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You're listening to episode 314 
of the Marathon Running Podcast.

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In this episode, we're going to 
talk about bone density and 

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menopause. 
Welcome to the Marathon Running 

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Podcast by Marathon Journal. 
Join us every week for the 

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insights and inspiration you 
need to get from the starting 

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line to the finish line and 
beyond. 

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Hey runners, and welcome to 
episode 314. 

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My name is Letty. 
My name is Ryan. 

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And we are here today to bring 
you a really, really great 

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episode, an interview that kind 
of woke something up in me. 

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Ryan, to be honest with you. 
I did an interview with Angela, 

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who we between each other 
referred to as Angela the nurse 

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because we know a bunch of 
Angela's and she's actually 

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local in our community. 
I met her through you at the 

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medical society meetings that 
you used to go to. 

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And I also know that she's a 
runner. 

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So while I got to know the fun, 
humorous side of her and I 

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always knew that she was in the 
field of medicine. 

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Obviously she's a registered 
nurse. 

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She's got all kinds of 
certificates, but I never really

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had a sit down in depth talk 
with her in regards to her 

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professional career and what she
does. 

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And Ryan, I was blown away. 
Tell me more. 

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Yeah, so I mean, it was a 
conversation to me. 

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It was almost life changing. 
There's so much stuff that I 

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don't know because I'm not in 
the medical field. 

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And not just basic stuff, but 
like, you know, stuff that 

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happens to us as women. 
And I was saying all this with a

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big asterisk. 
Yes, we are going to talk about 

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bone density and menopause, but 
I think this is also a podcast 

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for men to continue listening to
because if you have a mother, 

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you should be listening to that.
Anyone, male and female, as they

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age usually have less bone 
density and exercise 

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specifically anything that 
stresses the bones actually 

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increases their density or helps
keep the density up. 

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Fortunately for males, because 
of we're starting from a higher 

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point of higher density of 
bones, we don't typically run 

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into the same problems that 
females run into with regards to

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compression fractures or other 
fractures as you get older and 

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develop osteopenia or 
osteoporosis. 

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But it could still happen even 
to guys. 

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Our neighbor even, you know, had
a compression fracture because 

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his bones are a little too weak.
So it's not something you should

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only think about with women. 
It actually does happen to guys 

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too. 
It's just a lot less common. 

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So that's why it's not talked 
about as much. 

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Yes, yes, yes. 
But All in all, this 

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conversation was really good. 
So if you want to stick around 

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for this one, we're going to 
hear about estrogen and what 

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happens and when it happens and 
the impact of exercise and what 

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type of exercise is good for you
and little tidbits of knowledge 

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that she just kind of weaved 
into this. 

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I wish I could have made this 
into a 5 hour podcast. 

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I know she had lunch plans so I 
wasn't going to do that, but I 

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can't wait to have her back on. 
And specifically you talked 

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about estrogen and bone density,
but hormone replacement therapy 

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in general would be kind of more
of a general topic, I guess. 

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And so it does have some 
relevance with guys too, not 

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just females. 
But I guess you talk more more 

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about the estrogen, huh? 
We talked about that, but this 

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is also something she touched on
briefly and that we will 

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hopefully talk more about in 
future podcasts. 

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Just because we have so much 
knowledge now, not us. 

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I mean, society as a whole has 
so much knowledge and so many 

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things that changes, and she's 
such an advocate for all that. 

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So I can't wait, like I said, to
have her back on. 

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Cool, so you want to get into 
it? 

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Sure. 
So without any further ado, I'm 

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not going to play my 
conversation with Angela. 

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All right, so I'm on with Angela
Stirius. 

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Angela, thank you so much. 
For joining me today. 

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Thank you for letting me be 
here, I'm excited. 

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I'm honored because I know what 
I've known you for years now. 

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You live in the same city as me.
I met you through my husband's 

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medical society. 
So maybe just kind of tell us 

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who you are, what you do for a 
living to establish your 

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credentials. 
Sure, sure. 

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So I am a family nurse 
practitioner. 

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I've been in the medical field 
for over 30 years. 

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I'm dual certified not only as a
family nurse practitioner, but 

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I'm also a psychiatric mental 
health nurse practitioner. 

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I went back and I got my 
psychiatric degree because when 

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I was doing family practice, I 
noticed so many women were 

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coming in with Ohio. 
You know, I would take care of 

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the cholesterol and I would take
care of the blood pressure. 

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And then it was kind of like as 
they were going out the door. 

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Oh, by the way, I'm really, 
things are really rough in life.

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Things are doing this and wasn't
quite sure how to handle all the

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mental health. 
So I'm like, you know what, I 

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just kind of wanted to be my 
patients, everything which I've 

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since learned, you know, I can't
really do it all. 

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But I did go back to that and 
it's been really good and eye 

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opening because on that journey 
with mental health, I've also 

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seen where perimenopause and 
menopause has been just 

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dominating my practice where I'm
like, wait a minute, this cannot

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all be like mental health, 
anxiety, depression, poor sleep,

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there's hormones related. 
So now I actually have another 

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passion and speciality with 
menopause treatment too. 

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So I kind of have changed over 
the years to be more of the 

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psych, Women's Health and 
menopause treatment health. 

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I love it. 
So we're in absolutely good 

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hands because, yeah, it affects 
all of us runners, especially 

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our audience, who is, I want to 
say mainly 35 and up. 

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And you know, it's something 
we're going to have to deal with

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eventually as women or also as. 
Gentlemen, if you have a. 

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Woman that you love in your 
life. 

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So maybe for those of us that 
are not so familiar with it, can

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you maybe explain what happens 
to our body during menopause? 

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Absolutely. 
And So what I also like to 

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reference is, you know, 50% of 
the population is women. 

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And guess what, if we're lucky 
enough, we get to go through 

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menopause. 
And I'd like to word it that way

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because nobody can get out of 
it. 

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I mean, it's not something that 
we're like, we can beat the 

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system. 
You can't buy your way out of 

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it. 
It it's going to happen. 

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And we just hope we can get to 
that age where we're like, OK, 

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we've crossed that bridge. 
And I want us to take a more 

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positive view because there is a
lot of great things that can 

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happen during menopause, a lot 
of mental empowerment as well. 

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But let me just kind of all 
reverse just a little bit and 

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tell you a little bit about 
menopause. 

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We don't have the best 
definition. 

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It's basically when you have not
had a menses in 12 months, then 

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we could say you're in 
menopause. 

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But a lot of other factors can 
go into that. 

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Let's say if you've had a 
hysterectomy when you're young, 

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you know that doesn't always 
mean you're menopause if you 

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still have your ovaries. 
So by and large though, that's 

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the medical definition, but I 
will tell you the seven to 10 

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years leading up to menopause is
when women start to have 

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symptoms, perimenopause. 
And those can be the most 

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chaotic years for women. 
So let's say you're a early 

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menopause woman and you go 
through menopause at like 44, 

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which some women do, some women 
are late and go in at 50, 

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average age 51. 
But if you're early menopause 

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and you go to menopause 44, you 
start your symptoms 34. 

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So the sometimes I usually see 
in my office, it starts off poor

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sleep, anxiety, depression, I 
don't feel myself, I'm 

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irritable. 
There is a 40% increase in 

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antidepressants. 
SSR is in women 45 to 55. 

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And if you look at it, it's 
like, wait a minute, is, is it 

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that, or is it the menopausal 
symptoms or hormones are, are 

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kind of fluctuating. 
Other things. 

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You know what we, you know, the 
classic 1 is hot flashes. 70% of

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the women have hot flashes. 
About 30% of women never do. 

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But by and large, that's the, 
that is the classic sign. 

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But that's later. 
There's a lot of other things 

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that are happening. 
And then one thing that I know 

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we're going to discuss today is 
the bone density that we don't 

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always feel, we don't see, we 
don't even know that's going on.

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But there's the genital urinary 
syndrome of menopause. 

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We can talk at another 
discussion. 

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Maybe that's a whole topic to 
talk about. 

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But the moods that go with it, 
the bone that starts to degrade 

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because our hormones, we have 
receptors all over our body and 

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we need that estrogen and 
progesterone. 

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And as you start to get closer 
to that menopause date, we'll go

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to the 51, which is the classic 
day. 

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So as you start to March 
forward, it's not like 01 day, 

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I'm in menopause and now we have
the symptoms. 

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There's a build up of that, 
start having these symptoms. 

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And then we don't have to wait 
until you're 51 to treat. 

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We can actually start to treat 
and be aware of stuff. 

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And I think that's where we're 
getting where I'm seeing more 

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and more the countries like on 
board with wanting to learn, 

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wait, what is this going on? 
Can we do something about that 

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as we get closer to the to that 
time? 

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Wow, that's I mean, that's so 
much and it's good to obviously 

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educate ourselves. 
I'm just trying to my wheels are

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spinning. 
I'm trying to figure out how to 

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approach this next without 
obviously talking about 

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everything. 
I know we're going to talk about

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bone health today, but just so 
we all know, once menopause 

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happens, what happens after 
that? 

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Will everything kind of calm 
down and twindle off or what is 

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is it like a new US or what 
happens? 

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So it's interesting, you will 
spend 35% of your life in 

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menopause. 
So you get to perimenopause, a 

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lot of symptoms, your body is 
doing all this stuff and those 

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can be chaotic. 
Some women will have hot flashes

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the rest of their life. 
Some women will not sleep good. 

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They're wake up all the time. 
You wake up two or three times, 

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2O clock, 4 O clock, you're up, 
you kind of go back to sleep. 

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Maybe you're not having a hot 
flash, but you're like, I don't 

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my, my sleep is off. 
The irritability, the low 

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libido, we can get into that. 
The symptoms, if you, you do 

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nothing, some women will slowly 
their body will adjust and, and,

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and abate some of those 
symptoms. 

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You kind of have a new, a new 
you. 

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What just happened? 
Because if you remember, the 

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Women's Health Initiative in 
2002 came out and said, oh, you 

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know, the, we can't be to put 
women on hormones. 

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Hormones were the number one 
prescribed medication before the

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2002 Women's Health initiative, 
the number one in the, in the 

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United States. 
And when they that came out, 

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which has completely been 
debunked now, which we could 

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talk at another time too, all 
these women suddenly went into 

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going through all the hot 
flashes and the hormone changes 

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and all the things that the 
estrogen helps, which is your 

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bone density. 
It helps with sleep, it helps 

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with mood, a lot of those 
things. 

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Yes, there you can still live, 
you're still, you can still be 

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alive, but you have much better 
quality of life. 

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It's even linked to dementia 
now. 

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And if you think about looking 
in the nursing homes, you mainly

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see older, feeble, demented 
women in the nursing homes. 

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And I plan to change that. 
I feel like there's a bunch of 

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us that are like we are we are 
going to go down fighting. 

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We will be on our hormones for 
our bone strength, for our brain

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strength to help prevent colon 
cancer. 

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It helps prevent breast cancer. 
There's so many good benefits 

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and my goal, Letty, is just to 
let women know there's options 

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like this is what's available 
for you and and they're and 

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they're good options for you. 
I mean, you're doing it right 

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now. 
I didn't know any of this 

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because I've honestly never 
really looked into it. 

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I just figured it's something 
that happens in life and you 

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just kind of deal with it or 
it'll dwindle off. 

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But if there's something that is
helpful or preventative or keeps

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us feeling good about ourselves 
and allow us to be more active, 

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be healthy, then definitely. 
So you're saying normally that's

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hormones that are being 
prescribed? 

