Ep. 166 – Dr. Doug Lucas – How to Reverse Osteoporosis

If you have Osteoporosis or are exposed to its dangers, maybe it’s time you consider a comprehensive treatment approach. Osteoporosis is the diagnosis of having poor bone quality and quantity.

Its treatment includes lifestyle changes that can help you prevent, slow down, or reverse the disease and enjoy your retirement.

In this episode of the Secure Your Retirement podcast, we have Dr. Doug Lucas, a triple fellowship-trained physician with a passion for health optimization, epigenetics, bone health, hormone optimization, and orthopedic surgery. Listen in to learn how your gut and functioning impact your bone health.

In this episode, find out:

• Why Dr. Doug made the leap from traditional medicine to what he calls health optimization.
• Understanding Osteoporosis, how it develops, and how it can impact your life.
• The structure of traditional medicine in treating Osteoporosis vs. health optimization.
• How lifestyle changes can help you prevent, slow down, or reverse bone loss.
• How gut health or chronic inflammation can cause bone loss and how that can be changed.  
• Where to start to get comprehensive treatment for Osteoporosis.
• Where to find Dr. Doug, his telehealth services, plus his 6 months Osteoporosis treatment process.
• Why he screens leaky gut and gut function in bone loss treatment.  

Tweetable Quotes:

• “A lot of people don’t know that they have it; it’s estimated that about 50 million adult Americans have Osteoporosis.”– Dr. Doug
• “Everybody needs to know a little bit of their gut and how it’s functioning because most of us have dysfunctional guts.”– Dr. Doug

Get in Touch with Dr. Doug:

Website: https://optimalhumanhealth.com/ https://optimalbonehealth.com/

Resources:

If you are in or nearing retirement and you want to gain clarity on what questions you should be asking, learn what the biggest retirement myths are, and identify what you can do to achieve peace of mind for your retirement, get started today by requesting our complimentary video course, Four Steps to Secure Your Retirement!

To access the course, simply visit POMWealth.net/podcast.

Here’s the full Transcript:

