THINKWELL

AGEWELL

When Broken Bones Won’t Heal: The Functional Medicine Approach to Recovery

Dr. Heather Sandison, ND (00:01.054)
Welcome back to the Think Well, Age Well Podcast. I am your host, Dr. Heather Sandison, and today we’re diving into a topic that doesn’t get nearly enough attention until it becomes personal. This is bone health, healing, and what happens when the body doesn’t follow the expected recovery timeline. My guest is Dr. Ben Whites. He’s a doctor of chiropractic medicine with nearly four decades of clinical experience. He’s a certified sports chiropractor, functional medicine practitioner.

And host of the highly respected Rational Wellness Podcast, where I’ve been lucky enough to be a guest, one of 450 guests, with leaders in health and medicine. Beyond his clinical work, Dr. Waits has spent years building community among functional medicine practitioners through functional medicine discussion groups in Santa Monica. And his educational platforms, they also connect clinicians and researchers and health enthusiasts alike.

What I’m really excited about in today’s conversation, and what’s especially unique, is that we’re not just talking about bone health from the clinical perspective, we’re talking about Dr. Ben’s own experience with a serious fracture that failed to heal as expected, leading him into the challenging world of non-union fractures, but also through a discovery process around his own health, his own mortality, and really shifting the relationship that he had with his patients as he became one himself.

He uncovered valuable lessons about bone biology, nutrition, healing, resilience, and recovery that we all get to benefit from today. So, Ben, welcome. I’m so delighted to have you here.

Ben (01:39.692)
Thank you so much, Heather. No, go ahead.

Dr. Heather Sandison, ND (01:41.694)
I take go ahead. I w I just want to start kind of at the beginning of your your injury. take us back to what happened and then I’m really curious about that moment when you realized like you were not going to follow a normal path to recovery.

Ben (01:58.156)
Right. So I I just wanna say as as an intro, many functional medicine practitioners get into functional medicine because they have a problem, they have a gut problem, they have a something that doesn’t heal, and so they go down a functional medicine journey. And I’ve been to conferences where they try to help you become a better speaker and they say, you know, you gotta talk about, you know, your journey, your crisis, your and I never had a crisis. I lived a re relatively healthy life and

Despite minor things, I I now have had my major health crisis. So Halloween of 2023. I’m handing out candy to kids, and I’ve got a bowl of Halloween candy in my right hand, and I’ve got the dog’s leash in the left hand, and we have a very enthusiastic dog that would love to jump around and play with the kids, but we can’t allow that. So

and I decided to just have socks on on a wood floor, so I had no traction. And I was actually backing up from the door and the dog pulled, my leg, you know, I twisted, my leg went straight out and I went right down on my right hip. And my wife was there and she said, I’ll help you up. And I I knew something severe had happened, but I wasn’t quite sure. And then I looked down.

And my right leg was turned out. My foot was turned out. And I thought, that’s funny. I think I’ll just pick my foot up. And then I couldn’t pick my foot up. And at that point I told my wife, you better call the paramedics. I broke my leg. And so I I went to the emergency room. And the next day I had emergency surgery and from a trauma surgeon.

I had a big debate. I called an orthopedic surgeon I knew well when I was in the hospital and said, you know, Gary, what should we do? Should I should I let this trauma surgeon do it? Because he’s an expert at trauma. But he’s not a hip surgeon. And then we discussed it. And I talked to a hip surgeon. Well, hip surgeons are used to doing hip replacements and fixing certain other things, but they’re not used to fixing a traumatic femur fracture either. So

Dr. Heather Sandison, ND (04:07.785)
Right.

Ben (04:21.698)
Getting a hip, first of all, you know, there’s no time to wait because you can’t stay in intensive care for days on end. And if the insurance didn’t cover it, you’d be paying like fifty thousand dollars a day, given our healthcare system, which is probably a topic for another discussion. But so I elected to have the trauma surgeon do it, and he did the surgery. He put two steel rods inside my femur that crisscross and hold the bone together. Unfortunately.

After the surgery, what was supposed to happen is that the two bones were supposed to be touching each other so the body could meld it. But it unfortunately there was a gap. And so for whatever reason, I was waiting for the gap to close. And so once a month I was getting another x-ray, and every time there was still a gap. Even though I was feeling a little better, so I knew some sort of healing was probably occurring.

But it wasn’t bone. So then at that four-month mark, what am I gonna do? So I I sought a consult from a couple of different orthopedic surgeons, and I was told at that point that I was gonna have to get a revision surgery. And so that meant pulling the steel rods out from inside my femur. And of course, I’m sure the bone would have formed around it, so they’d have to chisel them out, and then I had to have a hole in my femur.

Dr. Heather Sandison, ND (05:35.166)
Mm-hmm.

Ben (05:49.498)
And and then they wanted a steel rod down the outside with like fifteen screws. And I said, you know, I’m not gonna do it.

Dr. Heather Sandison, ND (05:58.347)
What are my options here? my gosh, anything but that.

Ben (06:01.846)
Yeah, well, you know, unfortunately, the surgeon I was talking to said, well, if you don’t do it, your leg’s gonna collapse. So, you know, unfortunately that means that, you know, ninety-nine percent of most people would have just gotten a revision surgery. But I was not anxious to do the revision surgery. Something’s happening with my camera.

Ben (06:25.486)
I can’t hear you next.

