Thyroid Health & Bone Connection: Hidden Link

Kevin Ellis

Yeah, I would be happy to. And I am so glad to be here too. I think this is such an important topic. Your bone health is such an important topic. Hashimoto’s ties into that picture and thyroid health ties into that picture. And I am excited to talk about that. And for me, my journey started with my own health issues. I would actually take it back to before I was born. When my mother was five months pregnant with me, my father was told he had cancer, and two months after I was born he passed away. He was 35 years old at that time, and my entire life I had this fear that I was going to follow down that path to an early grave, not be there for my kids, and not have the opportunity to be a father. And when I was told that osteoporosis, in my early thirties, of all things, I thought my fate was going to be the same. I thought I was going down that exact same path. And my father was a marine. He did 22 months in Vietnam, he came back and he survived combat but he got cancer from agent orange, of all things, and that is what caused him to pass away. I decided I was going to be a marine to follow in his footsteps. And when I came out of the marine corps and I started having all these different health issues and I had high stress or sleep, I had chronic digestive issues, I was not absorbing my nutrients, some days my energy was almost non-existent, some days I could barely even get out of bed. And for somebody to go from being really active, this tough marine who can endure and who just has all this energy to do all this stuff to not even be able to get out of my bed and provide for my family or feel adequate. It was really a damage to the psyche but beyond that, my digestive health was still I think a major factor in driving these issues. And then I was told I had celiac disease and I was mal absorbing nutrients. Celiac disease is this autoimmune condition where when you ingest gluten or proteins that mimic gluten it can damage the villi in your small intestine, the nutrient absorption centers, these tiny little hair-like projections. And my villi were being blunted and damaged and I had no idea that they could not absorb these nutrients that I was taking in. And eventually what happened is my body still needed those nutrients to execute its daily functions. Where was it going? it was going into the bones and taking those nutrients out to serve the needs of the body and that eventually led to osteoporosis. And that was a bone loss at a really young age. 

When I was told I had osteoporosis, it was a letter in the mail, it said, hey, you have osteoporosis, go on a gluten-free diet. That was the extent of the plan that I had. And I realized as I did some research and looked it up that fractures and dependence on medication is what my future was at that point. And I was scared, honestly, I was scared. I had no idea where to start or what to do. I went down this path of reading and researching and consulting with people, spending a lot of money trying to figure all that stuff out. Not only was I making progress in my own health. I made this discovery along the way that it is not the 30-year-old male that typically is dealing with this or trying to get these answers it is the woman, 40s, or 50s, 60s plus, a lot of times that goes down this path and they are presented with take some calcium, vitamin D, go for a walk, here is your bone drug, see you in two years for your next bone density scan. And that is woefully inadequate and that is the reason why I became a coach. Built out a team of credentialed experts, have built a community of over 150,000 people at this point, and have programs that help people build stronger bones. And I am so passionate about this because it is the structure it is going to carry you to an active future. You need to preserve it, you need to strengthen it.

Jen Pfleghaar, DO, FACEP

I love your story. It is so important. And a lot of the Hashimoto’spatients they have celiac also, there is a connection there. And how when you are not absorbing things, your body is smart, trying to keep you alive, trying to keep things in homeostasis and part of that is taking away from the bone, it can be. I think it is so important what you are doing. And I agree with you. It is not good enough what conventional medicine does. And I think the frustrating thing is some people they just take the word for it, they are like, okay, I am fine on this bone drug and like you were told, you just go gluten-free, it is not enough, we really have to empower our cells. We have to treat our body like it is important and read and research outside of just going to the doctor. I love that. Let us talk about the connection between thyroid health and bone health. Everyone thinks that our organs do not talk to each other or sometimes we go to an endocrinologist and then we go to another doctor for our bones, an orthopedic doctor, and then we go to an, no, they all connect, they all talk. How do our thyroid and our bones talk?

Kevin Ellis

Well, I think I think the biggest connection, especially if we are talking about Hashimoto’s too, the some of the biggest connecting factors between your thyroid health and your bone health number one would be if we understand anything that is creating inflammation in the body that can contribute to in fueling bone loss if you have an autoimmune condition that is not in remission if you have you have Hashimoto’s and you have put that in remission and something is still going on there. Same thing with celiac disease or any other autoimmune condition not even just thyroid. There can be this underlying fire basically in your body that is taking place, that is contributing to and fueling bone loss. Part of the reason for that is that within your bones, bones are not just this static tissue, they are actually living tissue. And 95% of the blood cells that are produced in your body are produced within the bone marrow. It is a soft spongy material that produces 95% of these blood cells. And these blood cells they start out as stem cells and they become either platelets, red blood cells, or white blood cells based on conditions in your body. 

