April 2, 2019

Rethinking Bone Health: A Physiology Before Pharmacology Approach to Healthy Bones

Sponsored by PERQUE Integrative Health
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During this interview Russell Jaffe, MD, PhD, CCN, will share his thoughts on how to safely and effectively enhance and protect bone health. Listeners will learn how acid-alkaline balance impacts bone health, as well as key nutrients that can help support bone density. 

Approximate listening time: 30 minutes

Continuing Education Credits Available

This podcast interview qualifies for 0.5 general continuing education (CE) units. The Oregon Board of Naturopathic Medicine has approved this educational content for 0.5 “general” CE units for naturopathic physicians. Naturopathic physicians licensed in any U.S. state except California may obtain general CE by listening to this podcast and completing a 10-question test on the material contained within the clinical topic. Click the button below to take the test for FREE, thanks to an educational grant from PERQUE Integrative Health. Upon successful completion, you will receive an email confirming you passed. This CE approval may also qualify for the CE requirements of other practitioner types.

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About the Expert

Russell M. Jaffe

Russell M. Jaffe, MD, PhD, is CEO and Chairman of PERQUE Integrative Health (PIH). He is considered one of the pioneers of integrative and regenerative medicine. Since inventing the world’s first single step amplified (ELISA) procedure in 1984, a process for measuring and monitoring all delayed allergies, Jaffe has continually sought new ways to help speed the transition from our current healthcare system’s symptom reactive model to a more functionally integrated, effective, and compassionate system. PIH is the outcome of years of Dr. Jaffe’s scientific research. It brings to market 3 decades of rethinking safer, more effective, novel, and proprietary dietary supplements, supplement delivery systems, diagnostic testing, and validation studies.

About the Sponsor

Perque Integrative Health

PERQUE Integrative Health (PIH) is dedicated to speeding the transition from sickness care to healthful caring. Delivering novel, personalized health solutions, PIH gives physicians and their patients the tools needed to achieve sustained optimal wellness. Combining the best in functional, evidence-based testing with premium professional supplements and healthful lifestyle guides, PIH solutions deliver successful outcomes in even the toughest cases.


Karolyn Gazella: Hello, I'm Karolyn Gazella, the publisher of the Natural Medicine Journal. Thank you for joining me.

Today, we're talking about bone health with pioneering integrative health expert, Dr. Russell Jaffe. Before we being, I'd like to thank the sponsor of this podcast who is Perk Integrative Health. Dr. Jaffe, thank you so much for joining me today.

Russell M. Jaffe, MD, PhD: Thanks for the invitation.

Gazella: Well you know when we think of our bones, we often think of osteoporosis. Let's start there. How common is osteoporosis in particular?

Jaffe: Oh, far too common. Depending on how you make the measurements, somewhere between 50 and 100 million Americans are at risk. One in 4 women over the age of 40 will have a fracture of their bones due to the osteoporosis or osteopenia. Maybe 1 in 5 or 1 in 4 men, maybe more, the precision of diagnosis probably understates the issue. The point is that bones, whatever your birth date might be, your bones should be young.

Bones turn over every 10 years, which means no part of any bone that you or I have is more than 10 years old. Remember when we were 10 years old, we could jump around, we could leap around. I don't recommend behaving like a 10-year-old. What I'm saying is, your bones should be resilient, and flexible, and not brittle, and not being leeched by the stress and dietary choices of modern living.

Gazella: Yes. It's hard for me to even imagine a 10-year-old, but it would be fun to have bones like a 10-year-old, for sure.

Now is the DEXA scan still the gold standard for measuring bone density?

Jaffe: Yes. D-E-X-A, DEXA is the "gold standard" reference standard. There are other measures that are coming along. There's N-telopeptides which are a little hard to interpret. There are other measures, but to the best of my understanding, the expert experts in bone say that you can measure DEXA changes over 2years. My colleague, Susan Brown and I did an anecdotal prospective study with 11 people, 10 of whom had between 2% and 10% or 11% new bone growth, unprecedented new bone growth by following this approach to Alkaline Way bone health.

Gazella: Yes. How often do you recommend that patients get a DEXA scan?

Jaffe: Well, let me come at it 2 or 3 different ways. In regard to the usual and customary use of the DEXA scan, it's a 2-year waiting period. Now many doctors will do a DEXA after one year and try to compare, and interpolate, God bless. Other people will use other measures, including bone mineral protein and how much of that there is in say the urine.

