Your Blueprint For Lifelong Strong Bones

Margie Bissinger, PT, MS, CHC

Oh, well, thank you so much for inviting me. So glad to be here with you.

Sharon Stills, ND

Yes, I’m super, super excited. So I just want to dove right in. I guess I would love it’s common question, right? But like, how did you get into this? Like, why bones? Because as we were talking before we went live, like it’s a very niche,  to just focus on osteoporosis. So how did that end up happening for you?

Margie Bissinger, PT, MS, CHC

Well, it’s really interesting because I sort of fell into it. And so I’m a physical therapist, and my background is orthopedic physical therapy. So I was working with people with back pain, neck pain, and all sorts of other pains and orthopedic conditions outpatient. Then a group of doctors I had moved with did a group. I was in private practice; this was over 25 years ago. A group of doctors asked me if I’d see their endocrinologist, and they were working with people with osteoporosis. This is way back before some of the medications were available. They said, Would you see our patients, teach them the right exercises, and help them in terms of physical therapy? It was really wonderful that they wanted to do that, and I had taken numerous courses on osteoporosis, exercise, and women’s health. So I was well equipped to do this, but I was absolutely mortified at what I was seeing. Women were coming in doing exercises, and I can explain that afterwards. They were actually increasing their risk of fractures. I was so upset that I thought, Oh my gosh, you people were just well-intentioned and they wanted to help themselves, but they just didn’t have the right guidance. They didn’t know the doctor might say exercise, but they didn’t know what to do.

So they would turn to trainers or other things. It was before the Internet was really big, so even magazines and things were getting the wrong guidance. So I said, You know what? I have to take action here. And so I became very involved locally with the state of New Jersey as well as nationally, helping people in terms of exercise. So that was a while ago. Then I added to that long story. My son got diabetes, and I saw how nutrition was such an important piece, and I realized that was missing. So then I went back to school, studied nutrition, and added that piece to it as a health coach. Since then, I’ve realized that there’s just so much out there, and I really look at it as an opportunity when you have the diagnosis. But as we’ll talk about with menopause, this is an opportunity to prevent things, and there was so much that people could do that they didn’t know about it. So that’s how I got involved, really; I started studying and trying to spread the information and work with other people. So that was a while ago. But that’s why it’s been over 25 years now.

Sharon Stills, ND

I love that. But those doctors were very forward thinking.

Margie Bissinger, PT, MS, CHC

Yes, absolutely.

Sharon Stills, ND

And on that, that’s always exciting. I remember those days without the Internet, it was.

Margie Bissinger, PT, MS, CHC

Yes.

Sharon Stills, ND

All my books and my medical books, when I moved, I schlepped them with me, and I kind of think, Do I even use these anymore? Like now, we just have everything at our fingertips. But those were very, very different days. So let’s see, why don’t we start with, like, the diagnosis, the testing, because there’s, what’s the deal with the DEXA scan? Because if you are just in the mainstream world, you just get a DEXA scan, and that’s all. We know there are other ways. So I’d love to hear about your research.

Margie Bissinger, PT, MS, CHC

It’s such a good point. Because that’s how people are diagnosed solely by a DEXA scan. You could feel amazing because, for many people, it’s totally silent. You have no symptoms. Then you get these DEXA results. What the DEXA is is the bone density test. They look at your bones, measure them, compare them to the bones of a 30-year-old, and look at standard deviations away from that. But DEXA itself only measures bone quantity. It does not measure the quality of the bone. So you can have two people with a diagnosis, and then they look at it. So if you’re 0 to -1 standard deviations, it’s considered normal. If you’re -1 to -2.5 away from that 30-year-old, that’s considered osteopenia, and -2.5 or more is considered osteoporosis. So that’s purely based on this one test, which isn’t even the most accurate because unless you have a good person doing it, someone who’s really been trained in clinical dense cytometry, there can be mistakes. But that’s the test we have for now. So it only tells you one thing.