Radon Stancil:	Welcome everyone to our Secure your Retirement Podcast. Murz and I are certainly very happy to have you here today. As you know, purpose of our podcast is to really hit three topics, three different themes. One is all about financial, because we know that’s important in retirement. The second one is lifestyle, and the third is legacy.
	Today we’re going to be talking about lifestyle and our average listener, our average client is someone who is 55 to really 75, that’s the core client and core listener. And we know that as we get older, things begin to maybe change a little bit and so we brought on a specialist today, Dr. Doug Lucas, who is going to talk to us. And we’re going to talk today with Dr. Doug really around the idea of osteoporosis.
	We felt that would be a good topic. He’s got a lot of different things that he’s been trained on. And we’ll get into that a little bit. So let me just say this first. Thank you very much for coming on and talking with us, Dr. Doug.
Dr. Doug Lucas:	Absolutely. Thank you guys. Happy to be here.
Murz:	Yeah. So Doug, we had a little bit to get to know you and we would like our listeners to get to know you a little bit too. We know that you’re Stanford trained, so you’ve got a lot of knowledge, a lot of background in this world of medicine, orthopedic surgeons specifically. But tell us a little bit about your background and specifically you were in this, what you call, traditional healthcare model, and then you transitioned out of that. So tell us about that transition and that journey for you?
Dr. Doug Lucas:	Yeah, absolutely. Like you said, I was an orthopedic surgeon by training, went through the traditional residency, fellowship, finished up at Stanford and went into practice and did the traditional stuff. I took call, I fixed fractures. And in that group of patients that I treated, I saw a lot of people that were falling from weak bones and people would actually have their bones break and they would fall, or they would fall and break something.
	But what really left the impression on me was the impact that it had on their lives. And it’s something that we don’t think a lot of. As we’re aging you obviously recognize that things can happen, but the impact of some of these things can have on your life in a fractured hip or even a fractured arm or something, doesn’t really cross a lot of people’s minds, until they’re on the other side of it and they realize like, “ I did all of this stuff to prepare for retirement and now I can’t enjoy it the way that I wanted to.”
	So in that group, and a couple other different patient populations, I really looked at how else I could serve people. I liked what I was doing. And I was really good at what I was doing, but I found that I was really drawn to helping people to prevent these things. So I made that leap from the traditional medical model to what I call health optimization, which is a combination of functional medicine, integrative medicine, and precision health through genetics. But basically all of these different pathways put together to help people to go from what is our traditional model, basic level of care, to really where we need to be in order to optimize ourselves moving forward.
Radon Stancil:	Great. My dad had me when he was a little bit later in life, he was 52 when I was born. I, now, this year am going to turn 50 myself. And he was a very strong person, but he had that situation. It happened a little bit later in life, but he fell, broke a rib and it changed his life health wise. My mom is now 84. She has somehow… I told her she’s the best faller of all. She’s fallen, I don’t know, about 10 times. Not broken anything yet, but we talk to her all the time about, “Mom, if we don’t have things in place and you fall and break a hip or you fall and break something, that’s going to change your life.”
	We saw that happen, we have many clients who tell us the same story. Unfortunately, we’ve had clients who themselves have dealt with that. So this idea, and like I told you, we’ve got younger folks that are moving into retirement. Could you just give us maybe what we’re even talking about when you say osteoporosis and that whole side of things, just so we could take it from the very beginning and saying, “What does that even mean? Why do I need to know about it?”
Dr. Doug Lucas:	Yeah. And it’s one of these things that it isn’t talked about a lot in the medical community. It’s not really screened for very effectively, and it’s not something that people bring up. It’s not sexy to talk about it. But it certainly has an impact when it hits you.
	So what we’re talking about when we say osteoporosis, we’re really talking about the diagnosis of having poor bone quality and poor bone, really, quantity. Meaning the amount of actual minerals in your bone. And your bones are these amazing organs in your body. They’re very dynamic. Some people think of them as just the static structure of the body. But really they are constantly turning over. They’re constantly making cells. They are protecting us in so many ways and they get stronger as we get older. And then they very reliably get weaker as we age, after a certain point.
	And what a lot of people don’t know is that point in which your bones are at your strongest is very early in adulthood. You’re talking late 20s, potentially middle of that decade. And that’s it. And so from there, it’s a downhill slide for the rest of your life, which is hopefully going to last for many decades after that. And we don’t talk to young people about building up good bones. We only talk to people about bone at the very end, where we’re trying to scrounge to get back as much bone quality and quantity as you can.
	So when we look at bones, we really want to say osteoporosis is the loss of bone quality and quantity. And quantity being verified through the actual minerals, but quality of how strong they really are. And there’s a huge difference there in how we test that.
