Episode 128
Dr. John Neustadt:
Shatter Osteoporosis Myths with Science-Backed Strategies for Strong Bones
I had the pleasure of sitting down with the brilliant Dr. John Neustadt, who's challenging common beliefs with his holistic approach to preventing and reversing osteoporosis. Strap in as we explore why your bones are so much more than their density numbers and how you can keep them strong and resilient.
First Aired on: Feb 26, 2024
Episode 128
Dr. John Neustadt:
Shatter Osteoporosis Myths with Science-Backed Strategies for Strong Bones
I had the pleasure of sitting down with the brilliant Dr. John Neustadt, who's challenging common beliefs with his holistic approach to preventing and reversing osteoporosis. Strap in as we explore why your bones are so much more than their density numbers and how you can keep them strong and resilient.
First Aired on: Feb 26, 2024
Table of Contents:
In this episode:
Episode Summary:
In our chat, Dr. Neustadt shattered the common myths surrounding osteoporosis, emphasizing that true bone health extends far beyond the traditional advice of calcium and vitamin D intake. He introduced me to the concept that our lifestyle choices – what we eat, how we move, and the quality of our sleep – play pivotal roles in our bone health. John's insights into the impact of certain medications on bone density were eye-opening, reminding us of the importance of a personalized approach to our health.One of the most fascinating parts of our conversation revolved around the critical nutrients for bone health that rarely get the spotlight they deserve. Dr. Neustadt highlighted Vitamin K2 MK4, not just as a supplement but as a superhero for our bones, and shared his concerns about strontium, a commonly discussed bone health supplement, due to its potential risks and misleading effects on bone density tests.
Key Takeaways:
- Osteoporosis is a Silent Conversation: Our bones are telling us stories about our health that we need to listen to, beyond just looking at bone density numbers.
- Lifestyle is Key: The way we live our lives has a profound impact on our bone health. Integrating balanced nutrition, regular exercise, and quality sleep into our routine can strengthen our bones in ways no supplement alone can achieve.
- Supplementation with Caution: Not all supplements are created equal. It's vital to choose ones backed by solid research and capable of making a real difference, like Vitamin K2 MK4. And always, always question and research before adding anything new to your regimen.
- Medications Matter: We dove into how certain medications can influence bone density for better or worse. It's a reminder to discuss these effects with healthcare providers and consider all factors when evaluating treatment options.
- Empowerment Through Education: Knowledge is power, especially when it comes to our health. Dr. Neustadt's book, "Fracture Proof Your Bones," is a treasure trove of information for anyone looking to take charge of their bone health.
Memorable Quote:
"Bone health is not just about the numbers on a test; it's about reducing your fracture risk through a holistic plan that includes diet, lifestyle, and the right supplementation." - Dr. John Neustadt
Other Resources:
Connect with Dr. John Neustadt
Episode Transcript
Julie Michelson:[Page//00:00:00] Welcome back to the Inspired Living with Autoimmunity podcast. I'm your host, Julie Michelson. Today, we are joined by Dr. John Neustadt, founder and president of Nutritional Biochemistry Incorporated and published author of over a hundred medical articles and four health and wellness books. His most recent book is Fracture Proof Your Bones, A Comprehensive Guide to Osteoporosis, which is the topic of our conversation today.[Page//00:01:00]
Julie Michelson: Dr. Neustadt shares the importance of lifestyle in reversing and preventing osteoporosis and specific supplementation that can help keep our bones strong and healthy.
Julie Michelson: John, welcome to the podcast.
John Neustadt: Thank you.
Julie Michelson: I am so excited to have this conversation. As I already said, before we hit record, because we really haven't done a episode dedicated to bone health. And, um, as you already know, it's part of my personal journey and my family as well. Um, and not in the way people may think, you know, people think bone health and they think older adult.
Julie Michelson: Um, so we'll, we'll talk about all of it, but you have such an interesting way you came to focus on bone health and nutritional supplements. So I'd love to hear a little bit of your journey. I'm guessing when you were, you know, 12, this isn't what you thought you'd be doing.
John Neustadt: Not only when I was 12, but when I was 25 and 28 and [Page//00:02:00] I, I came across this out of, out of need my, one of my mentors in medical school and one of the founders of my university, Dr. Bill Mitchell said to me that if you listen to your patients, they will tell you what they need. And I was in clinical practice and I started working with, uh, people with osteoporosis.
John Neustadt: They were just coming to me. It's not as if I had some specialty in that area at the time and I was doing what I was taught to do. And I thought I was doing a great job because their bone density was going up. I was working with them through integrative medicine. I was helping them with diet lifestyle, nutritional supplements, recommending medications when they seemed appropriate.
John Neustadt: And my mother in law has osteoporosis and I was helping her a little bit. Um, there's always it's always challenging [Page//00:03:00] waters when you're have a family member as a patient. And I also learned early on to stop doing that and avoid that
Julie Michelson: It's not effective.
John Neustadt: but I was giving her some recommendations for some nutrients at the.
John Neustadt: clinical trial support and dietary recommendations and exercise that those sorts of friendly advice. And she had her physician. She was working with who had her taking Fosamax. Her bone density was going up. Her doctor was happy. She was happy. I was happy. And then she tripped on a throw rug in her house.
John Neustadt: And broke her hip. And I thought to myself, something's wrong here. What's wrong with this picture. So I dove into the research and what I found is that the nearly myopic focus just solely focusing on that number on the test, that bone density test number, which is how conventionally it's. Treated [Page//00:04:00] and even how integrative doctors also an integrative practitioners typically think about working with people with that disease, focusing just on that number on the test and thinking you're doing a good job is leaving people dangerously.
John Neustadt: Unprotected. What the research shows is that a bone mineral density test only predicts 44 percent of women with osteoporosis and only 21 percent of men who will break a bone. And that's the most dangerous thing about osteoporosis. It's not. The danger is not the number on the test. The danger is, are you going to fracture?
John Neustadt: And that test or any recommendation, any test is only as valid and helpful as it can predict your fracture risk and only recommend and any recommendation is only as valid as it can reduce your fracture. Risk. And what we know with the dangers of [Page//00:05:00] osteoporosis is that every 30 seconds, someone with osteoporosis is breaking a bone.
John Neustadt: In fact, globally, it's second only to cardiovascular disease as a global health risk and issue. If you're a 45 year old woman, your risk of an osteoporosis fracture is greater than your combined risk of breast uterine and ovarian cancer. And if you happen to break your hip with osteoporosis, there's up to a 36 percent chance that you're going to be dead within a year.
John Neustadt: And half of those Patients who survive never regain their full pre fracture level of mobility and pain free lifestyle and ability to join their, enjoy their life. So I became obsessed with, with really understanding not just what's going to change the number on the test, but how can I educate people, teach people and create information and resources that actually not just promote healthy [Page//00:06:00] bone density, but maintain strong bones as indicated by reducing fractures in clinical trials and educate people that those are the questions they need to ask what to ask their doctor, how to create a holistic plan for themselves and the The resources that I can provide them to do that.
Julie Michelson: Wow. And I love the, it, it so not surprising to me that the traditional Western approach and even in the integrative world, um, is, you know, a number on a test because that's, that's the whole problem, right? It's like this, this pretty, you know, bone density in absence of. All the rest of your health information, right?
Julie Michelson: How strong are you? How stable are you? How is your balance? Um, and I, I want to, we'll get to, I know we're going to get to it, but I want to add the, the, you know, those numbers of later in life, especially for women, post, you know, menopausal women, um, it's only [Page//00:07:00] if you do nothing. Right. So we're not never doom and gloom.
Julie Michelson: And that's what your book is about. Um, and that's what you're all about is like, wait, we're whole people and diet movement, lifestyle connection, community, all the things that make a healthy person also shocker make strong bones.
John Neustadt: Yeah. And it's, and it's hope based on the science. It's not pie in the sky. Hope these are what the, this is what the research support is. The best way to not only, uh, promote your bone health to protect yourself, but all of these integrative and holistic things that I talk about in my book, fracture proof, your bones also.
John Neustadt: Help reduce your risk for cardiovascular disease, dementia, cancer, all cause mortality, uh, you know, diabetes and on and on and on because it's diet, it's lifestyle, it's exercise and all of the systems in the body are connected. So if you're doing something that's healthy for your [Page//00:08:00] bones, you're going to be doing something that's healthy for your heart and your brain.
John Neustadt: Also,
Julie Michelson: Yes. And, and that connection of, you know, exercise is essential for cognition and preventing cognitive decline. I mean, there's, you cannot, again, we're, we're whole integrated humans and, and we need it's quality of life. I say this all the time. I didn't I didn't think I would be here having conversations at almost 55.
Julie Michelson: Um, and, but I, I don't want to just be here to be here, right? I want to be mobile. I want my brain to work. I want to enjoy my family and the things that I love to do. Um, so quality of life and health span is that's what we're talking about. And, and if your brain works, but your body doesn't, or your body works, but your brain, and all the things.
Julie Michelson: Um, and so I, I really, this is why I got so geekily excited for our conversation today. Um, because it's, it's another area where the conversation needs to change and [Page//00:09:00] that's what you're doing for us, is educating us. Well,
John Neustadt: uh, minerals if we're, and that's the, what the bone mineral density test detects. It detects how many, how much mineral Yeah. Minerals, how much minerals, how many minerals, the quantity of minerals that, that somebody has, thank you, has in their bone.
John Neustadt: I don't really talk about it usually that way, but you know, the amount of minerals somebody has in their bone, but if it were only minerals, it would be like a column of chalk and be brittle. So there are over 200 different proteins in bone bone also produces our blood cells, our red blood cells, our white blood cells for our immune system and our platelets.
John Neustadt: It does. It produces some hormones and it has hormone receptors. They're actually serotonin receptors in bone. And melatonin receptors, uh, in bone. So it's a complex, important tissue, uh, in our, in our body. And I, the more, there's a chapter in my, uh, [Page//00:10:00] in my book called, uh, I think miraculous bones. I mean, they're, they're miracles.
John Neustadt: The more I learned about them, the more I gained an appreciation. I mean, it's just, they are incredible.
