In this Q&A, the PBTH doctors introduce Dr. Amy Zacharias, and discuss osteoporosis prevention.
Questions Answered
- (00:21) – Dr. Amy Zacharias, could you tell us a little bit about yourself?
- (01:41) – Discussing osteoporosis.
- (08:24) – What type of exercise do you recommend for osteoporosis if your knees are weak?
- (14:35) – How can I get started on a plant-based diet?
- (22:13) – Any advice for slightly elevated homocysteine levels?
- (25:40) – Does caffeine cause osteopenia?
- (26:09) – Any advice on someone whose mammogram results have scattered areas of fibroglandular density?
- (28:02) – Can hormones make a difference in bone density?
- (30:07) – Any suggestions for B12 supplements?
- (31:57) – What are your thoughts on amla or Indian gooseberry powder for blood sugar and LDL lowering effects?
Complete Transcript
Dr. Laurie Marbas
(00:03)
So welcome everybody to our twice a month, on the second and fourth Thursday, live Facebook with our fantastic plant-based doctors. And today we have a new addition. We're excited to introduce Dr. Amy Zacharias. How are you today?
Dr. Amy Zacharias
(00:19)
Good. Thank you.
Dr. Laurie Marbas
(00:21)
Excellent. So you want to tell us a little bit about you, your specialty, and you'll be starting seeing patients next week?
Dr. Amy Zacharias
(00:27)
Yeah, so I'm starting to see patients next week. I'm from Illinois, and I'm board certified in family medicine, lifestyle medicine. I would say my special interest is helping patients lose weight and manage weight, since there's so many that are concerned with that. So that's probably my special interest. And then my other interest is athletic performance too. I have four children who are all very athletic. One running cross country and track in college, and so that's always been a special interest of mine as well. So I'm very excited to be here and to join this great group of physicians.
Dr. Laurie Marbas
(01:06)
Excellent. Well, we're excited to have you, and if everybody knows, if I'm looking down, I'm monitoring questions also on Facebook. Dr. Niki is joining us as well, so if you have any questions and you're in the webinar, please post those in the Q&A box on the webinar. If you're on Facebook, please go to our Facebook Plant Based TeleHealth Facebook page, and I will be monitoring there. Feel free to also share this to your page or other pages as well. And again, I'm not ignoring you guys looking down, I'm just monitoring the questions.
Dr. Laurie Marbas
(01:41)
I don't see any questions at this current moment. We had all kind of been talking a little bit about osteoporosis this week. It seems to be the recurring theme. Does anyone like to just maybe kind of start what would be some basic lifestyle medicine measures for osteoporosis prevention, because I think that can't be said enough. Anybody have of ideas while I get more questions going?
Dr. Elisabeth Fontaine
(02:06)
We have the chance to talk yesterday with Amy Green. We had a little webinar. Sorry, Dr. K, I kind of cut you. You want to go ahead before me?
Dr. Michael Klaper
(02:15)
No, that's okay. Go ahead.
Dr. Elisabeth Fontaine
(02:17)
Okay. Well, so good conversation. And I know that in our group, we're talking about potentially building something specific to lifestyle medicine and people that has concern about osteoporosis, certainly a lot of women, and we've discussed that altogether. Prevention is definitely the word out for this condition. So being able to have a good exercise, like weightbearing exercise, certainly have a good diet, and the plant-food base is a good diet. Probably one of the most important thing we forget is the fall prevention, because women that are getting toward my age, because you guys are all young, but women of my age, definitely if you see more fracture of the hip, it's often not a big accident.
Dr. Elisabeth Fontaine
(03:10)
It's often for a little something that we didn't pay attention. So that's something that we need to pay attention, fall preventions. Doing some exercise that allow you to work a little bit more in your stability, like tai chi or yoga, and that's very important. So I don't want to take the whole room. Dr. K, I'm sure you have many things to see about nutrition and osteoporosis. I'll let you go on that.
Dr. Michael Klaper
(03:37)
Thank you. Well said, Elizabeth. And I certainly second everything Elizabeth said. The important thing, keep your bones strong, feed them with a whole food plant-based diet, lots of fruits and vegetables for all those micronutrients. Use your bones. Never miss a chance to walk upstairs, carry packages, get a weighted vest, and keep those bones strong.