Murz:	When you think about bones and I’m of that… I’ll be 35 this year. So that’s not top of mind for me, and I’ve never broken anything either. So I’ve never had to worry about procedures or anything like that, knock on wood. But earlier, you mentioned about the traditional model, which is, and let me guess, I guess that’s prescribed medication and fix it with surgery if medication doesn’t work. So you also refer to this idea of health optimization. So tell me how the traditional model is different from what you’re doing now and maybe related to how you diagnose and help with osteoporosis?
Dr. Doug Lucas:	Yeah, absolutely. So the traditional medical model around osteoporosis, I mentioned briefly earlier about that we don’t screen for it well. And that’s part of the problem is that a lot of people don’t know that they have it. It’s estimated that about 50 million adult Americans have osteoporosis. And that’s obviously a pretty big chunk of the population. How many of those actually know that they have it is a much smaller percentage. I don’t actually know that number.
	And so when we talk about the traditional model, first of all, we’re not screening for it. But let’s say you have a great doc and they do screen for it and you know that you have it. The recommendations are, as you said, they’re basically built around the pharmaceutical industry and pharmaceuticals play a role, certainly, but they’re not great, honestly. And, and yes, they can prevent some things, they can help some things, but they need to be part of a bigger picture.
	The other side of the traditional model is the fracture care. So let’s say either you know you have it or you don’t, but you fall and you have a bad fracture, whether it be a hip, a pelvis, an ankle, or wrist, or upper part of your arm. All of those things can have a significant impact on your ability to function. The care that occurs after that there’s not a great transition from the orthopedic side into whomever could be caring for the bone health. And that’s part of the problem is that there’s not a group that really captures onto that. There’s not a subspecialist that said, “I am a bone specialist.” Because it’s not the orthopedic surgeon, it’s not the internal medicine doc, it’s not the endocrinologist, it’s not the Rheumatologist.
	All of these individuals have subspecialties, nobody really wants that hot potato. And the reason why they don’t want it is because it is a comprehensive picture and you really have to treat the whole thing, so that’s where it falls into this health optimization field. When I went into the optimization side of healthcare, I was really focusing more on performance, trying to help young professionals function at their best. That was kind of my interest out of the gate.
	To do that, I learned a lot about hormone optimization. I learned a lot about gut health and adrenal health and how to manage things from a functional perspective. And when I realized what was happening with my osteoporosis patients, I realized, “Gosh, this platform probably would work really well for these patients.”
	So then I started getting into, “Okay, well, what do these patients really need?” Well, they really need somebody to figure out why they’re losing bone and they really need somebody to figure out, “Okay, how can we help regain bone.” through pharmaceuticals and beyond. And then I started looking at the program that I’d built for Optimization Otherwise, and I thought, “Wow, it already exists. We just need to start running people through it and change the tests up a little bit.” And now we’ve created this platform and we’re really seeing some dramatic changes.
Radon Stancil:	So, when you say that… Okay, I’m going to back up here for a second. So I’m imagining that there’s this optimal thing, which is, “Start early, start doing these things early.” So our audience is where we are, so we’re 55 plus, that’s really our core audience. So let me ask it this way, is it too late? And I know that’s probably too easy of a question, but what I mean is can I really turn things or am I really just saying, “Let’s stop what’s occurring”?
Dr. Doug Lucas:	Yeah. No, you can absolutely turn this ship around. And that’s something that’s really misunderstood is that a lot of the focus is on, “Okay, I want to prevent or slow down bone loss.” And while that’s good, you should want to slow down bone loss. But ultimately we actually want to not only slow it down, we want to stop it, we want to reverse it. Are you going to get back to your peak bone health when you are in your 20s? Probably not. But can you prevent a fracture? It’s very likely that you can. And that’s ultimately the goal, right? Because it’s not osteoporosis that’s the problem, it’s the lifestyle changes that will occur after spine fractures and hip fractures and pelvis fractures.
Murz:	So what does someone do outside of just taking medicine? What does someone do to start turning that ship around, like you said? Is it a diet or lifestyle changes or what are we looking at here?
Dr. Doug Lucas:	All of the above, Murz. And the reason why I say that is that the number one thing is figuring out why you’re losing bone. And typically it’s going to be two main things. One’s going to be in the gut, and it’s in the gut because you’re not absorbing nutrients appropriately, or you have gut inflammation and you’re causing this inflammatory response in your body, which will cause bones to lose mineral. Or it’s in the other sources of chronic inflammation, which come from your adrenal glands in chronic cortisol presence, just from stress.
	So that chronic stress, chronic inflammation will result in significant bone loss. Then once we figure out why you’re losing bone, and there’s a hormone component to that too, which we can talk about later. But once we figure out why you’re losing bone, you have to plug those holes, picture it almost as in holes in the roof and you want to just plug as many as you can.
