Archive for Remedies for Health and Menopause


Improving the Gut Microbiome Part 3

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This video, available only here is split into two 3 minute sections. In it I discuss the gut microbiome, all the various bacteria of the gut that are involved with our immunity and our physical and emotional health. Through supplementing by eating probiotic foods and by nourishing by eating prebiotic foods (I explain these terms in the videos) you can improve and maintain that improvement in immunity and general health. Enjoy parts one and two then click on the contact form and send me your comments and your requests. I would love to be your guide in this type of healthy behavior improvement. As a physician assistant with 25 years of experience in womens health and a certification from the Cooper Institute as a Healthy Habits Coach, I am in a unique position to be a guide in your quest for health improvement. Let me know how I can help you.

As in previous posts, I recommend you purchase a copy of  “The Good Gut” by Erica and Justin Sonnenburg. The link below is my affiliate link. Using it helps keep this blog and the work I do financially afloat. Thanks for your support.

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What do you consider most important health factor that will enable you to continue to live life the way you want?

For some of us, it is to have a sharp mind to continue with the creative pursuits we want to engage. Our brains and creative process are the most part to us. We then hope our bodies are healthy enough to carry those minds around for a while.

For others it is to have the energy and strength to be as physically active as we want.

There is no doubt however, a healthy heart is needed for both types ways of living. It turns out that quite possibly striving for a healthy cholesterol profile may not be enough for menopausal women!

A recent study out of the Univ. of Pittsburgh School of Public Health reveals that having a high HDL cholesterol can cause cholesterol plaque, just as the bad LDL can.  This study followed 225  women in their mid to late 40′s for 9 yrs. They were determined to be clear of cardiovascular disease at the beginning of the study. It was noted that the women with higher HDL levels as they transitioned through menopause had a greater number of cholesterol plaques formed that the other participants. The researchers theorize that the changing levels of estrogen affects cholesterol metabolism, but they admit they do not know more than that.

We have been taught for years that having a high HDL, or “good cholesterol”, is protective against heart disease. We do not know all there is about cholesterol and how it is metabolized, but this small study would indicate that a lot more has to be determined before we have a clear picture or the final word on cholesterol and aging.

What can we women do in the meantime to protect our hearts?

We can improve all the other potential risk factors we may have for heart disease.

  • Consume a diet low in animal fats, trans fats and saturated fats. Increase healthy plant based fats
  • Decrease and eliminate processed starches, sweets and packaged foods. Studies have suggested that when saturated fat is consumed with processed starch (think chicken biscuit, pastries, fast food meals) more harm is done than consuming saturated fat by itself. Having said that, you still need to LIMIT the saturated fat you consume.
  • Stop smoking or using nicotine products. Nicotine basically inflames the walls of blood vessels, allowing cholesterol particles to adhere and gather.
  • Exercise in any way that is enjoyable and tolerable for you. Moving helps metabolize food energy so it is used, not floating around looking where is will live.

Talk with your medical provider about your cholesterol profile and how it may impact your health. There is a relatively new way of analyzing cholesterol called the NMR lipoprotein. This technology looks at the particle size and count of both good and bad cholesterol. We all make different sized cholesterol particles, and the more yours are large, the less likely they can stick to the walls or arteries and create plaques.

Until we know more about cholesterol, do what you can with your habits. This way you can be more active, creative, influential, involved, thought provoking and connected for many more years!



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I was recently contacted by the NIH regarding my thoughts on the use of HRT for treatment of menopausal symptoms. I was asked to review a brochure from NIH (National Institute of Health), to see if viewers may find some benefit from their information.

Hot flashes can can certainly be a very difficult symptom of the menopausal transition. They can interfere with sleep, affect our confidence at work as well as concentration. They are embarrassing, make us feel old; and can make coping with social situations difficult. Some of us have it bad, others not so much.

Now, according to a recent study, they are costing the companies we work for; in the form of lost time at work.


A recent analysis of data looking at the insurance claims of 500,000 menopausal women, all of whom were insured by Fortune 500 companies. Half suffered from hot flashes, and half did not. This analysis took place over the space of a year.