So two people with the same number. One can have really strong, healthy bones, and one could have—let’s not mention the quality, meaning the interconnectedness—what’s the quality of the bones like? So there are tests that anyone getting them for the first time, it’s called the TBS, or trabecular bone score. And what that is, is software that they use with some DEXA machines, some of the bone density machines, and they can then assess the quality. So it gives you so much more information. So anyone getting their first DEXA, absolutely. Look at it. I think, it’s now covered or is being covered by insurance. But if it’s not, it’s not very expensive. The additional trabecular bone scoring, and you can even go online to the TBS site and find out the places that you know are in the United States. I know the United States; I’m not sure about other places. But anyway, so that’s what I would recommend because there are some other things, but nothing has really been done, and people don’t feel that it’s ready for prime time for any of these other different possible tests.

But the best ones are the TBS and the bone density. If you already had one, the way this test works is that your value will depend on the machine you used. So they always recommend going back to the same machine. Then you’ll have to decide: do you want to compare them? You really can’t compare one year to another if you’re on a different machine. That’s how crazy this is. But anyway, that being said, those are the best tests. The crazy thing is that sometimes they say, Oh, you don’t need to do it until you’re 65 or older, unless you have risk factors. But you could be missing the boat. To me, I think that’s a terrible thing because you just may not know. And if you do know, then, as I said, there’s so much that can be done. So I think that at least before or during the least, like early menopause, see what your base is and what’s going on. But when you take that test, you get a number. So here’s what you asked about: more testing. You don’t know what that number means. Does it mean that as a young child, you didn’t build bones? if your bone responds to the forces placed upon it. So if you were sort of a couch potato or had any type of eating disorder or digestive issue as a child, you may not have built the bone, and we build on our bones before the majority of our bones. Men, it is 20 between 85 and 90%; for women, it is eight, around 18 to 20, and in the thirties of your peak bone. So the point is, you don’t know what that value means. So the next test that I really like people to do are bone markers. If you find out you have osteoporosis and what that does, the best one is called the CTx, and it just tells you if you are actively losing bone. Are the cells that break down bone? Do you have to increase activity there? If that’s the case, you want to know what to do so you can stop that. What are the root causes? I think it’s not like, Okay, I have a diagnosis of the Bastia process. I have to go on this medication. It’s not like that. It’s much more than I wish I could say. It’s a quick fix. It’s really not. I. But the good news is that it gives you a window to look at your life and see what areas you’re not paying attention to. Or you may have issues. And the good news is that when you correct that the bones are in isolation, everything gets better. There’s a lot of testing, but I think it’s most important to figure out what’s going on and whether you’re actively losing bone or if you just never acquired as much bone in the treatment. The treatment is very different for both of those.

Sharon Stills, ND

Yes, I am. You know, I’ve always wondered, like, who is the 30-year-old on the DEXA scan that they’re comparing me to, or my patients to, or whoever, because we all have some sad big bones. Some of us have little bones. We all have different constitutions. And so, when you’re talking and you bring up so many valuable points, it doesn’t just happen, like when you go through menopause and lose bones. A lot of these things are because our hormones are declining. So these things have been happening before; we could be marching towards something. Like you said, it’s silent, and these things have happened before. So, like, how about, and for a lot of us, it’s too late? But, for your daughters, your nieces, or your colleagues, how about getting your own DEXA with the TBS when you’re 30? So you can actually be the 30-year-old that you’re comparing yourself to. So you can see your own bone. And then, as Margie said, like you can see, did you not start with a lot of bone, or is it something that’s happening as you’re aging? You can start to figure out where this is an issue because, when you talk about the quality, I just keep thinking of the three little pigs. How is this? Are your bones just going to be blown over or broken apart? Quality is really important. So for the CTx, could you just talk a little bit about, like, the women listening and what they should like; they ask their doctor to do that; and then what should they be looking for?