Julie Michelson: and they're, they're alive, right? So you know, we, we tend to think of, we only see bones usually, hopefully when they're no longer in the body. Some of us, sometimes you see them when you shouldn't, um, but that's so important. And I, I already touched on hormones. So let, let's kind of go there, you know, we, we think, okay, maybe some people think that.
Julie Michelson: Okay. You know, young adults, your bones are, you're fully formed, you're done, right? Those are the bones you have for the rest of your life. But we're always should, could always be building bone and always tearing bone down. Can we talk about that a little bit? Because I really do think that most people are unaware of that, that this is an ongoing process throughout life.
John Neustadt: That's crucially important. So, uh, men and women gain their [Page//00:11:00] peak bone density in about their twenties. So, you know, 20 to 29, 25 to 29, somewhere around there. And then the conventional wisdom and you know, what we learned in medical school is basically it's a one way street from there downhill.
John Neustadt: You're losing about half a percent of bone density per year in, in women in particular. And I'll explain why women, uh,
Julie Michelson: We always, we, it's always us.
John Neustadt: Sorry
Julie Michelson: For the same reasons, though. It's okay. We also can, you know, carry babies.
John Neustadt: But it can be reversed. So, so, but what happens is that that's not accurate in terms of that. It's a one way street bone is a living tissue. Bone is constantly being old bone broken down in new bone built up in a process called bone remodeling. About every 10 years you actually have all new bone. Bone has turned over.
John Neustadt: What happens is osteoporosis is essentially a disease of imbalance. The destructive forces are winning. [Page//00:12:00] And when you have balance between the bone building cells called the osteoblasts and the, the, the, the cells that break down old worn out bone called osteoclasts, your bone health is, is not changing.
John Neustadt: It's, it's stable. As we go through puberty as we're growing and bones are getting you're getting more bone. Well, there's more osteoblast activity building bone and less relatively less osteoclast activity. And then what happens as we age that balance. shifts and the destructive forces of the osteoclasts take over.
John Neustadt: And that's when you start getting bone breakdown. There are lots of things that contribute to that. Some are in our control. Some are not in our control. One of the, the, the biggest things that I see talking about that is in our control is medications. There is a long list [Page//00:13:00] of medications that, uh, destroy bone.
John Neustadt: And create osteoporosis and increase the risk for fractures. Now people need to be on medications. If you need to be on one, then you should stay on it. But it's important. It is, it is, I consider it a modifiable risk factor because in many cases through integrative approaches, you can. Either decrease the dose or get off the medication altogether or switch to a safer one and I'll give you two examples.
John Neustadt: So some of the most commonly prescribed medications out there are antidepressants and acid blockers. Both of those categories of medications destroy bone. As I mentioned, there are serotonin receptors in bone. So people taking any medication that artificially increases serotonin. So that's like prozac.
John Neustadt: Lexapro, Welbutrin, those sorts of medications, they increase [Page//00:14:00] osteoclast activity, increase bone breakdown. And so much so that there have been multiple studies and looking at the body of research that's out there, the authors concluded that For women taking this category of medications like an SSRI medication for one to five years for every 19 women taking one, we would expect one to fracture.
John Neustadt: That's how dangerous they are for bones. And yet most doctors aren't aware of that. They don't know about that. They're well intentioned, but they just aren't up on the research. The other category of medications, the acid blocking medications, taking one of those specifically like a Prilosec, a proton pump inhibitor, which are available over the counter.
John Neustadt: Continuously over time raises your fracture risk. It, it damages bone so much so that the longest study was four years. And after four years, it [Page//00:15:00] increased the risk of a hip fracture by 60%.
Julie Michelson: Wow,
John Neustadt: And the first FDA warning about that medication that went out a letter by the FDA about that category of acid blocking medications and its ability to destroy bone and create fractures was what went out and was released by the FDA in 2010.
John Neustadt: So this is not a new issue. And with those acid blocking medications, half of them are prescribed just for acid reflux. And we know that simple dietary changes. And in many cases completely stop the acid reflux and people don't need the medication.
Julie Michelson: with mood disorders. So, you know, all of these approaches, you just gave me like an extra thing to put in my gratitude journal that I was on prescription PPIs. For years at four side effects from the, you know, eight other prescriptions I was on back when I was not well, um, so really grateful to [Page//00:16:00] know that I, my bone density is good and that didn't do, and that goes to what we're saying too, right?
Julie Michelson: There, there is, and we'll get into some other risk factors, um, but the, the body is resilient and we are designed to heal. So even, um, You know, not knowing what I didn't know back then. I feel better and I'm stronger. My bones are healthy, which I would not have thought
John Neustadt: Yeah. And to your, your point, you know, we were talking before you started recording about celiac and the connection between celiac and osteoporosis and the research shows that in, in, in children and young adults who are osteoporosis can be the only sign of celiac disease. And once though you get them on a gluten free diet.
John Neustadt: The bone density can reverse their bones can heal and and become healthy again. And similarly, people on prednisone commonly used for autoimmune diseases that damages [Page//00:17:00] bone. It is so destructive and most physicians know that and are aware of that. And once you come off of the, the, the, the prednisone, the dexamethasone, however, over time, that risk for fractured decreases.
John Neustadt: Now, we don't know if it ever gets back to what it was before the medication, but it does, it does decrease the risk for fractures. Once you're off that medication, once you remove. What's damaging it. Your body has the opportunity to do what it wants to do anyway, which is heal and thrive, which is why, like to your point about diet and nutrients and mental health.
John Neustadt: We want to give the body all of the raw materials, the environment in which our bodies can flourish and do the job that they want to do for us so we can feel amazing.
Julie Michelson: and it is, I'll share, I don't think I've ever shared this on air before, but that was what we were chatting about before we started was, um, my son, who [Page//00:18:00] I now know has celiac. Um, but when, before we knew, and, and again, if I knew then my kids, we laugh around the dinner table about my parenting skills when it comes to health back then versus now, but, um, because he had horrible GI issues.
Julie Michelson: Literally from birth and nobody ever said, you know, what? What are you eating? Or, you know, that was never part of the conversation, but he was as a young kid, you know, like, end of probably end of elementary school, beginning of middle school had osteopenia. Um, and they wanted to medicate him. And I, I confess to you, that was probably my one good health related parenting decision back then.
Julie Michelson: I said, let's just wait. And luckily he was not long after diagnosed with celiac. We never did it. We never treated the bone health. He's 28 and his bones are great and he's healthy and strong. And it is the only thing he has done. He does not live a totally healthy [Page//00:19:00] lifestyle like his mother would like him to.
Julie Michelson: But he's gluten free.
John Neustadt: we all have that dynamic with our kids,
Julie Michelson: Yup.
John Neustadt: them to eat better and sleep
Julie Michelson: Uh huh. Please, please. Yeah.
John Neustadt: I've got two of my own. Yes,
Julie Michelson: Yup. So, um, luckily, you know, he's my oldest. My other two are a little more proactive about full lifestyle. Um, but it is amazing. And so, again, we think of this as an older, an aging issue, and it is not always an aging issue because of some of these, these lifestyle factors.
Julie Michelson: Yup. Yup. Yup. One thing kind of connected to age, but can happen pretty early on that I really do want to talk about, um, is, is hormones and, and women, especially, can you tie, tie that up in a bow for us, you know, why, to me, that's a, that is a manageable risk factor, I
John Neustadt: absolutely. Absolutely. 80 percent of osteoporosis [Page//00:20:00] occurs in postmenopausal women. And the reason why Mm hmm. Again. Yes.
Julie Michelson: Well, because if you look at Alzheimer's numbers or, you know, all of the, like all of these major life impacting health, chronic health conditions, that's where you just kind of fall off that cliff for risk if you're a woman.
John Neustadt: And what's happening with with bones is a decrease in estrogen and progesterone during menopause through menopause. And for the 10 years after menopause is the fastest rate of bone loss in women. And that's because of that drop in estrogen. Estrogen is considered what's called an anabolic hormone. That means it builds bone.
John Neustadt: And why don't men suffer from this? Because you know, we produce testosterone. Well, estrogen actually comes from testosterone in the body. So we have enzymes and the mechanism [Page//00:21:00] to take testosterone and convert it to estrogen. And so it's thought that the reason why men don't suffer with this is because they're not really getting that drop.
John Neustadt: That change in, in hormone levels as dramatically as, as women are. And so when the estrogen drops, estrogen has many roles, like all hormones do in the body, one of them is to promote osteoblast activity, that bone building activity, promote collagen production. So bone is more like I mentioned, the proteins in bone, it's more than just the column of minerals.
John Neustadt: One of the major protein in bone is collagen, and it's the collagen that gives bone its ultimate strength and flexibility. Collagen, you know, strand per strand is, is, is the tensile strength is stronger than, than steel. And it's also flexible. So having healthy collagen levels in bone allows somebody to fall.
John Neustadt: For that impact to go through the bone be dispersed and the bone did a form a [Page//00:22:00] little bit and not be brittle to absorb it without breaking. And so, lowering estrogen decreasing estrogen also affects collagen. It also affects sleep. And insomnia is a risk factor for osteoporosis and fractures, not getting adequate sleep.
John Neustadt: So, that's why in postmenopausal women, you're getting a higher rate of osteoporosis. Now, that said, the assumption, unfortunately, if a physician has a postmenopausal woman coming to him or her, And they have osteoporosis, they're going to think, oh, it's just, it's menopause, but 30 percent of osteoporosis and postmenopausal women is caused by other things.
John Neustadt: Yes, the estrogen drop in estrogen is a contributing factor, but there are other things going on and I, those almost never get [Page//00:23:00] evaluated. And part of the challenge is how doctors are trained what the economic incentives are in medicine There's a study that came out a few years ago out of europe that there's just a lot doctors Just aren't adequately trained In this disease to treat it how it needs to be be treated and I can go into that if if you want, but the the the bottom line is is there are um Ways to look at and evaluate through an intake form, you know, somebody's lifestyle, the medications they're taking, independent of the age that they are, to really understand are there other potential contributing factors here, and there are ways to evaluate a bone density test, a little more subtle, nuanced evaluation of those test results that can point to a, what's called a secondary cause.