Radon Stancil:	Once you get those holes plugged, then we have to start rebuilding things. And then that’s the other side of it. And that is potentially replacing hormones, if somebody’s a candidate for that. And that’s a longer conversation. It’s making sure that you are getting the right amount of nutrient, making sure that you’re following a good diet that has adequate protein, the right kind of protein and making sure that you’re getting the right calcium, making sure that you’re absorbing all of those things and then checking all your micronutrient status, both from a blood panel perspective meaning, where are you now? But also from a genetic perspective, meaning what are you susceptible to? Because not all of these things we can actually measure.
Radon Stancil:	So you’ve mentioned a couple times they’re not screening for this, they’re not looking at this as a typical practice. So let’s say I’m listening to this episode and I go, “Okay, this makes sense to me.” Maybe you’ve got, like I’ve got, I’ve gotten two parents here, who one of them actually did have a break and it was life changing. I’ve got another one who I’m worried about for that. Maybe it’s top of mind for me, but let’s say, “Okay, what’s my first step? I’m listening to this. You’re giving me these, I know essence so far, big picture of what we need to look at. How do I go through this idea of saying, whether it be working with someone like you, or I got to go get information.” How do I start the process to say, “Do I have a problem?” Or “Where am I out of whack?”
Dr. Doug Lucas:	Yeah. If you’re really starting from zero, meaning that you’ve never been screened and you don’t know anything about your bones, probably the most important thing is to have a conversation with somebody who can order a screening test. And there are different tests and we can get into that if we have time. But ultimately just having a starting point is a great place.
	If you have had a fracture and you can consider it a fragility fracture, which I can define for you, then you really need to get aggressive about finding the right provider. And I’ll tell you that there aren’t many of us in this arena of taking a comprehensive approach to bone health. Let me just define fragility fracture real quick, because I’m sure your audience will want to know.
	So if you have had a fracture that occurred as a result of minimal trauma, meaning if you were in a car accident and you broke your arm because you got T-boned by another vehicle, that’s not a fragility fracture. But if you tripped over your dog and you landed on your wrist and you broke the top part of your arm, or you broke your hip when you hit the ground, the human body should be able to sustain that type of a fall and not fracture, like you mentioned.
	And so if you fraction under those circumstances, you have osteoporosis by definition. And that requires a significant investigation.
Murz:	Hmm. So obviously there’s a lot to learn and a lot to think through here. And I know it seems like you biggest purpose is to educate as much as possible and help people realize how big of a deal, not only osteoporosis, but the entire world of this side of medicine and what type of attention it deserves. So how can someone reach out to you, learn more about you or your company and be able to work with you?
Dr. Doug Lucas:	Yeah, so we actually created a mirror website for our company. So our main website is optimalhumanhealth.com. And that’s where we have the majority of our information. We created a mirror site for that called optimalbonehealth.com. My goal behind that website is to be able to provide, like you mentioned, as much information as I can. We’re just now starting to get the blogs up and transferring stuff from other areas and the resources page. But that’ll be my goal is to provide this website, Optimal Bone Health, where people can go and to learn more, watch videos, content that I’m going to create, resources to other providers, specifically people that have good testing in good avenues for management so that we can create as much of a community as we can.
Radon Stancil:	And we live in a world now where, especially since COVID, a lot of the things we do is on zoom where we can talk with somebody and have a conversation like this. I know that there are different programs like Telehealth and that kind of stuff, where you basically get on a video type thing, where you’re actually able to talk with someone. If we’re looking at this kind of help, and like you said, it’s limited. Does it require, or is it best, if I’m able to travel out to go see somebody like you that says, “Okay, I’m trying to deal with these things. Is it optimal to go out? But yet we can do it on video.” What’s the variances there?
Dr. Doug Lucas:	Yeah. I think it’s always great to see people in person if I can. But I’ll tell you I’ve I built this practice during COVID and I originally planned on having a great location where people could come to, but ultimately a lot of people don’t want to travel right now. This particular audience, a lot of them, they don’t have the capacity to travel. And so I say, let’s just do it all Telehealth. If we need somebody to lay hands on you, that’s why we use your traditional healthcare providers, have a primary care doc.
	But I consider a practice like ours, we’re in that next level up, where this is the base level, we’re up here trying to optimize your bones or optimize your performance, whatever it is. We can work with your traditional team if you need to go in and have somebody lay hands on you. But ultimately there isn’t much that I can’t do through a Telehealth visit. And at this point almost 100% of my patients are all Telehealth.
Murz:	And so if someone decides to engage with you and start that conversation and that first step, what does that whole process look like?