You asked the right question, which is what is does the measure that almost everyone agrees, or that about which there is reasonable agreement and consensus. The answer there, DEXA. Until something better is really validated and yes, new things come along all the time, but I'm seeing a lot of them go 'cause as you know, my PhD was in collagen and elastin cross-linking, and how you regulate that. That was half a century ago and learned a lot since then. But collagen has a lot to do with bone health and bone turnover.

Then there's certain other unique characteristics contributed by the liver that allow the minerals, not just calcium, but all of the minerals that are necessary to align properly to form what we call a bone.

Gazella: When it comes to bone health, what do you mean when you say physiology before pharmacology?

Jaffe: Well I mean the fact that bone is piezoelectric, which means when you walk, when you move, actually stimulating tiny electrical flows that say to the bone rebuilding cells, the osteoblast and osteoclast, "Do your job." Moving is a good thing, at least 45 minutes a day of walking. Yes, sitting is the new smoking, but if you get up at least 5 minutes an hour, you can undo most of the adverse effects of cutting off your circulation when you sit in most chairs.

Now if you happen to have one of these recliner chairs or something like that, more power to you, but you still have to get up out of the chair. Walk for at 45 minutes a day. [inaudible 00:05:24], to the extent that he had a doctor was me, and [inaudible 00:05:29] very active now, they both agree. Now walking is a terrific way of human beings stimulating bone growth because of this "piezoelectric" or tiny electrical flow that nurtures and nourishes the bone. That's an example of physiology before pharmacology.

Gazella: A great example. When it comes to your integrative approach, I want to dig into certain aspects of how we can enhance or protect bone health. You often talk about the acid alkaline balance. How does acid alkaline balance impact bone health?

Jaffe: Well in essence when your diet or your environment contributes acid, your bones melt slowly away and sometimes not so slowly. On the other hand, when you have a mineral rich environment that bathes the cells and renews the cell's mineral buffering abilities, now you build new bone. We want to build new bone. We don't want to melt the existing bone.

Gazella: Right. That makes a lot of sense. Let's stay on this topic for a bit because I know that most of our listeners understand how to support the acid alkaline balance, but what are some of your foundational aspects when it comes to supporting proper acid alkaline balance?

Jaffe: Well as you know, we start with the self-assessments. The assessment we want to start with measuring the pH, that means how much acid or how much mineral is in your urine after 6 or more hours of rest. It's the one time of day when you get a meaningful measure in a non-evasive way of the cellular mineral status, 'cause after 6 hours, the fluid in the bladder equilibrates with the lining cells, and lining cells, if they need magnesium then they put the extra acid into the urine.

If it's below a pH value of 6.5, then you're too acid. You're deficient in minerals, particularly magnesium at the cellular level. You should take 2, 3, 4 more doses a day of magnesium, but enhanced uptake magnesium with choline citrate. It must be choline citrate, it cannot be choline bitartrate. Try to fool mother nature and she'll come back and slap you on the tush.

You want to enhance the uptake and chaperone delivery of magnesium based on [inaudible 00:08:14] chemistry, and for your listeners who are technical, these are inverted [inaudible 00:08:20] droplets. I really am a biochemist. What that means is tiny little droplets that are taken up by [inaudible 00:08:28], that easily enhance the uptake. In recent studies near 100% comes in and then goes to the cells that are [inaudible 00:08:37].

Gazella: You know it seems like bone broth has been the rage for a while now. What are your thoughts on bone broth as a way to boost bone nutrition?

Jaffe: Well I'm a big advocate for broth, but not bone broth. Why not bone broth? Bone broth turns out to be far too rich in glutamate, and why is it rich in glutamate? You wouldn't think there's much glutamate in bone, it's glycine, and proline, and something else. No.

What the industry calls bone broth includes skin, it includes things that have no other commercial value that are left after you "render" the animal, or the chicken, or the whatever, [inaudible 00:09:27] bone. Bone broth, no. But meat broth, vegetable broth, fish broth, broth you make at home, or broth that's organic or biodynamic, yes, yes, yes.

Broth is a very good source of minerals, and I mean vegetable broth, fish broth, meat broth if you want, but real meat made into a broth, which means you very slowly simmer it until it falls apart, and then you have more or less a broth, especially if you either whisk it or put it in a blender. Broth, yes. Bone broth, no.

Gazella: Okay, good. That's a good distinguishing factor. Now we also hear about MSM and hyaluronic acid for bones and joints. I'm wondering what you think about these 2 ingredients when it comes to bone health.