If you need help with preventing bleeding or clotting that is where platelets are going to come in. If you need help with sending oxygen to the body’s tissues and carrying carbon dioxide away from the tissues back to the lungs that is where red blood cells are going to come in. But if you need help fighting infections, healing wounds, or anything to do with the immune system, this is a really important part here, anything to do with the immune system that is where white blood cells come in. The cells that break down bone, osteoclast, are a form of white blood cell. Anything stimulating the immune system is speaking in the same language as the cells that break down your bones. If you have an autoimmune condition that is not in remission, Hashimoto’s could be an example of any of these other autoimmune conditions, that can be speaking in the same language as the cells that break down your bone and that can contribute to bone loss. I think another big factor would be certain medications too for thyroid health. In terms of either increasing the rate at which bones are broken down or suppressing bone formation, all of those things could be affected potentially by thyroid medication. And then I just think to some of the more actionable things that people can focus on are things that you are actually putting in your body and are those leading to inflammation, stimulating the immune system, things like that. We can actually get into nutrition a little bit and in a minute also.

Jen Pfleghaar, DO, FACEP

Yeah, that is such a great point. And I have even had patients that were very hyper like Graves and they almost have this bone pain because it is speeding up that resorption of the bone. Definitely, you want to make sure that your levels are in homeostasis that they are optimal because they can affect your bones too. What exactly are osteopenia and osteoporosis? I know we use those terms a lot in medicine and we will be talking about it today. And how common is it? And how do you even know if you have it? Because screening actually does not start until later. And sometimes men are ignored. 

Kevin Ellis

I mean, perfect example, I mean, most of the time it is not going to be your young men that are getting this diagnosis, that are focused on it. Part of the reason for that is it has to do with, part of it is the medical system and when they are actually going to run one of these tests or approved one to be covered by insurance which is usually not until your 65. That is one issue but the other issue is that there are different types of osteoporosis. One is called primary osteoporosis and that is typically occurring in women. Typically occurs in women when they reach menopause, they have a decline in estrogen. Estrogen has a protective effect on bone. When those levels decrease as they do during menopause that causes an increase in the cells that break down bone and that is going to lead to a reduction in bone density if you do not do some of these protective things that we are going to talk about and it can also then increase your risk of fracture. Now, osteoporosis itself is actually there. It is about 10 million Americans, I would say, that have osteoporosis. Another 44 million have low bone density. One in two women up to one in four men will break a bone in their lifetime due to osteoporosis. And for women, the incidence of low bone density is greater than that of heart attacks, stroke, and breast cancer combined. It is something to be aware of. And I think the biggest concern for most people is as they saw maybe a family member, or their mother, or their grandmother, or something that happened with them, this is actually what I hear most commonly is I saw the progression that happened after a fracture and they want to prevent that from happening to them. 

And first, you have to understand what is osteoporosis, how do you know if you have it. Osteoporosis, it means porous bone. And it is when you do not have enough bone formation you have excessive bone loss or it is a combination of both of those things. And when you have osteoporosis both your bone density and your bone quality are reduced and that will increase your risk of fracture. A bone density scan is what tells you if you have osteoporosis and that is determined by a scoring system. When you get this scan done, you lay it out on the machine, it scans, it generates these scores. And if you have a score of minus one to minus two point five, that is considered osteopenia, we would call that low bone mass. And then if you have minus two point five or lower, minus two points six, minus two point seven so on and so forth, that is considered osteoporosis. And the greater the negative number becomes the more severe osteoporosis. And a lot of people, like I said, they are not getting these scans done until later in life. And I always like to see people getting them done earlier just to even get a baseline of where your bones are at now because you may not have built up enough bone in your younger years. 

To you and I before we hopped on this interview we were talking about we have got kids. And our kids are in this prime age right now where 90% of your bone mass is put on by the time you turn age 18. And by the time you turn 30, the remaining 10% approximately fills in. If when you are younger you have poor diet nutrition, you are eating a bunch of candy, and drinking a bunch of sugary soft drinks, if you are not getting the nutrients you need to form those building blocks to your bones from a young age, the calcium, magnesium, the vitamin D and the vitamin K2, those are all important that can affect you reaching peak bone mass, if you are not active or you were not active when you were a child, if you led a sedentary lifestyle, if you did not play sports, you were not moving in these sharp short dynamic movements, stimulating those bones, you were not doing gymnastics or things like that all of those things could have contributed to you not achieving peak bone mass. If you took certain medications like glucocorticoids which are like prednisone, for example, if you had an eating disorder, if you smoked or drank excessively, all of those things could have contributed to you not achieving peak bone mass and starting with what I call a full bucket. And there are a lot of other causes that we can talk about for bone loss.