Dr. Doug Lucas:	Yeah, great question. Typically, we start by engaging everybody in a free consultation to learn more about them and make sure that we’re a good fit. Because the last thing I want to do is put somebody through a whole bunch of testing that doesn’t need it. But we would meet, I meet with everybody that wants to enter into our practice and we meet through a free, generally, 15 to 30 minute conversation where we talk about the program and we learn about what’s going on with them and if we can help them.
	Assuming that they’re a good fit, then we enter into the six month program. That six month program is going to be aimed specifically for osteoporosis folks. “How can we achieve putting you in the right path so that we’re going to your bone quantity and quality as much as we can.”
	The first part of that, really the first month of that, is all about gathering data. So you work with my coach, my coach has a master’s in nutrition, she’s a registered dietician and a life coach. She talks a lot about the lifestyle stuff. You work with me to look at some lifestyle interventions. While we’re talking about all that stuff, we’re getting all this objective data. So we’re getting the genetics, we’re doing the functional testing on your gut, on your adrenal glands. And then we’re also getting an extensive lab panel, which is going to tell us, “How quickly are you losing bone? How quickly are you building bone? What does that mismatch look like? What do your hormones look like?” All those other things we mentioned earlier. That stuff takes about a month to cook and get done.
	Once we have all those results, then I sit down with the patients for an hour. We go over all of it. And then we come up with a plan that’s going to include supplementation, lifestyle, including nutrition, exercise, stress mitigation, and optimizing sleep. But then we also talk about hormones. We talk about peptides. We talk about medications. I have all of my patients do a consult, essentially with their case with my PA that works with me. He is an osteoporosis medication wizard. He works with the National Osteoporosis Foundation.
	So we talk about all of these cases as a group and come up with a plan. Now, whether they actually want to go on medications is a whole other topic. But I want them to know what the best approach is based on our history and their case. And then they can make that decision if they want to use pharmaceuticals or not, and I would say most of my patients don’t.
	And then they do that intervention for about four months. We repeat things near the end and make sure that some of these things are headed in the right direction. It would be too early to see differences on a test like a DEXA test. It really takes about a year to two years to see changes in bone quality and quantity. But all of the other metrics like gut health, micronutrients, all those things we can actually measure though, and we know that you’re headed in the right direction.
	At the end of six months, people can either choose to repeat that and do it again, and continue to dial in, or they can just take that information and continue to head off in the right direction, knowing that they need to repeat their DEXA testing or preferably some other better forms of testing at certain intervals. And generally that’s going to be a year and two year mark.
Radon Stancil:	So I know this is probably a completely different topic that we could talk a whole entire episode on, but could you give us an easy definition or explanation of what you mean when you say gut health? I hear that and I’ve heard that through different things I’ve read and everything. But could you just kind of say, “Hey, this is what I’m talking about, when I say look at your gut health.”
Dr. Doug Lucas:	Yeah. I’ll give you two different versions of it. So the gut is another amazing organ. I call it a… It’s a crazy organ. It does so much work to keep bad stuff out and let good stuff in. It is this very long interface between, basically the inside of you and the outside of you, but it’s all on the inside of you. It’s crazy actually, that it works. But when we talk about gut health, it’s really the ability for the gut to do what it is designed to do. So can it hold things out that it’s supposed to hold out or is it letting stuff seep through the cracks? So we call that gut permeability or leaky gut. I screen all my patients for leaky gut. Specifically though, for the bone health patients, I also want to know how is the gut working?
	When the gut does absorb food it has to break it down. And in order to break it down, you have to get things that are secreted from different organs, along the way. How much of those things are secreted, what the levels of those things are? How you’re breaking down food products makes a huge difference in how you can build up your bones and have the appropriate nutrients. So for my osteoporosis patients, I do both gut permeability or leaky gut, and then I also look at gut function.
	There’s a lot of other stuff you can look at in the gut and gut health it’s a pretty broad topic. But I think that everybody needs to know a little bit about their gut and how it’s functioning, because most of us, I’ll tell you, because I screen all my patients, most of us have dysfunctional gut.
Murz:	Well, I do agree. I think that could be a completely different podcast. But I know that we’ve learned a lot today with you, Dr. Doug. Thanks a lot for hopping on with us and sharing some of your insights and your goals and your mission with our listeners. And we appreciate your time.
Dr. Doug Lucas:	Yeah. Murz, Radon, thanks so much. Really appreciate it.
Radon Stancil:	All right. And for anybody listening, we will make sure that we have all of the links and everything to the websites that you mentioned. That’ll be on our website, on your show page, as well as in any show notes, all that kind of stuff. It’ll all be easy for people to get access so they can know how to go and check you out. Thank you so much, we appreciate it.
Dr. Doug Lucas:	Awesome. Sounds great. Thanks guys.