John Neustadt: Something else causing it like a medication or a disease process and [Page//00:24:00] not just the drop in estrogen. And so that's where my book hopefully is very helpful. Is it, is it walks people through these different issues and provides questions for them to ask their doctor to make sure they're really getting the best possible information and advice so they can create, make the best decisions for their themselves and their health and create a holistic Bone health plan to help reduce their fracture risk and, and maintain bone strength,
Julie Michelson: Which I think is, is so important. And your, your book is such a gift because, you know, we're talking about, I'm guessing, you know, that definitely the, it's the go to resource for somebody when they hear they have osteoporosis or they're, or they were sent for a scan, you know, they're, they're in that realm where they're starting to talk to their doctor about, am I osteoporotic or not.
Julie Michelson: But everything in your book, if we, if we were to just read it early,
John Neustadt:[Page//00:25:00] right?
Julie Michelson: Which is why you and I do what we do, right? It's yes, we want to help the people that are already for me. It's already where I was. Um, But it's this, this is the knowledge. This is where there's the empowerment to heal, but there's also this empowerment to prevent.
Julie Michelson: And so this is where I think your book is so impactful and so important. Um, and I want to, I could, we could talk for five hours. Like I already have a mental list of questions. Um, but I want to touch on. So we, we talked about hormones and so I will, I'm not a physician, but bioidentical hormone replacement, I've had, you know, amazing, amazing.
Julie Michelson: Cancer expert. I mean, you name a concern with bioidentical hormones, and it's already been addressed on the podcast. They are. This is I look at it this way. We are hormones decline, like, because we're just getting ready to shrivel and die. And I don't want to shrivel and die. [Page//00:26:00] And so to keep bones healthy, brain healthy, your inflammation down all of the things, um, that's we can put that one aside.
Julie Michelson: I want to talk about some of the other things. Just lifestyle areas. You just I'm so excited. You mentioned sleep. I'm such a geek about that again. Rain, how all the things we heal in our sleep. So it's not surprising that people that aren't getting enough sleep. It's affecting your bones as well. Again, we think of them as like this.
Julie Michelson: Separate part of the body and it's just part of the body,
John Neustadt: That's so true. I just quickly, uh, briefly to mention the hormones. I'm glad you brought it up. The research is clear that when it comes to bone health and osteoporosis Uh, hormone replacement therapy builds bone, but more importantly, it does reduce fractures. So one study showed overall a 40 percent reduction in fractures.
John Neustadt: Another specifically the most dangerous type of fracture, hip fractures, 28 percent reduction [Page//00:27:00] in hip fractures, looking at a meta analysis, you know, combining different studies together, the data. So it can be done safely. Uh, and we're just talking about getting things back into the normal range, not
Julie Michelson: We're not talking about
John Neustadt: high dose. It's just, you're a little deficient, like, like a nutrient that you're deficient. And that's how I encourage people to think about it. If I'm deficient, low in iron, well, I'm just going to give myself some iron, uh, to take iron to get me back in the normal, healthy range.
Julie Michelson: right? And so I, I, okay, we can put that, that one to rest. What L you mentioned a little bit. So we tell, you know, you touched on sleep and the importance of sleep. And, and again, there are resources for all of us. So, you know, not everybody is short on sleep because they're working too many hours. Um, so if you, if you have sleep challenges, we've had episodes on the podcast with sleep specialists and, and there's a lot of ways to improve sleep, but what else should people, and I know it's, it's all in the book and [Page//00:28:00] I encourage everybody to get the book because the, that's.
Julie Michelson: The beautiful thing. It's, these are the lifestyle pillars for wellness, period. No matter what condition, what, this is just, these are the things our body needs to stay strong.
John Neustadt: Absolutely. The other thing I would want to touch on is supplementation, because I think there's a lot of misinformation out there on the internet, a lot of mischaracterization of the research. And when you look at bone health supplements out there, You can see a long list of ingredients and in some of them calcium and vitamin D is commonly known and commonly recommended by all medical associations for bone health and osteoporosis.
John Neustadt: And, and I agree with that. That's a good recommendation because the research shows that, that taking and getting adequate amounts of calcium and vitamin D are associated with a 18 to 23 percent reduction in fracture risk. So again, not just about bone density, [Page//00:29:00] but what about fractures other than that?
Julie Michelson: Question on that though, um, is calcium safe across the board for people to be supplementing if they, period?
John Neustadt: Great, great question. Uh, the current recommendations of the Bone Health and Osteoporosis Foundation and the American College of Preventive Cardiology is that taking calcium up to the, um, uh, up to, uh, 2, 000 to 2, 500 milligrams per day Um, you know, you can't get within that ray. If you get up to 2000 to 200, 2500 milligrams of total calcium a day, that should be avoided.
John Neustadt: That's dangerous. Taking it up to the U. S. RDA of the recommended amount for bone at 1200 milligrams per day is considered, uh, safe. And There's no, what's interesting is so many doctors. I still, I get people coming to me and my [Page//00:30:00] doctor said, I need to take 1200 milligrams of calcium, or I need to take 1500 milligrams of calcium.
John Neustadt: And, and it's just the wrong recommendation because the U S recommended recommended daily allowance for any nutrient is the total intake. That's from diet and dietary supplement 1200 milligrams of calcium is not associated with any improved bone health. outcomes. So that's really just what you need. And you definitely don't want to get, you know, up to 2000 to 2, 500, then you run into, into some, some risks.
John Neustadt: So the, the average American woman consumes about 800 milligrams of calcium in her diet. And the average American man about a thousand milligrams of calcium. So just getting about 400 milligrams as a dietary supplement is fine. And if you end up getting a little bit more, you know, there's a buffer of safety, 500, 600, you know, 800, you know, you're still, you're still in [Page//00:31:00] that safe area, but being conscious that not 1200 milligrams, you know, the recommendation should be customized.
John Neustadt: And on average, you know, just getting 400 milligrams, that's really all, all you, you know, most, most people frankly, uh, need, uh, with vitamin D.
Julie Michelson: for going into that one because it's, I know I broke my shoulder, oh gosh, six years ago and they did that at your age. You know, you need to be taking this much calcium. Well, I have cardiac concerns in my family and there were reasons I chose not to and they were shocked at how quickly I put bone back in.
Julie Michelson: Um, I want a follow up question. I'm a little afraid to ask it. I'm rolling the dice. I'm trusting in everything I've ever heard you say in other interviews. Um, because this is a question I get all the time as I'm working on reducing inflammation and gut healing and customizing, nutrition plans for people.[Page//00:32:00]
Julie Michelson: Do you have to consume dairy to get enough
John Neustadt: absolutely not. Absolutely not. No, no, no. In fact, there's a blog on my website, you know, top non dairy, 10 top non dairy sources of calcium. No, you absolutely don't have to.
Julie Michelson: Thank you.
John Neustadt: You can, uh, but, but no, it's, it's not, it's not necessary. Uh, just quickly in terms of vitamin D, I do advocate people get their vitamin D levels checked and tested.
John Neustadt: The research supports that for, uh, fracture reduction, the maximum benefit is when your vitamin D is between 30 and 44 on the blood test nanograms per milliliter. Now, a lot of doctors, including myself, advocate even higher than that for immune health, 50 to 60.
Julie Michelson: Oh, I, I, I go higher
John Neustadt: Yeah, I, well, 50 to 60 is what a lot of, I, uh, mine is higher than that. I do recommend typically higher, but 50 to 60 is
Julie Michelson: It's a baseline. Yeah, it's a, it's a baseline. I, and I get [Page//00:33:00] so many people, um, I do, I want to follow up or add to the, For listeners, why you're saying that is because it's a fat soluble vitamin. So unlike a C or a B, you're not going to pee it out in the toilet and we don't want you. It is important to test.
Julie Michelson: People ask me all the time, how much D should I be taking? I'm like, I don't know. Let me see your labs. You know, like, um,
John Neustadt: true. But the research support, if you take up 2000 IUs of vitamin D, that's sufficient to get most people, uh, in that healthy range pretty quickly as a minimum. Now, a lot of doctors will go higher. I, I take higher than that
Julie Michelson: It took me eight years on way higher than that to build up, you know, I was down in the, in the 20s,
John Neustadt: Yeah. And
Julie Michelson: I see a lot with, with my autoimmune patients. They'll come in. My clients will come in if they're not supplementing or they're taking 2000 and they're still below 30. It's,
John Neustadt: Well, there, there are cases though, where, where people do need higher than that [Page//00:34:00] obesity, people who are obese, who have malabsorption issues, who have autoimmune conditions, they oftentimes need much higher doses than that to get their vitamin D up. So that 2000 units is, you know, just kind of for the general popular population.
John Neustadt: So. Other nutrients that are, that are important. So the way that I look at the research and the way that I think about this and, and, and nutrients is what, what nutrients have been shown in clinical trials, not only to promote healthy bone density, but to maintain strong bones as indicated by fewer fractures in clinical trial volunteers.
John Neustadt: Now, as I said before, there's a whole long list of nutrients that people, you know, companies are throwing into their supplements, just like what's the kitchen sink. Let's just throw everything in there. There are only four actually that meet that criteria, only four. And one of them I have safety concerns about.
John Neustadt: So the two I already mentioned, calcium and vitamin D. Um, the third one I would mention is a specific form of vitamin [Page//00:35:00] K2 called MK4. Now in dietary supplements, people will see MK7 as a form of vitamin K2 and MK4 as a form of vitamin K2. Now they are both types of vitamin K2, but they're not the same molecule as we know in biochemistry.
John Neustadt: If you, you know, you change one carbon atom, you can get overlapping benefits, overlapping activities, but also quite different activities as well. So MK7 in clinical trials has only been shown to slow down how fast somebody loses. Bone how fast they're losing that bone density and there are no clinical trials zero Involunteers showing that it reduces fractures as an outcome in the clinical trial.
John Neustadt: They just it hasn't been studied as an end point So it doesn't
Julie Michelson: know.