Jen Pfleghaar, DO, FACEP

Yeah, it is kind of scary when we talk about kids because look at the pandemic, no one was getting out and about, we were all eating badly. Well, a lot of people are drinking a lot. I am from Ohio. And when our governor would come on they would call it wine with DeWine and it was a big joke and I am like, let us stop joking about drinking alcohol, it is not okay. But I digress. But the kids’ thing is very important because if you are not filled, like you said, filling up your bucket and building that foundation then you are kind of a step behind everyone else. And it is really hard with nutrition with kids these days, I mean, a lot of sedentary sitting, all those big Starbucks drinks, all those tops, lots of sugar, we really do need to focus on our children’s nutrition. And leaky gut is big as with celiac, if you have a leaky gut, you have inflammation that is going to affect the bones. I love that you brought up kids. Because most people listening today they probably have children or they want to someday.

Kevin Ellis

I am so passionate about this area. We focus now on people with osteopenia and osteoporosis. That is who we work with and we have helped a lot of people there. My passion also is for kids preventing osteoporosis and preventing the disease from progressing. For me, I have young kids also. I want them to grow up strong and healthy but sometimes it is challenging. As the parent, as the grandparent, you are listening to this right now and you are like, gosh, I try, I try it is so hard, how can I do this? Well, some of the ways. Let us even talk about nutrition for a second. It is not necessarily about removing all the foods or taking all these bad things out sometimes it is about how can we add in better choices or swap things out for better alternatives where it does not have to be this deprivation mindset, it can actually be like, wow, I get to nourish my body with these amazing foods. Let me give you a few examples. Instead of like a bag of chips or something like that that somebody might eat like Lay’s, potato chips or something like that, you do not want that, that is going to be covered in glyphosate, it is going to have oils on it that are not good and it is just basically going to break down into sugar. How could you make a better swap? You could do kale chips. I love dino kale, those are great. You can actually pull the leaves off the stem, rinse them off, dry them, use extra virgin olive oil mister, mist them down, sprinkle a little sea salt on top of them, and put them in the oven for about 300 degrees for 10 to 12 minutes or so, get them a light crisp on there, right before they are brown you pull them out and they are crunchy like chips and the kids will love them. And that is so simple and basic. Another one would be, a lot of people give cookies and ice cream and things like that for dessert. Why can not dessert be something that still maybe has a little sweetness to it but is not having all these damaging effects on our health? What we do for our kids is we let them build their own organic berry bowls, we put the fruit out there, we let them make designs with it, cut it up small, build their own balls, and then maybe a little tiny little bit of honey or, a sprinkle of cinnamon or something on there. Let them get creative and get involved in the process. 

And then the last part of this, if you are thinking about your whole family, not just you and your kids but also yourself, sometimes the obstacle that I hear for people is that, well, I want to eat healthy but my husband is bringing the junk in the house or my kids would not eat this, get them involved in the process, get their buy-in first. You come to them in advance and you say, hey, what are your favorite meals? And then you go online and you find a better healthier version, if you are following something like a plan for Hashimoto’s and putting that in remission you may be following more of a paleo AIP or paleo-ish type plan, you can go find paleo versions of those recipes, get that, hey, if I made this would you try it? get them to buy in first and then when you make it, it is not a surprise, they were bought in and invested upfront. I know I went off on a little tangent there. But I am so passionate about nourishing our families and our friends too. You become the shepherd for other people in your life.

Jen Pfleghaar, DO, FACEP

That is so true. And it will catch on. If other people are seeing that you eat differently or you are like, no, we are not going to have a treat, we will have a treat at home, or we will go somewhere that has like better homemade ice cream instead of just the processed stuff. It is really hard with kids in finding swaps. They feel normal at school and have the same thing but it is a healthier version instead of maybe cooked in soybean oil, it is cooked in avocado oil, like for chips and stuff. It is hard. If you are listening out there, just try to implement one thing a week, if it is a spouse just swap out, if they are drinking Pops swap it out for, pop,  Zevia, or something. I think it is hard too. I have noticed that when people do not see the actual health effects and health consequences or they think they are invincible they do not have any motivation. And I will tell you, I know Kevin and I both see it, there are bad side effects to eating those foods whether it is a fracture, you break your hip, you break your wrist, you get to go under anesthesia then you are just not right, there are consequences. And we want to prevent disease. That is what this whole summit is about, heal your thyroid and prevent disease from happening, let us prevent bone loss. And none of us want to fall and break a hip, that is everyone’s worst fear, so let us be proactive now is the thing. 