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Those by and large are the 
number one thing that help abate

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00:11:16,400 --> 00:11:21,240
the symptoms and help it's the 
most natural thing to do right 

226
00:11:21,240 --> 00:11:25,000
before this, before all this has
kind of been coming out women 

227
00:11:25,000 --> 00:11:27,320
and they still are. 
There's, there's good data for 

228
00:11:27,320 --> 00:11:30,080
SSRIs, which is selective 
serotonin reuptake inhibitors, 

229
00:11:30,080 --> 00:11:32,840
which is medication, 
antidepressants, and some of 

230
00:11:32,840 --> 00:11:36,160
those can bind to some of your 
estrogen receptors and they do 

231
00:11:36,160 --> 00:11:38,000
help. 
And there's a time and place for

232
00:11:38,000 --> 00:11:39,840
that. 
And, and I have a fair amount of

233
00:11:39,840 --> 00:11:43,240
women that are on both hormones 
as well as a little bit of like 

234
00:11:43,240 --> 00:11:46,680
Prozac, Paxil that they need. 
So sometimes you do need both 

235
00:11:47,280 --> 00:11:50,760
for, for the, you know, when 
your bones, if you think about 

236
00:11:51,320 --> 00:11:55,560
the population that has 
osteoporosis, by and large, all 

237
00:11:55,560 --> 00:11:58,800
women, it's, it's, it's meant 
there's a few men that do, but 

238
00:11:58,800 --> 00:12:01,520
there's the you kind of look, 
are they on long term steroids 

239
00:12:01,520 --> 00:12:04,080
because of COPDI mean do they 
have autoimmune? 

240
00:12:04,480 --> 00:12:07,120
But most men do not have 
problems with their bones 

241
00:12:07,120 --> 00:12:08,560
because they keep their 
testosterone. 

242
00:12:08,560 --> 00:12:11,040
It's a hormone. 
Hormone keeps your bones strong.

243
00:12:11,480 --> 00:12:15,480
When we go through menopause, 
that is our biggest decline and 

244
00:12:15,480 --> 00:12:19,560
and our bone density, we lose 
like 7 to 10 to up to almost 20%

245
00:12:19,560 --> 00:12:23,080
that first five to seven years 
When we go through menopause, we

246
00:12:23,080 --> 00:12:25,040
lose that because we lose our 
hormones. 

247
00:12:25,240 --> 00:12:27,120
We suddenly don't have estrogen 
anymore. 

248
00:12:27,360 --> 00:12:29,600
So you don't feel that you don't
know that's happening. 

249
00:12:29,600 --> 00:12:32,920
But the other symptoms like hot 
flashes, poor sleep, 

250
00:12:32,920 --> 00:12:36,360
irritability, low libido, those 
are things that usually what 

251
00:12:36,360 --> 00:12:38,240
brings people into the office to
me. 

252
00:12:38,360 --> 00:12:42,160
And it gives me a chance to say,
do this for your health. 

253
00:12:42,160 --> 00:12:44,920
There's so many other benefits 
you can get if you can treat it 

254
00:12:44,920 --> 00:12:48,160
with something natural. 
So if I put you on SSRI, which 

255
00:12:48,160 --> 00:12:50,880
is fine, that's the selective 
serotonin rehibitor, it won't 

256
00:12:50,880 --> 00:12:52,560
help your bones. 
It's not going to protect your 

257
00:12:52,560 --> 00:12:55,200
heart, it's not going to help 
prevent dementia, but it'll help

258
00:12:55,200 --> 00:12:56,960
your mood. 
So that's why it's like 

259
00:12:56,960 --> 00:12:59,440
multifactorial. 
It's a very big discussion I 

260
00:12:59,440 --> 00:13:04,400
have with women about and 
nutrition and exercise, and 

261
00:13:04,400 --> 00:13:05,600
we'll get into some of that 
today. 

262
00:13:05,600 --> 00:13:08,560
But there's, there's a lot of 
things that we can do to help 

263
00:13:09,320 --> 00:13:11,520
maintain our, we call it health 
span. 

264
00:13:11,520 --> 00:13:13,920
There's two terms. 
It was lifespan and health span 

265
00:13:14,240 --> 00:13:16,600
and lifespan was like, how long 
can you live? 

266
00:13:16,600 --> 00:13:18,280
Like, let's live to, you know, 
whatever. 

267
00:13:18,560 --> 00:13:20,040
Well, now we're starting to 
change. 

268
00:13:20,040 --> 00:13:23,080
We want to say health span. 
We not only want to live longer,

269
00:13:23,080 --> 00:13:24,920
we want to live to our fullest 
capacity. 

270
00:13:24,920 --> 00:13:26,920
I want to be out playing tennis 
in my 80s. 

271
00:13:27,200 --> 00:13:30,600
I, I want to be running, you 
know, the five KS and 10 KS. 

272
00:13:30,600 --> 00:13:33,560
I want to live abundantly and 
strong and have good mental 

273
00:13:33,720 --> 00:13:37,160
capacity to have conversations 
and, and do things. 

274
00:13:38,200 --> 00:13:42,000
And I think what to to kind of 
tell you what's happened is 

275
00:13:42,000 --> 00:13:47,280
women were never involved in 
studies until the 1980s because 

276
00:13:47,280 --> 00:13:49,440
we were pregnant or because of 
the menses. 

277
00:13:49,440 --> 00:13:51,800
We were just, you know, not 
allowed. 

278
00:13:51,800 --> 00:13:54,760
And so women have by and large, 
not been studied. 

279
00:13:54,760 --> 00:13:57,240
So even though menopause has 
been going on since the 

280
00:13:57,240 --> 00:13:59,680
beginning of time, Aristotle 
talked about it. 

281
00:13:59,680 --> 00:14:02,400
I mean, this is not anything new
under the sun. 

282
00:14:02,400 --> 00:14:05,680
It's kind of been a hush. 
You know, nobody discussed 

283
00:14:05,680 --> 00:14:07,200
menopause. 
We didn't want to talk. 

284
00:14:07,200 --> 00:14:10,240
It was aging. 
Now it's coming out like, wait a

285
00:14:10,240 --> 00:14:13,120
minute, this is something that 
happens. 

286
00:14:13,120 --> 00:14:17,760
It's, it is normal and natural. 
But is there things that can 

287
00:14:17,760 --> 00:14:20,520
help mitigate some of these 
symptoms so we can live better? 

288
00:14:21,600 --> 00:14:26,400
Wow, there's so much to this and
I feel bad just discussing bone 

289
00:14:26,400 --> 00:14:29,040
health, but I mean, we're going 
to go into bone health knowing 

290
00:14:29,040 --> 00:14:30,880
that this is the whole grand 
pictures. 

291
00:14:30,880 --> 00:14:32,560
And if you have, while we're 
talking about this, any 

292
00:14:32,560 --> 00:14:35,560
references to other things that 
should be considered along the 

293
00:14:35,560 --> 00:14:46,560
way for that, we'll do that. 
But in regards to bone health, 

294
00:14:47,320 --> 00:14:51,080
maybe let's talk about how 
quickly we are losing bone 

295
00:14:51,080 --> 00:14:52,960
density because what you 
mentioned earlier that was 

296
00:14:52,960 --> 00:14:56,640
really I think eye opening, it's
that, you know, bone density 

297
00:14:56,640 --> 00:14:59,480
loss happens and we don't know 
because we can't see it. 

298
00:15:00,480 --> 00:15:01,400
Correct. 
OK. 

299
00:15:01,400 --> 00:15:04,960
So the bone density and and 
again multifactorial. 

300
00:15:04,960 --> 00:15:07,360
So when you look at a bone 
density, by and large, the 

301
00:15:07,440 --> 00:15:11,320
average when women start to lose
bone density can be up to 20%. 

302
00:15:11,480 --> 00:15:14,960
Those first five to seven years 
of menopause, that is your most 

303
00:15:15,760 --> 00:15:19,400
prevalent time of bone loss and 
then it kind of goes down to 

304
00:15:19,400 --> 00:15:21,840
about 1 to 3% over the next 
years. 

305
00:15:21,840 --> 00:15:24,440
You slowly lose it. 
There is always letting some 

306
00:15:24,440 --> 00:15:27,560
outliers. 
I always have a few women that 

307
00:15:27,560 --> 00:15:31,360
have strong bones and we don't 
know why most women do lose 

308
00:15:31,360 --> 00:15:34,240
their bone density because the 
estrogen starts to go down. 

309
00:15:34,560 --> 00:15:36,160
Other things that can play a 
factor. 

310
00:15:36,160 --> 00:15:39,320
If you're a heavy smoker, that's
going to increase your bone 

311
00:15:39,320 --> 00:15:42,840
density loss quite a bit. 
Smoking is a neurocurrent 

312
00:15:42,840 --> 00:15:45,760
disruptor. 
It also gives free radicals that

313
00:15:45,760 --> 00:15:49,320
can cause damage to the 
osteoblasts, which help build up

314
00:15:49,320 --> 00:15:51,440
the bone. 
Drinking alcohol, poor 

315
00:15:51,440 --> 00:15:54,200
absorption of nutrients that 
help with your bones. 

316
00:15:54,200 --> 00:15:59,160
So women who drink, who smoke, 
who don't exercise, if you're 

317
00:15:59,160 --> 00:16:01,840
just lethargic and you don't do 
anything, you don't have impact 

318
00:16:01,840 --> 00:16:04,360
on those bones, you're going to 
go, you're going to have 

319
00:16:04,360 --> 00:16:09,240
osteoporosis is a much more 
rapid rate than than average 

320
00:16:09,400 --> 00:16:10,920
people. 
So there's other things that go 

321
00:16:10,920 --> 00:16:14,880
into it, but by and large, women
are going to have osteoporosis 

322
00:16:14,880 --> 00:16:17,680
one, if they don't do some 
things to help with that. 

323
00:16:18,400 --> 00:16:20,120
And there's other things 
medication. 

324
00:16:20,120 --> 00:16:22,880
So if you have a thyroid 
disorder or if you're on long 

325
00:16:22,880 --> 00:16:26,520
term steroids, there are some 
people who have autoimmune. 

326
00:16:26,520 --> 00:16:29,000
Actually 80% of the people with 
autoimmune are women. 

327
00:16:29,000 --> 00:16:32,800
But anyway, autoimmune patients,
they are a lot of times on 

328
00:16:32,800 --> 00:16:35,640
steroids because that's the best
thing to kind of calm their body

329
00:16:35,640 --> 00:16:37,720
down from reacting against 
itself. 

330
00:16:38,080 --> 00:16:39,640
Terrible for the bones. 
It's it. 

331
00:16:39,880 --> 00:16:42,240
I love and hate steroids. 
I love and hate it. 

332
00:16:42,240 --> 00:16:44,760
And, and we don't have to go 
into great detail at that, but 

333
00:16:44,760 --> 00:16:47,200
steroids really do a number on 
your bone density. 

334
00:16:47,480 --> 00:16:50,400
So those people are going to 
have worse bone density as well.

335
00:16:50,720 --> 00:16:54,800
Your bones actually stop really 
building strong bones by the 

336
00:16:54,800 --> 00:16:57,480
time you're 30. 
So after that, we really need to

337
00:16:57,480 --> 00:16:59,880
be doing impact. 
We need to do weight training. 

338
00:16:59,880 --> 00:17:03,640
We need to be walking, running, 
dancing, fun things to really 

339
00:17:03,640 --> 00:17:08,319
build those bones up. 
Wow, again so much to it. 

340
00:17:08,319 --> 00:17:12,560
So you were mentioning bone 
density lower because of low 

341
00:17:12,560 --> 00:17:14,599
estrogen. 
Estrogen lowers because of 

342
00:17:14,599 --> 00:17:19,680
menopause and it goes away. 
So then how soon should we as 

343
00:17:19,680 --> 00:17:24,839
runners look into doing anything
about that which is going to be 

344
00:17:24,839 --> 00:17:27,480
happening? 
Is there something we should do 

345
00:17:27,480 --> 00:17:29,960
to prevent it? 
And maybe talk a little bit 

346
00:17:29,960 --> 00:17:31,760
about connecting this to 
running. 