Dr. Heather Sandison, ND (06:26.006)
So on on Riverside, it will let me make a note because I’m gonna have them edit that out, but you can just keep going. It’s uploading at a much better quality. So just keep going. Don’t stress at all. Just keep talking. If I get fuzzy, if I get wobbly, just it’s not like Zoom because Riverside is up uploading everything separately. So just know that you can just keep going. You don’t have to worry about quality at all.

Ben (06:35.914)
okay, okay.

Okay. Okay.

Ben (06:47.854)
okay. Okay. Okay. Thank you. Thank you. Thank you. Okay. So, you know, he said to me, look, you gotta get this surgery. If you don’t get the surgery, your leg’s gonna collapse. And I said, Look, you don’t know that. And if my leg collapses, I’ll be back, but I’m not gonna do it. So I then came up with the strategy to get my leg to heal. I talked to a bunch of different clinicians I know. I had already known about specific medications that help.

Bone formation. So when it comes to medications that stimulate bone, or medications that are used by patients with osteoporosis, they fit into two categories. And most people are familiar with the medications from the one category, which we can call anti-resorptive medications. So what that means is when you understand bone physiology, you realize that there is

Osteoblastic cells that are constantly building up bone and osteoclastic cells that are breaking down bone. And this occurs throughout your whole life. We can consider an analogy with say brain cells, which we, you know, were told you have all the brain cells you’re gonna have and you’re just gonna go downhill from the time you’re 30. And it turns out that brains regenerate and bones regenerate throughout your life. It’s just a question of the balance, and you know.

Do we want to tip the balance one way or the other? And I needed to tip it towards bone healing. And so I I knew that there were, so most of the drugs are called anti-resorptive drugs. So they block the osteoclastic activity. So these are drugs like the bisphosphonates, like Fossamax and Actinel and Boniva. And so they block the bone breakdown.

So you end up with more bone. The problem is that you’re basically the osteoclastic cells that do the bone breakdown, they’re like the cleanup crew that comes in at night. What most people don’t realize is as you go through your normal days’ activities, you’re actually breaking down bone. Just like you break down. Absolutely. Yeah. Yeah. It’s like breaking down muscle. You know, people go to the gym.

Dr. Heather Sandison, ND (09:02.666)
And you want to do that. There’s an upside to this. Right.

Ben (09:10.69)
They think they’re building muscle. You don’t build muscle in the gym, you break down muscle. But then the body rebuilds it stronger afterwards. And

Dr. Heather Sandison, ND (09:18.058)
The rebuilding stronger afterwards is so important, right? Because if you don’t break down bone, you your DEXA scan looks better. Your x-rays of bone density appear better, but you actually have more fragile bone. This is so a lot of people find this very counterintuitive. And it’s scary to think like, actually I’m at higher risk of a fracture, even though my bone density appears better.

Ben (09:28.13)
Yes.

Absolutely.

Ben (09:41.15)
Absolutely. So taking a drug like that, I’m not a big fan of those drugs necessarily, but it certainly wasn’t going to be indicated for a a non-union. So after four months, you know, they said it’s a non-union, it’s not going to heal. That’s because statistically, you know, but I never consider myself a statistical average person anyway. But so

there’s a limited number of drugs that we could call anabolic bone drugs, meaning they stimulate osteoblastic activity to cause new bone formation. And so I elected to I I did some research, so I had to find I found a a couple of meta-analyses that showed that a drug called Forteo had been shown to be beneficial, not in all the studies, but in some of the studies for non-union. And so

This is a synthetic form of parathyroid hormone. It’s been around for a while. there’s some possible risk with doing it for a long period of time, like more than two years. Not in humans but in rats, there’s been some increase in in bone cancer. So meaning you’re just revving up the bone formation so much. But

Dr. Heather Sandison, ND (10:55.67)
And with parathyroid, so parathyroid hormone controls calcium in the blood. And it’s interesting that you say that. I’m I’m a little confused. I want to dig into this because when we see elevated PTH and elevated blood levels of calcium, oftentimes what’s happening is that the PTH, the parathyroid hormone, made by the parathyroid glands that sit behind the thyroid but actually aren’t related in thyroid f to f thyroid function, they send out PTH or parathyroid hormone, and it

Ben (10:59.992)
Yes.

Dr. Heather Sandison, ND (11:21.014)
It can elevate whenever PTH is high, and the the half-life of p of parathyroid hormone is like 15 minutes. It’s very quick. But and a lot of people will miss a parathyroid adenoma because it’s gone so quickly, it won’t always be elevated, but it can be elevated in in fits and spurts, and then it’s pulling calcium from bone. So one of the s one of the signs or symptoms of a parathyroid adenoma is osteoporosis.

Ben (11:28.269)
Right.

Ben (11:34.573)
Right.

Ben (11:39.885)
Right.

Dr. Heather Sandison, ND (11:48.148)
So this is a little counterintuitive to me that a a medication that mimics parathyroid hormone would be helpful for bone.

Ben (11:55.97)
So if the medication was like infused and was in your system all day long, it would have that effect. But when you take the injection, it’s it’s a subcutaneous injection, it’s bumping it up and actually stimulates bone formation. Yeah. And it’s it’s been on the market for a while. And so I got a prescription for that and started taking an injection of that every day. the activity for Forteo.

Dr. Heather Sandison, ND (12:01.057)
Mm-hmm. Okay.

Dr. Heather Sandison, ND (12:11.617)
interesting, fascinating. Okay.