Now let us talk about the standard treatment. If someone would go to their doctor either they broke a hip and then that had them get a diagnosis of osteoporosis or osteopenia, or they just got their DEXA scan and they are in that category but they have not had a fracture yet, they went to their doctor, what is the standard treatment? And what are the pitfalls of those treatments?

Kevin Ellis

I would say the standard treatment for the majority of people is going to be calcium and vitamin D, go for a walk, and take your bone drug, we will see in two years for your next bone density. And there is so much more to it than that, that is woefully inadequate. And we have to understand that. Let us start with calcium. Calcium, it is the primary mineral constituent of your bones. Is it important? Of course, yes, it is important. Vitamin D, it is involved in so many processes in your body, it is not just a vitamin, it is a hormone and it is incredibly important for your health. Most people know that. Then the last part, we will talk about exercise more in-depth in just a little bit. But walking is not going to be enough, it is great for your health but it is not going to be enough, especially to support maintaining bone health and even building bone strength. And then the last part is the medication piece. And this is the recommendation that people get oftentimes when they go get the scan, they get the diagnosis and in a matter of 15 minutes, they have a prescription for a drug that has a dramatic effect on bone physiology. It is not like taking aspirin or some other medication, there are important considerations and risks and side effects, and short and long-term implications of using these different drugs.

And that there are two different categories of drugs typically that are going to be recommended. There are antiresorptives that are designed to slow down the activity level of cells that break down bone. And there are anabolics designed to build better quality bone and build it faster. Antiresorptive would be your bisphosphonates and your rank ligand inhibitors. Your bisphosphonates would be your Fosamax, your Boniva, your actinium, and Reclast, those are your bisphosphonates. And then your rank ligand inhibitors would be like Prolia. The safety and efficacy, let us talk about bisphosphonates because this is one of the more common ones that people are going to get prescribed, the safety and efficacy of these drugs are not really well known beyond five years. And what is really important to keep in mind is as you and I are going about our daily lives, doing our daily activities, for everybody, we are starting to get these tiny little micro-cracks and microfractures and damage in our bones, that is normal, you are doing a hard workout, you are going to move in directions that you are not usually moving, that is going to happen. And then what happens is you have cells within your bone called astrocytes that sense that damage and they send out a signal that says, hey, there is damage like we need to come to repair this. And then you have cells called osteoclast that receive that message and they come in and they scoop out that damaged bone. And then right behind it, it is a coupled process, you have osteoblasts that come in and fill in that stronger healthier bone. When you take some of these medications you can actually slow down that process too much where you start to accumulate that old worn damaged weakened bone over time. Even if you take some of these and your bone density scores show as being higher the quality may not actually be strong, the bone may actually be stronger. Bone density is the measure of how much bone you have, the actual mineral content of your bone. Bone quality is the structural integrity of that bone, the microarchitecture, and how that bone is organized. Those two things combine to create bone strength. Again, even if your bone density shows higher that quality may not be that great and the bone may not actually be stronger. 

There are also side effects that come with a lot of these medications. I know that the brain clogging inhibitor, Prolia that I just touched on, if you take that medication you can not just stop it. If you stop it, it will actually increase your risk of vertebral fractures. Then what you have to do is you have to follow it with a medication just to not have those vertebral fractures and the same thing with the anabolic medications too. They are just important considerations. And I am not saying that for every single person, I wish I could just say, no medication for anybody, sometimes it makes sense but the majority of the time there is so much more you can do before you get to that point.

Jen Pfleghaar, DO, FACEP

Yeah. And I think there is a lack of informed consent when patients are placed on these drugs. And if you dig into the literature, as you alluded to, you are building up a bone that is not as strong, it is not as dense because your osteoclast and osteoblasts are not working like they are supposed to be. And I do not know why we mess around with so much of like what God intended bodies to be able to do. And these medications are a little bit nerve-wracking because sometimes they are put out there as the only option, this is all we have, but if you dig into the literature, yes, the vertebral fractures, they are looking at these bone densities but they do not actually help with fractures. It is so weird to me that this is kind of just here is a script, this is all you can do, you have osteoporosis, you have osteopenia, and patients come to me and they are like scared about this, they are like, I do not want to go on this medication, my gut is telling me I do not want to go on it but this is my only option, I am like, it is not your only option. It is very frustrating I think, especially when we know that we could do better. I am glad you broke down the actual mechanisms of how these medications work because this is not communicated in a doctor’s office most of the time.

