brought this up to the power plate guys, I was like, Okay, your device is $3,000. This one's $300. What's the difference?
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Dr Doug: And what they'll say is, 1st of all, like it's theirs is going to last for 10 years. This one has a warranty for 10 years, so I don't know. I haven't been using them that long to know. And then the second side of that is the predictability of what it's actually delivering. So the power plate devices are very, very accurate, and what they're delivering, and the cheaper devices may have more variability, more range, and they're not being tested by anybody. So
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Dr Doug: if you do end up with more amplitude, you could definitely generate more G's than you want. And so then it's hard to know as a consumer like man, this feels like a lot. Maybe this is what I'm supposed to feel. I don't know. You don't have another one to compare it to. So it's just like.
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Dr Doug: I know, it's a lot of money. 3 $3,000 is a lot of money to spend on something you stand on for 10 min.
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Dr Doug: But
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Dr Doug: from a safety perspective, maybe it's worth it.
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Dr Doug: Somebody had their hand up.
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Breta Alstrom: Yeah candy heather. Had her hand up, and then, while she's unmuting and getting ready, I Lorna had asked if the high setting on powerplay is the only one to increase bone mineral density. But I don't think it's pot powerplay only has the one setting correct.
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Dr Doug: So the personal only has one setting. The the move actually has. I think it's 8 or 10. So it does. It does move up both in frequency and in amplitude. The low setting is actually the setting you want on the move and not the high setting.
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Dr Doug: so I'll do for me. If I'm thinking bone, I'll put it on the lowest setting and stand on it with my weight over my heels. And then, if, when I'm doing like squats or upper body. I do move it up higher and bit. Get bigger amplitude.
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Breta Alstrom: Alright, Candy, go ahead and ask your question.
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Candy Reichert: Okay. So I was just gonna respond to the Vt, 0 0 7. If you go to the gentleman's website.
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Candy Reichert: he actually has quite a few articles that goes into descriptions of and explains all of the different types like you have done. And he's. And it says on his website that it is a flat vertical
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Candy Reichert: up and down.
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Dr Doug: Yeah.
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Dr Doug: so yeah, I believe that. And then the power play guys would also then say, Well, but ours is ours is 3D. But I don't.
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Dr Doug: I don't really know what that means. What's the what's the significance of that? I don't know.
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Dr Doug: Sounds cool.
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Dr Doug: Yeah, Lorna.
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Lorna Nichols: I have the personal power plate, and it does have a low and high setting.
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Dr Doug: Hmm.
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Lorna Nichols: So
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Lorna Nichols: you know, the low doesn't feel like it's doing a whole lot. So I just sort of use that as a warm up and then try to get up to the high figuring. That's the only place that's doing any good.
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Dr Doug: Yeah, let me, we can. We can certainly clarify that. I thought it only had one. I apologize. It's not the one I have.
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Lorna Nichols: Okay.
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Dr Doug: I can. I can probably look, look this up real quick. And while we
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Dr Doug: ask more questions.
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Breta Alstrom: Yeah, awesome. And then somebody had posted the link to the tetra hurts
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Breta Alstrom: And oh, there was. There was also another question as well about. I pulled it. Have it here
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Breta Alstrom: up
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Breta Alstrom: about post electronic, magnetic field. You don't buy the device. You go into a treatment lab, lay on a map for 30 to 60 min, and then osteoporosis is one of the conditions listed as like that would benefit from something.
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Dr Doug: Yeah.
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Breta Alstrom: That's being familiar.
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Dr Doug: So I've looked at Pemf, and I was not able to find compelling evidence that it's doing anything
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Dr Doug: anything compelling for bone density. I couldn't find any good studies that showed improvement in bone density. So I think it's more theoretical like, it's gonna improve mitochondrial health and blood flow, and all those things, but I don't know that it's actually shown to increase. Bmd.
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Dr Doug: and I just went through their whole website. And I don't see the 2 different setting differences. So we'll have to find that out, Lorna.
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Dr Doug: and we'll post it.
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Breta Alstrom: Awesome, and I'm gonna redo in this
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Breta Alstrom: tetra hurts for you to pull up, so it'll be the 1st
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Breta Alstrom: one in the chat for you.
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Dr Doug: Yeah, I'll pull it up.
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Dr Doug: I do. Can do.
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Breta Alstrom: Any other questions about vibration therapy. Anybody wants to jump on and ask while we pull this up.