Dr. Michael Klaper
(04:02)
Most of our conventional colleagues however, if they get a scan or whatever, it says osteopenia or whatever, they, “Oh, you need to be on Fosamax or one of these bisphosphonate drugs.” And many people are. And I've never liked those drugs, when I understood what they do. There's two kinds of cells in our bones, osteoclast breakdown old bone from the little micro fractures we get every day when we bang our shin or fall or whatever. And the osteoclast come in and they melt down the old cracked bone, and the osteoblasts come in and build new bone.
Dr. Michael Klaper
(04:39)
Yay. That's the way it's supposed to work. Now these drugs Fosamax, they quote, they poison the osteoclast. They stop the osteoclast from breaking down old bone, and hope to give the osteoblast a head start to make new bone. But that doesn't, it didn't ever made sense to me. It's like plastering over rotten timbers in an old house, you would put new layer plaster over them, but the timbers are still rotten. So I never really… And I concerned that the little microfractures there are still there, that the osteoclast were prevented from melting away. Why am I going into this? Because of a study that I just ran into, and this is published in… I've just popped it into the chat here. Now, these are the long term effects of bisphosphonate therapy, perforations, microcracks, and mechanical properties. And they took three types of bones that were removed at surgery, and normal bones from someone who [inaudible 00:05:40] it was an accident, but didn't have osteoporosis. A person with osteoporosis, but not put on bisphosphonate, Fosamax, et cetera, and someone who was on Fosamax.
Dr. Michael Klaper
(05:53)
They looked at them under the microscope. And sure enough, the bone of the person who had been on Fosamax was filled with those little microcracks. They then took them over to the structural engineer folks. And they had them put in these presses that where they test how much strength the concrete will take before it crushes. And they put these bone specimens in there to see how strong the bone samples were before they crushed. Surprise, surprise, the person who had been on the bisphosphonates, their bones crumble first, and more quickly. The bones may look better on scan, because they're quote denser, but bone density does not equal bone strength. It's a physiologic parlor trick, as far as I'm concerned, to make the bones look better on the scan, but when the person falls, they still shatter.
Dr. Michael Klaper
(06:49)
So this was one more nail in coffin that I carry in my head around bisphosphonates. Keep your bones strong. Feed them and use them, and don't rely on pills that just poison your osteoclasts to think that that's going to really make for healthier bones. It doesn't. When I saw this study, I said, “Yes!” I knew that that's what they were going to find. I felt that way for years. So here's some validation of that. So keep your bones strong, love them, use them, and I would avoid taking these bisphosphonate type drugs. That's my story, and I'm sticking to it.
Dr. Laurie Marbas
(07:29)
Perfect. And Dr. K, for those who aren't in the webinar, could you tell us where exactly they could find that article?
Dr. Michael Klaper
(07:38)
Well, [crosstalk 00:07:39]. Oh, this doesn't show here? This is in [inaudible 00:07:42].
Dr. Laurie Marbas
(07:41)
It just shows on the webinar side. Is it science rep? What's that [crosstalk 00:07:47]?
Dr. Michael Klaper
(07:46)
Yeah. Let me go back. I still have it up here. This is on science, just says science reports, scientific reports.
Dr. Laurie Marbas
(07:58)
Okay.
Dr. Michael Klaper
(07:58)
That's… But if you just Google that title, and the lead author is Dr. Ma, and it was from 2017, actually, March 6th. So you can find it in Google Scholar or whatever.
Dr. Laurie Marbas
(08:15)
Okay. So yeah. So the name would be Science reports under long-term effects of bisphosphonate therapy, perforations, microcracks, and mechanical properties, if you're interested in that. That's cool. And then we have another question kind of related to osteoporosis. What type of exercise do you recommend for osteoporosis if your knees are weak? Do any of you have any thoughts or suggestions there?
Dr. Michael Klaper
(08:40)
Start really gently. I have a recumbent stationary bike in my living room, and it has adjustable resistance on it. So start with a really low resistance, and just start pedaling really easy, and get the seat high enough so your legs are pushing straight down instead of out. Because that's… When you see someone riding a bicycle and the seat's too low, you see that their knees are out at this absurd angle. It really puts a lot of strain on them. So raise the seat up there, but you don't have to use a stationary bike, get these elastic bands. And there's a lot of regimens that you can do just with these lovely elastic band things to work. And don't do anything that hurts. But with little creativity, you can find something that puts a little bit of stress on those bones, and that's all you need to do. It's the repetition, just do it every day or be regular with it. And your osteoblasts will respond, and spin out new bone there for you.