Margie Bissinger, PT, MS, CHC

Yes, the thing is that you’ll have to work with, well, I guess no regular physicians will do that. We’ll do that. I mean, there’s also NTx, a couple of them, and it’s called a C-Telopeptide, and there’s also P1NP. I don’t want to get too technical, but you want to work with people who know that. And I get that; I wouldn’t do this unless you have bone loss; just do the DEXA test, and unless there’s an issue, I wouldn’t do that. This is just when you find out you want to dig deeper and see what is going on. In terms of the numbers on the test, the numbers it’s actually; here’s what I’d recommend because it’s complicated. This is probably the greatest; it’s such a great it’s called Great Bones. It’s by Dr. Keith McCormick. He goes through all the testing and is really detailed because it would take us a half hour for me to really explain, but I would tell people to go to that. In terms of the numbers, it’s going to be different for different tests. But sometimes the values are large, like it might say it’s normal, but usually I’m trying to think, I think Dr. McCormick likes it to be like under 400, either nanograms per liter or, that’s what I’m thinking in terms of that to even be lower, but under 100 isn’t good either. If it’s too low, that means you’re not getting any bone turnover. So it’s a little complicated, but I would highly recommend that book because it’s so good and it goes into really good detail on all the testing because there’s a lot that can be done to give you good information. But I want to say about the summit that, like you mentioned, there is an opportunity, and what I think is missed so much is this menopause time because the bioidentical hormones really do prevent osteoporosis.

They are, and it’s not something that the doctors are really talking about, but it’s an opportunity to, now that they’re safe, and now that they’ve all the fear over that women’s health initiative, they found it was a very different animal, as it wasn’t bioidentical. I think it’s just an opportunity for people instead of waiting after menopause to lose bone and for things to happen because that doesn’t happen when we don’t have estrogen. We do lose a bone at that. There is a large loss after menopause. However, I think the important thing is the time. It is something that can be prevented when people do use the bioidentical hormone. So I’m just a big believer that this is a missed opportunity for a lot of people. Just because they’re not educated on it. But I know you are educated on this and the work you do, so I don’t think this crew has to worry about that. But I want to just say that it prevents bone loss. It really does. They’ve done studies on that, and they really show that you can really maintain your bones much better. if you are utilizing bioidentical. That being said, if you’re not, there are so many other things that can be done. But I just wanted to mention that I think that’s a good opportunity. You don’t have to be losing bones. You can do it preventatively.

Sharon Stills, ND

Absolutely. You won’t hear me argue about that. I mean, I talk about it all the time. I love bioidentical hormones. I’ve been using them with patients for 21 years now. They’re lovely for helping your hot flashes and your insomnia, and all of that is fantastic. But the preventative capabilities of them and the bones, brain, and heart of bones are such a big one. When women come to me and they’re concerned, it’s like hormones, and they’re like, Well, I’m not having hot flashes. I’m like, That’s great. But still a hormone. So what is that? There are, like, different viewpoints. I’d love to hear you speak, like, Should I take calcium? Should I take strontium? Well, what do I need to take to help my bones if I’m taking hormones or if I’m not? What are your views?

Margie Bissinger, PT, MS, CHC

Okay, regardless of what? This is why it’s such an interesting thing, because people think it’s either medication or not medication, like they’ll think, Well, if I’m taking the medication, I won’t worry about anything. It’s so far from the truth. Oh, my gosh. So we’ll get it. I definitely want to get into the exercise piece. So I think it’s nutrition. No matter what you have, you have a micronutrient deficiency. If you have a deficiency in the building materials that we need for our bones, that’s going to manifest as bone loss. So calcium is very important. There are different places with different recommendations. In the United States, they say anyone over 50 is 1200; 15 lower is like a thousand milligrams. But that’s a combination that’s found in other places. It’s just a thousand, or even less. But that’s a combination. So I always feel food should come first; only supplement what you’re not getting from your food. Because what I see is that most doctors will tell people about calcium, vitamin D, and weight-bearing exercise. Those are the three things, and possibly medication.