347
00:17:31,880 --> 00:17:34,000
You're mentioning the impact 
being key. 

348
00:17:34,840 --> 00:17:39,440
Let's let's dive into that. 
OK, yes, so I like where you 

349
00:17:39,440 --> 00:17:42,080
said, can we do it? 
I think the awareness is a big 

350
00:17:42,080 --> 00:17:43,560
thing. 
What you're doing right now, 

351
00:17:43,560 --> 00:17:45,560
letting letting women out these 
young. 

352
00:17:45,560 --> 00:17:47,280
You said your audience was about
35. 

353
00:17:47,280 --> 00:17:50,320
They need to be thinking, what 
can I do right now to start 

354
00:17:50,720 --> 00:17:53,520
protecting my bones? 
So that's one of the first 

355
00:17:53,520 --> 00:17:56,000
things, OK, if I'm drinking a 
lot of alcohol, let me limit 

356
00:17:56,000 --> 00:17:57,800
that. 
If I'm smoking, let's kind of 

357
00:17:58,120 --> 00:17:59,880
take a look. 
That's really going to damage 

358
00:17:59,880 --> 00:18:01,640
me. 
How can I start? 

359
00:18:01,720 --> 00:18:05,000
It's always better to do 
prevention and cure. 

360
00:18:05,000 --> 00:18:08,840
So once you get to osteoporosis,
then we're backpedaling, right, 

361
00:18:08,840 --> 00:18:10,880
to try and get you to normal 
bone density. 

362
00:18:10,880 --> 00:18:14,560
So I like your approach. 
What can we do today to help 

363
00:18:14,560 --> 00:18:17,960
prevent that from happening? 
And I truly think we can prevent

364
00:18:17,960 --> 00:18:21,920
that from happening. 
One is, you know, the awareness,

365
00:18:21,920 --> 00:18:23,640
what are the chemicals I'm 
putting in my body? 

366
00:18:23,640 --> 00:18:26,920
Am I putting in, you know, 
eating clean protein, protein 

367
00:18:26,920 --> 00:18:28,760
builds bones, protein builds 
muscles. 

368
00:18:28,760 --> 00:18:31,040
You have to have muscles for the
bones, for the structure. 

369
00:18:31,360 --> 00:18:34,920
So the latest guidelines on 
protein, it's kind of a lot, but

370
00:18:34,920 --> 00:18:37,520
it's 1g per pound of ideal body 
weight. 

371
00:18:37,520 --> 00:18:41,280
So I mean, if you, if you have a
person that weighs 250 lbs, they

372
00:18:41,280 --> 00:18:44,280
don't need to eat 250 grams of 
protein a day. 

373
00:18:44,280 --> 00:18:45,560
You that would be near 
impossible. 

374
00:18:45,560 --> 00:18:48,840
But roughly about 100 to 120 
grams is what you're looking at.

375
00:18:48,840 --> 00:18:51,640
Because if you can get that 
protein in, then you're going to

376
00:18:51,640 --> 00:18:54,400
help build those bones when 
you're, when you're running, 

377
00:18:54,600 --> 00:18:56,600
when you're dancing, when you're
exercising. 

378
00:18:56,760 --> 00:18:58,360
So you have to have good 
nutrition. 

379
00:18:58,360 --> 00:19:01,520
So we've got to base that good 
nutrition, good lifestyle. 

380
00:19:01,760 --> 00:19:05,480
You have to have good sleep 
also, and I know I'm talking a 

381
00:19:05,480 --> 00:19:09,120
lot Letty, but like cortisol, 
that's really bad for your bones

382
00:19:09,120 --> 00:19:11,080
because stress. 
So do what you can. 

383
00:19:11,080 --> 00:19:14,440
Like I always think it's good to
do some meditation, some deep 

384
00:19:14,440 --> 00:19:16,880
breathing, whatever your de 
stressors are, because if your 

385
00:19:16,880 --> 00:19:20,920
cortisol is up all the time, 
then that's very disruptive to 

386
00:19:20,920 --> 00:19:24,800
your metabolic help, which is 
going to be bad for your bone 

387
00:19:24,800 --> 00:19:28,280
health. 
So getting those things in line 

388
00:19:28,280 --> 00:19:31,800
right now and then as you start 
to go through menopause, you 

389
00:19:31,800 --> 00:19:34,480
need to find a provider that 
will say, hey, can we check my 

390
00:19:34,480 --> 00:19:36,280
hormones? 
Can we check where I'm at? 

391
00:19:36,560 --> 00:19:39,840
Another thing for young women, 
Letty, is if you're on a 

392
00:19:41,080 --> 00:19:45,240
progestogen only birth control 
that's very disruptive to your 

393
00:19:45,240 --> 00:19:47,560
bones, you have to have the 
estrogen for your bones. 

394
00:19:47,560 --> 00:19:51,600
So if you've had years and years
of being on the like, oh what's 

395
00:19:51,600 --> 00:19:55,200
the shot Medroxy progesterone 
shot, the depo provera shot that

396
00:19:55,200 --> 00:19:58,320
is a progestogen only you're 
really blocking all your 

397
00:19:58,320 --> 00:20:02,680
estrogen you will go into. 
Menopause quicker and if you do 

398
00:20:02,680 --> 00:20:05,400
have a total hysterectomy where 
your ovaries are gone then you 

399
00:20:05,400 --> 00:20:08,480
no longer are producing estrogen
so you will go into menopause 

400
00:20:08,800 --> 00:20:11,480
faster if your if your ovaries 
are gone. 

401
00:20:12,640 --> 00:20:17,320
What about the IUD? 
So the IUD there's, there's 

402
00:20:17,320 --> 00:20:19,640
different IU D's. 
Most IU D's have a little bit of

403
00:20:19,640 --> 00:20:23,240
estrogen with it. 
Some of the IU D's will have 

404
00:20:23,360 --> 00:20:25,800
progestogen, but it kind of 
works a little more locally. 

405
00:20:26,000 --> 00:20:30,280
So if you have an IUD and you 
still can have a menses, you're 

406
00:20:30,280 --> 00:20:32,920
still produce, you're still 
ovulating and you're still 

407
00:20:32,920 --> 00:20:35,800
producing estrogens. 
When you ovulate, your egg comes

408
00:20:35,800 --> 00:20:39,800
out and this is the cycle is 
very complicated, but when you 

409
00:20:39,800 --> 00:20:42,400
are so you have two ovaries and 
every month one of the ovaries 

410
00:20:42,400 --> 00:20:44,680
will release the egg. 
The inside of the egg comes out 

411
00:20:44,920 --> 00:20:48,560
during the day 14, you have a 
high rise in estrogen. 

412
00:20:48,560 --> 00:20:51,480
That's why I'm like the 14 day 
of your cycle, you feel amazing.

413
00:20:51,480 --> 00:20:53,600
You're on top of the world, your
brain is functioning, you feel 

414
00:20:53,600 --> 00:20:57,120
good and that is your highest 
level of estrogen in your body. 

415
00:20:57,120 --> 00:20:59,360
Your brain loves estrogen. 
That's why we worry about 

416
00:20:59,360 --> 00:21:01,160
dementia when we're older. 
We don't have estrogen. 

417
00:21:01,560 --> 00:21:03,360
I don't mean to go on the 
sideline, but you're feeling 

418
00:21:03,360 --> 00:21:06,360
good day 14. 
And then if you and then the 

419
00:21:06,360 --> 00:21:09,200
outside of that turns in to 
progesterone of the egg, which 

420
00:21:09,200 --> 00:21:13,520
is the corpus luteum, that's 
kind of getting the the the 

421
00:21:13,520 --> 00:21:16,160
uterus available to to fertilize
the egg. 

422
00:21:16,160 --> 00:21:18,520
Well, if there's no 
fertilization, then both of 

423
00:21:18,520 --> 00:21:20,080
those start to drop 
dramatically. 

424
00:21:20,080 --> 00:21:22,800
Then you have a menses, then 
your body sends a signal. 

425
00:21:22,800 --> 00:21:26,320
Hey, the estrogen level dropped,
the brain goes down to the 

426
00:21:26,320 --> 00:21:29,200
ovary, sends a message we need 
to release, she needs some 

427
00:21:29,200 --> 00:21:32,560
estrogen and egg is released. 
So if you have an IUD and you're

428
00:21:32,560 --> 00:21:35,560
still having, even if it's just 
a little scratch of a menses, 

429
00:21:35,840 --> 00:21:38,560
you're still getting estrogen. 
If you have one where you're 

430
00:21:38,560 --> 00:21:40,920
really not getting a menses 
anymore, you could have your 

431
00:21:40,920 --> 00:21:44,400
provider check to see what your 
estradiol level is and see if 

432
00:21:44,400 --> 00:21:48,800
you have estrogen still. 
My goodness, so many signals the

433
00:21:48,800 --> 00:21:50,120
body is trying to give us, 
right? 

434
00:21:50,920 --> 00:21:55,520
Yeah, yes. 
All right, so now when it comes 

435
00:21:55,520 --> 00:21:58,320
to running, we talked about bone
health. 

436
00:21:58,320 --> 00:22:01,120
Now let's talk about how running
impacts your bone health and 

437
00:22:01,120 --> 00:22:04,800
your bone density. 
OK, so one of the best things 

438
00:22:04,800 --> 00:22:09,280
for bones is when bones are 
stimulated, when you have an 

439
00:22:09,280 --> 00:22:12,440
impact on your bone, your bone 
wants to break down and get rid 

440
00:22:12,440 --> 00:22:14,080
of old bone. 
And then that's called an 

441
00:22:14,080 --> 00:22:17,160
osteoclast, OK? 
Those osteoclasts come in and 

442
00:22:17,160 --> 00:22:20,000
they chip away the old bone and 
then you have osteoblast that 

443
00:22:20,000 --> 00:22:23,240
comes in that's stimulated by 
estrogen and builds up bone. 

444
00:22:23,400 --> 00:22:26,680
So you have this good rate and 
breaking down bone and building 

445
00:22:26,680 --> 00:22:30,040
up bone, breaking down bone. 
And every 10 years you get a 

446
00:22:30,040 --> 00:22:32,400
whole new skeletal system, you 
get whole new bones. 

447
00:22:32,400 --> 00:22:35,640
It is breaking down and building
up like that is really amazing. 

448
00:22:35,640 --> 00:22:40,000
Our bodies will do that. 
But if we when we get older and 

449
00:22:40,000 --> 00:22:43,040
if we're, you know, heavy 
drinking alcohol, you name it, 

450
00:22:43,600 --> 00:22:46,120
it went through menopause early.
And then we don't have estrogen.

451
00:22:47,000 --> 00:22:49,000
Estrogen, like I said, builds up
bones. 

452
00:22:49,000 --> 00:22:52,240
And so the osteoclasts are 
continuing to break down and 

453
00:22:52,240 --> 00:22:54,960
you're barely building up bone. 
But what are some of the things 

454
00:22:54,960 --> 00:22:59,400
we can do naturally is to impact
those bones, to stress those 

455
00:22:59,400 --> 00:23:01,120
bones. 
And that will help. 

456
00:23:01,960 --> 00:23:04,840
You still may need some 
pharmaceutical help, but it will

457
00:23:04,840 --> 00:23:07,360
help if you can start running, 
walking. 