Dr. Laurie Marbas
(09:37)
Mm-hmm (affirmative). And I would also ask, why are the knee weak? Is it a muscular issue? Is it a joint issue? And then I feel like that's probably a good place for physical therapy or physiatrist to step in and help you build a plan. But yes, absolutely. If it hurts, don't do it until you see an expert. Pain is telling you something. That whole no pain, no gain is B.S. in my mind. So anyway, in certain things, most things, but here's some other questions for you guys. Have you seen people with osteoporosis have better scans after eating plant-based and using their bones? Dr. Kim has some personal experience with that. Yes?
Dr. Kim Scheuer
(10:13)
I do. So the one thing I wanted to mention also is it's not just women, men have to worry about osteopenia and osteoporosis too. So please, if you're a man, pay attention to this, because it's important too. And yes, I've had early scans because my family history, and I have always had osteopenia and pretty bad. Working on osteoporosis at a very young age, and then I went plant-based, and a couple of years later got another bone density, and it had improved. And I didn't understand why. I said that's wrong, the machine's wrong, there's something wrong because I'm not, I wasn't doing what I was supposed to do, like my exercises and everything like that.
Dr. Kim Scheuer
(10:59)
The only thing I had changed was the plant-based diet. Then I did research and yes, you can improve with a plant-based diet. If you stop eating the things that cause you to erode your bones. If you stop doing that, and start eating things that actually help you heal, and stop inflammation, and make you feel better, it helps. Now, everybody who has osteopenia, and everybody also, should be exercising and doing weight bearing, and moving a lot. But giving up the dairy makes a difference, giving up the crap makes a difference. So personally, yes, and then I've also seen it with my patients. So it's not just me, so definitely work on that.
Dr. Laurie Marbas
(11:45)
There you go.
Dr. Niki Davis
(11:46)
I had a patient, as well, that had osteoporosis diagnosed with a DEXA scan several years ago. Went plant-based, and then on repeat DEXA scan, had completely resolved it.
Dr. Kim Scheuer
(12:02)
Nice.
Dr. Laurie Marbas
(12:02)
There you.
Dr. Michael Klaper
(12:04)
Bones are alive, they're constantly responding to what we put into them and ask of them, they respond. It's one of the most exciting things in medicine to see that disease verse from good lifestyle practice.
Dr. Niki Davis
(12:15)
And Dr. Scheuer, I was going to mention too, that it's interesting that you mentioned not only is it important… We always talk about whole food plant-based, getting all those good veggies, and getting the greens and beans to help get your calcium, and making sure you get vitamin D. But a big part of this is moving the acidic diet, the protein heavy diet, because that is really what is harming your bones.
Dr. Niki Davis
(12:40)
It's not just about what you're not getting, because of course you're going to be lacking fiber, you're going to be lacking nutrients, when you're not eating whole food plant-based, but you're also taking in harmful foods that are destroying your bones, literally, that are leaching those things that your bones need, the calcium and all of that, because of the harmful diet that you have. So it's not only important to make sure that you're getting rid of that diet, but also that you are changing to the more helpful diet.
Dr. Laurie Marbas
(13:12)
Yeah. I would definitely reiterate, Niki, that everything you're saying is removing things, but it's smoking, alcohol, sodium, caffeine, even high vitamin A. So a lot of people take these high doses of vitamin A and supplements, but also where does this begin? Let's think about this as a childhood disease, right? So we really need to be focusing on our kids eating healthy, that they're getting out in the sun, and plenty of exercise. And so they're building their bone bank, so to speak, that you're really optimizing your bone health and getting your maximum bone density, which they say stops around 30.
Dr. Laurie Marbas
(13:46)
But I don't know. If you can see some improvement past 30, maybe there needs to be additional studies, but we really want to try to build these healthy, strong bones while we know that they're growing and building. So just some ideas to think of this as a pediatric disease. It starts in pedi when you're kids. So just parents, really push it, those kiddos out there. But great. So that's some great conversation about that, but here's a good question too. Sonya says, “Hello from Ottawa, Canada. My question is the transition to a plant-based diet. So much information out there. I just want to keep it simple, so stay on track. Any suggestions would be appreciated.” So anybody want to talk about getting started on a plant-based diet?
Dr. Laurie Marbas
(14:35)
Dr. Amy, I know you've done this, so you want to help us get started plant-based diet?