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Breta Alstrom: I think one of the big takeaways here is just making sure that it's definitely a great addition if it's something that works for you. But it's not necessarily the end. I'll be all to your treatment. So, looking at like what's gonna be important? As you pursue all the
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Breta Alstrom: all the different interventions for osteoporosis. And I know we also at the beginning talked about how resistance training might not actually be the best thing to build bone. But it is still this something that you want to have incorporated into your routine for health and longevity, preventing falls. Better balance, and things like that, too, also for improve metabolic health. So just because something's not going to be the best thing for building bone doesn't mean it's not something that you want to be doing.
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Dr Doug: What am I looking at here, Brenda?
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Breta Alstrom: I think Susan sent this, and it's
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Breta Alstrom: the tattoo her. O.
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Dr Doug: Turret.
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Breta Alstrom: Let me. I'll let's just follow up on this, and I'll put this in slack instead.
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Dr Doug: It might be. Oh, that's a thumb here, I don't know.
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Dr Doug: Go ahead. This is.
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sjcsr: So I have a hard time with Slack. I'd really I have a girlfriend. She's in the medical field. She's in the Philippines now she bought this
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sjcsr: for whatever reason, and I was interested in it. So I looked it up and it apparently like it's like Dr. Lucas said, it's but it's got. I think it's infrared, and it does say it will help phones. And it's it, I think, though, the website's pretty good. Maybe you could find some information on there.
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sjcsr: but I'm pretty compromised because I had an L. 5 fracture
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sjcsr: years ago. So I've got cement in my back, and I've had a lumbar and thoracic you know, MRI, and it's not looking so good there, and I just got a bone density from being on hrt. For a year, and that wasn't very impressive, either. So
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sjcsr: I, you know, and I go do weights 3 times a week and classes and cardio. So I'm looking at this. And I'm thinking maybe this could be helpful somehow.
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Dr Doug: Yeah. And, Sue, I'm sorry that you're struggling, and you're not alone in that right? So many people are doing what they feel like are all the things.
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Dr Doug: We could go through that list and and dissect, which you know. How are you doing each of the things? And that's where having a team to support you is really important, because, as we talked about, not all.
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Dr Doug: not all resistance is the same. Not all. Hrt is the same. So it's it's just it's challenging. When you you feel like you've really put together a solid program. And you're like, Shoot.
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Dr Doug: Hrt is not working for me or resistance. Training is not working for me.
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Dr Doug: but understanding that there's so many different ways to do all those things. So I'm sorry that you're dealing with that as far as this device, the plate wasn't actually on that link that Brett pulled up. There's a whole bunch of really interesting self care thing.
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sjcsr: It's a wand. It's not a plate, it's a wand it's a red wand, and apparently, you know, it does a lot of things, and I would love to do Osteo Strong. But I'm afraid, with what I have going on in my back.
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sjcsr: So I'm thinking, if this could help at all.
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Dr Doug: Well.
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sjcsr: I was a shock.
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Dr Doug: You be really wary of claims around improving bone health, because there's nobody. Nobody is going to validate a claim to improve bone health. If they were to say, Improve reverses osteoporosis, or improves osteoprocess by X percent, then the Ftc. Could potentially come down on them. If they don't have evidence for that.
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Dr Doug: But if they're saying good for bones improves bone health.
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Dr Doug: they can say whatever they want, even if it's an absolute lie, and nobody's going to expose them to the contrary.
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sjcsr: Well, they look like a pretty good company.
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Dr Doug: That is all. Marketing, Sue marketing.
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Breta Alstrom: Yeah. And and in being mindful, too, on like, what would you rather spend your money on as well like? There's plenty of things to. That might be a better investment for you. Especially when it comes to like you could spend the money on something like that that. Maybe we don't know that much about, and you can keep throwing money at different things, or you could have a better investment in your food and nutrition. Maybe you could get a got health test like if you were to add up all the things that you would do over 6 months.
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Breta Alstrom: you know. Maybe you could save that and put it towards something that's gonna show you more benefit. But there is a really good question here along lines of just infrared there in general, for, like with an infrared sauna benefits for bone, health like Dr. Yes or no, and then other benefits from that.
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Dr Doug: Yeah. And this is another one I've looked at. Because you see these, you see all these claims. And again, this is where, like
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Dr Doug: just recorded a video and kind of led with this idea I was recording on Osteo Boost. We talk about Osteo boost and vibration. So
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Dr Doug: when I look at, because I listened to as a quick aside. So I was listening to the CEO of Osteo boost talk about
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Dr Doug: the company because it was essentially she was in a she was at a business conference, and she was talking about the the opportunity to invest in this company.