458
00:23:07,640 --> 00:23:09,920
Now. 
I always say talk to a medical 

459
00:23:09,920 --> 00:23:12,240
doctor. 
If you have osteoporosis, I 

460
00:23:12,240 --> 00:23:14,880
don't want you falling because 
you're more at risk to break a 

461
00:23:14,880 --> 00:23:16,960
bone if you fall. 
If you have osteoporosis, but 

462
00:23:16,960 --> 00:23:19,880
osteopenia, which we can go 
into, that's kind of you have 

463
00:23:19,880 --> 00:23:23,040
normal bone actually brought a 
little, I don't know if you can 

464
00:23:23,040 --> 00:23:27,720
see this. 
OK, so anyway, so this is 

465
00:23:27,720 --> 00:23:31,080
considered the normal bone. 
This is more like osteoporosis. 

466
00:23:31,080 --> 00:23:32,920
So it's more like a Swiss 
cheese. 

467
00:23:33,080 --> 00:23:35,960
And as that starts to get 
osteoporosis and it gets really 

468
00:23:35,960 --> 00:23:39,200
weak bone, it just breaks and 
fractures pretty pretty easily. 

469
00:23:39,480 --> 00:23:43,040
So if we can kind of prevent it,
like you said, starting early, 

470
00:23:43,040 --> 00:23:46,000
what can I do nutrition wise? 
What can I do health wise? 

471
00:23:46,200 --> 00:23:48,040
Let me start impacting those 
bones. 

472
00:23:48,240 --> 00:23:50,120
Running and walking are very 
good. 

473
00:23:50,400 --> 00:23:54,400
There is Vonda, right? 
I follow her and she's she's got

474
00:23:54,400 --> 00:23:57,760
books out called Unbroken and 
she talks about jumping and 

475
00:23:57,960 --> 00:24:01,400
heavy, heavy like squats. 
The we jump up on a block and 

476
00:24:01,400 --> 00:24:03,920
back. 
She also talks about jumping 

477
00:24:03,920 --> 00:24:06,040
rope. 
So I don't really jump rope, but

478
00:24:06,040 --> 00:24:08,160
that's really good for your 
bones too, because one you're 

479
00:24:08,160 --> 00:24:11,760
up, down, jump, jump, jump, and 
that stimulates that bone to 

480
00:24:11,760 --> 00:24:15,680
grow. 
So getting out moving is just 

481
00:24:15,680 --> 00:24:19,040
imperative for really for 
everything, but really good for 

482
00:24:19,040 --> 00:24:21,200
the bones. 
There's a so if you can get out 

483
00:24:21,200 --> 00:24:23,280
and move, dancing, walking, 
running. 

484
00:24:23,600 --> 00:24:26,960
Check with your doctor before 
you do all these things, and 

485
00:24:27,120 --> 00:24:30,040
that's going to help impact 
those bones wonderfully. 

486
00:24:31,160 --> 00:24:33,440
How does strength training 
impact? 

487
00:24:33,440 --> 00:24:36,000
And because I'm getting the 
understanding that the more you 

488
00:24:36,000 --> 00:24:38,480
move them around, the more they 
feel an impact. 

489
00:24:38,680 --> 00:24:41,680
If you're strength training, 
you're obviously strengthening 

490
00:24:41,680 --> 00:24:43,960
your whole body, but how, how 
does that affect your your 

491
00:24:43,960 --> 00:24:46,280
bones? 
So I'm glad you said that. 

492
00:24:46,280 --> 00:24:50,200
So strength training, it really 
needs to be in addition to the 

493
00:24:50,200 --> 00:24:52,480
exercise. 
So strength training is where 

494
00:24:52,480 --> 00:24:55,720
it's going to actually put this 
tensile pressure on your 

495
00:24:55,720 --> 00:24:59,800
muscles, which is also on the 
the tendons and the ligaments 

496
00:24:59,840 --> 00:25:01,600
and that pulls at the bone, 
right. 

497
00:25:01,880 --> 00:25:06,520
And so the idea now is not to do
a ton of reps with small 

498
00:25:06,520 --> 00:25:09,640
weights, is to go a little bit 
heavier weight and do less reps 

499
00:25:09,640 --> 00:25:13,120
to really push and do some 
strength training on your upper 

500
00:25:13,120 --> 00:25:15,760
body, lower body. 
It is a excellent because 

501
00:25:15,760 --> 00:25:17,160
you'll, we always want to cross 
train. 

502
00:25:17,280 --> 00:25:18,880
So you don't want to just do one
thing. 

503
00:25:18,880 --> 00:25:21,800
You want to cross train. 
So also to get your, your arms, 

504
00:25:21,800 --> 00:25:24,840
your back. 
Because when women or men, we 

505
00:25:24,840 --> 00:25:28,360
can say both, if we fall, we 
need to be able to, to have the 

506
00:25:28,360 --> 00:25:29,920
strength to be able to get up 
off the ground. 

507
00:25:30,120 --> 00:25:33,040
You what some of the doctors 
that I follow, they're like, 

508
00:25:33,040 --> 00:25:35,200
it's not if you fall, it's when 
you fall and what are you going 

509
00:25:35,200 --> 00:25:37,560
to do about that fall? 
Can you fall and can you pick 

510
00:25:37,560 --> 00:25:41,720
yourself up from a a smart from 
a position on the ground? 

511
00:25:41,880 --> 00:25:44,240
So having the muscle strength is
very important. 

512
00:25:44,240 --> 00:25:48,360
So we need to be building the 
muscle Squats, one of the best 

513
00:25:48,360 --> 00:25:52,120
ones is the way you have the bar
down and you lift up. 

514
00:25:52,120 --> 00:25:54,680
I'm trying to think what that's 
called your back's kind of been.

515
00:25:54,680 --> 00:26:00,040
It's only dead lift that is one 
of the best from from the 

516
00:26:00,040 --> 00:26:02,960
research that I've found that if
you're going to do any exercise,

517
00:26:02,960 --> 00:26:05,800
if you're only going to do one, 
do some dead lifts like, and we 

518
00:26:05,800 --> 00:26:07,920
call them exercise snacks. 
You don't have to make this 

519
00:26:07,920 --> 00:26:10,120
super hard. 
You know, go for a couple run 

520
00:26:10,120 --> 00:26:13,280
walks a week and then a couple 
days a week do some dead lifts 

521
00:26:13,840 --> 00:26:16,400
maybe a couple times a day. 
If you have like it's your 

522
00:26:16,400 --> 00:26:17,800
office. 
If you have a weight and you're 

523
00:26:17,800 --> 00:26:20,000
like, you know what, I've got 
got 10 minutes. 

524
00:26:20,000 --> 00:26:22,480
We call it a snack. 
Grab that and do and do some 

525
00:26:22,480 --> 00:26:25,760
dead lifts and really build 
those bones and muscles. 

526
00:26:26,880 --> 00:26:30,160
I love the terminology. 
Exercise, snack. 

527
00:26:30,160 --> 00:26:31,920
Exercise not going. 
To start using. 

528
00:26:31,920 --> 00:26:34,200
That. 
But let's talk about some real 

529
00:26:34,200 --> 00:26:36,440
snacks. 
What are some other things that 

530
00:26:36,440 --> 00:26:40,320
people can consume that is at 
this point not pharmaceuticals 

531
00:26:40,480 --> 00:26:42,240
that will help us with our bone 
density? 

532
00:26:42,240 --> 00:26:44,120
Because we talked about what we 
are not supposed to do, no 

533
00:26:44,120 --> 00:26:46,320
smoking or drinking, at least 
limiting it. 

534
00:26:46,480 --> 00:26:48,720
But what is some stuff we can 
consume that helps us? 

535
00:26:50,120 --> 00:26:53,480
So having a gut, the protein, 
which I kind of said earlier, so

536
00:26:53,480 --> 00:26:56,680
having the protein, protein is 
very important in in your diet. 

537
00:26:57,080 --> 00:26:59,240
Fiber is too, but more for a gut
health. 

538
00:26:59,440 --> 00:27:01,440
You also want to have calcium 
and vitamin D. 

539
00:27:01,680 --> 00:27:03,480
I'm careful with calcium 
letting. 

540
00:27:04,200 --> 00:27:07,400
Try to get 1200 milligrams of 
calcium a day, but let it be in 

541
00:27:07,400 --> 00:27:10,480
your diet. 
I don't really recommend adding 

542
00:27:10,720 --> 00:27:15,040
a calcium supplement unless your
doctor says it because too much 

543
00:27:15,040 --> 00:27:16,560
calcium can lead to a kidney 
stone. 

544
00:27:16,560 --> 00:27:19,080
But if you can get it through 
yogurt, lots of protein and 

545
00:27:19,080 --> 00:27:20,360
yogurt. 
So then you're getting calcium 

546
00:27:20,360 --> 00:27:23,600
and yogurt winter, right? 
Different cheeses. 

547
00:27:23,600 --> 00:27:25,600
There's other things you can 
get, calcium, spinach. 

548
00:27:26,160 --> 00:27:29,360
So calcium is important, and 
vitamin D Interestingly, vitamin

549
00:27:29,360 --> 00:27:32,120
D comes from the sun. 
So I know you're out running. 

550
00:27:32,120 --> 00:27:34,840
You're getting probably a lot of
vitamin D, but you can have your

551
00:27:34,840 --> 00:27:37,560
vitamin D checked too. 
Calcium is checked and vitamin D

552
00:27:37,560 --> 00:27:40,280
is checked from your doctor. 
They can do a blood check and 

553
00:27:40,280 --> 00:27:43,360
see if your vitamin D is low. 
If it is low, you should 

554
00:27:43,360 --> 00:27:46,640
supplement 800 to 1000 
international units a day. 

555
00:27:47,240 --> 00:27:48,440
But you need to have it checked 
first. 

556
00:27:48,440 --> 00:27:51,440
You don't have too much vitamin 
D Vitamin D is a fat soluble 

557
00:27:51,440 --> 00:27:55,200
vitamin so you can get too much.
I've only seen it once literally

558
00:27:55,200 --> 00:27:57,560
in five years of checking the 
DS. 

559
00:27:57,560 --> 00:28:01,160
It's, it's being very hard. 
And, and surprisingly, even in 

560
00:28:01,160 --> 00:28:05,000
Florida, most of us are vitamin 
D deficiency because we lather 

561
00:28:05,000 --> 00:28:07,480
up with sunscreen before we go 
out or we stay out of the hot 

562
00:28:07,480 --> 00:28:09,040
sun. 
We go, you know, in the early 

563
00:28:09,040 --> 00:28:12,200
mornings we run. 
So being out in the sun really 

564
00:28:12,200 --> 00:28:14,360
does give you the vitamin D that
your body needs. 

565
00:28:14,360 --> 00:28:17,920
Again, I know my dermatologist 
wouldn't want me saying that 

566
00:28:17,920 --> 00:28:20,760
because skin cancer. 
So you weigh all that so you can

567
00:28:20,760 --> 00:28:23,000
take a supplement. 
So those are the two that help 

568
00:28:23,000 --> 00:28:25,520
with bone building is the 
vitamin D and the calcium. 

569
00:28:25,920 --> 00:28:28,320
If you have good Newton 
absorption. 

570
00:28:28,320 --> 00:28:30,880
Obviously if you've had a 
gastric bypass gastric sleeve, 

571
00:28:30,880 --> 00:28:33,840
you may have to take some extra 
supplements because you don't 

572
00:28:33,840 --> 00:28:36,600
absorb as well. 
Gosh I'm learning so much. 

573
00:28:36,600 --> 00:28:38,000
I'm so glad this is being 
transcribed. 