Dr. Amy Zacharias
(14:40)
Sure. I think the most important thing is to keep it simple. Start with meals that you like and make those plant-based. So for instance, trying to get my kids to convert, I would take tacos, and instead of having a meat and a cheese, we would do a black bean taco with a lot of veggies. Trying different sauces too, sauces can help a lot. So if you can make cashew based sauces, or salsas, and things like that to make it fun, that works well.
Dr. Amy Zacharias
(15:11)
I think having a variety, if you're trying to get a lot of people to convert, is good as well. So maybe you have black beans, pinto beans, maybe you have some cauliflower tacos. So just having variety. Having family members help pick out meals too, maybe take their favorite and convert their favorite into plant-based meal. But most important, keep it simple. A meal can be as easy as a green, a bean, and a starch. So starting really simple rather than making a complex recipe. I think a lot of times people get really, get off track when they look at all those recipes that have so many ingredients. There's a lot of great plant-based meals out there, a lot of great recipes, but it doesn't take a recipe to make a good plant-based dish for sure. Those are some of my tips, I guess.
Dr. Laurie Marbas
(16:02)
Cool. Anybody else have others?
Dr. Elisabeth Fontaine
(16:04)
Yeah, I think, and sorry, I'm just going to say. the idea of keeping it simple is so important. So when you think about it, whatever diet we eat, we tend to eat the same thing all over about two weeks. Not a whole lot of difference, whoever you're going to talk to, and you look for two weeks journal. So you have to think about it this way as opposed to, “Oh my gosh, what am I going to do next?” You most likely going to eat a little bit the same thing. So try to find things that you like, and use it all over until you feel more comfortable, and then you can add other things. So keep it like that. That to me has always been a very simple way to introduce my patient to the plant food base. Sorry, Kim. [inaudible 00:16:50]
Dr. Kim Scheuer
(16:50)
Oh, no worries. I also found that when I started, it was surrounding myself with people who were doing the same thing, so I had people to run things off of. So if you're on Facebook, join the Forks Over Knives Facebook group, or Plant Based TeleHealth, obviously. Or try and find support groups around you, or watch all the great movies that will remind you at time and time again why you're doing this. Remember your reason for starting this, and keep your why front and center in your life, because you'll get some people who will question, “Why are you doing this? Don't you need this? Don't you need your protein? Don't you need this?” So remember why you started it, remember how great you feel when you're on it, and get the help from others by just joining other groups or reading some of the books, watching some of the movies that are very typical in the plant-based field. And great job. Congratulations for starting this. That's awesome.
Dr. Laurie Marbas
(17:49)
Dr. K, you've, I'm sure, helped many, many, many, many, many people over the years. Tell us what are your golden nuggets?
Dr. Michael Klaper
(17:56)
Only four many's, not five many's. Aren't my colleagues wonderful and wise? I'm just loving hearing all this wisdom from these experienced physicians pour out, especially through the plant-based lens. It just makes my heart so happy that we're finally at this stage. It's just wonderful.
Dr. Michael Klaper
(18:15)
Yes. It's mostly common sense. Start with the dishes that your family already likes. They like spaghetti and meatballs, then make it pasta primavera. Take out the meat, put in lots of veggies. I'm not adverse as a transition to using some of the plant-based analog crumbles these days. If it helps them, if they, “Oh, I could eat that.” Yay! You've got big victory there. Especially with kids. Most kids like mashed potato, they like corn on the cob, they like green peas in the pot. We already like a lot of good plant foods, and then start incorporating them into soups and other kind of dishes.
Dr. Michael Klaper
(19:06)
I'm a big soup fan. We make lovely, thick vegetable, rich soups, and throw in some quinoa, and lentils, et cetera, but… And then season up however you would like. If you wanted the Mexican chili, or Asian curry, or whatever, you can have lots of fun with the various international cuisines. So find out what your family likes and meet them there in a plant base mode there, and they'll say, “Oh, that's nice. Oh, I like that.” And taste is worth a thousand words, and you'll you get them on board.
Dr. Laurie Marbas
(19:40)
Mm-hmm (affirmative). And don't be intimidated. Some people are, it's funny, they've been, they'll be cooking their whole lives, but suddenly they're like, “I don't know how to cook.” Like, yeah, you do. Just different things. The same principles apply to cooking plants, and I'm pretty sure plants aren't new to your diet. You had plants somewhere in your diet, so don't be afraid or overwhelmed. It is cheaper, I promise, if you're not buying all the processed stuff. You're buying the basic whole foods. This is going to be better on your bank account. In addition, the lot of things I hear are time. Batch cook, use your Instapot, use all these things. What we do is like right now we have a big thing of rice in there. I made some little taco meat, and then I've made like four or five different sauces. You can do different things.