Ben (12:26.082)
peaks at about five, six months. So I decided I was gonna do it for as short a period of time as possible where I could potentially get the maximal effect. So I ended up doing it for five months. And I also elected to do human growth hormone to put my body in a state of healing.

Dr. Heather Sandison, ND (12:28.788)
Mm-hmm.

Dr. Heather Sandison, ND (12:44.831)
As Samoorlin, or what was the product that you use?

Ben (12:47.394)
No, I actually got human growth hormones from a compounding pharmacy and I took two IUs five days a week. Yeah, the the conventional medical doctor didn’t want to prescribe it, but one of my integrative doctor friends did. And

Dr. Heather Sandison, ND (13:05.195)
And so I think that th what you’re doing, it sounds like both of these maybe would potentially have this side effects risk profile of potentially stimulating cancer. And that makes sense here because what you’re trying to do is promote growth, right? You’ve a human growth hormone, that anything that’s gonna signal bone growth specifically. But all of the and that’s why you mentioned like this potential side effect of bone cancer, because you’re stimulating growth. And when you have something to repair, you really, really want that. And a potential risk for cancer later on is like.

Ben (13:17.112)
Right.

Ben (13:27.821)
Right.

Ben (13:31.276)
Right.

Ben (13:34.636)
Right. Right.

Dr. Heather Sandison, ND (13:34.743)
probably not that big of a deal if what you need is for your a union fra that union fract non union hat fracture to heal.

Ben (13:39.712)
Yeah, you know, it’s it it’s interesting because this kind of parlays into the whole discussion we have about longevity for so many years and you have practitioners out there saying anything that promotes growth, mTOR, it’s bad, it’s bad. And you know, when longevity medicine first got started, it was all about promoting growth and everybody was doing HGH and and there have been a fair number of studies. In fact, the first study that actually showed a

Dr. Heather Sandison, ND (13:46.304)
Yeah.

Ben (14:08.045)
Improvement in biological aging, use growth hormone as the Faye study as one of the measures. So, but it’s a question of balance. You need a certain amount of growth and regeneration and rebuilding because you don’t want to fall apart, you don’t want to lose muscle, you don’t want to lose bone as you get older, but you don’t want too much as can stimulate possibly cancer. So

You know, there’s a healthy balance that we need for these things. So anyway, at this point, I need to put my body in growth mode bone growth mode. So I also used a bone stimulator directly on the area, and it was an ultrasound one, and I used it twice a day. And I also took all the bone supplements. So I I bumped up my vitamin D to ten thousand a day. I’ve been monitoring my vitamin D for years and

I get my vitamin D up to about 60, take in five to ten thousand. And if I’m not super consistent or I don’t get much sun, it’ll drop down to forty or forty-five. And so I want it to be at the upper end. So I said, okay, let’s do 10,000. And now I’ve also become convinced that MK4, which is a form of vitamin K two.

Is probably the more beneficial form of vitamin K. And vitamin K is super important for bone formation.

Dr. Heather Sandison, ND (15:34.859)
Yeah, for anyone with osteoporosis, that’s the takeaway here today, is the MK four. Are you using the ultra the ultra K two K yeah, Ultra K two? Is that what it’s called from SFI?

Ben (15:45.662)
no, I’m using the one from Designs for Health and it’s it’s it’s their BRF bone regenerative formula is the forty-five milligrams. Most people are taking K two at fifty or a hundred micrograms MCG, but this is milligrams, so a thousand times that.

Dr. Heather Sandison, ND (15:48.256)
Okay.

Dr. Heather Sandison, ND (15:53.303)
That’s exactly what

Dr. Heather Sandison, ND (16:03.103)
Okay, so let’s just underline that for everyone. Microgram dosing of K2 is not enough for osteoporosis, for bone regrowth, what Dr. Ben is talking about here. You need milligram dosing. And I’ve heard anywhere from 45 to 90 milligrams of K2. So a lot of people are taking the D3, K2 combo products. That is never going to have enough for bone health.

Ben (16:16.568)
Yes.

Ben (16:20.034)
Yeah.

Ben (16:27.702)
Most of them are also doing the MK7 version of K2. And that’s the popular version. And people touted as more effective. And yet there’s a lot more studies for bone formation for MK4. And if you look at the form that vitamin K2 exists in most of the organs in the body, other than the liver, it’s in the MK4 form.

Dr. Heather Sandison, ND (16:54.965)
Including the brain. So yep, important for brain, important for bone health. Awesome. Okay. So you got on this whole stack. So you said vitamin D, the K four version of K two, and then boron. So the minerals, the a mineral stack. So talk talk us through those.

Ben (16:56.524)
Yes. Yes.

Yeah.

Ben (17:06.136)
War on

Yes. calcium magnesium. So boron’s been shown to be something beneficial for bone health. it’s also been shown to be helpful in increasing free testosterone. and so there was a great article by Lara Pizzorno she wrote years ago called Nothing Boring About Boron. You can check that article out. she wrote a book about osteoporosis and bone health.

And I also took calcium magnesium. And so when we come to calcium magnesium, there’s lots of controversies, as there is for a lot of things in nutrition. And I had stopped taking calcium for I hadn’t taken calcium for a couple of decades because everybody became afraid that calcium is gonna increase heart disease. And the reason why calcium was even studied in terms of heart disease is because there were no

number of studies that showed that taking calcium supplements or consuming more calcium actually helped lower blood pressure and had other beneficial effects on the heart. And then there were a couple of studies that seemed to show that it was harmful and the worry was that it would cause calcification of the cholesterol leading to plaques in the arteries, leading to heart attacks. And I think for the most part that’s not correct.