John Neustadt: we don't know and it doesn't promote healthy bone density in terms of increasing bone density It just slows down how fast somebody loses how it [Page//00:36:00] slows down how fast somebody lose it in contrast mk4 And by the way, MK7 is not produced by humans.
John Neustadt: It's produced by bacteria. MK4 is the preferred form of vitamin K2 that accumulates in our bodies, that we can actually manufacture small amounts of it. We can convert MK7, we convert vitamin K1 to MK4, but in much higher doses than you can get in diet, which is why you need to supplement with it, and much higher doses than what our own biochemistry can, can manufacture.
John Neustadt: MK4 has been shown to, Increase bone density, so promote healthy bone density and maintain strong bones as indicated by over 70 percent fewer fractures in clinical trials in postmenopausal women with osteoporosis and that MK four dose that was used in those clinical trials was 45 milligrams per day.[Page//00:37:00]
John Neustadt: And it's been so well studied that's been approved since 1995 by the Ministry of Health in Japan for bone health. There were 25 clinical trials
Julie Michelson: Why are we so always late to the party in this country? It's amazing.
John Neustadt: Yeah, that's a whole, that's a whole
Julie Michelson: It's another, it's another podcast. It's a different, different conversation.
John Neustadt: the reason why I became an expert in, in that, in this research and lecture about it and medical conferences is because when my mother in law fractured her hip, and I was working with patients in my clinic, and I started looking at the research, I, I learned about this powerful nutrient MK4, and there's nothing in the U.
John Neustadt: S. that had that dose of MK4 In it. So I created, that's why I created my company NBI to create solutions that didn't exist. So many products on the market do not have the combination [Page//00:38:00] or dose of nutrients shown in clinical trials to actually work. Maybe we'll cite a study, but then they'll use less of the nutrient, a lower dose that was actually shown to even work.
John Neustadt: So I created my osteo K minis and formulas with that clinical dose of. Mk4 with calcium and vitamin D to be a very targeted bone support solution for people. And the only difference between the formulations is the amount of calcium. Like we talked about, not everybody needs the higher amount. Some people need lower.
John Neustadt: So the osteokinesis has less calcium.
Julie Michelson: Interesting. And, and so the fourth one that you have the qualifier.
John Neustadt: Yeah. The fourth one is strontium. And that's, uh, people hear about that on the internet as well. Strontium is a mineral. It was approved in, uh, the European union for osteoporosis. And yes, strontium has been shown to improve bone density and [Page//00:39:00] reduce fractures. However, every clinical trial that's been done was on a form of strontium called strontium ranolate.
John Neustadt: That's what was approved in Europe and used as a medication. Strontium ranolate does not exist in the United States in dietary supplements. It's only a strontium citrate. There are no clinical trials on strontium citrate showing that it improves bone density or maintain strong bones. There are no fracture outcome studies on strontium citrate.
John Neustadt: So we can assume, okay, well, let's assume, um, it's not really the ranolate part. It's not the citrate part that's doing the job. It's the mineral. It's the strontium that's, that's actually having the benefits. So let's, let's just for argument's sake, give that benefit of a doubt. Well, what are the clinical trials in Europe show for strontium ranolate?
John Neustadt: Well, five of the six large clinical trials that were run or part of the approval process. Showed that it only reduced hip [Page//00:40:00] vertebral fractures. It didn't reduce hip fractures. Only one of the studies showed us statistically significant reduction in hip fractures. So it's not clear that it actually works to reduce the most dangerous type of fracture.
John Neustadt: Importantly, post marketing research determined, however, that for every one fracture that's prevented, the strontium medication was creating blood clots that could cause strokes and heart attacks.
Julie Michelson: Well,
John Neustadt: So for every one person you're helping, you're potentially giving somebody a stroke and a heart attack. So it was removed from the market.
John Neustadt: Now, strontium citrate may be safe. It may not. We don't know. And in addition to that, strontium as a mineral incorporates into bone. Bone, uh, strontium is heavier than calcium. And so what happens in a bone mineral density test, the x rays of a bone density test bounce off the [Page//00:41:00] minerals and they, the way that they bounce off the angle that they create when it's when they're deflected is then interpreted by the machine.
John Neustadt: And, and that's what calculates the test results what's called the T score and a Z score. That's what determines your bone density. But because strontium is heavier, it changes how the x rays bounce off of bone and creates a false bone density test result. So, so despite the fact that bone density tests have their limitations, I, I personally want them to be.
John Neustadt: As accurate as possible because it is one indication. It's not the most important indicator of your fracture risk But it is one important indicator.
Julie Michelson: Wow. Well, that I, I know I'm not trying it. Um, and I'm very experimental and I want to, I want to touch on, you know, you have this supplement company because again, out of [Page//00:42:00] necessity, right? You weren't able to, as you're doing the research to provide your patients with the supplementation that you knew would help them.
Julie Michelson: Um, can you define supplements for me? Cause I, cause People just think, fine, I'll just take the supplements and the other stuff just seems like it's too much work.
John Neustadt: right Not a good attitude in my opinion not the best
Julie Michelson: And that's, to be fair, they're probably not listening to this podcast if that's their attitude, but we all know those people.
John Neustadt: And, and really recommend people take dietary supplements as the FDA and the law intended that is as a supplement to a healthy diet, diet and lifestyle are always first. That's why in my treatment plans are there is always and there was always diet and lifestyle first the supplements were just to support those.
John Neustadt: Processes in [Page//00:43:00] the body. Now, dietary supplements are not approved by the FDA to diagnose, treat, prevent, or cure any diseases. They should be viewed and used as a supplement to promote health, promote healthy physiology, to promote bone health. And with respect to diet, there are certainly Reasons why people will want to supplement.
John Neustadt: So for example, MK4 is in dairy products, but you can't get enough of the MK4 that's been shown to support bone physiology and bone health. You have to supplement in order to get that higher amount. And by the way, as an aside, the MK4 has been, uh, studied not only in postmenopausal osteoporosis, but because we mentioned medications before there are multiple clinical trials showing that it Stopped and reversed.
John Neustadt: Uh, the improve the bone density tests in people taking medications like prednisone and loop relied, for example, so it's been studied in [Page//00:44:00] different situations. Back to the supplements. So there are other reasons why you should supplement. Protein is a good indicator. I believe a lot of people, even if they're there, say I'm following such a healthy diet.
John Neustadt: Are not getting enough protein, adequate protein as we age to, to maintain muscle mass
Julie Michelson: I would say most people and especially women,
John Neustadt: Yes, yes,
Julie Michelson: to focus on protein.
John Neustadt: yes. So based on the research, I recommend people get a minimum of 1. 3 grams of protein per kilogram body weight per day. And this is in my book now. Now we don't really think in kilograms, we think in pounds.
John Neustadt: So if you just take your body weight in pounds and you multiply it by 0. 59, that's the minimum amount of protein people should be getting. Unless of course they have, you know, chronic kidney disease or on dialysis and they've been put on a low protein
Julie Michelson: sure,
John Neustadt: right? Okay. And that can be difficult to get that amount of protein in diet.
John Neustadt: And so that's where a protein supplement can, [Page//00:45:00] can be helpful. Uh, similarly supplementing with a collagen supplement, which has been colleges has been shown to promote healthy bone density, support bone density, support healthy skin and nails and that sort of thing. Then, you know, maybe you protein are the building blocks of collagen.
John Neustadt: So if you're getting enough collagen, enough protein, then, you know, your body can produce collagen, but you also can supplement with a collagen. Dietary supplement that has hydro, hydro, um, hydrolyzed collagen peptides in it that are the, the, the, the building blocks of college. You're just giving your body the building blocks in a concentrated form to produce more collagen.
Julie Michelson: Love that. Such, such amazing advice. And again, this is where, you know, I cannot recommend enough, like picture, pick up fracture proof, your bones, because as I said, anybody listening, this has to be somewhere, [Page//00:46:00] you know, on your mind or should be on your radar. Um, and it is something that, that. I joke, you know, as I not joke, it's true.
Julie Michelson: As I work with women, I work with men also. But again, numbers, right? I work with more women. Um, and to change those, those dynamics of how children are growing up, you know, this, the, with lifestyle forward. Thinking and, and, you know, actual education on, you know, what is, what is a healthy lifestyle and what does it include also is like, Hey, let's protect our bone health as we go.
Julie Michelson: I mean, I have three like really active athletic kids. I'm an equestrian and my daughter is in a competitive equestrian. We need our bones to be healthy. I mean, we're going to tumble if we're having fun. So at any age, it's, it's important to be aware of. And, and I think the book is, is great. I'm excited about the, the resources, [Page//00:47:00] um, you know, just your supplement lines so that people can actually get the dosage and the forms of these supplements that they need, I think is, is so important.
Julie Michelson: So I'm glad you answered the call.
John Neustadt: Thank you. Thank you.
Julie Michelson: So before we wrap, what is one step that listeners can take today to start to improve their we'll go with bone health.
John Neustadt: Great question. I think one, one step is especially, and I'm talking to people who, um, have. Diagnosis of osteoporosis. So people who have gotten that bone density test result, they've gone into their, their, their doctor to review it. They have the diagnosis oftentimes almost 100 percent of the time, not 100%, but most of the time, the doctors are recommending a medication right away.
John Neustadt: Now medication may or may not be a good recommendation for you, but I hear over and over people come to me and they've just [Page//00:48:00] felt so much pressure to start the medication immediately when they have that, that first, uh, visit with the doctor where they reviewed the test results. They've had no time to let anything sink in and they're being told they have to take this medication.
John Neustadt: And I just counsel people, take a deep breath. Let's take a deep breath. This is not an emergency. There is time to educate yourself and put a holistic plant bone health plan together that works for you and a medication may be part of that, but not necessarily. And so that's where my book is an important resource because it walks people through doing.
John Neustadt: Just that questions to ask their doctor to make sure they're getting the best advice, including on medications and how to create step by step a bone health program that makes sense for them.