This analysis revealed a surprising 1.5 million more health care visits in the group with hot flashes compared to the control group. The cost of lost work by this group was estimated to be over 27 million dollars and the cost of this additional health care almost 340 million!

I am not sure that 250,000 hot flashing women could actually rack up this amount of cost to their employers and health insurers; but the point is noted. Hot flashes affect women and affect productivity.

This change has apparently been amplified since the Women’s Health Initiative findings of an increased incidence of stroke and heart attacks to users of HRT; resulting in more women opting not to use hormone replacement.

While hormone replacement therapy may carry an increased risk of breast cancer and cardiovascular events if you are in a high risk category for either of these, it can also be very safe to use for several years. This can be a life saver if you are someone suffering from hot flashes.

For my readers following me for the past few years, you are probably aware that I am a proponent of HRT if you are low risk. I feel they are safe to use for a limited time and can help ease the transition.

The following link to an NIH brochure containing information regarding Hormones and Menopause will allow you to review the position of National Institute of Health regarding the safety of hormone use for many women at low risk for cancer and heart disease. It contains some good information that I basically feel is sound. The brochure can be read online or ordered for free.

So check it out! Don’t be afraid to discuss possible use of hormones to ease your menopausal symptoms if they are interfering with work and social activities. As they did for me, they may help ease the worst of it for a few years, and help you establish some changes in your routine to accommodate the changes that menopause can bring!

ps. There is no financial incentive for me promoting this brochure, I receive nothing from NIH or any other organization; and the brochure is free.

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HPV and Throat Cancer-know your risk

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When you think of HPV, most of you will think about cervical cancer and genital warts. Women are becoming aware of the importance of HPV and cervical cancer and getting screening for this virus through their yearly PAP exam.  HPV is unfortunately extremely common, with 1 in 49 people acquiring a new infection every year! What many men and women are unaware of is the risk of throat cancer from an oral HPV infection.

For this reason, it is important to know your risk and the potential symptoms in order for early detection of throat cancer. Unfortunately there is no screening test for HPV of the throat, although screening for HPV of the cervix is routinely done through PAP smear.

Both men and women are at risk for throat cancer from HPV through the practice of oral sex, with heterosexual men having the greatest incidence. HPV is shed through vaginal fluids as well as present on the skin of the penis; with vaginal fluid having the higher concentration. Many specialist predict a drastic increase in the incidence of oral cancer in coming years.  HPV is currently felt to account for 80% of throat cancers.

It is assumed that if you are over 40 and have had more than one sexual partner; you most likely already have been exposed and acquired an HPV infection. The key factor in HPV infections is whether your immune system is able to suppress the virus, thus limiting its destructive abilities. Most people can suppress the virus, but it is important to keep your immune system healthy in order to facilitate this. You cannot assume however, that a suppressed virus means lack of shedding. It is still possible for you to unknowingly spread the virus to a partner.

Screening for oral cancers is difficult as there is no test. It is really up to you to check yourself regularly for any suspicious changes in your mouth and tongue. Some of the symptoms include:

  • A new lump or lumps on tongue or back of throat, as well as lumps in the neck.
  • Soreness in your throat or tongue that persists
  • Painful swallowing or speech, change in your voice
  • Painful chewing and/or sores in your mouth that are not healing

If you are concerned about oral cancer or have any of the above symptoms, it is important to get evaluated by an otolaryngologist who can do a thorough exam of the back of your throat and perhaps perform a biopsy of any unusual areas or lumps. It is important to remember that most people will suppress and clear this infection without any problems.

There is promise for prevention for younger people that have not yet been exposed to HPV. Gardasil and Cervarix are 2 vaccines developed for the prevention of HPV infections causing genital warts and cervical cancer. It has shown promise in reducing or elimination the amount of HPV found in saliva upon recent studies. Actual prevention of throat cancers through use of these vaccines has not been demonstrated but it is hopeful that they will.

Early detection of HPV throat cancers have been shown to respond very well to all forms of therapy for throat cancer including radiation, chemotherapy and surgery. New treatments and trials are ongoing.