574
00:28:44,560 --> 00:28:47,440
OK, Angela, so you're talking 
about testing this, testing that

575
00:28:47,720 --> 00:28:50,760
for someone like me, I've never 
looked into testing companies 

576
00:28:50,760 --> 00:28:51,760
out there. 
I know they're all over 

577
00:28:51,760 --> 00:28:53,400
Instagram. 
If you're a runner, you need to 

578
00:28:53,400 --> 00:28:56,360
get everything checked. 
But I want to get a test done. 

579
00:28:56,520 --> 00:28:59,880
What kind of test should I get? 
Where should I get it and what 

580
00:28:59,880 --> 00:29:03,160
should I look for in in those 
different panels that they let 

581
00:29:03,160 --> 00:29:05,200
us choose? 
Yes. 

582
00:29:05,200 --> 00:29:09,240
So if you have insurance, you 
can go to a primary care doctor 

583
00:29:09,240 --> 00:29:11,960
and they can do a baseline, 
which is a comprehensive 

584
00:29:11,960 --> 00:29:15,320
metabolic panel, and that will 
check your electrolytes. 

585
00:29:15,320 --> 00:29:18,040
It will check your calcium 
level, and then you can ask for 

586
00:29:18,040 --> 00:29:22,840
the vitamin D as well. 
Now, if you're 50 and older, you

587
00:29:22,840 --> 00:29:26,440
can get a bone density scan 
called a DEXA scan, and that is 

588
00:29:26,440 --> 00:29:28,920
an X-ray that you can get to 
show a baseline. 

589
00:29:29,240 --> 00:29:32,880
What I find very frustrating, 
Letty, is that in the United 

590
00:29:32,880 --> 00:29:39,320
States, insurance lets you get 
it at age 6515 years after 

591
00:29:39,320 --> 00:29:42,240
menopause. 
So, you know, you need to ask 

592
00:29:42,240 --> 00:29:44,640
first of all, how much is it 
going to cost you with the bone 

593
00:29:44,640 --> 00:29:46,760
density? 
But I recommend getting a 

594
00:29:46,760 --> 00:29:48,880
baseline. 
I got one for myself just so I 

595
00:29:48,880 --> 00:29:51,280
know like, OK, where are my 
bones today? 

596
00:29:51,280 --> 00:29:54,600
So then like every couple years 
to five years, my bones were 

597
00:29:54,600 --> 00:29:57,200
solid strong, but so I probably 
won't get another one for five 

598
00:29:57,200 --> 00:29:59,320
years. 
But I really think especially if

599
00:29:59,320 --> 00:30:01,440
you've gone through early 
menopause, especially if you're 

600
00:30:01,440 --> 00:30:05,280
on high dose steroids for many 
years for autoimmune disorder, 

601
00:30:05,480 --> 00:30:08,960
if you had, you know, early 
menopause, get the bone density.

602
00:30:08,960 --> 00:30:11,320
It's been around forever. 
I can't imagine it being much. 

603
00:30:11,320 --> 00:30:14,160
I don't have the price on what 
it would be like if you were to 

604
00:30:14,160 --> 00:30:16,960
call rad regional just to see 
like could you pay cash for a 

605
00:30:16,960 --> 00:30:19,640
bone density? 
But a bone density will let you 

606
00:30:19,640 --> 00:30:23,640
know where your bone status is. 
Do you have osteopenia, 

607
00:30:23,640 --> 00:30:25,880
osteoporosis or normal healthy 
bone? 

608
00:30:26,200 --> 00:30:29,640
There's a score. 
It's AT score, test score and 

609
00:30:29,640 --> 00:30:31,960
anything that's in the positive 
is good. 

610
00:30:31,960 --> 00:30:37,120
But if you have a -1 to a -, 
2.5, that's considered an 

611
00:30:37,120 --> 00:30:41,440
osteopenia, meaning you're 
starting to have some problems 

612
00:30:41,440 --> 00:30:44,320
with the bones or starting to 
get very weak. 

613
00:30:44,480 --> 00:30:47,960
You need to be doing something. 
If you go in, and I have had, 

614
00:30:48,160 --> 00:30:51,800
the other day, I had a young, 
she was 52, and she'd only been 

615
00:30:51,800 --> 00:30:54,440
in menopause for two years. 
Osteoporosis. 

616
00:30:54,440 --> 00:30:58,960
I was like, wow, her bone 
density -2.5 and over and less. 

617
00:30:59,160 --> 00:31:03,520
So then that's osteoporosis. 
So now she's so fragile that I 

618
00:31:03,520 --> 00:31:05,160
have to tell her, be very 
careful. 

619
00:31:05,440 --> 00:31:09,640
So on those women, I tell them 
first let's start with yoga. 

620
00:31:09,640 --> 00:31:12,680
I need you to learn how to 
balance because the problem is 

621
00:31:12,680 --> 00:31:15,400
the break, it's the fracture. 
I don't want you to fracture 

622
00:31:15,400 --> 00:31:16,720
yourself. 
So how can we give you good 

623
00:31:16,720 --> 00:31:19,200
balance? 
So then we learn to, you know, 

624
00:31:19,200 --> 00:31:21,760
stand on one leg while you're 
cooking or brushing your teeth. 

625
00:31:21,760 --> 00:31:24,280
Then you do yoga. 
So you get those core muscles. 

626
00:31:24,280 --> 00:31:27,400
And as you start to get some 
balance, we're also going to do 

627
00:31:27,400 --> 00:31:29,680
some strength training. 
We're also going to start 

628
00:31:29,680 --> 00:31:31,480
walking. 
You can put your weighted vest 

629
00:31:31,480 --> 00:31:34,600
on if you want to, just to add 
more impact and start to build 

630
00:31:34,600 --> 00:31:38,840
those bones up and then adding 
the nutrition you've got to, you

631
00:31:38,840 --> 00:31:41,320
know, I think a lot of people in
America don't realize how 

632
00:31:41,320 --> 00:31:43,240
important it is to have good 
nutrition. 

633
00:31:43,240 --> 00:31:45,640
Eat clean. 
That's kind of like I any diet. 

634
00:31:45,640 --> 00:31:48,160
I'm, you know, whatever works 
for you is fine, but just make 

635
00:31:48,160 --> 00:31:51,520
sure you have enough protein in 
your diet to build the bones. 

636
00:31:52,280 --> 00:31:54,680
So the blood test and the bone 
density. 

637
00:31:54,680 --> 00:31:57,400
I'm sorry, I know I'm, I'm going
through a lot, but you really 

638
00:31:57,400 --> 00:32:00,480
get, get your baseline, your 
blood test and then you can get 

639
00:32:00,480 --> 00:32:04,200
a bone density if you know it's,
it's hard to get one if you're 

640
00:32:04,200 --> 00:32:06,320
still having your period, you're
still having estrogen. 

641
00:32:06,320 --> 00:32:07,840
So your bones are probably 
really good. 

642
00:32:08,160 --> 00:32:11,400
So it's usually when when you 
hit menopause, then I would be 

643
00:32:11,400 --> 00:32:14,440
pushing my provider to say, hey,
I want to get I want to get a 

644
00:32:14,440 --> 00:32:16,320
baseline to see where my bones 
are at. 

645
00:32:17,440 --> 00:32:20,000
Okay, no, I mean, I love that 
you're elaborating on this 

646
00:32:20,000 --> 00:32:23,200
because I think it's helpful. 
I'm, I'm learning so much and 

647
00:32:23,200 --> 00:32:26,680
I'm not in the medical field, as
you know, so it's difficult to 

648
00:32:26,680 --> 00:32:28,840
even draft the correct questions
to ask you. 

649
00:32:28,840 --> 00:32:32,320
So this is super helpful. 
But you're kind of saying early 

650
00:32:32,320 --> 00:32:34,440
detection is key. 
Now, I'm going to ask this 

651
00:32:34,440 --> 00:32:38,640
question because we live in 
America and America is difficult

652
00:32:38,640 --> 00:32:41,720
right now with insurance. 
If you do not have insurance and

653
00:32:41,720 --> 00:32:43,480
you're going to be paying out of
pocket. 

654
00:32:43,680 --> 00:32:47,720
There's so many companies out 
there advertising for testing. 

655
00:32:47,720 --> 00:32:50,960
And I guess not just testing, 
but it comes down to having a 

656
00:32:50,960 --> 00:32:54,520
good interpretation of a test. 
But then also they don't make it

657
00:32:54,520 --> 00:32:57,800
easy because they let you select
what you want to have on that 

658
00:32:57,800 --> 00:33:01,360
test. 
Are there any companies that you

659
00:33:01,360 --> 00:33:05,200
recommend that do good tests for
people that don't want to or 

660
00:33:05,200 --> 00:33:08,880
can't go through insurance? 
So yeah, there there are some. 

661
00:33:08,880 --> 00:33:13,320
I also follow Mary Claire Haver.
She is like the leading person 

662
00:33:13,320 --> 00:33:14,920
in my opinion. 
She's been on Oprah and 

663
00:33:14,920 --> 00:33:18,480
everything and she's a OBGYN 
certified out of Galveston, TX 

664
00:33:18,840 --> 00:33:21,480
and she recommends MIDI Health 
MIDI. 

665
00:33:21,600 --> 00:33:25,360
So that's an online health 
program that you can go to and 

666
00:33:25,360 --> 00:33:28,200
you will talk to a doctor and 
they will order your tests. 

667
00:33:28,440 --> 00:33:31,120
They will, you know, kind of 
walk you through that. 

668
00:33:31,440 --> 00:33:34,560
And then there's also, I wrote 
its name down. 

669
00:33:34,640 --> 00:33:36,800
Let's see Vonda, right? 
I don't know if she has one, but

670
00:33:36,800 --> 00:33:41,440
Vonda right, has good, she's 
called Unbreakable and she talks

671
00:33:41,440 --> 00:33:44,080
about the bone health. 
So that's somebody you can find 

672
00:33:44,360 --> 00:33:46,280
locally. 
Are you talking about locally 

673
00:33:46,280 --> 00:33:50,520
here or or no? 
No more nationally and also if 

674
00:33:50,520 --> 00:33:53,760
someone's listening from another
country, which we have 40% of 

675
00:33:53,760 --> 00:33:57,280
our audience is overseas. 
So just kind of wanted to get a 

676
00:33:57,280 --> 00:34:01,720
grasp of what to ask for. 
Because if the the physician is 

677
00:34:01,720 --> 00:34:05,800
not into running, maybe to have 
some information ready of what 

678
00:34:05,800 --> 00:34:09,440
you really want to know, not 
just for bone density but also 

679
00:34:09,560 --> 00:34:12,040
to make sure running can 
continue being healthy sport for

680
00:34:12,040 --> 00:34:16,040
you. 
OK, so are you specific labs 

681
00:34:16,040 --> 00:34:17,360
that would be good. 
You want to make sure your 

682
00:34:17,360 --> 00:34:21,080
thyroid is OK and that's a 
thyroid stimulating hormone TSH.

683
00:34:21,080 --> 00:34:24,600
So I would ask your doctor for 
ATSH level because if your 

684
00:34:24,600 --> 00:34:27,760
thyroid's off, that can really 
take away from your bones, 

685
00:34:27,760 --> 00:34:30,120
right. 
And then if you have the CMP, 

686
00:34:30,120 --> 00:34:33,040
which is your comprehensive that
lets you know your calcium. 

687
00:34:33,040 --> 00:34:35,639
There's there's a few women that
will have something wrong with 

688
00:34:35,639 --> 00:34:37,800
your parathyroids. 
It has nothing to do with 

689
00:34:37,800 --> 00:34:40,840
thyroid. 
They're just para beside beside 

690
00:34:40,840 --> 00:34:43,159
your thyroid and they're in 
charge of your calcium. 

691
00:34:43,360 --> 00:34:47,120
And if you have one of those 
that acts up like my mom did, it

692
00:34:47,120 --> 00:34:49,280
sucks the calcium, it's acting 
up. 