The problem is that I see people taking too much calcium. They’re getting it in their diet, and then they’re supplementing, maybe 1200 or something. With calcium, more is not better. You want enough. Just like you said, like Goldilocks, you want enough. But if you have too much, there’s been some research, but nothing 100% conclusive. But people are getting kidney stones. They’re getting more cardiovascular problems because you’re getting calcium in the arteries and other places that you don’t want it. You don’t want to have too much. So I always tell people, See what you can get from your food and don’t add more dairy. That’s what people think. Oh, I’ll just add tons more dairy, because for so many people, that’s inflammatory. They haven’t shown that the places that have the most dairy have fewer bone fractures, just the opposite. But then, calcium is important, and you need calcium. That’s not a question. Vitamin D is very important. Everyone should get it, and most doctors order vitamin D25 hydroxy, so most people are looking to make sure they have enough vitamin D. So those two are critical.

But besides that, the one that is often ignored in conventional medicine and is so important is vitamin K2. Because vitamin K2 will take their calcium, make sure it goes into the bones, and sweep it out of the soft tissue. We’ve done research on—I mean, there are two different types, and there’s controversy on which type is better, so there’s an MK-7 and an MK-4. The MK7 is from Natto fermented food, and Natto is a Japanese food. If you can eat the Natto, you’re set. But it’s slimy and not very tasty. That’s the problem. So the MK-7 is not that expensive, and it has a very long half-life that lasts in your body. They have done research showing that people in Japan have a much lower incidence of osteoporosis where they have the Natto, but also that studies have shown that people in Japan can reduce bone loss and could also affect the size of the vertebrae. So there have been research on the MK-7, and then there’s also human research on the heart with the MK-7, but for the MK-4, there’s research that they did in Japan at very high doses, 45 milligrams, where the MK-7 research was around 180 micrograms, a much lower dose than the MK-4, which was 45 milligrams and has a very short half-life. You have to remember that the research was done like three times a day, but most of the doctors, if they use that, use it twice a day. The benefit of that is that there’s more research on fat fracture prevention. So my feeling is that both are good. I just think it’s important to get enough, and most people don’t get enough from their food. So it’s just an important supplement, just as magnesium is really essential. I’m a big believer that if you can get the I, you’ll get well with osteoporosis. I want everybody here. I don’t want to miss a beat here. So I like that tests; don’t guess. If people can do things like get micronutrient tests and just see what maybe they’re not absorbing or what they might be missing, but we can eat from the rainbow. Proteins are critical. People used to think too much protein wasn’t good for the bones, but they’ve found that that’s not the case in the research. And as people get older, they’re not getting enough. So protein, and just again, the rainbow—when people eat from the rainbow, it’s going to make a big difference so that you get all the nutrients for your bones.

Sharon Stills, ND

I just have a couple questions and then I want to move us to exercise. 

Margie Bissinger, PT, MS, CHC

Yes, sure. 

Sharon Stills, ND

So do you have a kind of calcium you prefer?

Margie Bissinger, PT, MS, CHC

I personally do. I like it, you know. Well, I have one. I don’t want people to use calcium carbonate because calcium carbonate needs stomach acid, but it also reduces stomach acid. That’s what people take. Not like Tums to reduce stomach acid. And they found that people with osteoporosis don’t have enough stomach acid. As we get older, we lose stomach acid. I’m a doctor right out in Seattle, and 90% of his osteoporosis patients had reduced stomach acid. When that happens, you’re not going to absorb your nutrients. So I don’t want calcium carbonate, which is going to reduce any stomach acid and needs stomach acid to even be effective. So the one I like is the one I never pronounce: Microcrystalline Hydroxyapatite. That’s my absolute favorite. But the other one that’s okay that people use is calcium citrate as well. So I would say so.