Jaffe: Well MSM is a sulfur source. Sulfur sources are very important in protecting and enhancing bone vitality and renewal. Now we recommend that physiology before pharmacology approach, which we use garlic, ginger, onions, brassica sprouts and eggs. G-G-O-B-E, garlic, ginger, onions, brassica sprouts. All sprouts are good, but broccoli sprouts, brassica sprouts especially, and eggs.

Why not MSM? 'Cause it's pharmacology. It is water soluble DMSO. DMSO makes you smell like a fish. Not a very healthy fish or a decomposing fish actually. MSM is a supplement that's been around for 20 plus years. It has a certain [inaudible 00:11:04] that comes and goes, but it's pharmacology. We want to start the physiology, the G-G-O-B-E, garlic, ginger, onions, brassica sprouts and eggs. Then if a particular practitioner feels that additional MSM is helpful, I think they make the final decision along with their client.

As you can hear from my comments, we want to use nature's pharmacy, which means you generally have to cook the food the way it's traditionally done. If you just chop up an onion, the cell walls will prevent you from getting the good stuff. But if you sauteed the union until it's clear, now you have a nutritious and delicious detoxifying physiologically helpful bone joint and vitality enhancing material that you can make into any broth you want. However, you want to eat the foods you can digest, assimilate and eliminate without immune burden. If your body reacts to one or more of the G-G-O-B-E foods, then substitute with the other 4.

Thomas Jefferson said they should be stables in the diet, not condiments. I'm a Jeffersonian democrat, which means I'm a grieving optimist. I believe that we should make these staples in our diet again.

Gazella: Yeah, that makes a lot of sense. What about hyaluronic acid?

Jaffe: I'm glad you asked that too. Hyaluronic acid is different. It is physiologic, so when you take ... I'm a pathologist, [inaudible 00:12:40] certified pathologist. When you look under a microscope at a joint, more than at bone, but at the joints you do see what are called water absorbing compression-friendly molecules, hyaluronic acid among them.

Hyaluronic acid goes back to the early '80s, when a Canadian company thought that this was going to be the answer to joint erosion, to the kind of bone-on-bone pain that very commonly occurs to people who haven't walked enough, and have sat too much, or have been on planes too much, as I have been from time to time. Hyaluronic acid has a medical application. It's an injection.

I think after you use nature's pharmacy, after you engage, when you eat and think, drink and do in a comprehensive and holistic way, that injections in hyaluronic acid in the right hands, in experienced hands, are an option. It does provide relief to some people for a period of time while other renewal should be engaged in.

Gazella: Okay, that makes a lot of sense. Now let's dig into some of your other go-to nutrients for healthy brains. I'm sorry, health ...

Jaffe: Bones.

Gazella: Bones. Yeah.

Jaffe: That applies to brains too.

Gazella: Yeah, yeah. That's good. When it comes to bones, what are some of the nutrients that you like to recommend?

Jaffe: Well in regard to the nutrients, there are over a dozen and a half. You can divide these into vitamins, minerals and co-factors. It's mostly about a family or a symphony of minerals. Remember a symphony has many different instruments, each of whom plays a slightly different tune. We recommend, in addition to vitamin K1 and K2, in addition to vitamin D3, we recommend biotin necessary for healthy bone. We recommend half a dozen forms of calcium, half a dozen forms of magnesium. Specialized bio available forms, low contaminant forms of zinc and magnesium, and chromium and selenium, methionine. Copper is the sebacate, iodine and iodide, you need both.

Boron, acid citrate, vanadium, which balances out blood sugar and chromium. Silica, but from horsetail. Stable strontium is the gluconate, and fiber, croscarmellose fiber to enhance the easing digestibility making it food-like. Those are the over 18, 19, 20 essential bone building nutrients. Now vitamin D should be the D3. There should be some vitamin C to keep everything reduced and happy.

Gazella: 'Cause this does seem like a big list. These all work synergistically?

Jaffe: And they're all essential. If you lack any one, your bones won't renew properly. It's amazing how many co-factors, how many minerals and necessary nutrients that allow for bone health. But Dr. Susan Brown and I published an article a decade ago, we're working on an update now, which basically says the more tonic, or soda, or acid beverage you consume, the more quickly your bones will dissolve, the more quickly your bones will melt away.

Then on the other hand, when you have a healthy traditional diet, rich in minerals, the Alkaline Way, the joy of living the Alkaline Way, documented by morning urine pH, keeping it in the 6 ½ to 7 ½ range, that's green rather than sandy color which is acid, or blue which is too alkaline, you want to keep it in the green zone. It's Goldilocks scenario. Not too much, not too little. Just right is just right.