693
00:34:49,280 --> 00:34:52,159
It's like a, it's like a bad 
child that keeps telling your 

694
00:34:52,159 --> 00:34:54,960
body, hey, we need more calcium 
in the blood and your calcium 

695
00:34:54,960 --> 00:34:57,840
levels really high in the blood 
because it's sucking all the 

696
00:34:57,840 --> 00:35:00,840
calcium out of the bones. 
And so that's why it's important

697
00:35:00,840 --> 00:35:04,120
to have that basic comprehensive
metabolic panel to see like do 

698
00:35:04,120 --> 00:35:06,680
you have, and if your calcium's 
high, why it shouldn't be? 

699
00:35:06,680 --> 00:35:09,240
You have a beautiful regulatory 
system in your body. 

700
00:35:09,480 --> 00:35:12,400
So you need to check that your 
vitamin D, you need to check a 

701
00:35:12,400 --> 00:35:14,800
TSH, which is your thyroid 
stimulating hormone. 

702
00:35:15,160 --> 00:35:17,960
If you're menopausal, you should
have your hormones checked. 

703
00:35:17,960 --> 00:35:22,000
Or if you're not having a menses
and you haven't had one in like 

704
00:35:22,000 --> 00:35:25,040
6 months and you're younger and 
you're not on hormone, if you're

705
00:35:25,040 --> 00:35:27,600
not on a birth control, you can 
have your hormones checked to 

706
00:35:27,600 --> 00:35:29,760
see if that's playing into it as
well. 

707
00:35:30,920 --> 00:35:33,800
And then it's always good just 
to have a basic CBC, which is 

708
00:35:34,000 --> 00:35:36,560
your blood count to see if your 
hemoglobin hematuric, make sure 

709
00:35:36,560 --> 00:35:40,240
you're not anemic. 
So those are kind of basis for 

710
00:35:40,240 --> 00:35:45,040
that for your bone health. 
And I'm going to ask you later 

711
00:35:45,040 --> 00:35:48,920
on to write all of it down for 
me because, yeah, or I can use a

712
00:35:48,920 --> 00:35:51,400
transcript to. 
Either way, we have some great 

713
00:35:51,400 --> 00:35:54,800
information here. 
Now to kind of finish up this 

714
00:35:54,800 --> 00:35:58,400
podcast, from your experience, 
what is the biggest mindset 

715
00:35:58,400 --> 00:36:02,640
shift that women need to make 
during menopause to make it kind

716
00:36:02,640 --> 00:36:06,440
of come full circle? 
Understanding that their age is 

717
00:36:06,440 --> 00:36:08,840
changing, their health is 
changing, and maybe their 

718
00:36:08,840 --> 00:36:11,760
activity level slash 
accomplishments will change a 

719
00:36:11,760 --> 00:36:16,080
little bit. 
I really feel I want women to 

720
00:36:16,080 --> 00:36:19,800
empower themselves to be 
proactive for their own health 

721
00:36:20,160 --> 00:36:24,360
because there is a lot of 
providers out here that really 

722
00:36:24,360 --> 00:36:28,000
they just don't have the time to
do the details. 

723
00:36:28,000 --> 00:36:31,720
Like in the medical field, most 
doctors, you get about 10 

724
00:36:31,720 --> 00:36:35,400
minutes and it's like, oh, you 
know, I have a GI issue or my 

725
00:36:35,400 --> 00:36:38,240
back pain or let's work on the 
the blood pressure and then 

726
00:36:38,240 --> 00:36:41,680
they're out the door. 
So I want women to be like, no, 

727
00:36:41,680 --> 00:36:43,880
like research it. 
OK, I know this is going to 

728
00:36:43,880 --> 00:36:46,160
happen. 
This is, I know my bones are 

729
00:36:46,160 --> 00:36:48,600
going to get weaker because 
that's what happens in menopause

730
00:36:48,600 --> 00:36:53,000
and I'm itching or inching 
towards that door and that's 

731
00:36:53,000 --> 00:36:55,960
more than likely going to be 
what's going to happen to me. 

732
00:36:55,960 --> 00:36:57,840
So let me take matters into my 
own hand. 

733
00:36:57,840 --> 00:37:00,400
What do I need to do? 
Can I find someone that will 

734
00:37:00,400 --> 00:37:03,120
listen to me and say I'm this is
important to me? 

735
00:37:03,240 --> 00:37:07,040
What are my options? 
You know, besides just the 

736
00:37:07,040 --> 00:37:08,840
nutrition. 
We talked about working out, 

737
00:37:08,840 --> 00:37:11,400
meditation, relaxing, getting 
rid of cortisol. 

738
00:37:12,040 --> 00:37:14,120
There's some new studies on 
vibration plates. 

739
00:37:14,120 --> 00:37:15,920
Have you ever stood on a 
vibration plate? 

740
00:37:15,920 --> 00:37:17,360
Do you know what those are, 
ladies? 

741
00:37:17,360 --> 00:37:21,240
I've heard of it, yeah. 
Some of the Expos I've been to 

742
00:37:21,240 --> 00:37:23,800
actually for some of the 
marathons, I'll see some of them

743
00:37:23,800 --> 00:37:27,480
out there. 
And for women or men who really 

744
00:37:27,480 --> 00:37:29,920
can't get out and exercise as 
much, you can stand on these 

745
00:37:29,920 --> 00:37:33,200
vibration plates. 
The studies are a little not 

746
00:37:33,200 --> 00:37:35,800
great on it. 
It doesn't show robust, but I do

747
00:37:35,800 --> 00:37:37,880
think it's another tool for some
people who can't. 

748
00:37:37,880 --> 00:37:40,280
It's a stimulating plate you 
stand on for like 5 minutes a 

749
00:37:40,280 --> 00:37:42,920
day and it's supposed to kind of
have the impact. 

750
00:37:43,160 --> 00:37:45,760
Those are some things just that 
you can look into and say like 

751
00:37:45,760 --> 00:37:48,880
what what could be right for me?
How can I, you know, empower 

752
00:37:48,880 --> 00:37:53,400
myself to make changes? 
So I don't because it's what 

753
00:37:53,400 --> 00:37:56,280
happens is it's called a 
fragility fracture if you fall 

754
00:37:56,280 --> 00:37:58,400
from standing height. 
Now if you fall and you're on 

755
00:37:58,400 --> 00:38:01,280
the roof, OK, even a young 
person can fracture and break 

756
00:38:01,280 --> 00:38:03,280
something. 
But if I am and you and I are 

757
00:38:03,280 --> 00:38:07,880
walking and I trip on the curb 
and I fall and I break something

758
00:38:07,880 --> 00:38:10,240
I shouldn't because that's 
standing height, I should be 

759
00:38:10,240 --> 00:38:13,040
able to kind of roll hold 
myself. 

760
00:38:13,040 --> 00:38:16,920
But if I do, that's considered a
fragility fracture that is very 

761
00:38:16,920 --> 00:38:19,200
dangerous. 
If I have a fragility fracture, 

762
00:38:19,400 --> 00:38:24,040
20% of the women who have a hip 
fracture from a, a standing 

763
00:38:24,040 --> 00:38:26,280
height will not make it after 
one year. 

764
00:38:26,280 --> 00:38:30,360
They will either die from 
surgical complications to emboli

765
00:38:30,360 --> 00:38:34,000
infection. 
So the whole goal is not to 

766
00:38:34,000 --> 00:38:35,520
fall. 
That's why when I talked about 

767
00:38:35,520 --> 00:38:39,080
learn to get the balance, but we
need to know like if you don't 

768
00:38:39,080 --> 00:38:41,360
know you have osteoporosis, you 
don't know what your risk are. 

769
00:38:41,560 --> 00:38:44,640
So like you said earlier, be 
prepared like when you're in 

770
00:38:44,640 --> 00:38:47,360
your 35, like you know, like, 
OK, these things could happen. 

771
00:38:47,360 --> 00:38:50,240
How can I better to do 
prevention and cure? 

772
00:38:50,360 --> 00:38:53,160
Let me start building my bones, 
let me get strong, let me do 

773
00:38:53,840 --> 00:38:57,880
resistance training, let me also
cross Tain and impact my bones 

774
00:38:57,880 --> 00:39:01,440
and do running, walking, dancing
and then let me get my nutrition

775
00:39:01,440 --> 00:39:04,200
and for doing everything right. 
And then you have that checked. 

776
00:39:04,200 --> 00:39:08,160
And then of course, hormones is 
a whole nother topic episode 

777
00:39:08,360 --> 00:39:11,600
that really does help because 
our bone our there's nothing 

778
00:39:11,600 --> 00:39:14,000
that will replace estrogen. 
There's not enough 

779
00:39:14,280 --> 00:39:18,080
phytoestrogens or soy. 
And that's proven that will give

780
00:39:18,080 --> 00:39:21,080
you what you need if you need 
the estrogen and it is proven to

781
00:39:21,080 --> 00:39:25,120
be very safe. 
And, and, and the whole like 

782
00:39:25,120 --> 00:39:27,000
Women's Health initiative. 
We could, we could do a 

783
00:39:27,000 --> 00:39:29,360
discussion on that and the 
medications they use. 

784
00:39:29,360 --> 00:39:33,400
You know, they did horses urine 
primarine is pregnant mayor's 

785
00:39:33,400 --> 00:39:35,920
urine primarine. 
So there's it was just different

786
00:39:35,920 --> 00:39:41,760
stuff that they use. 
So that yes, yes. 

787
00:39:42,320 --> 00:39:44,600
Yeah. 
So I mean, I guess, I guess I'm 

788
00:39:44,680 --> 00:39:48,200
completely ignoring that just 
because of my own lack of of 

789
00:39:48,200 --> 00:39:51,800
knowledge to this topic. 
But obviously all of this is 

790
00:39:51,800 --> 00:39:53,720
happening because of lack of 
estrogen. 

791
00:39:53,720 --> 00:39:58,920
So maybe let's touch on how 
taking estrogen, what that looks

792
00:39:58,920 --> 00:40:02,280
like, what form it comes in, is 
it a shot, is it pills? 

793
00:40:02,280 --> 00:40:05,400
And then how does that affect 
everything? 

794
00:40:05,600 --> 00:40:09,240
How is that a tool to kind of 
solve the bone density problem? 

795
00:40:10,760 --> 00:40:14,160
So you, you don't need estrogen 
until you're, you know, as long 

796
00:40:14,160 --> 00:40:15,880
as you have some estrogen in 
your body. 

797
00:40:16,080 --> 00:40:19,720
And if you're still having your 
menses or even if you've had a 

798
00:40:19,720 --> 00:40:21,760
hysterectomy, that can be 
checked if you have your 

799
00:40:21,760 --> 00:40:24,400
ovaries, if you have estrogen, 
your bones will be strong. 

800
00:40:25,400 --> 00:40:27,560
You can take other things to 
help mitigate some of the other 

801
00:40:27,560 --> 00:40:29,720
symptoms. 
But as you lose estrogen and you

802
00:40:29,720 --> 00:40:31,480
start to have symptoms, even hot
flashes. 

803
00:40:31,480 --> 00:40:35,760
So I'll have some women in their
mid 40s, they're already on 

804
00:40:35,760 --> 00:40:37,800
estrogen. 
So your question was what, how 

805
00:40:37,800 --> 00:40:40,560
can you get estrogen? 
So there's estrogen patches. 

806
00:40:40,560 --> 00:40:42,560
Those are the safest. 
That's twice a week and there's 

807
00:40:42,560 --> 00:40:45,560
different dosages. 
So you do a patch twice a week. 