Dr. Heather Sandison, ND (18:36.927)
Yeah, and i i like also with what you were going through, some extra calcium probably made a lot of sense. Now, you mentioned boron, but I’m curious like was strontium, vanadium, silica, like Yeah. Okay, see we’re doing other minerals too. You know, what I tend to tell people and I’m I want your pushback, like you’ve been through this personally, and I think there’s a happy ending at the end of this. but I

Ben (18:49.078)
I did strong DM Cy Trade. Yes.

Dr. Heather Sandison, ND (19:03.231)
I wanna understand, you know, i I wanna have this conversation and flesh this out because what I typically tell people is take a mixed mineral, take like sea salt, in like almost encapsulated sea salt, because it’s in these ratios that our body knows what to do with. And whenever we have like a ton of calcium all at once, I do worry.

that it’s almost at the expense of the ratio. And magnesium, right? If if you have and I I guess there’s these different debates about like, well, why are we mineral deficient? Is because the soil is depleted? Is it because, you know, in some areas of the world there is more of one one type of mineral b versus others like like selenium. There’s more selenium in certain soils so that you people in those eight areas won’t be as depleted. Right. There’s

Ben (19:46.998)
Sure, there’s more or less iodine, there’s more or less yeah. Yep. Lithium, yep.

Dr. Heather Sandison, ND (19:52.352)
More lead. There’s more good stuff. There’s more bad stuff, right? So right. Yeah, lithium being a big one. So, like when you’re getting a mixed mineral, I guess my thought is our body knows what’s to do, what to do with that. We evolved with sea salt coming into our system in the ratios that it naturally occurs. And so whenever you take sodium really high, like in canned foods and per preserved foods, now all of a sudden you end up with high blood pressure. But sea salt actually modulates blood pressure because it has

magnesium and potassium in it, which can bring high blood pressure down a little bit and low blood pressure up a little bit. So you actually get better balance in the system if you’re using a mixed mineral. And you know, you okay, you had a non-union fracture that needed to heal. So some extra calcium, magnesium, some of these specific minerals for bone health make sense temporarily, but do you think for someone who is like a postmenopausal female with osteoporosis, how important do you think it is to think through

yeah, like the these mineral ratios.

Ben (20:53.61)
So I think first of all, I think it does make sense. I think most of us are not getting enough calcium in our diet, unless you’re eating lots of dark green leafy vegetables. A lot of us are not eating dairy, partially for gut problems and and because of other issues with dairy. and there may be questions about whether the calcium in dairy is really that well absorbed. And so I I do think that massive amounts of calcium probably don’t make sense, but

I think if you look at the studies on calcium that made people worry, first of all, the first thing you have to think about is when it comes to a plaque in your arteries, when or when it comes to cholesterol in your arteries, there’s two kinds of plaque. There’s soft plaque and there’s hard plaque. And the hard plaque is calcified. And the biggest risk is the soft plaque. So one of the benefits that say

statin medications have and very controversial medication. A lot of people in the natural world don’t like statins, but they tend to calcify the plaque. And so some patients will see their coronary calcium scan get worse. But you want your plaque first of all, you don’t want any plaque. You want to have zero plaque. But if you do have plaque it’s better that it be calcified because it’s a soft plaque that breaks off and forms

A clot that leads to a myocardial infarction. So calcifying your plaque is generally not a bad thing. And taking calcium is not going to make more cholesterol deposit in your arteries. That’s a totally different mechanism. And when you look at the studies that look showed some risk with calcium, they also didn’t use vitamin D and vitamin K and magnesium and so.

Dr. Heather Sandison, ND (22:20.224)
A stroke.

Ben (22:45.09)
You know, you you need vitamin D to direct the body to take the calcium and bring it into the bones, and the vitamin K to make sure it doesn’t end up in the soft tissues like the arteries.

Dr. Heather Sandison, ND (22:55.175)
Right. Yeah, so it’s important that these all they they collaborate, right? Like they complement each other. And so it’s not just about taking.

Ben (23:02.21)
Right. Right. So I think taking say four or five hundred milligrams of calcium with s some magnesium and vitamin D and vitamin K several times a day, I think is very safe.

Dr. Heather Sandison, ND (23:16.171)
Yeah, it awesome, awesome.

Ben (23:17.752)
Better to take it with a meal because you want the hydrochloric acid from the meal to help you break it down. We used to think it was better to take it at night, but I think it’s probably better to take it d with meals.

Dr. Heather Sandison, ND (23:31.009)
So how long did you do all this for? You’re swallowing a bunch of supplements. How many

Ben (23:33.25)
Five months. Yeah. Five months after the four months, so total of nine. and my hip ended up healing a hundred percent with no pain, no no restrictions, no limitations.

Dr. Heather Sandison, ND (23:50.306)
There’s the happy ending we were looking for. So, but it it took, right? I I think the point of your story, if I can just like extrapolate this for other people, is that a surgeon has a surgical tool, right? Like what they’re gonna want to do is another surgery if the first one didn’t work. And the question becomes: is there something less invasive I can do? Is there a reason that I’m not healing? Can we work with someone? You know, if I can’t do the research, if I can’t make sense of it myself.

Ben (23:51.752)
Yeah.

Ben (24:08.749)
Yeah.