Keeping your immune system and mouth health optimal by eliminating tobacco products, limiting alcohol, getting plenty of sleep, and eating a healthy diet full of vitamins and nutrients; is very important to help fight any infection.

It is scary to think about cancer and serious illnesses, and many of you will choose the path of ignoring new problems and symptoms. I encourage you to think about what you fear most and whether avoidance will help or hinder your ultimate health.

Have any new symptom evaluated by a professional, they may very well be able to put your concerns to rest!


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This One Big Easy Change Can Improve Your Life!

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OK, so you just came back from your yearly physical and your provider told you that  your blood pressure and cholesterol are too high, your are in the obese category, and you need to lose 30 lbs.

On top of all this, you are menopausal, hot all the time, tired all the time and can’t think straight. Your head is screaming WHERE DO I START?

Oh, and did I mention you did not get any advise on how to accomplish all this!

Don’t give up and throw in the towel, letting it all go. You can start with changes, one at a time. It will be slow, but steady progress with a result in a lower blood pressure, cholesterol and weight. Oh, and you may get rid of those troubling menopausal symptoms as a side benefit!

OK, lets get started.

First is diet. Throw out the sugar and go just 3 days, only 3 days without sugar. This means no sodas, no sweet tea, no candy, desserts. It ALSO means no dairy as this has lactose which is a type of sugar, and yes that includes cheese. No fruit, as this has sugar. No starches as these cause spikes of blood sugar and fuel cravings for sugar. REMEMBER, this is only 3 days.

What good will this do you may wonder? It gives you control over your blood glucose, it detoxifies your system, and it lessens food cravings. And it may just make you feel better! Exercise is important, but diet needs to come first. Food is like a medicine, it profoundly affects your body system and can heal you, or kill you.

Sugar and refined packaged foods are the most destructive things to our health, other than cigarettes. Choose these 3 days of no sugar to eat as much natural food as you can. Go for salads, fresh cooked vegetables, and water…lots of water. You can eat small amounts of nuts, this will give you some healthy fats which will help you feel full. You can eat protein, pick leaner cuts of meat not hot dogs or sausages as these are processed and very high in fat. You can have a few eggs. Try an omelet with veggies for breakfast, salad with some meat and a light salad dressing for lunch, a lean meat and 2 cooked vegetables for dinner. Snack on nuts, raw veggies and humus. Drink water, water, water; you can squeeze some lemon in it for flavor.

Ok, so you have detoxed from sugar for 3 days. What’s next?

You may be surprised what the scale has done and hopefully this will motivate you to continue with some diet changes. For the next few weeks, slowly add in some cheese, then other dairy and some fruit. Not all at once, but 1-2 things every day. As you do this, you should continue to notice a benefit in how you feel. It is still important to avoid processed foods and sweets.

Some strategies to avoid complete deprivation of the foods you like is to pick one day a week, and allow yourself some foods that you enjoy. Don’t go overboard, and get right back on track the next day. If you feel yourself really craving these foods, you may need to avoid doing this and pick only one day a month. You may actually find though, that your stomach does not like these fatty processed foods after you haven’t eaten them for a while. This is progress!

This is a start, it will not solve all of your problems but it is a significant help. Blood glucose spikes fuel cravings making us eat more. Eating more causes weight gain which makes the heart work harder, and what isn’t used for energy is stored as fat or cholesterol. Blood glucose spikes can also trigger hot flashes and make them more powerful. A higher plant based diet can provide you with the plant version of estrogen called phytoestrogens; which can help lessen menopausal symptoms.

Coming home from your medical providers office needn’t make you feel dome and gloom. Make this one small change to start and see what happens. Check in with me later to see other changes that can help you reverse any negative biological process going on!


New Recommendations for HRT

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Hormone Replacement Therapy has been both embraced and vilified over the last decade and more. It was once considered the magic potion to keep women young, until the Women’s Health Initiative published some of its’ findings in 2002.