Kevin Ellis

Yeah. And the other piece of this too, the anabolics, those are the other category of medications. Those are the ones that are designed to build bone, build better quality bone, and build it faster. And they can do that as long as there is not an underlying cause contributing underneath. But again, there are side effects in the short and long-term implications of use. Those drugs you can not take for longer than a certain period of time. And then when you come off of them you have to follow them with an antiresorptive also just to not lose the bone you just gain. Keep those things in mind too as you are making these decisions and also understand like, look, medication is over here, everything else that you have to do, and there is a lot that can be done, is over here. Regardless of whether medication is in the picture or not you still have to do all of these things right here. And we can talk about what those things are.

Jen Pfleghaar, DO, FACEP

Yes. Let us touch base on diet a little bit. Is there a perfect diet to prevent osteoporosis or to reverse it?

Kevin Ellis

This is such a good question. Because nutrition is essential, it is essential for life, it is essential for healing and it is essential for having the building blocks we need to build a stronger healthier body and stronger healthier bones. Now, a lot of times when it comes to diet and nutrition, I think everybody needs to understand we are all biochemically and genetically unique individuals, you are going to respond to different foods and supplements and dietary approaches differently. And also, you might hear people talk about this specific superfood is great for this and this, that is great, make note of those things that may be helpful for you but also may not, if something creates inflammation in your body it is not going to be a health food for you. When you are approaching diet and nutrition, I always encourage people you are going to have things that do not work out, you are going to have hope that you put behind this one food or this one supplement ad you know what, sometimes it is just not going to work. If you can change your mind to just approach things with curiosity instead of the expectation that disappointment is going to disappear. I said one more time, if you approach things with curiosity instead of expectation your disappointment will disappear, not just with diet and nutrition but anything else too that can be really helpful. Because if it does work out it is a pleasant surprise. 

And then from a diet nutrition standpoint, especially if you have got Hashimoto’s or you are working through other autoimmune conditions too and you are trying to put those things into remission your diet, or you have Candida or SIBO or something like that, your dietary approach is going to be adjusted and tweaked then somebody who does not have those things. Keep that in mind as you start planning this out. If you are trying to put an autoimmune disease into remission, one of the most important or one of them, not most important necessarily but one of the best sources of calcium that people hear about which is an important nutrient is dairy. Can I do dairy? What is that going to look like? Should I incorporate it or not? That is a big question I get. And if you have an autoimmune condition that might not be the right approach for you. Especially cows dairy, if you can not tolerate sheep or goat or something like that maybe camel milk might be okay, camel milk or camel milk kefir or something like that could be okay, but again, you just have to kind of test these things to understand. And then if you are consuming any dairy products whether you are on an autoimmune condition or you have an autoimmune condition or not cultured and fermented would be the way to go, it is not drinking a bunch of milk, that is not a great approach, I would say focus on things like kefir or a 24-hour yogurt or something like that, that is also providing you with additional nutrients and some beneficial bacteria and yeast and things like that. That is kind of a note. But dairy is not necessarily for everybody. 

And then when it comes to nutrition, it is like, okay, if I can not do dairy and I can not use that as a source of calcium, what else can I possibly do? Well, you could do bone-in fish, you could do sardines, or mackerel, or can wild sockeye salmon, get these BPA-free cans but get the bones in. And the reason you want the bones in these fish is because those bones contain all the nutrients that your own bones need in the right ratios that nature put them in. Okay. They also contain protein, sardines, mackerel, and salmon, they all contain protein. Protein is essential for your bone health. Your bone structure is 50% protein by volume. They need amino acids. When you consume things like fish or meat or something like that you are going to get those amino acids. And then the last part of this would be omega 3, omega 3 fatty acids. Omega 3s are dampeners of inflammation. Anything contributing to inflammation like we talked about that contributes to and fuels bone loss that can be great. And then other sources of calcium could be cruciferous vegetables also, you could bring in steamed broccoli, steamed Brussels sprouts, you could do some collard greens, you could do arugula. Arugula is one of my favorite, absolute favorite leafy greens. And that one not only has bioavailable calcium it also has vitamin C, vitamin K, and a whole host of other nutrients there too. Those are some good ways to start making some swaps and bringing in some other foods. And then I think another big one is to try to close as many gaps as you can with diet and nutrition first and then handle diet nutrition first, then close the gaps or supplementation if and when necessary.