808
00:40:45,560 --> 00:40:48,320
I tell women, Sundays, you put 
one on and then on Thursday you 

809
00:40:48,320 --> 00:40:50,520
take the Sunday patch off and 
you put the Thursday 1:00 on the

810
00:40:50,520 --> 00:40:52,160
other side. 
So you kind of keep up with that

811
00:40:52,520 --> 00:40:55,800
different dosages. 
And then younger women, they 

812
00:40:55,800 --> 00:40:58,240
just need a little touch extra 
because they're just starting to

813
00:40:58,240 --> 00:40:59,560
lose it. 
As we get a little older, we 

814
00:40:59,560 --> 00:41:02,040
have to go up in the dose. 
So we we measure that blood 

815
00:41:02,040 --> 00:41:04,880
test. 
OK, if you don't want to do 

816
00:41:04,880 --> 00:41:07,280
that, there's a gel. 
I wish I had my little tools I 

817
00:41:07,280 --> 00:41:08,920
have. 
There's a little gel packet that

818
00:41:08,920 --> 00:41:11,280
you can do. 
It's everyday tiny little packet

819
00:41:11,480 --> 00:41:13,760
and you put it on your inner 
thigh and let it dry. 

820
00:41:13,760 --> 00:41:15,880
So that's another systemic 
estrogen. 

821
00:41:15,880 --> 00:41:18,440
So let me be clear, lady, 
there's two different types of 

822
00:41:18,440 --> 00:41:20,880
estrogen. 
There's vaginal estrogen, which 

823
00:41:20,880 --> 00:41:24,320
is just for women who like maybe
have breast cancer who can't use

824
00:41:24,320 --> 00:41:28,640
systemic estrogen, but have 
genital urinary syndrome of 

825
00:41:28,640 --> 00:41:32,280
menopause, which is a lot of 
vaginal dryness and your urinary

826
00:41:32,280 --> 00:41:35,360
tract infections because they 
don't have the Lactobacillus. 

827
00:41:35,360 --> 00:41:39,240
So you can do even any women can
do that, but that's just going 

828
00:41:39,240 --> 00:41:43,080
to help kind of lubricate and 
plump up and keep that vaginal 

829
00:41:43,640 --> 00:41:47,360
moist. 
OK, but that that is that is 

830
00:41:47,360 --> 00:41:49,680
just a local. 
Then the systemic estrogen, 

831
00:41:49,680 --> 00:41:51,320
which is the one I'm talking 
about, that's going to help your

832
00:41:51,320 --> 00:41:53,880
brain, your bones, your heart, 
it's going to help your whole 

833
00:41:53,880 --> 00:41:56,440
body. 
Then that's the patches, a cream

834
00:41:56,560 --> 00:41:59,160
or a spray. 
There's also pellets that's kind

835
00:41:59,160 --> 00:42:03,280
of an off label use, but a 
pellet can go in your bottom and

836
00:42:03,280 --> 00:42:05,840
that's good for like 3 months. 
It's an incision they make and 

837
00:42:05,960 --> 00:42:07,960
you put like it's a little like 
looks like a little grain of a 

838
00:42:07,960 --> 00:42:10,600
tic tac that goes in there. 
So those are your types of 

839
00:42:10,600 --> 00:42:12,520
estrogen. 
If you have, if you're on 

840
00:42:12,520 --> 00:42:14,600
estrogen and you have a uterus 
and you're on menopause, you 

841
00:42:14,600 --> 00:42:16,920
have to be on progesterone. 
You have to protect your uterus.

842
00:42:17,200 --> 00:42:20,400
So if you don't and you're have 
a hysterectomy, you can just do 

843
00:42:20,400 --> 00:42:23,800
estrogen only. 
What is the risk of estrogen? 

844
00:42:23,800 --> 00:42:27,840
Why don't all of us just once we
hit menopause, take estrogen 

845
00:42:27,840 --> 00:42:30,880
then? 
Well, I, I think that's going to

846
00:42:30,880 --> 00:42:32,360
be changing. 
I think more and more women, 

847
00:42:32,360 --> 00:42:35,080
there's actually a national 
shortage of estrogen patches 

848
00:42:35,080 --> 00:42:37,800
right now. 
It's been in some of the news. 

849
00:42:37,800 --> 00:42:40,480
I know it's been in the New York
Times that there is, it is 

850
00:42:40,640 --> 00:42:43,600
getting harder for women because
we're, we're finally getting 

851
00:42:43,600 --> 00:42:46,640
this freedom to be like, wait, 
we were, we were, we were 

852
00:42:46,640 --> 00:42:50,560
misinformed. 
OK, so the only women that 

853
00:42:50,560 --> 00:42:55,160
really have to be cautious at 
this time is women who have 

854
00:42:55,160 --> 00:42:58,840
breast cancer or have have had a
stroke. 

855
00:42:59,320 --> 00:43:01,280
I didn't mention there is a oral
estrogen. 

856
00:43:01,280 --> 00:43:04,000
I don't prescribe the oral 
estrogen hardly ever because any

857
00:43:04,000 --> 00:43:06,360
oral medication goes to your 
liver. 

858
00:43:06,360 --> 00:43:11,480
Liver is the called first pass 
your clotting factors go up and 

859
00:43:11,480 --> 00:43:14,280
there's a risk for a blood clot 
very small. 

860
00:43:14,400 --> 00:43:16,800
OK, It's still the benefits 
outweigh the risk. 

861
00:43:16,800 --> 00:43:18,800
So, you know, and you have to 
weigh it in. 

862
00:43:18,800 --> 00:43:21,000
If you have an obese patient 
that's smoking, it's kind of 

863
00:43:21,000 --> 00:43:22,640
like, you know, the birth 
control pills. 

864
00:43:22,640 --> 00:43:24,880
If you're obese and you're a 
smoker, you don't want to be a 

865
00:43:24,880 --> 00:43:25,880
birth control. 
Why? 

866
00:43:26,120 --> 00:43:29,000
Because you're taking a hormone 
that goes to your liver, which 

867
00:43:29,000 --> 00:43:31,760
increases your clotting factors,
which increases your chance of 

868
00:43:31,760 --> 00:43:34,880
having a blood clot. 
So I try to avoid that and just 

869
00:43:34,880 --> 00:43:38,280
do the transdermal, which is 
your patches or the cream or a 

870
00:43:38,280 --> 00:43:42,080
spray, But there is a pill. 
So you said why don't women do 

871
00:43:42,080 --> 00:43:44,240
that? 
Women just it's because the 

872
00:43:44,240 --> 00:43:48,040
Women's Health Initiative came 
out in 2002 and shut it down and

873
00:43:48,040 --> 00:43:50,400
said there was a risk of breast 
cancer. 

874
00:43:50,880 --> 00:43:53,200
And there's two arms. 
I don't know if we have time to 

875
00:43:53,200 --> 00:43:55,280
go into this, but there was 2 
arms in the Women's Health 

876
00:43:55,280 --> 00:43:58,520
Initiative. 
One arm where women had a 

877
00:43:58,520 --> 00:44:02,120
hysterectomy and they were just 
on Premarin, which was the 

878
00:44:02,120 --> 00:44:04,600
pregnant mare's urine. 
That was the form of and that's 

879
00:44:04,600 --> 00:44:07,280
still out on the market today. 
And then the other arm was the 

880
00:44:07,280 --> 00:44:11,320
women who had a uterus and they 
were on Prem pro, which is 

881
00:44:11,320 --> 00:44:14,120
pregnant mare's urine and 
progesterone, which is your 

882
00:44:14,120 --> 00:44:16,480
hydroxyprogestogen. 
So they had that was the two 

883
00:44:16,480 --> 00:44:18,680
because if you have your uterus,
you have to have progesterone. 

884
00:44:18,960 --> 00:44:21,840
So the two arms went on and then
after five years they came out 

885
00:44:21,840 --> 00:44:25,600
and there was in this this study
where they had both the study 

886
00:44:25,600 --> 00:44:29,320
with just the estrogen big 
reduction, 30% reduction in 

887
00:44:29,320 --> 00:44:31,560
breast cancers, reduction in 
colon cancer. 

888
00:44:31,560 --> 00:44:34,520
Nobody talked about that and, 
and, and women loved it. 

889
00:44:34,520 --> 00:44:36,320
They were thriving. 
Even on this one, women were 

890
00:44:36,320 --> 00:44:40,000
thriving. 
There was on the placebo arm 

891
00:44:40,000 --> 00:44:45,440
there was 4 people and 1000 that
ended up with a breast cancer. 

892
00:44:45,600 --> 00:44:48,400
And then when on the Prem pro 
there was 5 and 1000. 

893
00:44:48,400 --> 00:44:50,080
So they said there was a 25% 
increase. 

894
00:44:50,080 --> 00:44:54,520
Well, that was a relative risk. 
I mean, it, it got misconstrued 

895
00:44:55,440 --> 00:45:01,720
and it was synthetic hormones. 
So what we use now is progestin 

896
00:45:01,720 --> 00:45:04,480
progesterone, which is a 
mycotized by eagle identical 

897
00:45:04,480 --> 00:45:06,920
progesterone, not 
hydroxyprogestogen. 

898
00:45:07,160 --> 00:45:10,200
And then we also use the 
estradiol, which is a patch, 

899
00:45:10,200 --> 00:45:14,520
which is a natural estrogen, not
a synthetic from, from the 

900
00:45:14,520 --> 00:45:16,680
horse's urine. 
And birth control is a 

901
00:45:16,680 --> 00:45:20,480
synthetic, the estrogen they 
that's the estrogen. 

902
00:45:20,480 --> 00:45:24,000
And birth control is synthetic, 
which is 300 times more potent 

903
00:45:24,000 --> 00:45:26,360
to bind to the receptors of 
estrogen, which I'm not a huge 

904
00:45:26,360 --> 00:45:30,080
fan of the birth control, but 
because of some of those 

905
00:45:30,080 --> 00:45:33,120
synthetic parts of it. 
But yes, in the future, I do 

906
00:45:33,120 --> 00:45:36,000
think that's slowly changing as 
I can see in the market, it's 

907
00:45:36,000 --> 00:45:38,720
harder and harder for me to get 
patches for some women. 

908
00:45:39,040 --> 00:45:42,920
And I and I think women are 
going to going to find that 

909
00:45:42,920 --> 00:45:46,160
they, they're live longer, they 
have better lives, they have 

910
00:45:46,160 --> 00:45:47,880
better quality of lives, health 
span. 

911
00:45:48,880 --> 00:45:52,080
I love this. 
This is so informative and also 

912
00:45:52,080 --> 00:45:54,200
so much so for the runners that 
are listening. 

913
00:45:55,160 --> 00:45:58,120
What is the best first step to 
take if you were to pick one 

914
00:45:58,120 --> 00:46:01,400
thing that you said that is the 
most important take away and. 

915
00:46:01,400 --> 00:46:03,680
Most workable first step? 
What would that be? 

916
00:46:05,800 --> 00:46:08,760
You know what I think it would 
be to get a basic blood work 

917
00:46:08,760 --> 00:46:10,720
done. 
Just get see where you're at 

918
00:46:10,720 --> 00:46:12,840
with everything. 
Like make sure that we're not 

919
00:46:12,840 --> 00:46:16,360
missing a thyroid disorder. 
Make sure your calcium levels is

920
00:46:16,360 --> 00:46:18,600
good. 
That would be the first step. 

921
00:46:18,600 --> 00:46:21,080
Like just get your baseline and 
if you want to throw the 

922
00:46:21,080 --> 00:46:23,520
hormones in there, ask your 
doctor to say, let me see where 

923
00:46:23,520 --> 00:46:26,480
I'm at with everything. 
And then we can build on that. 

924
00:46:26,680 --> 00:46:28,760
And then you start to kind of 
get your plan together. 