The WHI raised significant concerns regarding the safety of HRT in terms of breast cancer and cardiovascular health. This large study seemed to indicate an increase of breast cancer with HRT users, as well as an increase in stroke and heart attacks. Use of HRT has plummeted, and many women have suffered through the menopausal transition too afraid to ask for relief from their providers.

In a turn of attitude, new recommendations have been released in the UK. British researchers have re-analyzed much of the WHI data, as well as data from the Million Women’s Study; and found that some of the conclusions were possibly faulty. This has also been an increasing thought of researchers in the US.

To summarize possible misconceptions from the WHI, the slight increase risk of cardiovascular events with use of HRT was mostly confined to women who started HRT after the age of 60. HRT is felt to inflame cholesterol plaque which had formed in the years following menopause. Starting HRT at the time of menopause is not felt to increase risk of heart attacks or strokes in low risk patients.  A Danish study actually showed a lower risk of heart events when started early following menopause.

There still remains concerns shared by all menopausal researchers regarding the association between breast cancer and prolonged HRT use. A slight increased risk after 5 years of use of estrogen and progesterone has been seen in many studies. Use of estrogen alone has shown no increase in risk and in some instances a decreased risk. The problems with estrogen use alone is the increased risk of uterine cancer, a risk well known and studied extensively. Therefor, estrogen use alone for menopausal women is confined to women who have had a hysterectomy.

The current recommendations of the UK is to individualize the decision to take or not take HRT for your menopausal symptoms; rather than follow a blanket guideline recommendation. It is also recommended to consider HRT if your menopausal symptoms are significantly interfering with your life. The decision regarding HRT safety for you will depend on your personal history of cardiovascular health, as well as your family history of this and of cancer.

Here is how I think of HRT use. If should and can be considered if:

  • You are significantly impacted by menopausal symptoms in terms of mood swings, hot flashes, insomnia, muddled thinking and fatigue.
  • You are having difficulty with your work and daily chores because of these symptoms
  • You do not have a personal history of female cancers (breast, ovarian, uterine,vaginal), and possibly colon cancer (there is a genetic link)
  • You do not have a strong family history of any of these cancers ie. no mother, sister, daughter
  • No strong family history of heart disease ie. no family members had stroke, heart attacks, blood clots before the age of 50-55
  • You have never had a heart attack, stroke, blood clot of any kind and you had no problems with hormonal birth control use if ever used
  • Use of non equine estrogen (no premarin) and natural progesterone in low risk situations described above can usually be safely used for up to 5 yrs.
  • Use of estrogen patch and prometrium (natural progesterone) is felt to be safest combination, and I recommend tapering off in 3-5 years.
  • If you have had a hysterectomy for non cancerous reasons like fibroid, heavy menses; then estrogen patch alone is usually safe for 5-8 yrs but I recommend tapering off by 10 yrs.
  • If you are going to use HRT, I feel regular mammograms are a must. It is not the perfect screening tool but it is the best we have at this point. If you are going to do something that may increase your risk of developing a problem, you would be wise to screen for that problem and catch it early.

I am an advocate for HRT use in the safe and proper setting. I used it myself for 2 years at the onset of menopausal symptoms and it helped me cope with hot flashes, sleep deprivation and fatigue. My menopause came early, 45 yrs old, and took me completely by surprise! I tapered off when the findings of WHI came out because of the initial concerns this study raised; even though I am at low risk for cancer and cardiovascular illness. My own journey since then has focused on controlling symptoms though healthy diet and exercise, time for relaxation to promote sleep, and occasional use of herbs to help with sleep. After 10 yrs and more, I still get hot flashes but they are mild.

Every women’s journey through menopause is different. We have some similarity of symptoms, but the degree to which symptoms affect us are variable as is our ability to cope. Thus the need for an individualized approach!



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Now that the New Years has arrived, you may have made a resolution to get fit! Putting this plan into action may cause some hesitation if you are not ready for a gym membership. There are many ways to get fit in the privacy of your home, it is certainly cost effective!

One part of your fitness program will need to include aerobic activity. This improves heart and lung function in addition to helping you lose weight. Aerobics is the best way to increase metabolism and energy expenditure, helping with fat burning and weight loss.