Sharon Stills, ND

I’m glad you brought up HCL. Because there are a few things when everyone is individualized, but when a patient comes in, it’s like, We’ve got to optimize your vitamin D, your K, and your micronutrients, and we’ve got to optimize your stomach acid to make sure you’re going to be absorbing, and I think that’s the piece that’s best. So I’m so glad, you know.

Margie Bissinger, PT, MS, CHC

It’s so myth and it’s so prevalent and it’s something people really need to know about because how sad if you don’t have adequate stomach acid that you’re not going to be absorbing.

Sharon Stills, ND

You’re going to be taking all the right stuff. And, so it’s one thing; it’s something that’s an epidemic. And I see it in my, as I used to say, after 30, after 35, our hydrochloric acid production goes down. But I see it in even ten-year olds now. It’s just, yes, it’s really sad. So it’s really something that you want to make sure you’re looking at. And then my two more nutrient questions, and then we’ll go to exercise. Do you have a level of vitamin D you want to share? Because it is great. Lots of people are checking vitamin D now, but I have lots of patients who come in and have this range of 30 to 133, and they’re told they’re fine. So what’s your answer?

Margie Bissinger, PT, MS, CHC

It’s really so interesting because I know, and again, it really varies, and it’s interesting because I work with so many functional medicine and integrative physicians. And you’re right, because conventional medicine will look at 30 years old and be okay. We’re more, I would say, more the integrative medicine, which is one of at least 45 to 50. However, I have been, there’s a parathyroid surgeon that I’ve been so fortunate that I’ve been able to get to know, Dr. Deva Boone, and so she sees a different population of people who have issues with the parathyroid. It’s way more common than you think. I mean, the last time I had a summit, 20 people from the summit found out that they had parathyroid tumors. Even younger people. And so what she told me is that she really feels that people are in that population. I mean, there are people who are just taking way too high a dose of Vitamin D.

Again, I work with other people’s physicians. I’m not the person who says get it this way.” But I like people to be a minimum of 45. And, in terms of the real, real high levels now, I’ve had to be careful because I’ve seen that too high is also an issue. So, I don’t know. I think between 45 and 60; I know people think higher than that. But that’s again, I work with the different. Each person is different. If someone has autoimmune issues, you may want it higher, so there’s not one thing I would say is at least 45, though, in terms of the low end, because I think 30 is a little too low. I think a lot of people say, I don’t know how you feel about that. I used to think higher was great up until working with Dr. Deva Boone and seeing that some people had too much and it was actually causing a problem with their parathyroid.

Sharon Stills, ND

Yes, I,  standardly I like 80 to 90 because I work with a large population is autoimmune or dealing. But I’m always running intact PTHs or ionized calcium,  I’m running these markers to make sure and screen because that’s a very good point and to make sure that you’re not way over dose because more is not always better.

Margie Bissinger, PT, MS, CHC

So yes. So that’s.

Sharon Stills, ND

Yes.

Margie Bissinger, PT, MS, CHC

Exactly. You have to look at the individual people in all the other tests. So it’s hard to say a blanket number given that what I’ve learned about the parathyroid I have certain people are really,  taking too much. So it depends.

Sharon Stills, ND

On my patients who have parathyroid issues. We are keeping the vitamin D about that 45. It’s like that sweet spot and monitoring it closely. I’m so glad you brought that up because,  everyone talks about thyroid, no one talks about the parathyroid. So that’s a good thing for everyone listening to just have on your radar. Actually now let’s split readings.

Margie Bissinger, PT, MS, CHC

Can we go into that for two seconds? 

Sharon Stills, ND

Absolutely.