Jen Pfleghaar, DO, FACEP

That is great advice. I say that a lot. The goal is not to be on a million supplements, the goal is to have a good diet and then add in the supplements as needed. I love those examples. Yeah, arugula is so good. And I love broccoli. And kids usually like broccoli too. That is good, that in the kale chips. Now, I do not know if I could get my kids to eat bone-in sardines. Do you have any tips for that?

Kevin Ellis

It is interesting when our kids were still in a highchair I could get them to do it but I would drizzle a little bit of Primal Kitchen dressing on them. Primal Kitchen still is, for those who are not familiar, by the way, I have no affiliation with Primal Kitchen, I am just saying that is a good brand if you are trying to get away from dressings or sauces that do not have canola oil or soybean oil, these seed oils is the main ingredient switch to something that is like an avocado oil-based dressing and that can help bring some flavor to some of these meals because that is another thing, just because you have an autoimmune condition or Hashimoto’s or something like that does not mean your food has to be boring and not have any flavor or life or taste to it, it still makes things taste good and this is just one way to do it. What I would do is I would just drizzle a little bit on there and get them to try to eat a little piece. Kids, though, it is harder to get them to eat those things. But I will say for kids, I talked about berries earlier. 

Vitamin C is actually a really important nutrient for your bones too. And I also touched on sugar. When you are eating a lot of sugary foods or drinking sugary soft drinks that is not good and it actually has a connection to vitamin C in your bones. Sugar it is damaging your bone by triggering an inflammatory response, it is reducing your vitamin D levels, it is depleting bone-healthy minerals, your calcium, magnesium, your chromium, your copper but it is also blocking the absorption of vitamin C. And vitamin C is key to developing and maintaining a healthy skeleton whether you are a kid, whether you are an adult. Vitamin C is actually. Remember how I said your bones are this collagen protein matrix upon which minerals are lade? Vitamin C is stimulating procollagen. It is enhancing collagen synthesis and it stimulates alkaline phosphatase activity which is a marker for bone-building cell formation which is pretty cool. On the other side of it too, not only can vitamin C help with supporting and maintaining healthy bones it can also help with the prevention of bone loss too. That is a great one. 

Berries are a good source of vitamin C. If you only have access to berries in your local grocery store get organic blueberries or find organic strawberries or raspberries, whatever, always get them organic. The Environmental Working Group did some studies on this and showed that the most chemically laden foods out there, the most dirty foods out there are your berries, do not ever compromise on that if you can absolutely help it or go to the farmer or the farmer’s market and ask the farmer too, you need to ask the farmer, do you spray, do you spray your crops and understand that upfront so that you are not slowly getting this kind of leak of pesticides into your diet. Berries can be a great one. You can also go online and find frozen berries that may have a little bit higher antioxidant levels. And some of those berries would be huckleberries are a great source of antioxidants and vitamin C, and then another one would be lingonberries and Aronia berries and a couple of other ones. Those are some great choices. And then lemons, limes, those are great sources of vitamin C, and then your vegetables. I would say peppers are your highest source of vitamin C from a vegetable perspective but they are a nightshade. And if you have an autoimmune condition and you are not incorporating nightshades then that is probably not going to be the right fit, that is when you can bring in those steamed cruciferous vegetables, your broccoli, your Brussels sprouts, your lacinato or dino kale, I talked about the kale chips earlier, those are all can be helpful additions.

Jen Pfleghaar, DO, FACEP

Yeah. vitamin C is so important not only for our immune system but, yes, bone collagen production. All the ladies listening that are worried about their collagen and their skin, so important. And getting it through food is great. And yes, peppers, surprisingly, they are higher in vitamin C than oranges. Yeah. Do not drink orange juice, a lot of sugar just eat your oranges. Another thing is that fruit juices are really high in sugar and that is going to affect your bone health, that is going to affect your gut health, inflammation, thyroid, and all of that, so eat that when you can for that fiber. Yeah. What about exercise? I know you were talking a little bit about it is the short explosive movement, it is important for kids growing up to be out there running around, from a young age to an actual diagnosis of osteoporosis, what kind of exercises are helpful?