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Dr Doug: The way that she talked about the Osteoporosis and Osteopenia community was just create. It was cringeworthy. It's on Youtube. Look it up. She defines the community very well. But then she also goes on to essentially just define it as a target, rich environment for creating products. And it is
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Dr Doug: so you really have to understand that you are in a vulnerable position as a part of this community, because people are going to throw stuff at you without any evidence whatsoever, just marketing just a website. You can. I mean, it is so easy
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Dr Doug: now, because marketing and digital media and everything has gotten so easy, you could with AI in a couple of $1,000, create a product and a website and sell 2 people with osteoporosis with 0 evidence whatsoever.
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Dr Doug: So you really have to vet what you're working on.
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Breta Alstrom: Yeah.
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Dr Doug: Jennifer.
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Dr Doug: I totally didn't answer your question. So
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Dr Doug: for Ir Saunas.
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Dr Doug: I have one. I tried to look at this again, because it's people brought it up. And is there any evidence that I could find directly improving bone? Health? No.
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Dr Doug: but indirectly, through blood, flow through detox through, you know, the exercise response, which is, gonna be all cardiovascular benefit. But there's a lot of benefits to Sauna. There's not as much evidence on Ir Sauna as there is on traditional sauna. You can kinda say that. Maybe that's the same. We don't really know that that's true. Ir, Sauna is just cheaper. You know you're looking at a much less expensive unit. Is that the same as buying a less expensive vibration played on Amazon?
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Dr Doug: Maybe. But it's what fit in my bathroom. So that's what we have. I sure sweat, I can tell you that. But don't think it's gonna directly impact bone.
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Breta Alstrom: Yeah. And I wanna we have a couple of questions about Hrt, so we'll switch gears there. But Lillian does have a good question that I'm actually Lian. I'm I'm gonna push off for 2 weeks. Because I think this will actually be a really great full Hsn session. And the question is in terms of things to try. At which point would somebody introduce a vibration? Plei actually think it'd be really awesome if maybe in 2 weeks to start
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Breta Alstrom: druggs gonna be gone next week. We'll go through kind of like what what does like a good trajectory for a bone health program look like as you're, you know, encountering all of the things.
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Breta Alstrom: So you know. And next week we're gonna be meeting with one of our health coaches, Edie to really talk about managing like the stress and overwhelm, and how to start conceptualizing your osteoporosis journey. So I think it'll be a really natural flow into that where we can find a lot of those benefits and and how we would put together a program, and how you can take some of those tools and workshop that for yourself.
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Dr Doug: That's great!
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Breta Alstrom: Awesome. So for Hrt how long before we know Hrt is working, it's a great one to start off with.
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Dr Doug: Yeah, based off of what? So if we're talking about bone, then we're still kind of, we're kind of stuck in the same situation we are, with whatever modality we're using.
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Dr Doug: which is, if you're looking for imaging, it's at least 6 months on rems, probably more like 12. Dexa, really probably 12 to 24 months. It's just slow. The biomarkers will show changes within weeks, though, and so when we, if we think about each of them independently, so estrogen is been the most studied in this.
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Dr Doug: We know very clearly when we start a woman who's deficient in estrogen on estroadial, that we'll see Ctx drop within a couple of weeks. So you can. You can see already the the benefits of estrogen. If you're getting the right systemic levels pretty much right out of the gate.
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Dr Doug: So from a bone, health perspective, that's kind of what you're looking for, the dementia, the cardiovascular health. Those things are really hard to measure, and it's hard to know when you're seeing the benefit, unless you're like thinking differently, which is really hard to measure other things, you're gonna see more quickly, though, would be like improvement. And like the way that your skin looks. If you're dealing with like genitar urinary stuff like vaginal chronic uti, those things can reverse really quickly.
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Dr Doug: what am I missing?
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Dr Doug: Strength bustle. That takes time.
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Dr Doug: Yeah. So some things quickly. Some things takes more time.
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Breta Alstrom: And so any risk with coming like, what are the risks with coming off of Hrt. After being on them for a period of time?
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Dr Doug: But you're going to go through menopause again. Right? All those symptoms of estrogen withdrawal you're going to experience again. Probably assuming you had adequate
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Dr Doug: systemic levels in the 1st place. But I've heard different
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Dr Doug: stories on this, as far as what people experience as they go through this. If you had adequate levels, though you're likely going to experience the withdrawal, and it could last
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Dr Doug: just as long as it potentially did the 1st time.
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Dr Doug: which is one of the reasons I would argue not to come off of Hrt.
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Breta Alstrom: And like, even if you're not.
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Breta Alstrom: if if you've been on it for a while. And you know, pending that there's not those bone health changes that you've been wanting to see, evaluating the other benefits. And also it might just take more time. Because I think the question here is, it's for it's after 9 months, and you might not see, you know, changes in your dexa in 9 months, or the imaging right? So.