Dr. Heather Sandison, ND (24:19.489)
Can we work with somebody who can help me think through this so that we can really explore like what are the things preventing my body from doing what it does best, which is healing? Does it need more nutrients? Do we need to get toxins out of the way? Do we need to get infections out of the way? Do we need more rest? What is the imbalance that’s here preventing the body from healing itself?

Ben (24:32.142)
Right. Right. Right.

Ben (24:40.012)
Right. There was another interesting discussion that we had along the way, which was when we decided or when it was decided that it was a non-union, was any healing actually occurring? Was there a fibrotic cut tissue that was closing the gap? And I was convinced that there must have been. It was a CAT scan that seemed to show that. But then the question was I talked to several experts. Is that a good thing or is that a bad thing?

And I, you know, my doctor said, well, I think it might be a bad thing because I had a non-union in my wrist and to get it to heal, we had to scrape out the fibrosis to allow it to heal. And I talked to another friend of mine who’s the top physical therapist at USC, and he said, No, no, you body’s trying to close the gap, so it’s gonna put fibrotic collagen to start to close the gap and then later turn it into bone. So so I also

Dr. Heather Sandison, ND (25:32.449)
Make fine.

Ben (25:38.53)
took supplements to help promote the collagen formation. So I took collagen, I took glucosamine and chondroidin. I’m a big supplement guy and I don’t have a problem taking twenty, thirty pills at a time. Yes. Absolutely. Yep. Yeah, big believer in vitamin C. We always leave out vitamin C. You know, we go for the exotic ones, but

Dr. Heather Sandison, ND (25:52.161)
Vitamin C is important for collagen production as well. Yeah. Yeah.

Dr. Heather Sandison, ND (26:04.245)
Yeah, it can make a big difference. And I’m sure you were eating well. You were s resting. You Yeah. Yeah.

Ben (26:07.874)
Course. And I was doing rehab, you know. You know, one of the things that happens after hip fracture is a lot of people go downhill. In fact, there’s a high rate of people dying. Yes, absolutely. So I was not gonna let my condition go downhill. So after the hospital, I I went to a rehab facility. They told me it was gonna be super vigorous, rehab, the best place, and and

Dr. Heather Sandison, ND (26:18.881)
Death. Yeah.

Ben (26:35.798)
It was okay. I’m sure it’s better than a lot of other places, but after four or five days I was out of there and I was I took my walker to Gold’s gym and I was working out.

Dr. Heather Sandison, ND (26:47.607)
Could you probably couldn’t get in the pool at that point. but did you use that? Okay. Yeah.

Ben (26:51.372)
I’m not a pool guy. Yeah. So I did use a vibration plate to stimulate the bone before I could really do any leg exercises. But I was I was walking around on my walker and in a crotch and it was a big ordeal, but it’s behind me now. And now I the one thing I never did, which is interesting, is get a bone density test.

Dr. Heather Sandison, ND (26:56.895)
You’re dead.

Dr. Heather Sandison, ND (27:07.127)
Wild, wild, what a ride.

Dr. Heather Sandison, ND (27:18.315)
Why not? Have you now at this stage? I still

Ben (27:20.224)
I still I still have it, you know. I you know, I I do a lot of testing. I thought, do I really want to know? Because the word is if you fall and have a hip fracture, you probably have low bone density because it shouldn’t happen. Now I personally think I just happen to fall at the right angle, landed right on that greater trochanter. I don’t have a ton of fat, so it you know, landed right on that bone. I didn’t brace myself.

So I think it was just freak. But I thought, you know what? I’m just gonna treat myself like I have bone low bone density. So as soon as I could start doing leg exercises, I decided I was so you know, when it comes to exercise for bone density, so there’s a lot of controversy about this, and a lot of people think that walking is enough or using three-pound dumbbells, and unfortunately.

Dr. Heather Sandison, ND (27:56.416)
Okay.

Dr. Heather Sandison, ND (28:09.111)
Yeah.

Ben (28:18.988)
That’s not been shown to be the case. A lot of studies that have looked at exercise have not shown a lot of benefit. And the one set of studies that have consistently shown an increase in bone density and reduction in fracture risk are the lift more trials from Australia from Dr. Belinda Beck, who I had on my Rational Wellness podcast. And so her protocol involves doing squats, deadlifts.

Overhead presses at five rep max, that means as much weight as you can possibly lift for five reps. So, you know, you gotta put down those three pound dumbbells and you might have to do a hundred and fifty pound deadlifts or more, you know. Yes. And then the other thing you have to include is some ballistic activity, which is scary, but in

Dr. Heather Sandison, ND (29:03.755)
And lift heavy. Yeah.

Ben (29:15.33)
Yeah, something where you’re in the air and landing and loading your bones. So she has patience jump up onto a pull-up bar and drop down.

Dr. Heather Sandison, ND (29:19.457)
Like

Dr. Heather Sandison, ND (29:25.097)
Like a burpee kind of maybe? No. More than

Ben (29:27.818)
No, more dramatic than that. So what I did was I just started to slightly jump in the air, just slowly leave the ground higher and higher over time. And and now I continue to include like I did my leg routine today at Gold’s. And I get up on like a 24 inch block and just jump down and do that repeatedly as part of my routine.

Dr. Heather Sandison, ND (29:39.136)
On your broken hip?

Dr. Heather Sandison, ND (29:50.392)
Okay. great. Good. Okay. That’s helpful. I mean, for everyone listening, work with a trainer. Work with someone who can help you make sure that you don’t get hurt.