Kevin Ellis

Yeah. And we can even kind of span. Let us even just talk about in general, like I said, before walking for exercise like most people are just told, hey, do some walking, you will be fine. If we actually think about that, when you are walking you are only really working or providing a stimulus to the lower half of your body, what about your forearms where a lot of fractures happen? What exercises is your forearm getting as you are doing walking? It is not much, it is nothing, there is no stimulus really being applied to that. And your bones need two different types of stimuli and they need muscle pulling on bone and they need impact. When you have muscle pulling on a bone, there is a mechanical signal that sends that chemical signal to tell those bones to become stronger. The impact is also important, that is where I was talking about those short sharp movements, dynamic, different directions, those can be really helpful. And then there are different types of exercise that someone could incorporate. Let us break down each of those. There is a weight-bearing exercise which is where your body and your bones have to work against gravity to keep you up right there. There are things that you are doing on your feet and when you do them on your feet they are placing a good kind of healthy stress on your bones. For example, walking is a weight-bearing exercise and it is good, walking, jogging, hiking, running, dancing, and gardening, it does not have to be a formal exercises necessarily be weight-bearing or it could be pilates, yoga, tai chi, qigong, those kinds of exercises, all of those are weight bearing. 

We want some weight-bearing in our exercise plan. Within weight bearing there is also non-weight bearing too, and there is non-weight bearing exercise, this is where your body and your bones do not have to work against gravity to keep you upright, they are not placing a good kind of healthy stress on your bones. The most important ones would be biking or cycling, especially really long distances that are not going to be the best thing for your bone health. But then another big one would be swimming. Swimming is your body and your bones are not working against gravity at all, this is the same kind of thing astronauts deal with in space. And you can lose bone density in short periods of time, if you are not using it you can lose it. It is not to say if you do like to cycle or ride your bike, or you are swimming and you enjoy it, it is not to say that you can not do those things or that you should not ever do those things, I think that would be a little extreme to say, but do not count them as your only form of exercise, do not get in the pool five times a week, do ten laps, get your cardio in, get out and feel like, hey, my workout is good because if you do that ongoing you have not given your body the stimulus that it needs to become stronger. 

You need to incorporate this last piece of exercise that I want to talk about now which is muscle strengthening and resistance training exercise. You have to bring this into your plan and especially if you are somebody that has Hashimoto’s or thyroid conditions and you are not going to want to run really long distances or cycle really long distances and completely drain your body. You want to get the biggest bang for your buck in the shortest period of time by providing a good stimulus to your body and your bones. And listen to your body also, you do not necessarily have to push beyond your energy levels at that given time too there is a balance there. And when it comes to resistance training and muscle strengthening exercises you can use resistance bands, you can use the weights at the gym, you can use machines at the gym if you are not that comfortable and you are just kind of starting out, you can do that, you can use barbells, you can use dumbbells. And the great exercise to incorporate would be ones that work a lot of the major muscle groups, squats, squats are fantastic to incorporate, deadlifts, I know that sounds intimidating, especially if you are not familiar with working out but those can be a great addition. If you have never done deadlifts before I would not just go watch a video on YouTube and jump right into it, that could actually lead to injury, but find somebody to understand your body mechanics to help you figure out how to start where you are with the knowledge you have in your current body state and slowly progress up to where you are doing it safely and you are providing the stimulus, your body, and your bones need to become stronger.

Jen Pfleghaar, DO, FACEP

Love that. I love resistance training. Especially as women age, Hashimoto’s patients, and bone density patients we need to lift weights. It is so important to battle sarcopenia or muscle loss as we age. It is also good for our hormones including the thyroid. I love that you brought that up.

Kevin Ellis

Let us even just touch on this because we are talking about muscle too. You have to have protein in your diet, be intentional here whether it is essential amino acids, you are bringing in some collagen peptides, you are bringing in if you are in Hashimoto’s maybe you are doing a beef hydrolyzate or something like that. Whey protein may not be the right fit in that situation, if you do okay with that, that may be an okay addition, but you would probably want to get tested to make sure you do not have a sensitivity to it. But getting maybe a little more protein in that first meal of the day can be great if you are in the 30, got to be at least 30 grams I would try to aim for, and try to aim for that as a minimum target for your meals throughout the day, that is great for muscle protein synthesis. Again, your body, your muscles, your bones, protein, and amino acids are the building blocks of everything inside.

Jen Pfleghaar, DO, FACEP

Yeah. Get obsessed with protein. I talk with my patients about that a lot of like, got to hit these protein goals, got to hit them first. I love that you are also encouraging everyone to do that for their bone health too. It is really important.