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Dr Doug: Yeah. So there's I'm gonna do a follow up video on this. I had a really fantastic interview, and meeting with Kim Zamvito if you are familiar with her.
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Dr Doug: So Kim Zambido is another orthodox. She's up in New Jersey, and she has a rems in in bone health clinic. She's still mostly in the traditional model of like talking about pharmaceuticals and bone quality, and not really on the same path. We are. But she knows the data around imaging like nobody I've ever heard. So so 2 points to that. So one is, you really need to to understand how to to read your
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Dr Doug: dexa. So I'm gonna probably do a follow-up video on that, because one of the things I see people doing. And I used to do this, too, until recently, which is, you know, we're so concerned about T. Score T. Score T. Score. But understand that your T. Score changes
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Dr Doug: when you're 8 when you age. So like you actually, if you really want to know the the improvement, you have to look at the actual bone marrow density in grams per centimeter squared.
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Dr Doug: and most people don't get that information in their dexa.
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Dr Doug: So especially if it's been 2 years, you're comparing apples to oranges even on Dexa.
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Dr Doug: And then the percent difference from one imaging from one image to another is a plus or minus 6%.
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Dr Doug: That's a huge huge swing.
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Dr Doug: So to think that we're going to see any real change in 9 months, especially if you're only looking at T- score is just unrealistic.
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Dr Doug: So you have to. You have to have the right data, and I think we're we. We were all, and most of us are looking at the wrong data. The other thing I wanted to say about that, too, is, if you feel like your Hrt. Isn't working. I'm literally writing a book, and the title of it is top 10 reasons why your Hrt is not working for you. And and I'm doing that because I see so many people, especially, I mean here, but in in Youtube, and they'll, you know.
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Dr Doug: think grateful. These women will just tell us their whole story, but they go through the whole thing, and when you look at what they're taking. Of course it's not working.
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Dr Doug: right, people will say, like, I'm on Hrt, and this darn Birth Control just isn't improving my bones. And it's like, but like that's not Hrt, you know, or women that are on a very low dose and never have had a test. And then, man, this estradial doesn't seem to be improving my bones, but they probably don't have any.
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Dr Doug: or they're testosterone deficient. They don't have testosterone, or they're using a progesterone cream and a low dose. They don't have progesterone. So there's just. There's so many ways that Hrt. Can be done, and most doctors are giving very, very low doses, and it's not enough to saturate bone receptors.
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Breta Alstrom: Yeah. And with just
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Breta Alstrom: along the lines of the deck, says, Can you talk about the T scores and the Z scores real quick. Or if you want me to. Just so, people know, like, what? What are we like? What? What is that cause I feel like? That's maybe not.
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Dr Doug: Yeah. Yeah. So I did one video, I think it's it's up. And it's the one that's like, is osteoporosis. Inevitable.
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Breta Alstrom: Yeah. And and I would highly recommend that. I mean, that's a it's a really really good video for understanding your Dexus scores, for sure.
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Dr Doug: Because I even so, this
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Dr Doug: kind of blew my mind out of the gate, too, when people when I started really looking into this, and I was looking at at Texas scores, and people would say, Oh, my gosh! I have ostopenia! I'm really concerned.
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Dr Doug: and I look at the curve.
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Dr Doug: and I'm like, well, according to this, statistically, everybody in this racial and gender group is going to have osteopenia like it.
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Dr Doug: It doesn't. This shouldn't be a concern except that 50% of fragility fractures occur in people with osteopenia. So well, I guess it is a concern. But it depends. There's just so many factors. So let's just talk about the the actual thing. So like the T score, the Z score and the bone density because they're all 3 different physical measures.
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Dr Doug: So the bone density is the the ability of X-ray to penetrate through the bones. Right? So Dexa is an X-ray you're laying on the table. You do the thing. X-rays go through the bones, and it tells you what your bone density is in the units or grams per centimeter squared. So that's the actual bone density. Whenever we're talking about improvement of bone density, we need to use those metrics, not t score, not z score. We need to use grams per centimeter squared
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Dr Doug: and a lot of times you don't get that right. You get this report, and it says, well, your T. Score is negative, whatever, and you don't know what your bone density is. So that's why it's really important to get the full report with the images, too. And this is something Kim really beat into my head, which is, if you're not looking at the images, you really don't know
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Dr Doug: now, to be fair because of the way that we do it. We don't have control over our imaging center, so doesn't actually change what we do. But still, you can get a sense, you know, was their rotation. What's the position? What does the femoral head look like? What's the neck look like? Are they getting a good shot of the trocaner? So the images actually do help. But
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Dr Doug: for what we do, it's it's not that relevant. So the grams per centimeter squared is really important.