Julie Michelson: I love that. And this is all back to [Page//00:49:00] my goal in life is empowering people, right? It's we, we have input and, and that's our body. And so we need to educate ourselves so we can ask the right questions. And not fall for the scare tactic of, you know, nobody lost their, their bone density overnight. So I love that you say this is not like, you know, you don't have to address it this week with medication.
Julie Michelson: And, and I always qualify to, I'm not anti prescription either. There's a time and a place. Um, but it, it's. Nobody was born with a medication deficiency. And so if we, if we look at the lifestyle areas first, that definitely will help. And even, even again, if you need the prescription, that's great, but doing, addressing lifestyle is going to help support health overall as it is.
Julie Michelson: So I love that advice.
John Neustadt: Without a doubt. You're absolutely right. Yep.
Julie Michelson: For people that are listening on the [Page//00:50:00] go and are not going to click the show notes, where's the best place to find you,
John Neustadt: My website is the best place, nbi health.com. The the company is Nutritional Biochemistry Incorporated, or NBI and the URL. The website is nbi health.com.
Julie Michelson: John. Thank you so much. You have given us a lot to think about a lot of amazing gold today
John Neustadt: thank you.
Julie Michelson: for everyone listening. Remember you can get the transcripts and show notes by visiting inspired living. show. I hope you enjoyed this episode as much as I did today. I'll see you next week. [Page//00:51:00]
Julie Michelson: Dr. Neustadt shares the importance of lifestyle in reversing and preventing osteoporosis and specific supplementation that can help keep our bones strong and healthy.
Julie Michelson: John, welcome to the podcast.
John Neustadt: Thank you.
Julie Michelson: I am so excited to have this conversation. As I already said, before we hit record, because we really haven't done a episode dedicated to bone health. And, um, as you already know, it's part of my personal journey and my family as well. Um, and not in the way people may think, you know, people think bone health and they think older adult.
Julie Michelson: Um, so we'll, we'll talk about all of it, but you have such an interesting way you came to focus on bone health and nutritional supplements. So I'd love to hear a little bit of your journey. I'm guessing when you were, you know, 12, this isn't what you thought you'd be doing.
John Neustadt: Not only when I was 12, but when I was 25 and 28 and [Page//00:02:00] I, I came across this out of, out of need my, one of my mentors in medical school and one of the founders of my university, Dr. Bill Mitchell said to me that if you listen to your patients, they will tell you what they need. And I was in clinical practice and I started working with, uh, people with osteoporosis.
John Neustadt: They were just coming to me. It's not as if I had some specialty in that area at the time and I was doing what I was taught to do. And I thought I was doing a great job because their bone density was going up. I was working with them through integrative medicine. I was helping them with diet lifestyle, nutritional supplements, recommending medications when they seemed appropriate.
John Neustadt: And my mother in law has osteoporosis and I was helping her a little bit. Um, there's always it's always challenging [Page//00:03:00] waters when you're have a family member as a patient. And I also learned early on to stop doing that and avoid that
Julie Michelson: It's not effective.
John Neustadt: but I was giving her some recommendations for some nutrients at the.
John Neustadt: clinical trial support and dietary recommendations and exercise that those sorts of friendly advice. And she had her physician. She was working with who had her taking Fosamax. Her bone density was going up. Her doctor was happy. She was happy. I was happy. And then she tripped on a throw rug in her house.
John Neustadt: And broke her hip. And I thought to myself, something's wrong here. What's wrong with this picture. So I dove into the research and what I found is that the nearly myopic focus just solely focusing on that number on the test, that bone density test number, which is how conventionally it's. Treated [Page//00:04:00] and even how integrative doctors also an integrative practitioners typically think about working with people with that disease, focusing just on that number on the test and thinking you're doing a good job is leaving people dangerously.
John Neustadt: Unprotected. What the research shows is that a bone mineral density test only predicts 44 percent of women with osteoporosis and only 21 percent of men who will break a bone. And that's the most dangerous thing about osteoporosis. It's not. The danger is not the number on the test. The danger is, are you going to fracture?
John Neustadt: And that test or any recommendation, any test is only as valid and helpful as it can predict your fracture risk and only recommend and any recommendation is only as valid as it can reduce your fracture. Risk. And what we know with the dangers of [Page//00:05:00] osteoporosis is that every 30 seconds, someone with osteoporosis is breaking a bone.
John Neustadt: In fact, globally, it's second only to cardiovascular disease as a global health risk and issue. If you're a 45 year old woman, your risk of an osteoporosis fracture is greater than your combined risk of breast uterine and ovarian cancer. And if you happen to break your hip with osteoporosis, there's up to a 36 percent chance that you're going to be dead within a year.
John Neustadt: And half of those Patients who survive never regain their full pre fracture level of mobility and pain free lifestyle and ability to join their, enjoy their life. So I became obsessed with, with really understanding not just what's going to change the number on the test, but how can I educate people, teach people and create information and resources that actually not just promote healthy [Page//00:06:00] bone density, but maintain strong bones as indicated by reducing fractures in clinical trials and educate people that those are the questions they need to ask what to ask their doctor, how to create a holistic plan for themselves and the The resources that I can provide them to do that.
Julie Michelson: Wow. And I love the, it, it so not surprising to me that the traditional Western approach and even in the integrative world, um, is, you know, a number on a test because that's, that's the whole problem, right? It's like this, this pretty, you know, bone density in absence of. All the rest of your health information, right?
Julie Michelson: How strong are you? How stable are you? How is your balance? Um, and I, I want to, we'll get to, I know we're going to get to it, but I want to add the, the, you know, those numbers of later in life, especially for women, post, you know, menopausal women, um, it's only [Page//00:07:00] if you do nothing. Right. So we're not never doom and gloom.
Julie Michelson: And that's what your book is about. Um, and that's what you're all about is like, wait, we're whole people and diet movement, lifestyle connection, community, all the things that make a healthy person also shocker make strong bones.
John Neustadt: Yeah. And it's, and it's hope based on the science. It's not pie in the sky. Hope these are what the, this is what the research support is. The best way to not only, uh, promote your bone health to protect yourself, but all of these integrative and holistic things that I talk about in my book, fracture proof, your bones also.
John Neustadt: Help reduce your risk for cardiovascular disease, dementia, cancer, all cause mortality, uh, you know, diabetes and on and on and on because it's diet, it's lifestyle, it's exercise and all of the systems in the body are connected. So if you're doing something that's healthy for your [Page//00:08:00] bones, you're going to be doing something that's healthy for your heart and your brain.
John Neustadt: Also,
Julie Michelson: Yes. And, and that connection of, you know, exercise is essential for cognition and preventing cognitive decline. I mean, there's, you cannot, again, we're, we're whole integrated humans and, and we need it's quality of life. I say this all the time. I didn't I didn't think I would be here having conversations at almost 55.
Julie Michelson: Um, and, but I, I don't want to just be here to be here, right? I want to be mobile. I want my brain to work. I want to enjoy my family and the things that I love to do. Um, so quality of life and health span is that's what we're talking about. And, and if your brain works, but your body doesn't, or your body works, but your brain, and all the things.
Julie Michelson: Um, and so I, I really, this is why I got so geekily excited for our conversation today. Um, because it's, it's another area where the conversation needs to change and [Page//00:09:00] that's what you're doing for us, is educating us. Well,
John Neustadt: uh, minerals if we're, and that's the, what the bone mineral density test detects. It detects how many, how much mineral Yeah. Minerals, how much minerals, how many minerals, the quantity of minerals that, that somebody has, thank you, has in their bone.
John Neustadt: I don't really talk about it usually that way, but you know, the amount of minerals somebody has in their bone, but if it were only minerals, it would be like a column of chalk and be brittle. So there are over 200 different proteins in bone bone also produces our blood cells, our red blood cells, our white blood cells for our immune system and our platelets.
John Neustadt: It does. It produces some hormones and it has hormone receptors. They're actually serotonin receptors in bone. And melatonin receptors, uh, in bone. So it's a complex, important tissue, uh, in our, in our body. And I, the more, there's a chapter in my, uh, [Page//00:10:00] in my book called, uh, I think miraculous bones. I mean, they're, they're miracles.
John Neustadt: The more I learned about them, the more I gained an appreciation. I mean, it's just, they are incredible.
Julie Michelson: and they're, they're alive, right? So you know, we, we tend to think of, we only see bones usually, hopefully when they're no longer in the body. Some of us, sometimes you see them when you shouldn't, um, but that's so important. And I, I already touched on hormones. So let, let's kind of go there, you know, we, we think, okay, maybe some people think that.
Julie Michelson: Okay. You know, young adults, your bones are, you're fully formed, you're done, right? Those are the bones you have for the rest of your life. But we're always should, could always be building bone and always tearing bone down. Can we talk about that a little bit? Because I really do think that most people are unaware of that, that this is an ongoing process throughout life.
John Neustadt: That's crucially important. So, uh, men and women gain their [Page//00:11:00] peak bone density in about their twenties. So, you know, 20 to 29, 25 to 29, somewhere around there. And then the conventional wisdom and you know, what we learned in medical school is basically it's a one way street from there downhill.
John Neustadt: You're losing about half a percent of bone density per year in, in women in particular. And I'll explain why women, uh,
Julie Michelson: We always, we, it's always us.
John Neustadt: Sorry
Julie Michelson: For the same reasons, though. It's okay. We also can, you know, carry babies.
John Neustadt: But it can be reversed. So, so, but what happens is that that's not accurate in terms of that. It's a one way street bone is a living tissue. Bone is constantly being old bone broken down in new bone built up in a process called bone remodeling. About every 10 years you actually have all new bone. Bone has turned over.
John Neustadt: What happens is osteoporosis is essentially a disease of imbalance. The destructive forces are winning. [Page//00:12:00] And when you have balance between the bone building cells called the osteoblasts and the, the, the, the cells that break down old worn out bone called osteoclasts, your bone health is, is not changing.
John Neustadt: It's, it's stable. As we go through puberty as we're growing and bones are getting you're getting more bone. Well, there's more osteoblast activity building bone and less relatively less osteoclast activity. And then what happens as we age that balance. shifts and the destructive forces of the osteoclasts take over.