Gazella: Now before I move on, I want to talk about this combination of vitamins, minerals and co-factors. Are these in one product? What will be ...

Jaffe: Oh, yes. This is what Dr. Brown and I used in our prospective study. When I say gaining 2% to 11% new bone, by DEXA in just 2 years, I'm saying people taking this formula and also following a healthy lifestyle of foods they can digest, assimilate and eliminate.

Gazella: Okay, great. What's the name of this product and what's the recommended dosage of this product?

Jaffe: Well the recommended dosage is 4 tabsules a day to build, 2 tabsules a day to maintain, 6 tabsules a day if you have osteopenia or osteoporosis.

Gazella: Okay, so 4 per day, 2 per day. Then, I'm sorry, that was 6 per day if there is osteoporosis or osteopenia? Dr. Jaffe?

Jaffe: Oh, I'm back. Sorry.

Gazella: Okay, perfect. The dose for osteoporosis or osteopenia is 6 per day.

Jaffe: Yes, that would be 6 per day. What I would say would be 3 in the morning, 3 in the evening, so a twice a day dose of 3 tabsules, these are fully active, fully available, and they contain all of these different nutrients, each one of which is necessary, and together they form a symphony or a bone building team.

Gazella: Okay, perfect. Great. Now I want to switch gears a little bit. What's your view of bone morphogenic proteins and the long-term effect on bone status?

Jaffe: Well you're absolutely up to the minute. Bone morphogenic protein is being studied as we speak. It's promising, but we really don't, in my opinion yet, have enough information. What we know is it's built upon something called 2-Beta Coxatene, for those of you who are technical. This is bone mineral protein precursor.

Dr. Brown and I are, at this moment in time, encouraged by what we have heard about this. She and I are collecting information as we speak, and stay tuned for bone [inaudible 00:19:21], as they say.

Gazella: If we were going to look into the future when it comes to integrative health and bone support, bone building, is this where we're headed with the morphogenic proteins? Is this an exciting area?

Jaffe: Well yes, definitely an exciting area. The question is, how much do you need for each person because, as you can imagine, given that you started with a really healthy organic or biodynamic bone, and then you somehow got out of it, this magic complex, how much do you need, and how much does it cost, and how long will it take before you really confirm what is asserted by some clinicians based on their observations? The observations are encouraging, but stay tuned for the bulletin.

Gazella: Okay. Perfect. Now I want to dig into diet and lifestyle. I want to circle back with your G-G-O-B-E, the garlic, ginger, onions, brassica vegetables and eggs. Explain it again or in more detail as to why these 5 dietary items are foundational for you.

Jaffe: Right. They're foundational because in traditional societies they are sulfur rich. You can think of sulfur as a fire that burns away bad stuff and toxins. That's a metaphor, but biochemically it's not far from the case.

For those of you who are technical, they form thioethers. This makes compounds that would otherwise be free radical generating harmful compounds more water soluble and less harmful, so once they're complex, what these sulfur rich foods, or the sulfur in the foods, then they can be treated in urine, sweat and stool more safely and effectively, and it's been used for millennia in traditional societies. We just have rediscovered it in recent times.

Gazella: Perfect. Well I want to stay a little bit with eggs because I've done a lot of writing about eggs, and I had the belief that eggs have gotten a bad rap. I personally eat eggs almost every morning. Explain to us about why eggs got the bad rap, and why eggs are actually good for us. Just remind us of that.

Jaffe: Yes, eggs got a bad rap because Levy and Fredrickson had the idea of the diet-heart hypothesis that the amount of fat or cholesterol you ate was determinative or it actually determined how much blood fat you have. Now it turned out to not be the case, but Levy ran the Heart Institute and Fredrickson ran the NIH. They had the dominant ... in their time.

At that time, there was a man named Olson, and he pointed out that eggs are the perfect food when you combined the white and the yolk, when you make a gently coddled or gently cooked egg you have a near perfect food in regard to easy to digest, assimilate and eliminate for people that have healthy digestion.

Now implied in what you said, I think, is getting a healthy egg. My preference today are goose and duck eggs, or quail eggs because they haven't been messed with very much. If you put in front of me a biodynamic chicken egg, or a home harvested fresh egg, I'll be delighted. Commercial eggs I'm not so sure of. I'm concerned about what the chicken ate the got into the egg and that's what she wrote, as they say.

Gazella: I would have that same feeling as well. Let's talk a little bit about what we should not eat if we're trying to protect and enhance bone health. What do you tell your patients not to do from a dietary standpoint?