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Dr Doug: The T score is the statistical average. And this is a really confusing thing. So I'll try to make it simple. It's the statistical average is the right word. It is the.
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Breta Alstrom: And delivery.
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Dr Doug: Standard deviation. Thank you. It's the standard deviation from the mean for the peak bone density age of that specific gender and sex. I'm sorry race, race and sex. So those 2 things. And so if you look at the different. And I show this in the video, look at different curves. You see, very different anticipated results. So I use this example in the video, which is, if you look at black men.
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Dr Doug: they can live to a hundred, and within one standard deviation. They will not have osteopenia
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Dr Doug: that just are. It is just not common in that sex and race. Okay, if you look at Asian and Caucasian women.
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Dr Doug: All of you will have osteopenia or osteoporosis if you live to a hundred
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Dr Doug: statistically.
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Dr Doug: So does that mean that we don't worry about it. No, it just means we have to understand what the expectation is, and understand what the Delta is, but go back to the T- score, so the T. Score is looking at your peak bone density. So go back to, you know. Peak bone density, probably late. What late twenties, early thirties. So look at your peak bone density. You have a yeah, that kind of helps.
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Dr Doug: So this is the standard deviation traditional bell curve. And so when I say standard deviation. What I'm talking about is in the middle here, where it says 0 negative one to positive one. So you're going to capture 65% of people within one standard deviation. So when you say A T score of negative one, you are.
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Dr Doug: you are negative. You're 32.5% below the mean. But understand that
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Dr Doug: you should have
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Dr Doug: equal distribution on either side. So you're actually lower than lower than half, and you're lower than what 80
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Dr Doug: 2.5%
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Dr Doug: if you go to standard deviation. So now we're talking about osteopenia, right? Negative one to negative 2.5. That's osteopenia. But that's actually not a big percentage of the population if you think about it, because you should have people on the other side of that bell curve, too.
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Dr Doug: But yet if you look at this. And actually, Brett? If we have a do we have a picture of a
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Dr Doug: Dexa report, probably do somewhere.
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Dr Doug: But anyway, you can see how small it is to in theory be an osteoporosis. But we know that that's actually
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Dr Doug: that's not true.
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Dr Doug: And so this is where it gets really confusing around when you say that it's a standard deviation, because it's actually also not an actual standard deviation. And this is where it gets really confusing because it is again based off of sex and race and
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Dr Doug: expected numbers. But here's the thing that's important is your T score is going to change, even if your bone density stays the same, your T. Score is going to change as you age.
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Dr Doug: Does that make sense?
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Dr Doug: Because you are further away.
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Dr Doug: It's really confusing. It's why it's a terrible metric, terrible biomarker. Then Z. Score is adjusted for age, so your Z score will also change, but your Z score is adjusted for age, and that's why z scores look better than T. Scores, because you're comparing yourself to your age matched counterparts.
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Dr Doug: But we should use T. Score to talk about osteoporosis, but really we should use bone density to talk about improvement. Grammars per centimeter, squared.
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Breta Alstrom: Wasn't
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Breta Alstrom: and what? Well, I I have some of these. I'm gonna save. I'm gonna save the rest of these questions, and I will. I'll just open up the opportunity, since we only have 5 min left. If anybody wants to jump on and ask a question about stuff we've talked about today, so far, and all the other questions in the chat I will save
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Breta Alstrom: for us to talk about later
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Breta Alstrom: and in slack
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Breta Alstrom: anybody.
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Breta Alstrom: Okay? Well, then, I have one more question. Can you talk about cash?
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Dr Doug: Hold on! Hold on, Brett, and Diane has a question.
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Breta Alstrom: Oh, okay. Go ahead.
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Diane Gould: I just I just want. I wonder why
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Diane Gould: we should
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Diane Gould: cause as you just explained, I and I totally understand the Z score T score.
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Diane Gould: I've had someone go over those and the the actual grams per whatever. But,
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Diane Gould: I wonder why
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Diane Gould: we expect to age.
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Diane Gould: We expect to get wrinkles. We expect
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Diane Gould: to lose some muscle mass as we get older, etc, etc. But our T
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Diane Gould: The the dexa is based on
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Diane Gould: a 35 year old person.
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Dr Doug: Right.
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Dr Doug: And and I understand
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Dr Doug: when you, when I think about this from like a public health perspective, it makes sense. But when you think about it from a treatment perspective.
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Dr Doug: it's again, it's just not a good bio marker.