Dr. Laurie Marbas
(20:26)
Always have greens available. You can make a big salad, have a big salad in a bowl already. So you can use all those different sauces and like Dr. K and the others are saying, make it a different ethnic and journey every night with the same basic ingredients. So absolutely, get the kids involved. I agree a hundred percent. I've converted three, and it's done wonders. One's a doctor now, she's promoting plants, so what can I say? It works. So don't give up. Good question here is… Let me get back over here.
Dr. Laurie Marbas
(20:56)
I'm concerned about the ability to work with a PCP regarding whole food plant-based lifestyle and medications can a telehealth physician help? What do you guys think? Maybe? Yeah, yeah. A lot, right? We do this a lot. We're going on our second year of doing this, which is really exciting. We'll be two in March. And yes, we work with regular folks who want to keep their primary care doctor, which is fantastic. We don't replace your primary care doctor, but we're happy to help you walk along that journey, how to discuss it, what to be doing. Many times we take over management of some of the things that we feel like we're going to get better medical management, just from the medicine side of things.
Dr. Laurie Marbas
(21:35)
You go to plantbasedtelehealth.com, and you can click on there, and make an appointment and meet the docs. Meet all of these amazing doctors that are on our team. We have some brilliant people here, guys. I'm humbled every day. It's so fun. Oh my gosh. And it's been a blast, and we work together a lot to help each other even become better. You're not going to find that anywhere else, at least in the plant-based world in my mind. Yeah, we can definitely help. So I had to throw that out there. Here is another question I had to get back. It was a really good question actually. It's kind of a three part. Okay. Rich is asking, “I'm completely plant-based vegan, but I have slightly elevated homocysteine levels at 10.9. I've been taking a gram of creatine based on Dr. [Greger's 00:22:23] advice. Get started plant-based diet it? My B12 and folate levels were normal.”
Dr. Laurie Marbas
(22:29)
Any thoughts on the homocysteine level?
Dr. Michael Klaper
(22:34)
There are folks… Homocysteine, let's, for those not familiar with it, in our diet, we eat proteins. Proteins are made up of amino acids, and there is one amino acid called methionine, and we need methionine for all sorts of things. And methionine has this little group sticking up, a carbon with three hydrogens on it, called a methyl group. And methyl groups are very useful in the body. The body throws methyl groups around back and forth to turn enzymes on, turn genes off. Methyl groups are very important. And methionine is very happy to be a methyl donor and give up its methyl group. And when it does, when methionine loses that methyl group, it becomes homocysteine. And homocysteine is not terrible in itself, but if it builds up to too high a level, it can start damaging the artery walls and it might increase your risk for atherosclerotic plaque formation, and all the trouble that that produces.
Dr. Michael Klaper
(23:29)
So how do we get rid of homocysteine? Well, if you add that methyl group back on, homocystine turns back into methionine, and that's how we get rid of that. And that's how most people do it. And you need vitamin B12, excuse me, and folate to be the methyl donors. But there's some folks whose enzymes are working a little bit slow. They may have what's called an MtHFR mutation in their genes. And these folks may need a special form of vitamin B12 or folate called methyl B12 and methyl folate. And there are, you can Google it and you can find it on Amazon, there are products, HomocysteX is one of them.
Dr. Michael Klaper
(24:17)
I have no connection to the company, but now there are products that have methylcobalamin, and methyl folate. And you might try one of these for a few months and then get your homocysteine level B check, and there's a good chance it'll be down. And you should just be taking those forms of B12 and folate to make sure your homocysteine level doesn't get too high. Hope that wasn't too complex. If you just Google elevator homocysteine, you'll see these references here.