Margie Bissinger, PT, MS, CHC

Because I think one person listens and it prevents because it’s a real, real problem because the values that are on the test are for all ages? Even in medical school, they are people. The doctors are taught that if it’s a little high, it’s no big deal, but it is a big deal. Any time the parathyroid is going to take calcium from your bones because it thinks your blood level is high, if there’s a tumor, it’s going to be working too much and taking too much calcium from your bones. You’re definitely going to be losing bones as well as having some other symptoms. So anybody who’s over 40 on the calcium, when you look at your blood work, as Dr. Deva Boone taught me, you have to look at your own blood work because the doctors can miss it, and it’s missed a lot. So the point is that it should not be over ten, if you know it; as long as it’s in the nines if you’re over 40, that’s okay. But it should not be getting any higher at all. So if you see that, yes. It’s something again, also with the parathyroid, or just that itself, and it’s interesting that my husband is an OB/GYN, and he had listened to Dr. Deva Boone talk, and he had a 40-year-old patient, and he would normally have said it was a little high. He wouldn’t have thought it made any big deal of it, but he watched it. But sure enough, he had her in the center with her numbers, and sure enough, she needed surgery. She had a tumor. So anyone listening, check your numbers. If it’s over ten, just get it evaluated and go further into that.

Sharon Stills, ND

Valuable, valuable tidbit there. Okay. So now let’s go to, Oh wait. Now, actually, I have one more question before we go to exercise. I want to know what you think about strontium?

Margie Bissinger, PT, MS, CHC

Oh, I’m so glad you asked that. I am very against strontium. Okay? I’m very against strontium for a couple of reasons. Number one, it’s a heavier element than calcium. So what happens is that when you take strontium, your DEXA test will show improvements. It will show that your bone density is better, but it has not improved your strength. So now it makes me sad because I see people who are so excited. Oh, my gosh, my bone density is better, but it really isn’t because it’s inaccurate now. Because you can’t, you’ve taken the strontium. So number one, it makes the DEXA test inaccurate, and you can’t use it. Number two, strontium, regulates the one that they’ve done some studies on, and they show there could be increased blood clots. So there are some negative side effects to it as well. So there’s really, I don’t see any benefit other than it’s going to fake, it’s going to make it look better. and all the organizations do not recommend it. So I’m in the no strontium camp.

Sharon Stills, ND

There you have it, people. Okay, so now let’s talk about exercise.

Margie Bissinger, PT, MS, CHC

It’s okay. This is so important. No matter what, the good news is that at any age, you can exercise. That’s what’s so exciting. Even for people who are, there are two different things. Number one is that the problem with osteoporosis is not so much that you want to get your bone density grade; you don’t want to have any fractures in life. That’s the issue. We want to be fracture-free, and we want to live our lives healthy, not worried about fractures. Balanced exercises for everybody are so critical. Every age, because as we get older, we lose our balance; it deteriorates. So even standing on one leg, I loved Qijong. Tai Chi. All of that is amazing. It’s a balance exercise every single day, but it’s how the bones respond to the forces placed upon them.

So anything between the two things that really increase weight, like weight bearing but high impact, if you’re somebody pre-menopausal or menopausal and you don’t have significant osteoporosis, do jumping. Anything out there that getting forces on your bones against gravity is going to cause more bones to be produced, so for all the younger people listening to this at any age, get your kids, jump, or do things. Do hopscotch, but that’s going to make a big difference because of the high impact, and so that’s for women, but resistance training, or strength training, is crucial at least twice a week. And the areas most susceptible to osteoporosis are the spine, hips, and wrists. So do squats with weights, lunges, and resistance training in good posture. If you do have osteoporosis, you don’t want to round out because that puts force on the front of the spine, which is the most prone to fractures.

So anyway. So yes, exercise is critical resistance training, and for people who have osteoporosis, usually physical therapy is covered. So, the doctors don’t often recommend it, but that’s my go-to first because they can really make sure you’re doing everything with good posture, which is essential when you’re doing different resistance types of exercise. So a good program will be the resistance training and strength training, as well as balance, posture, and aerobics, just so people stay in shape. But I think the good news is that I’ve seen so many people improve their bone density and change their lives because exercise and strength training are empowering people. You just feel so good. Even if you were a couch potato, it doesn’t matter. Because a lot of people think walking is enough, it’s not enough to improve. It’s good. It will help prevent fractures, and certainly, anything you can do is good. But a lot of people think, Oh, I walk 20 miles a day now. And one more thing. It’s the resistance. It’s not the reps; it’s the resistance that adds more bones to what they found: around 8 to 10 repetitions is ideal. You want it to be somewhat hard. It’s the repetitions and the force that are going to cause more bone to be produced. So if you want to do more than $0.01, that’s okay. But doing 50 repetitions for bone is not going to be as good as doing a higher weight and lower reps.