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Dr Doug: because there should be well, there will be bone loss as we age there will be muscle loss as we age. My goal, as like a health span doctor, is to say, how do we minimize this? And for people that don't have osteoporosis. It's a much simpler thing, right? So all the things that we would do for health span otherwise are gonna help us to prevent bone loss.
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Dr Doug: But the problem with the osteoprosis community is that we already are starting in kind of a bad starting point.
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Dr Doug: So there's such broad variation of what does that mean? What does a t-score of negative 3 mean for someone who is at high risk of fracture or not at high risk of fracture
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Dr Doug: either way. Probably both of them need to work on their bone. One just might might need to be more aggressive. And and so it is. You're right. It's a bad bio marker. Why are we comparing 65 year old women to 30 year old women? I think we do that enough in our culture. But but let's just take it for what it is, because it's just one. It's just one bio marker, right? It's an imaging biomarker. But then we have to use all the others, too. And so my goal is to help
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Dr Doug: reverse osteoporosis where we can, and then educate people so that they can slow down bone loss just like same thing. Slow down, muscle loss, same thing. Slow down, you know. Deterioration of your of your disks between your spine. All these things are. Gonna help us to have a healthy health span. A good health span may or may not improve our lifespan. Hard to know, but I want to feel better longer.
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Dr Doug: that makes sense.
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Diane Gould: May makes total sense to me. I mean, when you get a dexa, and it's it's like closer to 4 than it is negative 4 than it is to negative 3.
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Diane Gould: And the people that use that a person that the patient goes and sees it's like you gotta get on drugs. Now, cause it's bad you're gonna break. You're gonna be in that 25 that's probably gonna die all this stuff right? And you're 61 years old. When I 1st got that information, and then I go back. But you can't ask those questions. And
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Diane Gould: I mean, that's why this is so valuable, because it's like. It's an overall thing, and and I have to keep telling myself that that Dexa may have been the one powerful thing that came zooming in at me, but it truly is only one in all of the things that I now know. And
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Diane Gould: again I still say like, why am I being compared to a 30 year old.
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Diane Gould: Women who might be not Caucasian like Well, at least it did say race, but might not be small.
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Dr Doug: They should, they should adjust for that they should adjust for size, too. But I agree that it's the our, the more petite the frame, I think the less accurate probably is they'll they'll deny that in the Dexa studies. But
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Dr Doug: we just see it. We see it so globally right. It just makes sense that a woman with a small frame is not going to have as as dense a bunk. But why why should she? And she's not lifting 180 pounds every day when she walks.
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Diane Gould: Alright. Thank you. I appreciate just kind of you know everyone's mind, if for may reaffirming to to not be so scared.
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Diane Gould: Yeah. And.
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Mary: Brett. Can can I come back to Hrt. Really quick cause? There was a question in there about effectiveness 60 and over.
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Dr Doug: Yeah, I saw that.
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Mary: Yeah. Can you talk to that for a minute?
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Dr Doug: Yeah, absolutely. So the question here is
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Dr Doug: from Sharon. It says, I heard a podcast where they were talking about HOT. And that all the protective benefits are lost after age 60. So, Sharon, there was a study that was actually just published last month that is absolutely
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Dr Doug: counter to everything that that says, and that's the old belief that there is this decade, this window where women are. Gonna see cardiovascular benefit, and all the good things that happen with estrogen, and then, after 60, you're screwed. But that's not true. And what this study showed it was a cohort study, showing that women that stayed on hormone replacement therapy after the age of 60 had lower overall mortality, cardiovascular mortality, breast cancer, colon cancer, fracture, risk on and on and on and on.
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Dr Doug: because hormones are powerful, they are protective, even if there isn't a good study showing that in that population, because those studies would be really hard to do
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Dr Doug: so. There is benefit for staying on it. The bigger question which we can address another time is, what's the risk of starting it? That's another challenge, if you haven't started it, but it is it is beneficial. It pretty clearly in the literature to stay on it after the age of 16.
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Breta Alstrom: And Sharon, if you wanna unmute, I know you raised your hands. We can.
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Dr Doug: I think she.
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Sharon: Can you hear me? Can you hear me?
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Sharon: So if you have access to rams, why, even do a dexa, especially if you're a petite Asian person.
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Dr Doug: It's a good question. I think that you should compare apples to apples. So if you have access to Rems, and you're near one, and you can just do rems after rems fine.
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Dr Doug: As long as you are comfortable staying out of the insurance traditional market. If you take your rems data to your traditional doctor. They're not gonna know what to do with it. But if you're if you're managing your osteoprosis or we're managing your osteoporosis and you have rams after rems. I'm totally fine. With that we don't need a dexa. If we have repeated rems, I do recommend people do continue to get apples to apples. Comparison, though, because we know that Dexter rams is not a good comparison.