Ben (30:00.052)
absolutely a hundred percent. Yeah, y if you’re gonna do some kind of ballistic activity, you I recommend working up to it slowly. In fact, probably the first thing to do is to just go up on your toes and drop down. That we call that a heel drop. And

Dr. Heather Sandison, ND (30:09.983)
Yeah.

Dr. Heather Sandison, ND (30:18.603)
Yeah. And that’s great after after a big meal to help you digest too, right? We use that for reflex.

Ben (30:21.774)
By the way, it’s also a treatment for for hiatal hernia. You drink a bunch of water and you do some heel drops and it pushes your diaphragm down.

Dr. Heather Sandison, ND (30:27.926)
Yeah.

Dr. Heather Sandison, ND (30:33.507)
Just use gravity as medicine. I I’m curious, Judge Ben, when going through this process, how did it change how you relate to and work with patients?

Ben (30:47.018)
well I feel like I know more about bone health. And I think there’s a lot more thinking about how do we treat patients in terms of pharmaceuticals for drugs, for osteoporosis. And the traditionally you’re most likely if you go to your doctor and you get a bone density scan, and by the way, we could have a whole discussion about bone density scans because there’s a lot of things to know about that, and and

Dr. Heather Sandison, ND (31:14.817)
Well let’s do it. Let’s dive in. Yeah.

Ben (31:16.576)
Okay, okay, so let me just finish this first. So what was I gonna say? yeah, so most likely they’re gonna prescribe a bisphosphonate because those are the most common drugs. And the newer thinking is you use an anabolic drug first, say for a year.

Dr. Heather Sandison, ND (31:34.677)
This anabolic means stimulates growth rather than stops breakdown.

Ben (31:37.58)
Right. Exactly. And then because when there’s an increase in bone formation, the body will tend to increase the bone breakdown. So when you stop, you do a bisphosphonate or you do a prolia, which is another classification of drugs that blocks the bone breakdown. So like a common combination that is being used is

Dr. Heather Sandison, ND (31:50.464)
Naturally.

Ben (32:06.03)
a a drug called AVISTA, which is another anabolic drug followed by Boneva, followed by prolia, followed by prolia, so that you ramp down the bone breakdown. Now I think there’s a better way to do it, which is what I did, which is by testing. And Western medicine fr does not like to do testing because insurance doesn’t want to cover it. So

Dr. Heather Sandison, ND (32:33.449)
And this you because you didn’t do bone density testing, right? What you did was blood testing. So like a P1 and P and osteocalcin, beta cross ups, those those ones. So to talk us through those and how you interpret.

Ben (32:38.317)
Yes.

Ben (32:45.346)
Yeah, use the C CTX and the P1NP and the SL calcin. Yeah. So the P1NP stimul is measuring bone formation and the CTX is measuring bone breakdown.

Dr. Heather Sandison, ND (32:59.959)
Okay. And so if you go if someone’s going to their doctor, it’s Ctelopeptide, right? Is what CTX stands for and P one N P stands for

Ben (33:06.786)
Yes, yes.

Ben (33:11.234)
you know, I actually wrote it down. it’s it’s it’s it’s a long name. Here it is. It yeah, it stands for pro and and this is the short version of it. Pro collagen type one N terminal pro peptide. And and the CTX stand is C terminal teloptide of type one collagen.

Dr. Heather Sandison, ND (33:15.383)
Let’s look it up because I do want people to be able to

Dr. Heather Sandison, ND (33:29.375)
Awesome. So and it

Dr. Heather Sandison, ND (33:38.494)
Awesome. Okay, so if people know to ask their doctor about this, how can they how can they track changes over time? Because a DEXA scan is what we use for for bone density, right? And you don’t want to look at that more than every two years because you’re not gonna get enough of a signal on those images. So what you’re suggesting is basically there are things that we can look at in between to understand if our body is or bones are going in the direction of osteoporosis or if they might be improving even.

Ben (34:05.004)
Yeah. Exactly.

Dr. Heather Sandison, ND (34:08.693)
And so how would someone like talk to their doctor about this? Would you want to look at them every six months? What would the ranges be? How do you interpret it?

Ben (34:16.462)
Well, depends what you’re doing. So if you’re gonna be taking medication, really important to get it done first. And then yeah, and then I would say two or three months in to see what’s happening. Like if you’re taking a drug and you’re trying to increase bone formation and you don’t see the P one NP going up, then maybe it’s not the right drug for you.

Dr. Heather Sandison, ND (34:23.219)
Have a baseline.

Ben (34:42.05)
So, you know, we tend to just do things, you know. You have an infection. Here, take this antibiotic. How do you even know it’s a bacteria? Well, we don’t want to test because the insurance company doesn’t want to pay for it. So

Dr. Heather Sandison, ND (34:51.547)
Right. Yeah. We got a test. Test don’t get. Right. Yeah. And it but I don’t think that those are particularly expensive, right? They’re maybe a couple hundred dollars, but they’re not thousands of dollars, right? Yeah. So you know, as we’re aging, bone health and and strength becomes increasingly important. When you have like especially through the lens of your experience,

Ben (35:03.544)
Yeah. No, absolutely.

Dr. Heather Sandison, ND (35:17.633)
What do you think the biggest mistakes people are making when they’re trying to protect their bone or or think about treating osteoporosis?