Kevin Ellis

Yeah, so important.

Jen Pfleghaar, DO, FACEP

Yeah. What does a stronger bone plan look like? Could you give us a little bit more information about someone that is listening and maybe they are worried about osteoporosis or osteopenia, what does this plan look like?

Kevin Ellis

Yes, this is a great question. Because when I talked about most people when they are told they have osteopenia, they have osteoporosis, they get a 15-minute conversation that says to do this handful of things, that is not enough, we know that is not enough, there is more to it than that, it actually takes us a bit longer, it takes us about 12 weeks usually when people come through our programs that is about how long it takes us to teach what we need to teach them. There is no way they could fit all that into a 15-minute conversation. I do not want to fault anybody for the system that they are in and the way that system is designed to not help people achieve their best possible health outcomes. But you as the educated informed empowered advocate for your health you need to understand there is more to that picture. 

Here is more to that picture. The first part is you have to understand the root cause issues and contributors to bone loss and osteoporosis. Do not make assumptions make objective decisions. Know how to have those conversations with your doctor and know what lab tests are important. I will say for lab testing even if somebody has a workup done those workups are oftentimes incomplete or missing really important things, know the tests that you have to do. The next part is to understand what your results mean when they come back. A lot of times things are within a normal range, normal for any of us that have ever been on a health journey, no, normal is not always normal, you can see normal on a lab test and not feel normal at all. There may be other things taking place that need to be picked up, you need to know how to do that. And then the other part of this is diet, digestion, and absorption, you need to be taking in the right nutrients in the right amounts, you need to actually absorb those nutrients. If you have overt digestive issues absorption is almost always an issue, but even if you do not have overt digestive issues you could still have problems with absorption. And the third layer is, are those nutrients making it to the cell level? A lot of times even if somebody is eating healthy they might not be hitting layer one and it is really hard for the rest of those things to line up. That is the second step. And the third step in the process has to be to now build. You have to build,  strength the body, strengthen the mind, and strengthen the bone in a way that is going to prevent fracture and injury, not just now but in the future also. You need to reduce your stress. 

And I am not talking about just a sigh, once a day or on the weekends, I am talking about do you have a plan to reduce your stress. It is critical for your health and your bones. Cultivating a healthy practice of meditation or prayer or something like that is going to be really important. Sleep, improve your sleep, prioritize your sleep. If there is one lever that you can pull that is going to have a greater impact than just about anything else it is your sleep. Sometimes there are conditions that are not allowing you to sleep that have to be resolved first and then we circle back to step one, figure out what are the contributing factors, and address those things. But sleep is a big one, it is pretty well documented. If you have poor sleep it will reduce your bone quality. And then optimizing your hormones, getting the right exercise plan in place, provide the stimulus you need to build stronger bones in a way that is safe and effective, those things are the most important things. It is not what is the single supplement I am taking or what is the device that I can get to fix this, in the world of bones there are no quick fixes or magic cures, I wish there were but there are not. You have to develop a strategy and a plan to accomplish these things.

Jen Pfleghaar, DO, FACEP

That is amazing. And it is a lifestyle. It is not just like you said, it is not a magic fix and the pills are not magic fixes either and we see that in the literature. This is so great that you are out here doing this. I would love for you to share some upcoming. You have a master class that is coming up. How everyone could find you if you hang out on social media? Where do you hang out at and all of that?

Kevin Ellis

Absolutely. You can always find me at bonecoach.com. We have got amazing resources there, recipes, helpful bone health tips, building stronger bones, all that kind of stuff. You can find all that stuff there at bonecoach.com. You can find me on Instagram at BoneCoach Kevin. You find me on YouTube at Bone Coach. And we have got the other social channels, Facebook and things too but bonecoach.com is the best place. We do have a free Stronger Bones masterclass, you can always get access to that. And again, you can find that at our website, bonecoach.com. And then I would just say, if you are lost, or confused, or overwhelmed, or even if you know someone if you are listening to this and you know somebody who needs this help share this with them, share this with them so they can get the plan in place because the help that they get now could be life-extending if not life saving for them. Just help them get the plan in place and that is going to be the best thing for everybody.

Jen Pfleghaar, DO, FACEP

Yes, that is so true. And I know so many people have loved ones that are struggling with this. Kevin, thank you so much for sharing your expertise and your story. And also thank you for your service in the military.

Kevin Ellis

Thank you so much.