925
00:46:28,760 --> 00:46:32,440
OK, I want to make changes. 
I want to make sure I, I have 

926
00:46:32,520 --> 00:46:35,080
good, strong, healthy bones. 
I don't want to fall and break a

927
00:46:35,080 --> 00:46:38,880
hip because the dangers of 
breaking hip, as you know, 20% 

928
00:46:38,880 --> 00:46:41,760
of the women don't make it 
within one year of a hip 

929
00:46:41,760 --> 00:46:44,480
fracture from a fragility. 
So then you start to put your 

930
00:46:44,480 --> 00:46:46,720
workout plan together. 
Let me start running. 

931
00:46:46,720 --> 00:46:48,840
Let me start walking. 
Let me start resistance 

932
00:46:48,840 --> 00:46:50,800
training. 
Let's get our diet in order. 

933
00:46:50,800 --> 00:46:53,240
But the first line is just to 
get your baseline. 

934
00:46:53,440 --> 00:46:56,080
Let's, let's see, let's see 
where I'm at with everything and

935
00:46:56,080 --> 00:46:59,120
then you can build on it. 
Wow, I love it. 

936
00:46:59,120 --> 00:47:01,000
Angela, thank you so much for 
coming on. 

937
00:47:01,000 --> 00:47:02,880
I really appreciate it and 
hopefully we can have you back 

938
00:47:02,880 --> 00:47:06,440
on the future to elaborate more 
on the other hormones and and 

939
00:47:06,440 --> 00:47:08,680
stuff like that is like a both 
of knowledge. 

940
00:47:08,680 --> 00:47:10,920
Thank you. 
Oh, you're welcome. 

941
00:47:10,920 --> 00:47:12,440
Thank you for having me, I 
enjoyed it. 

942
00:47:24,360 --> 00:47:28,320
Thank you Angela for this super 
enlightening conversation we 

943
00:47:28,320 --> 00:47:30,040
had. 
I didn't tell you, but in 

944
00:47:30,040 --> 00:47:34,320
reality my awareness of all this
was so limited that I didn't 

945
00:47:34,320 --> 00:47:36,800
even think of bones as living 
tissues. 

946
00:47:36,840 --> 00:47:39,720
And I think that comes from non 
medical standpoint. 

947
00:47:39,720 --> 00:47:42,240
You just think of skeletons and 
how you know when someone dies, 

948
00:47:42,240 --> 00:47:44,520
the bones stay leftover. 
So the bones are always there, 

949
00:47:44,720 --> 00:47:48,360
but just the fact that those 
bones renew themselves and you 

950
00:47:48,360 --> 00:47:50,640
end up with a new skeleton and 
all that stuff, it's really 

951
00:47:50,880 --> 00:47:52,440
cool. 
And then everything else that 

952
00:47:52,440 --> 00:47:56,400
she was saying, this is so good.
I think you're exactly right. 

953
00:47:56,400 --> 00:47:59,600
Most people see the bones as a 
skeleton, as someone that died. 

954
00:48:00,080 --> 00:48:03,160
In that case it's not living 
tissue, it's just a leftover 

955
00:48:03,160 --> 00:48:06,640
calcium that survives the 
weather and stuff. 

956
00:48:06,640 --> 00:48:09,720
But when you're alive, the bones
actually are very alive. 

957
00:48:09,720 --> 00:48:11,800
And they're constantly 
regenerating. 

958
00:48:11,800 --> 00:48:13,840
And so it's kind of interesting 
and most people don't don't 

959
00:48:13,840 --> 00:48:15,600
think about that. 
I'm glad you see where I'm 

960
00:48:15,600 --> 00:48:17,880
coming from because I also think
of it as like hair, right? 

961
00:48:17,880 --> 00:48:20,440
Hair is dead except for your 
follicle up there and grows 

962
00:48:20,440 --> 00:48:22,560
more. 
But what's hanging down that 

963
00:48:22,560 --> 00:48:24,800
doesn't renew itself? 
No, all these shampoos that you 

964
00:48:24,800 --> 00:48:27,840
can buy that say have a big 
claim of like renew your hair 

965
00:48:27,840 --> 00:48:29,480
and everything. 
No, this is dead hair. 

966
00:48:29,480 --> 00:48:32,080
If it's split ends, it's going 
to continue being split and 

967
00:48:32,080 --> 00:48:34,360
maybe it'll be more shiny 
because you put something on it.

968
00:48:34,440 --> 00:48:36,680
Yeah, you can maybe put 
something, you know, 

969
00:48:36,680 --> 00:48:41,640
moisturizing conditioner, things
like that might help a bit, but 

970
00:48:41,640 --> 00:48:43,640
they're not going to, you know, 
fix. 

971
00:48:43,760 --> 00:48:46,680
But it's not going to repair 
itself, so I mean unless you 

972
00:48:46,680 --> 00:48:49,160
like fuse it with. 
Something yeah, yeah, bones are 

973
00:48:49,160 --> 00:48:51,560
different because your body uses
calcium all the time and it's 

974
00:48:51,560 --> 00:48:53,280
kind of like a storage of 
calcium too. 

975
00:48:53,280 --> 00:48:55,920
So it like takes away when it 
needs it and puts it back. 

976
00:48:55,920 --> 00:48:59,720
But as you age and especially if
you don't aren't very active and

977
00:48:59,720 --> 00:49:01,840
you're not stressing those 
bones, they say, well, why do we

978
00:49:01,840 --> 00:49:03,520
need to be strong? 
We're not being used. 

979
00:49:03,520 --> 00:49:05,240
So they just start getting 
absorbed. 

980
00:49:05,680 --> 00:49:08,680
Yep, Yep. 
So that was that for today. 

981
00:49:08,680 --> 00:49:09,840
What do we have to look forward 
to? 

982
00:49:09,840 --> 00:49:13,800
So I guess Ryan, we have our 
anniversary episode coming up 

983
00:49:14,000 --> 00:49:15,960
next week. 
I'm not going to say what 

984
00:49:16,120 --> 00:49:17,880
anniversary number it is. 
I'm going to let you do the 

985
00:49:17,880 --> 00:49:19,840
math. 
We started the podcast in 2020, 

986
00:49:19,840 --> 00:49:22,640
in May and we have done six 
seasons. 

987
00:49:22,640 --> 00:49:25,760
So it is our. 6th. 6th 
anniversary. 

988
00:49:25,760 --> 00:49:27,200
For whatever reason it's not 
7th. 

989
00:49:27,280 --> 00:49:29,000
I don't understand this math. 
Well, we've done it. 

990
00:49:29,000 --> 00:49:32,480
If we did it for 6th and it 
would be 6th anniversary, you 

991
00:49:32,480 --> 00:49:34,440
wouldn't add a year. 
Yeah, I don't know. 

992
00:49:34,440 --> 00:49:36,680
It's like a baby, right? 
A baby's born and you have the 

993
00:49:36,680 --> 00:49:39,160
first year and then you, I guess
you turn 1. 

994
00:49:39,160 --> 00:49:41,400
I don't know. 
Yeah, when you turn 6, I mean, 

995
00:49:41,400 --> 00:49:44,000
it's kind of the same thing. 
We have the same conversation 

996
00:49:44,000 --> 00:49:45,480
every year. 
I'm struggling with it. 

997
00:49:45,720 --> 00:49:49,560
And for our anniversary episode,
I think we have something really

998
00:49:49,560 --> 00:49:54,560
cool for you guys. 
We have a topic that we are 

999
00:49:54,560 --> 00:49:56,440
working on and hopefully it'll 
come through. 

1000
00:49:56,480 --> 00:50:00,000
Besides that, for our 
anniversary, we also have 

1001
00:50:00,000 --> 00:50:04,160
decided to make this podcast 
bigger by adding a separate 

1002
00:50:04,160 --> 00:50:06,200
segment to it. 
I've said it for the last two 

1003
00:50:06,200 --> 00:50:09,920
episodes that we are going to 
have a segment called Your 

1004
00:50:09,920 --> 00:50:13,240
Story, Your Why. 
When we talk to runners about 

1005
00:50:13,240 --> 00:50:15,720
their story. 
The reason being is that we are 

1006
00:50:15,720 --> 00:50:19,200
so technical, scientifical and 
into training for all these 

1007
00:50:19,200 --> 00:50:22,480
other podcasts that we want to 
bring in the human side of it. 

1008
00:50:22,640 --> 00:50:27,120
So it's going to be all separate
episodes starting next Thursday,

1009
00:50:27,280 --> 00:50:31,160
which is May 28th. 
So I'm super looking forward to 

1010
00:50:31,160 --> 00:50:33,120
that. 
I'm very excited because we have

1011
00:50:33,120 --> 00:50:37,520
been recording non-stop and I'm 
very grateful for everyone that 

1012
00:50:37,520 --> 00:50:39,600
reached out to be on these 
episodes. 

1013
00:50:39,600 --> 00:50:42,320
I encourage you guys to continue
reaching out to us. 

1014
00:50:42,320 --> 00:50:46,040
You can reach me at 
letty@marathonjournal.com. 

1015
00:50:46,040 --> 00:50:50,680
That's LETTY and I will schedule
you and we will talk about your 

1016
00:50:50,680 --> 00:50:53,480
story and your why. 
So that's coming up. 

1017
00:50:53,920 --> 00:50:56,560
Anything else from you, Ryan? 
I guess besides the fact that we

1018
00:50:56,560 --> 00:50:59,600
are travelling for the summer. 
Yeah, we'll be in Germany again.

1019
00:50:59,600 --> 00:51:01,680
Should be fine. 
We'll do our hiking and get our 

1020
00:51:01,680 --> 00:51:03,880
exercise in that way. 
So I guess with that, there will

1021
00:51:03,880 --> 00:51:07,200
be more content on Instagram 
about what we're doing, where 

1022
00:51:07,200 --> 00:51:10,520
we're hiking. 
We, very gratefully to Solomon, 

1023
00:51:10,680 --> 00:51:14,680
were gifted some shoes for not 
just us but also our children to

1024
00:51:14,680 --> 00:51:18,520
have proper hiking attire. 
So we'll be flaunting those 

1025
00:51:18,520 --> 00:51:20,320
shoes because they are pretty 
amazing. 

1026
00:51:20,320 --> 00:51:23,080
We tried them out already in 
California and you know, it's 

1027
00:51:23,080 --> 00:51:26,040
nothing better than having some 
good and sturdy shoes that you 

1028
00:51:26,040 --> 00:51:28,880
can hike with that are not 
actual hiking boots. 

1029
00:51:28,880 --> 00:51:31,240
I guess they're more like trail 
running shoes, which I 

1030
00:51:31,240 --> 00:51:33,840
definitely prefer. 
Yeah, I prefer trail running 

1031
00:51:33,840 --> 00:51:35,800
shoes more so, but yeah, they do
seem kind of neat. 

1032
00:51:35,920 --> 00:51:38,360
It'll be cool to wear them some 
more and give them a good test. 

1033
00:51:38,640 --> 00:51:42,600
Yes, yes, yes, and I guess yeah.
So again, thank you for tuning 

1034
00:51:42,600 --> 00:51:46,320
in. 
Stay tuned for next week and. 

1035
00:51:46,480 --> 00:51:50,440
Have a good week of running. 
You've been listening to the 

1036
00:51:50,440 --> 00:51:52,560
Marathon Running Podcast by 
Marathon Journal. 

1037
00:51:53,320 --> 00:51:55,360
If you've enjoyed the show, 
check us out at 

1038
00:51:55,360 --> 00:51:58,280
marathonjournal.com or follow us
on social media. 

1039
00:51:58,440 --> 00:51:59,360
Happy training.