Sharon Stills, ND

Perfect. I was going to ask about the walking because we here get our ten case steps in, and I fully agree with you that walking and moving is great, and it doesn’t mean to not do that. It just means you have to add it in, and I’m happy to hear about the jumping things because my granddaughter makes me jump rope with her all the time. Great job doing hopscotch! So my daughter-in-law made a hopscotch board out of, like, electrical tape on the floor in their living room. So always hopscotch.

Margie Bissinger, PT, MS, CHC

So that’s why it’s so preventative. That’s the crazy thing. They did one study where they had women hop differently on one foot, and not everybody can do that, but the point is that they didn’t do the other leg as a control on the leg that they hopped on to increase the bone density.

Sharon Stills, ND

That is super cool that you’re using it. Even just when I’m at the mirror, like standing on one leg. Now I’m brushing my teeth, then switching to the other. Yoga is obviously a good way to improve your posture and get that balance. As a result, I adore it. You can see what Marjorie’s talking about. It’s the whole gestalt of it. It’s not just doing one thing that’s really mixing it up. And so we’ve talked about how to know about it, how to prevent it, what you can take, eating, and exercising. And then the last thing I want to cover is that you are a happiness trainer. I just love that. That’s like the coolest title ever. So how does one become a happiness trainer? What does that mean, and how does that relate to the bones?

Margie Bissinger, PT, MS, CHC

Oh, it’s so funny. So way back when I first started working, I was actually in my early twenties, and I had gone through a bad situation. I was working with chronic pain patients, and they were like, Margie, you’re so happy. If they only knew what I’d gone through. They really wouldn’t say that. But it hit me that it was an inside job and that what it did depends on your circumstances. So I started teaching. They were miserable. They were in so much pain. I started teaching them to help me get through certain things, and all of a sudden, chronic pain started getting better. So I’ve been doing this for, Oh, gosh, over 35 years as a teacher, teaching what I now call happiness habits. But then I studied positive psychology, and then I worked with a person, Marci Shimoff, who actually taught people how to teach happiness. And so I’ve been, as I said, teaching my patients for over 35 years. But then I really learned how to teach it on a personal level, like in classes, and really teach people how they can improve their base level of happiness. So anyway, I’ve been teaching a happiness class now for many years, but how this relates to bones is that they found people who are happier and more content with their lives have increased bone density. Plus, stress is a huge factor because cortisol is the body’s stress hormone. And they found that cortisol reduces the activity of the bone-building cells and increases bone breakdown. So it’s huge. It’s such a big piece for every person I work with. We work on stress reduction. Look, the world’s stressful, so we’re not going to take the stress out of the world, but we can learn techniques and practice them. And with happiness habits, life just becomes more miraculous. So that’s what I tell people. You get this diagnosis, you start exercising, you change, you learn what to do with your food and nutrients, and you also correct underlying problems. For example, I see a lot of people with inflammation from gluten and different things. So you need to figure out what’s going on. But when you correct that, and then you do the expert, and then you learn the different happiness techniques, your life just changes. So it’s my favorite thing I do and everything. I just think it’s the most powerful because if you go through life with just a little—I mean, even just the negative thoughts that people are swarming with—by just making a few changes and looking at life through a different lens, it just changes everything, including your bones.

Sharon Stills, ND

Do you have a happiness habit as we wrap up to share to our listeners? 