Ben (35:25.89)
I talk to a lot of women who think that doing like three-pound dumbbells means they’re putting stress on their bones. And it’s just not.

Dr. Heather Sandison, ND (35:34.113)
What about the the weighted vests? I see a lot of people walking around the neighborhood with the weighted vests. Do you think that’s enough? Yeah. All right.

Ben (35:40.768)
I don’t. You know, and the studies haven’t shown that to be the case. So, you know, I think something like the good old fashioned deadlift is can be super beneficial. You have to load the bones and then you need some bit of ballistic activity, I think, as well. Now, yeah, there there are, you know, I use the vibration plate because at first I couldn’t, you know, do a squat, but

and and I think that gives some stimulation, but I

Dr. Heather Sandison, ND (36:12.075)
And what about people who say, I can just do the vibration plate and that’s enough for my bones? Do you think that’s true?

Ben (36:17.42)
That’s it’s not been shown in studies to really have a significant enough effect.

Dr. Heather Sandison, ND (36:20.107)
No.

Okay. And then what about supplements? What if you just take the supplements? Could that be enough? Yeah.

Ben (36:28.758)
I don’t think so. You’ve got to tell your body what to do. And the way you tell your body what to do is you put stress on your bones and the body reacts by making the bones stronger. You know?

Dr. Heather Sandison, ND (36:39.351)
More resilient. And do you think there’s a place for bone it’s a for bisphosphonates, anything in that category that stops bone breakdown?

Ben (36:50.626)
Yes. So what you should do is if you have osteoporosis, consider, you know, talking to talk to your doctor, consider doing an anabolic drug and for a period of time, six months to a year or something along those lines. And then when you stop, see if your bone resorption markers go up. And if they do, then use abysphosphorinate. But the protocol now is to just automatically use abysphosphorinate.

Dr. Heather Sandison, ND (37:19.201)
So sequence them in a way that promotes actual good quality bone production versus Yeah.

Ben (37:24.11)
Yeah, try to keep in that mid range, you know. You need that cleanup crew to come and clean up the junkie bone.

Dr. Heather Sandison, ND (37:32.307)
Yeah, absolutely. I am curious, you know, with how you’re doing now, doing well, and what did your recovery teach you about patience, resilience, and healing that you share with patients, with your patients?

Ben (37:46.456)
We c we can never forget the amazing ability of the body to heal itself.

You know.

Dr. Heather Sandison, ND (37:54.539)
And really we need to just support it, right?

Ben (37:56.8)
I know you wanted to talk about the DEXA scan. Yeah.

Dr. Heather Sandison, ND (38:00.63)
Yeah, let’s do it. Let’s dive in. Cause I want people to understand how to evaluate this for themselves.

Ben (38:05.996)
Right. First of all, you’ve got to make sure you’re being properly positioned in the machine when you’re getting the DEXA scan. And that doesn’t always happen. There’s supposed to be a cushion there so your feet are slightly turned in. and and you should if you get a DEXA scan and then you get another scan a year or two later, it’s ideal if it’s on the same machine because machines can differ.

Dr. Heather Sandison, ND (38:35.051)
Yeah, I’ve learned a lot of this looking at brain images on brain MRIs. If you have a 1.5 Tesla machine versus a three Tesla MRI machine, you are talking apples and oranges. You cannot compare them. And although this is an X-ray, it’s slightly different. It’s it’s a little bit easier. You really do want the same sequences, the same x-ray, the same positioning. You really want to limit the variables between those two images.

Ben (38:47.853)
Yes.

Ben (39:04.556)
Right. And then

Dr. Heather Sandison, ND (39:05.129)
Otherwise it’s really hard to t compare them.

Ben (39:07.616)
And then if the patient happens to have scoliosis, that can change the reading because you’re not seeing a a relatively flat spine, you’re seeing rotation, and you’re not so that can skew the findings if they have osteoarthritis and bone spurs. That can make it look like there’s more bone when there’s not. if there’s you know, surgery, that can all affect it. And and then

Dr. Heather Sandison, ND (39:28.215)
Mm-hmm.

Dr. Heather Sandison, ND (39:34.237)
Wow. Yeah, there’s a lot of things.

Ben (39:36.844)
And then when you get the findings, they’ll tend to give you this brief report, and it’ll typically give you a few things. It it will tell you your T score, and they’ll compare you to a 30 year old, and it’ll give you a reading for your hip and your spine. But as for the complete printout, it should be like five pages or so, and it should have a little diagram showing exactly.

how they collimated it and what they measured, because they don’t always do it the way it’s supposed to be done. So you want to make sure it’s done exactly the right way, at the right part of the hip, the right part of the spine, et cetera. And then if the lab offers, you you want to ask for, you you want to look at not only bone density, but the quality of the bone. So you

I’m drawing blank right now. you wanna ask for

Dr. Heather Sandison, ND (40:36.353)
Well, so I’ve bet had a bunch of patients recently who, you know, especially people on GLP once, they’re getting their body composition tested. And they’re they tell me they’ve got a DEXA, that they’re getting a DEXA. But they go to a body composition b thing that’s like either a pop-up in a gym or they’ve there’s a mobile unit that comes around and they get a package of six and they’re gonna look every 12 weeks as they’re losing weight.

And they tell me that there’s a DEXA on there, but what you’re describing is something much more sophisticated, much more nuanced. So for someone

Ben (41:09.026)
Yeah, so you want to ask for a trabecular bone score.