Dr. Laurie Marbas
(24:48)
Another thought too, if you're taking a biotin supplement that can interfere with it and it may give you a false elevation. So stop any biotin supplements that you might be taking. Yeah. So B6, B9, B12 are very, very important. And if you're going to take a methylated, I'd also take an adenosylcobalamin, so you not shunting all into one pathway. I got a really cool, interesting…. My patients continue to educate me. She sent me one from some European nutritional thing. This patient happens to be dealing with some cancer, and she's really diving into the B12 because the certain chemical therapeutic agents that they're using with her are using up her B12. And anyway, some very interesting conversations, but you might want to do a half and half methyl and adenosylcobalamin. So just some thoughts there, but yep. Those are some helpful things. Check it out, and again, Plant Based TeleDoctor should be able to help you with that. So, moving on. [inaudible 00:25:40]
Dr. Kim Scheuer
(25:40)
There was one from Clara asking, Clara [inaudible 00:25:44] asking about caffeine, whether it causes osteopenia. And it's one of the things, there's a bunch of things that help you lose calcium in your urine, which we don't want to necessarily do. And that's salt, and that's the animal proteins, the caffeine, processed sugars, things like that, alcohol, nicotine. So yeah, if you have osteoporosis certainly, and if you have osteopenia be careful on that. Okay?
Dr. Laurie Marbas
(26:09)
Cool. Keisha also ask, “Any advice on someone whose mammogram results have scattered areas of fibroglandular density?” Well, I would just say maybe talking about breast health in general, or women's health. Any thoughts or suggestions, Dr. Elisabeth? I know you've got tons of experience in that realm.
Dr. Elisabeth Fontaine
(26:28)
Oh, it's always a touchy thing regarding the breast density. Some women definitely have more than others, and there's some studies, but it's not all the time so clear like caffeine, as an example, is a good example. But in my experience, and I wish I could tell you and maybe some of you have had the better result, but in my experience, I've never really being able to suggest any type of supplement that will take care of that. So for me, it's more being able to have a good diet and again, the whole plant food based diet, and trying to eliminate some of what Niki was talking about before, is actually excellent for the same conversation of osteoporosis for the breast density.
Dr. Elisabeth Fontaine
(27:21)
Just to be careful of not putting too much of what we have in the typical American diet, including as an example, caffeine, that will have a tendency to bring more density, for reasons that are not easy to understand. Definitely some women have more density. And if you say it makes the mammogram a little bit more difficult to read because it decreased the sensitivity of the exam, and it's a little bit more difficult for the radiologist to be able to perceive any calcification. So just need to be extremely careful about what we put in our body. Any other thing, thought, guys?
Dr. Laurie Marbas
(28:02)
No, I think that's great. There was also another question, can hormones make a difference in bone density? Do you want to speak to that as well, Elisabeth?
Dr. Elisabeth Fontaine
(28:11)
Well, obviously we all know that, and Kim was right, it's not just women, but let's say that women is certainly representing a good 70% of the population that will have more chance of osteoporosis. And this happened definitely after age 50, which is the time where we lose our estrogen. So the biggest issue with the estrogen is we had all these studies, good or bad, that had came out to say that estrogen can increase other risk, breast cancer, cardiovascular disease. Unfortunately, most of these studies have been done in the wrong population, as an example, women that are older, and there are obese, already have chronic disease, and therefore does not really demonstrate their potentially estrogen. And not the synthetic form, may not be as bad as we think.
Dr. Elisabeth Fontaine
(29:04)
Anyway, in itself, it is true that once you go to menopause and you're losing this important hormone, that is estrogen, you are definitely losing your bone mass a little bit faster. Now, if you are at least careful and have the best whole plant food based diet to try to help you, you're reducing the chance of continuing in that slow. Do I discuss with the patient? Well, depending of all the other element that is happening around menopause for them. Some women are so symptomatic that you have to be able to look at the pros and cons, and being able to see with them what would be the best, but the studies that demonstrate that estrogen definitely help you to maintain your bone. So unfortunately, there's other side effects, so you got to be careful.
Dr. Laurie Marbas
(30:01)
Yes. It's a balance for sure.
Dr. Kim Scheuer
(30:03)
Soy products make a difference.
Dr. Laurie Marbas
(30:07)
Soy products, yes. [crosstalk 00:30:09] Two servings a day, definitely two servings a day. Absolutely. So Olivia ask, “Any suggestions for B12 supplements? Everything I tried causes stomach distress.” Do you guys have any particular brand or type that you feel makes a little less on the queasy stomach?