John Neustadt: And that's when you start getting bone breakdown. There are lots of things that contribute to that. Some are in our control. Some are not in our control. One of the, the, the biggest things that I see talking about that is in our control is medications. There is a long list [Page//00:13:00] of medications that, uh, destroy bone.
John Neustadt: And create osteoporosis and increase the risk for fractures. Now people need to be on medications. If you need to be on one, then you should stay on it. But it's important. It is, it is, I consider it a modifiable risk factor because in many cases through integrative approaches, you can. Either decrease the dose or get off the medication altogether or switch to a safer one and I'll give you two examples.
John Neustadt: So some of the most commonly prescribed medications out there are antidepressants and acid blockers. Both of those categories of medications destroy bone. As I mentioned, there are serotonin receptors in bone. So people taking any medication that artificially increases serotonin. So that's like prozac.
John Neustadt: Lexapro, Welbutrin, those sorts of medications, they increase [Page//00:14:00] osteoclast activity, increase bone breakdown. And so much so that there have been multiple studies and looking at the body of research that's out there, the authors concluded that For women taking this category of medications like an SSRI medication for one to five years for every 19 women taking one, we would expect one to fracture.
John Neustadt: That's how dangerous they are for bones. And yet most doctors aren't aware of that. They don't know about that. They're well intentioned, but they just aren't up on the research. The other category of medications, the acid blocking medications, taking one of those specifically like a Prilosec, a proton pump inhibitor, which are available over the counter.
John Neustadt: Continuously over time raises your fracture risk. It, it damages bone so much so that the longest study was four years. And after four years, it [Page//00:15:00] increased the risk of a hip fracture by 60%.
Julie Michelson: Wow,
John Neustadt: And the first FDA warning about that medication that went out a letter by the FDA about that category of acid blocking medications and its ability to destroy bone and create fractures was what went out and was released by the FDA in 2010.
John Neustadt: So this is not a new issue. And with those acid blocking medications, half of them are prescribed just for acid reflux. And we know that simple dietary changes. And in many cases completely stop the acid reflux and people don't need the medication.
Julie Michelson: with mood disorders. So, you know, all of these approaches, you just gave me like an extra thing to put in my gratitude journal that I was on prescription PPIs. For years at four side effects from the, you know, eight other prescriptions I was on back when I was not well, um, so really grateful to [Page//00:16:00] know that I, my bone density is good and that didn't do, and that goes to what we're saying too, right?
Julie Michelson: There, there is, and we'll get into some other risk factors, um, but the, the body is resilient and we are designed to heal. So even, um, You know, not knowing what I didn't know back then. I feel better and I'm stronger. My bones are healthy, which I would not have thought
John Neustadt: Yeah. And to your, your point, you know, we were talking before you started recording about celiac and the connection between celiac and osteoporosis and the research shows that in, in, in children and young adults who are osteoporosis can be the only sign of celiac disease. And once though you get them on a gluten free diet.
John Neustadt: The bone density can reverse their bones can heal and and become healthy again. And similarly, people on prednisone commonly used for autoimmune diseases that damages [Page//00:17:00] bone. It is so destructive and most physicians know that and are aware of that. And once you come off of the, the, the, the prednisone, the dexamethasone, however, over time, that risk for fractured decreases.
John Neustadt: Now, we don't know if it ever gets back to what it was before the medication, but it does, it does decrease the risk for fractures. Once you're off that medication, once you remove. What's damaging it. Your body has the opportunity to do what it wants to do anyway, which is heal and thrive, which is why, like to your point about diet and nutrients and mental health.
John Neustadt: We want to give the body all of the raw materials, the environment in which our bodies can flourish and do the job that they want to do for us so we can feel amazing.
Julie Michelson: and it is, I'll share, I don't think I've ever shared this on air before, but that was what we were chatting about before we started was, um, my son, who [Page//00:18:00] I now know has celiac. Um, but when, before we knew, and, and again, if I knew then my kids, we laugh around the dinner table about my parenting skills when it comes to health back then versus now, but, um, because he had horrible GI issues.
Julie Michelson: Literally from birth and nobody ever said, you know, what? What are you eating? Or, you know, that was never part of the conversation, but he was as a young kid, you know, like, end of probably end of elementary school, beginning of middle school had osteopenia. Um, and they wanted to medicate him. And I, I confess to you, that was probably my one good health related parenting decision back then.
Julie Michelson: I said, let's just wait. And luckily he was not long after diagnosed with celiac. We never did it. We never treated the bone health. He's 28 and his bones are great and he's healthy and strong. And it is the only thing he has done. He does not live a totally healthy [Page//00:19:00] lifestyle like his mother would like him to.
Julie Michelson: But he's gluten free.
John Neustadt: we all have that dynamic with our kids,
Julie Michelson: Yup.
John Neustadt: them to eat better and sleep
Julie Michelson: Uh huh. Please, please. Yeah.
John Neustadt: I've got two of my own. Yes,
Julie Michelson: Yup. So, um, luckily, you know, he's my oldest. My other two are a little more proactive about full lifestyle. Um, but it is amazing. And so, again, we think of this as an older, an aging issue, and it is not always an aging issue because of some of these, these lifestyle factors.
Julie Michelson: Yup. Yup. Yup. One thing kind of connected to age, but can happen pretty early on that I really do want to talk about, um, is, is hormones and, and women, especially, can you tie, tie that up in a bow for us, you know, why, to me, that's a, that is a manageable risk factor, I
John Neustadt: absolutely. Absolutely. 80 percent of osteoporosis [Page//00:20:00] occurs in postmenopausal women. And the reason why Mm hmm. Again. Yes.
Julie Michelson: Well, because if you look at Alzheimer's numbers or, you know, all of the, like all of these major life impacting health, chronic health conditions, that's where you just kind of fall off that cliff for risk if you're a woman.
John Neustadt: And what's happening with with bones is a decrease in estrogen and progesterone during menopause through menopause. And for the 10 years after menopause is the fastest rate of bone loss in women. And that's because of that drop in estrogen. Estrogen is considered what's called an anabolic hormone. That means it builds bone.
John Neustadt: And why don't men suffer from this? Because you know, we produce testosterone. Well, estrogen actually comes from testosterone in the body. So we have enzymes and the mechanism [Page//00:21:00] to take testosterone and convert it to estrogen. And so it's thought that the reason why men don't suffer with this is because they're not really getting that drop.
John Neustadt: That change in, in hormone levels as dramatically as, as women are. And so when the estrogen drops, estrogen has many roles, like all hormones do in the body, one of them is to promote osteoblast activity, that bone building activity, promote collagen production. So bone is more like I mentioned, the proteins in bone, it's more than just the column of minerals.
John Neustadt: One of the major protein in bone is collagen, and it's the collagen that gives bone its ultimate strength and flexibility. Collagen, you know, strand per strand is, is, is the tensile strength is stronger than, than steel. And it's also flexible. So having healthy collagen levels in bone allows somebody to fall.
John Neustadt: For that impact to go through the bone be dispersed and the bone did a form a [Page//00:22:00] little bit and not be brittle to absorb it without breaking. And so, lowering estrogen decreasing estrogen also affects collagen. It also affects sleep. And insomnia is a risk factor for osteoporosis and fractures, not getting adequate sleep.
John Neustadt: So, that's why in postmenopausal women, you're getting a higher rate of osteoporosis. Now, that said, the assumption, unfortunately, if a physician has a postmenopausal woman coming to him or her, And they have osteoporosis, they're going to think, oh, it's just, it's menopause, but 30 percent of osteoporosis and postmenopausal women is caused by other things.
John Neustadt: Yes, the estrogen drop in estrogen is a contributing factor, but there are other things going on and I, those almost never get [Page//00:23:00] evaluated. And part of the challenge is how doctors are trained what the economic incentives are in medicine There's a study that came out a few years ago out of europe that there's just a lot doctors Just aren't adequately trained In this disease to treat it how it needs to be be treated and I can go into that if if you want, but the the the bottom line is is there are um Ways to look at and evaluate through an intake form, you know, somebody's lifestyle, the medications they're taking, independent of the age that they are, to really understand are there other potential contributing factors here, and there are ways to evaluate a bone density test, a little more subtle, nuanced evaluation of those test results that can point to a, what's called a secondary cause.
John Neustadt: Something else causing it like a medication or a disease process and [Page//00:24:00] not just the drop in estrogen. And so that's where my book hopefully is very helpful. Is it, is it walks people through these different issues and provides questions for them to ask their doctor to make sure they're really getting the best possible information and advice so they can create, make the best decisions for their themselves and their health and create a holistic Bone health plan to help reduce their fracture risk and, and maintain bone strength,
Julie Michelson: Which I think is, is so important. And your, your book is such a gift because, you know, we're talking about, I'm guessing, you know, that definitely the, it's the go to resource for somebody when they hear they have osteoporosis or they're, or they were sent for a scan, you know, they're, they're in that realm where they're starting to talk to their doctor about, am I osteoporotic or not.
Julie Michelson: But everything in your book, if we, if we were to just read it early,
John Neustadt:[Page//00:25:00] right?
Julie Michelson: Which is why you and I do what we do, right? It's yes, we want to help the people that are already for me. It's already where I was. Um, But it's this, this is the knowledge. This is where there's the empowerment to heal, but there's also this empowerment to prevent.
Julie Michelson: And so this is where I think your book is so impactful and so important. Um, and I want to, I could, we could talk for five hours. Like I already have a mental list of questions. Um, but I want to touch on. So we, we talked about hormones and so I will, I'm not a physician, but bioidentical hormone replacement, I've had, you know, amazing, amazing.
Julie Michelson: Cancer expert. I mean, you name a concern with bioidentical hormones, and it's already been addressed on the podcast. They are. This is I look at it this way. We are hormones decline, like, because we're just getting ready to shrivel and die. And I don't want to shrivel and die. [Page//00:26:00] And so to keep bones healthy, brain healthy, your inflammation down all of the things, um, that's we can put that one aside.