Dr. Heather Sandison, ND (41:12.855)
Tribecular bone score. And what does that mean? What does that indicate?

Ben (41:14.622)
Right. So there’s Okay, so that’s gonna measure the quality of the bone, the bone resilience, which has a lot to do with its ability to resist fracture. So it’s a calculation done, and they have to have the software. So bone consists of the cortical bone, which is the outside of the bone, and then inside the bone, you have the trabecular, which is these cross hatches that gives the bone a lot of its

flexibility and strength. And so you want to get that TBS score as well. And that will calculate your fracture risk by telling you how resilient your bone is.

Dr. Heather Sandison, ND (41:55.628)
And then you can get a DEXA at almost any place that has an X-ray machine, right? But it’s almost sounds like it would be better to be going to a bone specialty imaging center. Is that true or is there a way that you can ask your doctor to order this more advanced DEXA scan that would include this trabecular score?

Ben (42:14.38)
Yeah, you just have to call the lab and see if they have the software for it. They have to buy a software package.

Dr. Heather Sandison, ND (42:18.175)
Mm.

Got it, got it, got it. Okay, and so not every place is gonna have that. The other thing that we’ve or imaging center. Yeah, the other thing that we’ve seen come up with that is like you mentioned, you want to use the same machine year after year and ha maybe have even the same radiologist reading that or the same AI system or the same software involved. And what we saw, at least with like the NeuroQuant NeuroReader software for brain MRIs.

Ben (42:25.184)
Especially not a small rural hospital or something.

Ben (42:38.136)
Yes.

Dr. Heather Sandison, ND (42:50.687)
Is that one imaging center would have it for a year and then they would lose their software license, and so then they wouldn’t be able to run it the next year. It’s really it it’s nuanced, right? There’s a lot, and I think that that speaks to the value of the P1NP and the CTX scores, is they’re a way to get out of the nuance of needing imaging. So get the imaging done, get your DEXA scores done, understand that there is some complexity to that.

Do your best, get the advanced DEXAs done with this trabecular score and make sure that they put you in the right position and do what you can to evaluate for that. But don’t get overwhelmed. Use those blood biomarkers in between to understand what’s going on with your bones. Does that feel like a fair takeaway? yeah, and then a K2, MK4. That’s the other big takeaway, right? I’m curious.

Ben (43:34.143)
Absolutely.

Ben (43:41.07)
Absolutely.

Dr. Heather Sandison, ND (43:44.201)
You know, if after forty years in practice and hundreds of podcast interviews, this personal journey, i adding to that, what are you most excited about in the future of bone health and really like medicine in general?

Ben (44:00.482)
I think we’re on the verge of increasing longevity. So I think we’re trying to figure out the matrix and I I feel like there’s w hints at what’s gonna work and and and so I I I think that we’re close to new developments that are gonna help us to be able to live longer, healthier lives. There’s all sorts of advanced

strategies that people are using, plasmapuresis and ways to cause regeneration and you know, so I think all that stuff’s really exciting.

Dr. Heather Sandison, ND (44:38.727)
And how long would you want to live?

Ben (44:42.402)
Well the key is can you be active?

Dr. Heather Sandison, ND (44:45.281)
Right. Healthy.

Ben (44:46.882)
Yeah, who wants to be in a bed not able to do anything?

Dr. Heather Sandison, ND (44:52.021)
Yeah. well what brings you the most joy at this stage in life? What would you want to be doing if you could live forever?

Ben (44:59.598)
I don’t know. I don’t really think about it that much. But I I guess I want to continue to help people like I am doing. You know, that that gives me a lot of satisfaction feeling that I’m contributing to the world.

Dr. Heather Sandison, ND (45:15.586)
Keep hang ha handing out Halloween candy.

Ben (45:18.126)
Yeah, create create more diabetes and tooth decay.

Dr. Heather Sandison, ND (45:23.647)
That’s

Dr. Heather Sandison, ND (45:27.445)
Hopefully not break any more hips though.

Ben (45:29.24)
Ha ha ha.

Dr. Heather Sandison, ND (45:31.617)
What fun. Well, Dr. Ben, always a privilege, always fun to catch up with you. Thank you for sharing this deeply personal story and all of the insights. You know, I think that is really one of the most powerful aspects of this conversation. It just reminds us that healing isn’t always linear. It doesn’t always go the way we expect. And even a very experienced healthcare professional can find themselves in this unexpected you know.

Labyrinth that you need to navigate with unexpected challenges, but they often this path becomes our greatest teacher. And so I really, really appreciate your willingness to share both the science, the research that you did, and the personal side of your journey so that it can really help someone else who’s navigating a difficult recovery and and both bone health issues that come up. There’s a lot of practical tools that you discussed.

That you that you learned through this perseverance and dedication to to getting through this. So for our listeners, I hope that you’ve enjoyed today’s conversation. And if you have, please be sure to check out Dr. White’s Rational Wellness Podcast and also his extensive educational work in the functional medicine community. Thank you so much. Yeah. Yeah, what do you spell that for people?

Ben (46:42.198)
And you can go to my website, doctorwhite dot com.

Yeah, D R W E I T Z dot com.

Dr. Heather Sandison, ND (46:51.817)
Excellent. And so you can see all that that Dr. Ben Whites has to offer there. Until next time, thank you so much for joining us on the Think Well, Age Well podcast. And remember, it is never too early or too late in to invest in your brain, bone, and body health for your future. Until next time, be well.

Ben (47:10.872)
Thank you.