Jaffe: Well as you know, I don't have a private practice. I get to influence other doctors and their probable cases, but what I do recommend is stay alkaline. Stay alkaline means eat foods that are mineral rich, eat foods that are antioxidant rich, eat foods that are nutrient dense and rich, and you are sweet enough as you are, do not add sugar to your diet, do not use edible oils. I think edible oils is an oxymoron. What I mean by that is you avoid packaged goods, shipped foods, crisp foods, extruded foods, things that have been processed because processed means you lost the good stuff and you gained the bad stuff.

Do a makeover in your kitchen, eat the foods that are whole, eat more fruits and vegetables that are vying ripe. If you want to have healthy fat in your diet, have an avocado, a whole one. Once you separate the oil from the seed, you know, like the olive oil, once you separate the oil from the seed the protective material is now gone and what you have are dense calories. Fat are dense calories, but those fats, those edible oils are easily oxidized, damaged and rancid. Then they get masking agents to make sure that your tongue and your brain get addicted to wanting those rancid processed fats.

I don't think that's a good idea. I can tell you lots of reasons why [inaudible 00:25:15], who taught me about this in the early '80s, late '70, [inaudible 00:25:19], why Patty Deuster is so correct about these issues, but slowly we turned in regard to nutrition [inaudible 00:25:26].

Gazella: Let's talk a little bit about lifestyle factors. Now you mentioned movement and exercise in a scientific literature is so clear that that's protective of bone health. What about other lifestyle factors, like if we're looking at stress, or sleep, or just other things that we do? What do you tell your doctors to tell their patients?

Jaffe: Well what I learned from [inaudible 00:25:52] and the Dalai Lama was that afflictive responses, that is the traumas of early life or the traumas of daily living that contribute stress hormones, afflict us, they erode us, they reduce new bone formation. By the way, no one gains from any of that.

In the famous words of Bobby McFerrin, "Don't worry, be happy." I don't mean live by denial. What I mean is practice relaxation response. Know that your breath is a refuge and know that stress hormones only come out when you feel under attack. You may have heard about fight or flight, but there's also fortitude, there's also gaining the resilience to know that when you go to your breath, you can stay at ease even if everyone around you is hysterical. I can tell you from personal experience, in my family, if you didn't shout, no one paid any attention to you because everyone else was shouting. They just didn't know it.

Gazella: Yeah, that's true. The relaxation ... Stress is a big deal. What about sleep? I know often times, sleep and stress go hand in hand, and one can lead to the other, and vice versa. What's your philosophy on sleep?

Jaffe: Yes, my philosophy on sleep is that it's really important, restorative sleep, and how do I prepare for restorative sleep? Well I take a salt and soda bath. I put half to a cup of baking soda and Epsom salts in a warm tub of water, and get in for 20 minutes. First 5 minutes I breathe like a baby into my abdomen, the next 15 minutes I pray that my heart won't attack me, and whatever active mediation you want to do, then I get out and I dry off before I get into bed, and I stretch when I'm in bed before I fall asleep.

Then I might even ask myself a question that I would like my dreams to answer if I'm inclined to do that. [inaudible 00:28:03] dreaming myself. In the morning I wake up and I stretch. I got to bed early enough that I get up early enough that I don't need an alarm clock. There is no screen, there is no clock, there's no unnatural sound.

Occasionally I'm woken up by a wind chime or by a bird, but that's a nice thing to get woken up by. Then I stretch before I get out of bed, and then I get in the shower and I stretch when I'm in the shower, 'cause if you're not stretching a lot, you'll contract. Look at most old people, they slow down and contract. I am how you say old, but not that old, and I'm not yet contracted.

Gazella: That's a good thing.

Jaffe: That's a good thing. I'm working on it.

Gazella: It's perfect. What would you like to be the most important bone health message that our listeners of health care professionals receive today? What's the most important thing that you want to get across?

Jaffe: Most important is that bone health is a choice. It is about what you eat and drink, think and do. When you put it together in this proactive way, you have healthy bones for life. If you follow the "Conventions of modern living and pharmaceutical pill-based solutions," you end up slowing the loss but creating brittle, more fragile bones. In the famous words of Mel Brooks, the 2,000 Year Old Man, "Don't do that."

Gazella: Right. Yeah, the physiology before pharmacology, I think, is such an important message.

Well this has been very interesting, Dr. Jaffe. Once again, I would like to thank the sponsor of this topic, who is Perk Integrative Health. Dr. Jaffe, once again I'd like to thank you for joining me today.

Jaffe: Pleasure to be with you as always.

Gazella: Yes. Have a great day.

Jaffe: You have the same.

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