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Dr Doug: Yeah.
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Breta Alstrom: And.
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Sharon: So should you even get a rims? I mean, if you're doing Dexa to Dexa, is it? You switch.
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Dr Doug: I think there's yeah. I think there's value in rems. Because in rems you're gonna get the fragility score and in in theory, Rems might be more accurate, we could never prove that. But my guess is, it's probably more accurate just because of all the potential variables of the 2 dimensional X-ray.
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Breta Alstrom: And we are at time, and Dr. Dog probably has to run to see a patient. But I have all of your questions saved. And so I'll drop those in slack and we can continue the conversation. And then it sounds like we have a lot of questions about like Hrt labs. So I'll put that on the docket, too, for in a few weeks but yeah, Dr. Doug, you're more than welcome to jump out, and I can stay on for a few minutes. If anybody has has any technology questions.
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Mary: Not technology. It does seem like the big, bigger question is starting Hrt, after 60. Cause that's like, I'm 59. And I just had my program review. So trying to figure out what I'm gonna do.
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Breta Alstrom: Yeah, we we definitely have people who start Hrt, after 60 all the time. And there's been some new research from like some women's health initiative cohorts
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Breta Alstrom: that I think mitigate a lot of the risk. We'll have some Youtube videos come out about that. But we can also talk about that in slack, because Dr. Doug would be more the expert there. But we definitely have people post menopausal after 60 start hrt.
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Mary: Okay. Cool. Thank you.
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Breta Alstrom: Yeah. Beth, go ahead.
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Beth L.: Yeah, I just wanted to add, I'm fairly new. But I'm 69, and I started to Hrt at 69. So yeah, I'd like to hear more about all of this, too. So yeah, I felt like the benefits definitely outweighed the risks. So, yeah.
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Breta Alstrom: And I, it's also right. It's gonna be a personal decision, too. But the questions for these in slack are gonna be for the hrt, though those will be in the women's hormones. And then in live session follow up
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Breta Alstrom: we can, I would say, any vibration therapy things we'll put there, and then we'll drop in, because I know there's some questions in the women's hormone section as well. But again, we can also talk about in the live session. Follow up. If you guys want me to consolidate them instead, I can put them there, and then we can have a bigger conversation about that, but it looks like for the next few weeks we'll have Edie next week, which I'm really excited about, and like I said, she's a health coach, and she's gonna kind of go through all of the
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Breta Alstrom: just like the really taxing mental that is, osteoporosis and seeking interventions for that. And then the week after it'll be Dr. Doug and I again, and we'll go through kind of like that. What? What does like a really great treatment plan look like. And how can you piece those things together? And then the week after that, maybe we'll do a deep dive on Hrt. And Labs and safety. Cause. There's been quite a few questions there. And again, if you guys want to.
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Breta Alstrom: oh, hold on. There's just one more question. Slack is our community platform. If you're logged into Hsn on the website, there's gonna be a little button on the side that says, Join slack and you can click on that, or you can send me a message
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Breta Alstrom: or actually message Hsn support@ohatohhmd.com! And we can get you access to slack, too. But it's a community messaging. So you can have access to everybody here, and just kinda and even more people, and kind of support each other, answer questions, share your experience. So, yeah.
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Breta Alstrom: but yeah, that'll be the next few weeks. And I would say, too, if you are a member of our full service program. If you have specific questions about your hormones and the labs and stuff like that.
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Breta Alstrom: refer back to your team. That's like one of the best benefits of you being part of the full service program like, yes, this is nice, because you get to connect with people. But if you are a member of our full service program, you're gonna get the most specific answers for you. And like, by being part of our program, you don't have to diy it anymore. So just reach out to your team.
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Janet Parnes, Historical Portrayals by Lady J: But I have a question about the channels and slack. Do you have to S sign up for the different channels? Or how do you get access to the different channels.
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Breta Alstrom: Let me show you, because I have set it up so that if you've joined recently, you should be added to all of the channels.
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Breta Alstrom: But if you joined a while ago.
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Breta Alstrom: all you need to do, hold on. Let me screen. Share
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Breta Alstrom: all you need to do. Here is click more on this left hand side.
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Breta Alstrom: and then you're gonna come down to channels and you can go browse channels.
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Breta Alstrom: and then you should be able to see all of them, and you can done.
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Janet Parnes, Historical Portrayals by Lady J: And you know.
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Breta Alstrom: Ever ones, you think. Yeah.
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Breta Alstrom: And I would recommend joining all of them. I'm I think there's gonna be a lot of good stuff. So but if you've signed up recently, you should just automatically have access cause. I did update
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Breta Alstrom: any questions.