Julie Michelson: I want to talk about some of the other things. Just lifestyle areas. You just I'm so excited. You mentioned sleep. I'm such a geek about that again. Rain, how all the things we heal in our sleep. So it's not surprising that people that aren't getting enough sleep. It's affecting your bones as well. Again, we think of them as like this.
Julie Michelson: Separate part of the body and it's just part of the body,
John Neustadt: That's so true. I just quickly, uh, briefly to mention the hormones. I'm glad you brought it up. The research is clear that when it comes to bone health and osteoporosis Uh, hormone replacement therapy builds bone, but more importantly, it does reduce fractures. So one study showed overall a 40 percent reduction in fractures.
John Neustadt: Another specifically the most dangerous type of fracture, hip fractures, 28 percent reduction [Page//00:27:00] in hip fractures, looking at a meta analysis, you know, combining different studies together, the data. So it can be done safely. Uh, and we're just talking about getting things back into the normal range, not
Julie Michelson: We're not talking about
John Neustadt: high dose. It's just, you're a little deficient, like, like a nutrient that you're deficient. And that's how I encourage people to think about it. If I'm deficient, low in iron, well, I'm just going to give myself some iron, uh, to take iron to get me back in the normal, healthy range.
Julie Michelson: right? And so I, I, okay, we can put that, that one to rest. What L you mentioned a little bit. So we tell, you know, you touched on sleep and the importance of sleep. And, and again, there are resources for all of us. So, you know, not everybody is short on sleep because they're working too many hours. Um, so if you, if you have sleep challenges, we've had episodes on the podcast with sleep specialists and, and there's a lot of ways to improve sleep, but what else should people, and I know it's, it's all in the book and [Page//00:28:00] I encourage everybody to get the book because the, that's.
Julie Michelson: The beautiful thing. It's, these are the lifestyle pillars for wellness, period. No matter what condition, what, this is just, these are the things our body needs to stay strong.
John Neustadt: Absolutely. The other thing I would want to touch on is supplementation, because I think there's a lot of misinformation out there on the internet, a lot of mischaracterization of the research. And when you look at bone health supplements out there, You can see a long list of ingredients and in some of them calcium and vitamin D is commonly known and commonly recommended by all medical associations for bone health and osteoporosis.
John Neustadt: And, and I agree with that. That's a good recommendation because the research shows that, that taking and getting adequate amounts of calcium and vitamin D are associated with a 18 to 23 percent reduction in fracture risk. So again, not just about bone density, [Page//00:29:00] but what about fractures other than that?
Julie Michelson: Question on that though, um, is calcium safe across the board for people to be supplementing if they, period?
John Neustadt: Great, great question. Uh, the current recommendations of the Bone Health and Osteoporosis Foundation and the American College of Preventive Cardiology is that taking calcium up to the, um, uh, up to, uh, 2, 000 to 2, 500 milligrams per day Um, you know, you can't get within that ray. If you get up to 2000 to 200, 2500 milligrams of total calcium a day, that should be avoided.
John Neustadt: That's dangerous. Taking it up to the U. S. RDA of the recommended amount for bone at 1200 milligrams per day is considered, uh, safe. And There's no, what's interesting is so many doctors. I still, I get people coming to me and my [Page//00:30:00] doctor said, I need to take 1200 milligrams of calcium, or I need to take 1500 milligrams of calcium.
John Neustadt: And, and it's just the wrong recommendation because the U S recommended recommended daily allowance for any nutrient is the total intake. That's from diet and dietary supplement 1200 milligrams of calcium is not associated with any improved bone health. outcomes. So that's really just what you need. And you definitely don't want to get, you know, up to 2000 to 2, 500, then you run into, into some, some risks.
John Neustadt: So the, the average American woman consumes about 800 milligrams of calcium in her diet. And the average American man about a thousand milligrams of calcium. So just getting about 400 milligrams as a dietary supplement is fine. And if you end up getting a little bit more, you know, there's a buffer of safety, 500, 600, you know, 800, you know, you're still, you're still in [Page//00:31:00] that safe area, but being conscious that not 1200 milligrams, you know, the recommendation should be customized.
John Neustadt: And on average, you know, just getting 400 milligrams, that's really all, all you, you know, most, most people frankly, uh, need, uh, with vitamin D.
Julie Michelson: for going into that one because it's, I know I broke my shoulder, oh gosh, six years ago and they did that at your age. You know, you need to be taking this much calcium. Well, I have cardiac concerns in my family and there were reasons I chose not to and they were shocked at how quickly I put bone back in.
Julie Michelson: Um, I want a follow up question. I'm a little afraid to ask it. I'm rolling the dice. I'm trusting in everything I've ever heard you say in other interviews. Um, because this is a question I get all the time as I'm working on reducing inflammation and gut healing and customizing, nutrition plans for people.[Page//00:32:00]
Julie Michelson: Do you have to consume dairy to get enough
John Neustadt: absolutely not. Absolutely not. No, no, no. In fact, there's a blog on my website, you know, top non dairy, 10 top non dairy sources of calcium. No, you absolutely don't have to.
Julie Michelson: Thank you.
John Neustadt: You can, uh, but, but no, it's, it's not, it's not necessary. Uh, just quickly in terms of vitamin D, I do advocate people get their vitamin D levels checked and tested.
John Neustadt: The research supports that for, uh, fracture reduction, the maximum benefit is when your vitamin D is between 30 and 44 on the blood test nanograms per milliliter. Now, a lot of doctors, including myself, advocate even higher than that for immune health, 50 to 60.
Julie Michelson: Oh, I, I, I go higher
John Neustadt: Yeah, I, well, 50 to 60 is what a lot of, I, uh, mine is higher than that. I do recommend typically higher, but 50 to 60 is
Julie Michelson: It's a baseline. Yeah, it's a, it's a baseline. I, and I get [Page//00:33:00] so many people, um, I do, I want to follow up or add to the, For listeners, why you're saying that is because it's a fat soluble vitamin. So unlike a C or a B, you're not going to pee it out in the toilet and we don't want you. It is important to test.
Julie Michelson: People ask me all the time, how much D should I be taking? I'm like, I don't know. Let me see your labs. You know, like, um,
John Neustadt: true. But the research support, if you take up 2000 IUs of vitamin D, that's sufficient to get most people, uh, in that healthy range pretty quickly as a minimum. Now, a lot of doctors will go higher. I, I take higher than that
Julie Michelson: It took me eight years on way higher than that to build up, you know, I was down in the, in the 20s,
John Neustadt: Yeah. And
Julie Michelson: I see a lot with, with my autoimmune patients. They'll come in. My clients will come in if they're not supplementing or they're taking 2000 and they're still below 30. It's,
John Neustadt: Well, there, there are cases though, where, where people do need higher than that [Page//00:34:00] obesity, people who are obese, who have malabsorption issues, who have autoimmune conditions, they oftentimes need much higher doses than that to get their vitamin D up. So that 2000 units is, you know, just kind of for the general popular population.
John Neustadt: So. Other nutrients that are, that are important. So the way that I look at the research and the way that I think about this and, and, and nutrients is what, what nutrients have been shown in clinical trials, not only to promote healthy bone density, but to maintain strong bones as indicated by fewer fractures in clinical trial volunteers.
John Neustadt: Now, as I said before, there's a whole long list of nutrients that people, you know, companies are throwing into their supplements, just like what's the kitchen sink. Let's just throw everything in there. There are only four actually that meet that criteria, only four. And one of them I have safety concerns about.
John Neustadt: So the two I already mentioned, calcium and vitamin D. Um, the third one I would mention is a specific form of vitamin [Page//00:35:00] K2 called MK4. Now in dietary supplements, people will see MK7 as a form of vitamin K2 and MK4 as a form of vitamin K2. Now they are both types of vitamin K2, but they're not the same molecule as we know in biochemistry.
John Neustadt: If you, you know, you change one carbon atom, you can get overlapping benefits, overlapping activities, but also quite different activities as well. So MK7 in clinical trials has only been shown to slow down how fast somebody loses. Bone how fast they're losing that bone density and there are no clinical trials zero Involunteers showing that it reduces fractures as an outcome in the clinical trial.
John Neustadt: They just it hasn't been studied as an end point So it doesn't
Julie Michelson: know.
John Neustadt: we don't know and it doesn't promote healthy bone density in terms of increasing bone density It just slows down how fast somebody loses how it [Page//00:36:00] slows down how fast somebody lose it in contrast mk4 And by the way, MK7 is not produced by humans.
John Neustadt: It's produced by bacteria. MK4 is the preferred form of vitamin K2 that accumulates in our bodies, that we can actually manufacture small amounts of it. We can convert MK7, we convert vitamin K1 to MK4, but in much higher doses than you can get in diet, which is why you need to supplement with it, and much higher doses than what our own biochemistry can, can manufacture.
John Neustadt: MK4 has been shown to, Increase bone density, so promote healthy bone density and maintain strong bones as indicated by over 70 percent fewer fractures in clinical trials in postmenopausal women with osteoporosis and that MK four dose that was used in those clinical trials was 45 milligrams per day.[Page//00:37:00]
John Neustadt: And it's been so well studied that's been approved since 1995 by the Ministry of Health in Japan for bone health. There were 25 clinical trials
Julie Michelson: Why are we so always late to the party in this country? It's amazing.
John Neustadt: Yeah, that's a whole, that's a whole
Julie Michelson: It's another, it's another podcast. It's a different, different conversation.
John Neustadt: the reason why I became an expert in, in that, in this research and lecture about it and medical conferences is because when my mother in law fractured her hip, and I was working with patients in my clinic, and I started looking at the research, I, I learned about this powerful nutrient MK4, and there's nothing in the U.
John Neustadt: S. that had that dose of MK4 In it. So I created, that's why I created my company NBI to create solutions that didn't exist. So many products on the market do not have the combination [Page//00:38:00] or dose of nutrients shown in clinical trials to actually work. Maybe we'll cite a study, but then they'll use less of the nutrient, a lower dose that was actually shown to even work.
John Neustadt: So I created my osteo K minis and formulas with that clinical dose of. Mk4 with calcium and vitamin D to be a very targeted bone support solution for people. And the only difference between the formulations is the amount of calcium. Like we talked about, not everybody needs the higher amount. Some people need lower.