Dr. Michael Klaper
(30:26)
Well, I've seen some drops that you just put under your tongue and I would think those would… A lot of it's absorbed in through the cheek, and what does drizzle down into your tummy really shouldn't cause much [inaudible 00:30:36] of distress there. So just look for the liquid supplement, start with that, or the sublingual tail that just go right under your tongue. That ought to do the trick. And I see someone's asking what's better methyl or cyanocobalamin? Cyanocobalamin is cheaper and it's more stable and works for most people. But if your homocysteine is up, then move on to methylcobalamin or, and plus, as I've just learned this morning… I'm in Hawaii this morning. It's only nine in the morning here. Adenosylcobalamin as well-
Dr. Laurie Marbas
(31:07)
I'll send you the article, Dr. K.
Dr. Michael Klaper
(31:09)
Thank you, I appreciate that.
Dr. Laurie Marbas
(31:09)
I'll send it to everybody.
Dr. Michael Klaper
(31:09)
Okay.
Dr. Laurie Marbas
(31:12)
It's very interesting, actually.
Dr. Michael Klaper
(31:13)
Very interested.
Dr. Laurie Marbas
(31:14)
I was like, “Oh, okay.” Because I have a ton of patients on the methyl, and I was like, “Wow.” So as I was reading this, I'm like, “Oh, my goodness. That's really interesting.” And okay, so… Also, just with the supplement, and the B12, and the upset stomach, a lot of times when women are taking prenatals, they'll get an upset stomach. I know I certainly did. So the one thing that I did, that worked just fine, was I took it after dinner and before bed, and that seemed to resolve the issue.
Dr. Laurie Marbas
(31:42)
So if you do a liquid and after you've eaten, and when you're going to go to sleep, you'll probably be okay, but you definitely need to be told don't not take it because of your stomach. That's really, really important to do. And I would say, I know we're running up on our time here. One last question was, and which is a good one, what are your thoughts on amla or Indian gooseberry powder for blood sugar and LDL lowering effects? Would you guys, any of you guys like to talk about that or I can? Okay. I use amla a lot, but go ahead.
Dr. Kim Scheuer
(32:15)
Oh, I was going to say, I use amla a lot too. If you get straight amla it tastes terrible!
Dr. Laurie Marbas
(32:21)
Quite sour.
Dr. Kim Scheuer
(32:21)
But it does help decrease the sugars, and blood pressure, and some other things. I have found that for me, the ones that I like is, there's a amla green or a powdered one that you can use as a tea, which really works really well. It doesn't taste bad. And if you don't like caffeinated products, I like the amla hibiscus, because that will help decrease your blood pressure even more so that combination in a tea is a really nice one for me.
Dr. Laurie Marbas
(32:54)
Yeah. I like amla powder a lot too, about half a teaspoon a day. And I've seen some least stubborn plant-based eaters who are doing everything right in their diet, who's just stuck, it'll drop 30 points. Your total cholesterol. It's pretty fascinating. The blood sugar, I'm seeing some improvement, but not as dramatic, but it's a great antioxidant. It's very, very tart, so just be prepared. I like those ideas, how you can mix it. And Mastering Diabetes has also created a really concentrated amla tea powder that you can use if you want to proceed with that, which is good too.
Dr. Michael Klaper
(33:29)
Does it come in veggie caps or can you put it into a smoothie? Is there any other… How else can you get it in there?
Dr. Laurie Marbas
(33:36)
I put it in my smoothie every morning.
Dr. Michael Klaper
(33:37)
Okay.
Dr. Laurie Marbas
(33:38)
Just because it is really tart, and TerraSol's a good brand on Amazon. It just keep it in the fridge, and I make a little concoction of all that, and off we go. So, but yeah. All right guys, thanks for listening, and we really appreciate you. We'll be here in two weeks again. You can find these wonderful docs, and even some more, on plantbasedtelehealth.com. We have some exciting stuff coming up.
Dr. Laurie Marbas
(34:06)
We're excited to work on some osteoporosis program, which we'd love to hear your feedback if you think that that would be something you would benefit from or would like to see. And we're going to be hosting some, probably an educational webinar about it and then set you up and tell you how we can move forward with one of our doctors on the program that we're building. Because we really feel like we're the tip of this spear, and we're practicing lifestyle medicine here and we have a brain trust, that's like none other. So with that being said, come see us at plantbasedhealth.com. And if you have any further questions, save them, and we'll be back in two weeks at the same place, same time. Thanks guys. Have a good one.
Dr. Michael Klaper
(34:42)
Thank you. Bye-bye.
Dr. Laurie Marbas
(34:42)
Bye.
Dr. Kim Scheuer
(34:42)
Bye.
*Recorded on 9.9.21