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Mary: Did you say the Hrt. Would be in one called women's
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Breta Alstrom: Yeah, women hormone. So let me go back to slack. It will be in
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Breta Alstrom: women's hormone replacement.
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Mary: Okay. Thank you.
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Breta Alstrom: Any other questions.
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Janet Parnes, Historical Portrayals by Lady J: So, Brett up. So if you, if all these channels don't show up, how do you? How do you access them?
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Breta Alstrom: So you should be able to click on this more button right here.
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Janet Parnes, Historical Portrayals by Lady J: Okay. Now, okay.
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Breta Alstrom: And then go to channels.
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Janet Parnes, Historical Portrayals by Lady J: Okay.
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Breta Alstrom: And then you'll see all the channels.
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Janet Parnes, Historical Portrayals by Lady J: Okay.
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Breta Alstrom: And then all you have to do like this. I'm sorry my zoom is in the way. Just click join.
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Janet Parnes, Historical Portrayals by Lady J: I am so good, Jonathan. Thanks.
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Breta Alstrom: These 2. We're gonna archive, though I had to pull some info. So I had I UN archive for them. But for the most part all of this stuff. Will be great to to jump into, get some good good info.
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Janet Parnes, Historical Portrayals by Lady J: Okay.
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Breta Alstrom: Yeah.
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Breta Alstrom: awesome. Any other questions.
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Breta Alstrom: And I know that I think somebody said the last 2 videos were missing. I'm gonna make sure that those are there today, so they should have been uploaded. But
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Breta Alstrom: there's just a little I thing on the back end that will make sure is all squared away. So you guys have access to the last 2 sessions in the transcripts and everything. Other than that, though I think the transition to the new platform. We're all good to go. Things are running smoothly. There should be.
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Breta Alstrom: Let me open that up real quick.
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FNSA Secretary: While you're looking at that, Brada, I'm just noticing in slack that
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FNSA Secretary: like some of these, only have
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FNSA Secretary: 21 members in the different channels. The announcements has 262, but in crime year there's 41 exercise 140
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Breta Alstrom: That's because people haven't joined them. So if we added them after. So now everyone should. Every every new member signing up now will have access to all of them. But for everybody here, and listening to the recording, if you go in and join those we've put it in
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Breta Alstrom: in the announcements channel a few times. But that's just the thing that you'll need to do to access those channels is just how I showed you go to more click channels and add all of those and Don, we can do another post and announcements. And if you guys if you ever see like the hash. The yeah, like the hashtag sign, you can just click on that, and it'll actually take you into the channel anyway.
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Breta Alstrom: So you can like reference channels that way.
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Breta Alstrom: Did you have other questions about that, Don?
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Breta Alstrom: Now?
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Breta Alstrom: Awesome. And then on the health span.
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Breta Alstrom: I wanna go over the vault really quickly. We're gonna be adding more and more stuff. Here.
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Breta Alstrom: you guys haven't seen this this is within health span nation. So if you click into health Span nation access. Now and then you'll have our upcoming events, the recordings. And then the health span nation vault is new. We're gonna be updating the user experience on this
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Breta Alstrom: still. So make it a little bit more user friendly. But if you click into this a lot of the clips, so if you don't want to go back and watch, you know the entire
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Breta Alstrom: recordings and all the videos and all of the things like that, you can actually just jump into these topic. Specific areas. And as what we're what we're doing is from the recordings, we're pulling out those really great valuable snippets, and we'll classify them into like what components or like, what categories they fall into. And you'll be able to watch much shorter videos to just kind of give you some of those highlights and see how things are are doing. So like
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Breta Alstrom: trying to think of a good one.
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Breta Alstrom: Be imaging.
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Breta Alstrom: Yeah. So if you wanna hear Dr. Doug talk about strontium. You can check that out. Exercise. Just hit review the vault, and then when you open them up, you go watch the clip.
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Breta Alstrom: sorry, and then you'll be able to see
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Breta Alstrom: like you can. It's a really short clip about for this one about. If exercise is more important than like supplementing. Or should you have both and things like that? So you can explore there.
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Breta Alstrom: cool any other? Any questions
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Breta Alstrom: not
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Breta Alstrom: guys can have have a great Wednesday and a great rest of your week, and I know there's quite a few questions in slack, so we will
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Breta Alstrom: jump in there and get all that stuff answered. And the more that we support each other as a community, I think it's gonna be a really awesome experience. But love seeing all of you guys faces every week.
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Diane Gould: Thank you.
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Breta Alstrom: Yeah. Have a great day. Have a good week bye.