Margie Bissinger, PT, MS, CHC

Let’s do one. Since I mentioned thoughts, let’s do one about thoughts. So what happens is that, so often, 80% of the average person’s thoughts are negative. So, what you want to do; and we were wired for negativity because, in caveman times, we were more concerned if there was a tiger lurking than if someone gave us a compliment. So that’s sort of how our brain works; it’s just like if you get a compliment and you get ten compliments from one person on something negative, what do you focus on? So what you want to do is, number one, be a detective for good. You want to start magnifying the good in your life because what you focus on grows. So sort of see, we want to see what good is there—like, what good is here that you may not see when you wake up in the morning? What good is here that I presently cannot see? So you want to start looking for things that are good, and when something good happens, and they’ve done research on this, savor it for 20 seconds, and they actually find you can create new neural pathways. So when something good happens, someone says to you, Oh, what a great summit you’re doing here,  and you say, Oh, it’s nothing.  I’ve worked really hard on this and just take it in and just take in the good you see a sunset, just absorb it for around 20 seconds. 

And then the third is when something negative happens and you have a negative thought. Again, there are techniques they teach where you can’t just throw it in the closet. You have to deal with things. That’s not true. But you don’t have to be. You don’t have to magnify it and let it take over. So, okay, you have that negative thought. I’m not going to go in two directions about what to do with it. Question it; it’s a good thing, but get the negative thought. Then what you want to do is stop and say, Okay, but think of three true but positive things that you could also focus on. That’s just a way to start reducing negativity and focusing on more positive things. And I promise you’ll start noticing a difference because a lot of people don’t even realize that they are just focusing on all the things that are going wrong. I would say those three little things, to start with, will make a big difference.

Sharon Stills, ND

I love that. Thank you for sharing those with us. I think the savoring of 20 seconds and learning to digest, embrace, and take in compliments and, watching yourself and that, either you are the one who says, Oh, this old dress, or can you just say, Wow, thank you, thank you, thank you, thank you, in 20 seconds. And it shifts your whole nervous system. So I love that that is just a golden nugget. So this has been so informative, comprehensive, and thorough. Where can the audience learn more? Do you teach exercises online? Like, what are you up to? And how do they learn more about you?

Margie Bissinger, PT, MS, CHC

Yes. So my website is margiebissinger.com, and I have a podcast called Happy Bones, Happy Life, where we go through all sorts of different things relating to bone, happiness, and stress. You’ll have to come on the podcast. That’s another way; I have all sorts of programs. I have Qijong, strength training, and different things. Right now, I’m finishing up the Happy Bones roadmap. I have a program called Happy Bones, Happy Life as well. So all sorts of programs exist to help people really get on track. By the time this airs, also my membership, where we have different guest speakers and we combine Q&A and just really help people on their path and also bring different experts so that people can figure out what’s best because one exercise isn’t great, There are so many different ways that you can incorporate these concepts into your life. So I like to dance. We have all sorts of different

Sharon Stills, ND

Oh, I love it.

Margie Bissinger, PT, MS, CHC

Things that people can choose. So yes. So the best way, I guess, is the website. I’m also on Facebook, Instagram, and other things, but the website’s the best place to really see what I’m up to.

Sharon Stills, ND

I love it. I love it. And yes, all roads lead home, so find many roads and find the ones that work for you. So.

Margie Bissinger, PT, MS, CHC

Exactly.

Sharon Stills, ND

Beautiful. Well, this has just been so joyous and beneficial and has all the ingredients of what it takes to be healthy. And we’re focusing on the bones. And the bones are really important, especially at this time in life. But a lot of the things we talk about just amplify into good health in general. So, oh, thank you for being here and being a part of the summit, for sharing your wisdom and your joy, and for helping to educate the audience. I truly appreciate it.

And thank you, everyone, for being here. I hope you took notes because there are a lot of good little nuggets in there that can really help you on your journey to really understanding bone health and what you need to do to keep those bones healthy and strong. So thanks for being here. We’ll be back with another interview.