John Neustadt: So the osteokinesis has less calcium.
Julie Michelson: Interesting. And, and so the fourth one that you have the qualifier.
John Neustadt: Yeah. The fourth one is strontium. And that's, uh, people hear about that on the internet as well. Strontium is a mineral. It was approved in, uh, the European union for osteoporosis. And yes, strontium has been shown to improve bone density and [Page//00:39:00] reduce fractures. However, every clinical trial that's been done was on a form of strontium called strontium ranolate.
John Neustadt: That's what was approved in Europe and used as a medication. Strontium ranolate does not exist in the United States in dietary supplements. It's only a strontium citrate. There are no clinical trials on strontium citrate showing that it improves bone density or maintain strong bones. There are no fracture outcome studies on strontium citrate.
John Neustadt: So we can assume, okay, well, let's assume, um, it's not really the ranolate part. It's not the citrate part that's doing the job. It's the mineral. It's the strontium that's, that's actually having the benefits. So let's, let's just for argument's sake, give that benefit of a doubt. Well, what are the clinical trials in Europe show for strontium ranolate?
John Neustadt: Well, five of the six large clinical trials that were run or part of the approval process. Showed that it only reduced hip [Page//00:40:00] vertebral fractures. It didn't reduce hip fractures. Only one of the studies showed us statistically significant reduction in hip fractures. So it's not clear that it actually works to reduce the most dangerous type of fracture.
John Neustadt: Importantly, post marketing research determined, however, that for every one fracture that's prevented, the strontium medication was creating blood clots that could cause strokes and heart attacks.
Julie Michelson: Well,
John Neustadt: So for every one person you're helping, you're potentially giving somebody a stroke and a heart attack. So it was removed from the market.
John Neustadt: Now, strontium citrate may be safe. It may not. We don't know. And in addition to that, strontium as a mineral incorporates into bone. Bone, uh, strontium is heavier than calcium. And so what happens in a bone mineral density test, the x rays of a bone density test bounce off the [Page//00:41:00] minerals and they, the way that they bounce off the angle that they create when it's when they're deflected is then interpreted by the machine.
John Neustadt: And, and that's what calculates the test results what's called the T score and a Z score. That's what determines your bone density. But because strontium is heavier, it changes how the x rays bounce off of bone and creates a false bone density test result. So, so despite the fact that bone density tests have their limitations, I, I personally want them to be.
John Neustadt: As accurate as possible because it is one indication. It's not the most important indicator of your fracture risk But it is one important indicator.
Julie Michelson: Wow. Well, that I, I know I'm not trying it. Um, and I'm very experimental and I want to, I want to touch on, you know, you have this supplement company because again, out of [Page//00:42:00] necessity, right? You weren't able to, as you're doing the research to provide your patients with the supplementation that you knew would help them.
Julie Michelson: Um, can you define supplements for me? Cause I, cause People just think, fine, I'll just take the supplements and the other stuff just seems like it's too much work.
John Neustadt: right Not a good attitude in my opinion not the best
Julie Michelson: And that's, to be fair, they're probably not listening to this podcast if that's their attitude, but we all know those people.
John Neustadt: And, and really recommend people take dietary supplements as the FDA and the law intended that is as a supplement to a healthy diet, diet and lifestyle are always first. That's why in my treatment plans are there is always and there was always diet and lifestyle first the supplements were just to support those.
John Neustadt: Processes in [Page//00:43:00] the body. Now, dietary supplements are not approved by the FDA to diagnose, treat, prevent, or cure any diseases. They should be viewed and used as a supplement to promote health, promote healthy physiology, to promote bone health. And with respect to diet, there are certainly Reasons why people will want to supplement.
John Neustadt: So for example, MK4 is in dairy products, but you can't get enough of the MK4 that's been shown to support bone physiology and bone health. You have to supplement in order to get that higher amount. And by the way, as an aside, the MK4 has been, uh, studied not only in postmenopausal osteoporosis, but because we mentioned medications before there are multiple clinical trials showing that it Stopped and reversed.
John Neustadt: Uh, the improve the bone density tests in people taking medications like prednisone and loop relied, for example, so it's been studied in [Page//00:44:00] different situations. Back to the supplements. So there are other reasons why you should supplement. Protein is a good indicator. I believe a lot of people, even if they're there, say I'm following such a healthy diet.
John Neustadt: Are not getting enough protein, adequate protein as we age to, to maintain muscle mass
Julie Michelson: I would say most people and especially women,
John Neustadt: Yes, yes,
Julie Michelson: to focus on protein.
John Neustadt: yes. So based on the research, I recommend people get a minimum of 1. 3 grams of protein per kilogram body weight per day. And this is in my book now. Now we don't really think in kilograms, we think in pounds.
John Neustadt: So if you just take your body weight in pounds and you multiply it by 0. 59, that's the minimum amount of protein people should be getting. Unless of course they have, you know, chronic kidney disease or on dialysis and they've been put on a low protein
Julie Michelson: sure,
John Neustadt: right? Okay. And that can be difficult to get that amount of protein in diet.
John Neustadt: And so that's where a protein supplement can, [Page//00:45:00] can be helpful. Uh, similarly supplementing with a collagen supplement, which has been colleges has been shown to promote healthy bone density, support bone density, support healthy skin and nails and that sort of thing. Then, you know, maybe you protein are the building blocks of collagen.
John Neustadt: So if you're getting enough collagen, enough protein, then, you know, your body can produce collagen, but you also can supplement with a collagen. Dietary supplement that has hydro, hydro, um, hydrolyzed collagen peptides in it that are the, the, the, the building blocks of college. You're just giving your body the building blocks in a concentrated form to produce more collagen.
Julie Michelson: Love that. Such, such amazing advice. And again, this is where, you know, I cannot recommend enough, like picture, pick up fracture proof, your bones, because as I said, anybody listening, this has to be somewhere, [Page//00:46:00] you know, on your mind or should be on your radar. Um, and it is something that, that. I joke, you know, as I not joke, it's true.
Julie Michelson: As I work with women, I work with men also. But again, numbers, right? I work with more women. Um, and to change those, those dynamics of how children are growing up, you know, this, the, with lifestyle forward. Thinking and, and, you know, actual education on, you know, what is, what is a healthy lifestyle and what does it include also is like, Hey, let's protect our bone health as we go.
Julie Michelson: I mean, I have three like really active athletic kids. I'm an equestrian and my daughter is in a competitive equestrian. We need our bones to be healthy. I mean, we're going to tumble if we're having fun. So at any age, it's, it's important to be aware of. And, and I think the book is, is great. I'm excited about the, the resources, [Page//00:47:00] um, you know, just your supplement lines so that people can actually get the dosage and the forms of these supplements that they need, I think is, is so important.
Julie Michelson: So I'm glad you answered the call.
John Neustadt: Thank you. Thank you.
Julie Michelson: So before we wrap, what is one step that listeners can take today to start to improve their we'll go with bone health.
John Neustadt: Great question. I think one, one step is especially, and I'm talking to people who, um, have. Diagnosis of osteoporosis. So people who have gotten that bone density test result, they've gone into their, their, their doctor to review it. They have the diagnosis oftentimes almost 100 percent of the time, not 100%, but most of the time, the doctors are recommending a medication right away.
John Neustadt: Now medication may or may not be a good recommendation for you, but I hear over and over people come to me and they've just [Page//00:48:00] felt so much pressure to start the medication immediately when they have that, that first, uh, visit with the doctor where they reviewed the test results. They've had no time to let anything sink in and they're being told they have to take this medication.
John Neustadt: And I just counsel people, take a deep breath. Let's take a deep breath. This is not an emergency. There is time to educate yourself and put a holistic plant bone health plan together that works for you and a medication may be part of that, but not necessarily. And so that's where my book is an important resource because it walks people through doing.
John Neustadt: Just that questions to ask their doctor to make sure they're getting the best advice, including on medications and how to create step by step a bone health program that makes sense for them.
Julie Michelson: I love that. And this is all back to [Page//00:49:00] my goal in life is empowering people, right? It's we, we have input and, and that's our body. And so we need to educate ourselves so we can ask the right questions. And not fall for the scare tactic of, you know, nobody lost their, their bone density overnight. So I love that you say this is not like, you know, you don't have to address it this week with medication.
Julie Michelson: And, and I always qualify to, I'm not anti prescription either. There's a time and a place. Um, but it, it's. Nobody was born with a medication deficiency. And so if we, if we look at the lifestyle areas first, that definitely will help. And even, even again, if you need the prescription, that's great, but doing, addressing lifestyle is going to help support health overall as it is.
Julie Michelson: So I love that advice.
John Neustadt: Without a doubt. You're absolutely right. Yep.
Julie Michelson: For people that are listening on the [Page//00:50:00] go and are not going to click the show notes, where's the best place to find you,
John Neustadt: My website is the best place, nbi health.com. The the company is Nutritional Biochemistry Incorporated, or NBI and the URL. The website is nbi health.com.
Julie Michelson: John. Thank you so much. You have given us a lot to think about a lot of amazing gold today
John Neustadt: thank you.
Julie Michelson: for everyone listening. Remember you can get the transcripts and show notes by visiting inspired living. show. I hope you enjoyed this episode as much as I did today. I'll see you next week. [Page//00:51:00]
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Dr. John Neustadt
Dr. John Neustadt (New-Stat), ND, the Founder and President of Nutritional
Biochemistry, Inc. (NBI). Dr. Neustadt earned his naturopathic medical degree from Bastyr University where he was awarded the Founder’s Award for academic and clinical excellence. Dr. Neustadt has published more than 100 medical articles, written four health and wellness books, and is now a #1 Amazon Best-Selling Author in the field of Osteoporosis. His most recent book is, Fracture-Proof Your Bones: A Comprehensive Guide to Osteoporosis. Dr. Neustadt was also an editor of the textbook, Laboratory Evaluations for Integrative and Functional Medicine, which was used across the United States to train and educate physicians on using functional medicine with their patients.
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