You do not need to run to participate in aerobic activity but the harder you exercise, the more calories you burn. Options for this type of exercise including walking (not strolling) a mile in 15-20 minutes, working up to 150 minutes a week, spread out however works for your schedule. Over time, you may be able to add is a few minutes of jogging at intervals.

If outside is not an option, exercise DVD‘s are available to use in your living room. Treadmills and exercise bikes are also fairly easy to find used if new is not an investment you would like to make. The benefit to inside exercise is not having time of day or whether infer with your plans.

Strength training is another important part of any exercise program. The ultimate in strength training is weight lifting, but this degree of exercise is not necessary for everyday fitness. There are many things you can do at home without purchasing an expensive piece of equipment.

You can purchase hand weights of differing weights and use one of the many free workout regimens available on the internet. It is important for you not to start with too heavy of a weight and not to progress too rapidly.

There are many exercises you can do without any equipment, using your own body weight. The following is a link to a good starter program:
You will want to start with 2 sessions a week and over time add in a 3rd if time and energy allows. This is what is required for any significant muscle strength and toning improvement.

You can also use exercise balls, and exercise bands to strength train. These items are easy to use and are affordable. A good website for exercises using bands and a ball is: . More advanced muscle building and toning may require you to use a more advanced weight system and/or a trainer.

It is important for you to realize that women are not likely to build up bulky muscles without the use of protein supplements and intense weight lifting. We do not have enough testosterone in our systems to support enlarged muscles. Strength training will tone and strengthen your muscles, giving you a leaner look and improved energy.

The 3rd part of the triangle of fitness involves flexibility. Stretching improves muscle and tendon pliability. This helps with movement, joint strength and can prevent some minor injuries. The following website can give you some ideas of stretches to do:

You may feel you cannot possibly do all of this, but hopefully that will not prevent you from starting and trying. Very few people are perfect in their execution of a regular exercise program. Continued work and planning can help you to become more regular in what you do.

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Many Americans have a significant distrust of government and all that it endorses. This distrust can extend to any large organization or group that seem to endorse certain recommended courses of action. While this can be a healthy distrust in some areas, it can pose dangers when is comes to medicine.

As pharmaceutical companies have indeed underwritten much research in today’s medical world, this fact can cause many people to question the validity of benefit from certain forms of therapy. This distrust can leave people open to the draw of alternative therapies.

Alternative therapies can include a wide range of treatments, some recognized by the medical community as safe and some considered to have unsubstantiated claims. How can you tell which is being recommended to you, or if your provider has a personal stake in recommended therapies?

It is first important to understand the difference between all the alternative medicine groups. Current conventional western medicine has arrived at therapies through research, rigorous testing and peer review. This validates the efficacy of therapeutic options and has been substantiated with follow up studies. Physician and practitioners are graduates of conventional medical programs that are licensed and regulated to provide a level of quality if their educational training.

Alternative medicine can include practitioners trained in the conventional model, who have chosen to include alternative therapies along side mainstream medical therapies. These alternative therapies include the use of herbal products, chiropractic and manipulation therapy, mind-body medicine. This field of medical practice is called Complementary and Alternative Medicine.

Many conventionally trained physicians have not been received training in integrative medicine, and this has caused skepticism within the conventional medical community. Integrative medicine is still not completely accepted by many in the conventional medical community; but through their own studies, testing and peer review they have proven the legitimacy of many therapies. CAM has been gaining in popularity, and many larger medical centers are now developing Integrative health clinics and programs.

The vast majority of CAM practitioners have been educated in conventional western medicine, and turned towards integrative medicine as a tool to look at whole body in place of individual systems for treatments. These integrative practitioners use both treatment modalities in illness and disease.

There is now a National Center for Complimentary Medicine (NCCAM) that is part if NIH. The site monitors the latest studies and has much information on finding and evaluating  Integrative practitioners that your are interested in.

When evaluating a recommended therapy, you want to closely evaluate any studies that have shown efficacy. Ask your practitioner to give you information on this topic. Ensure that you are not being asked to forgo important conventional therapy, the avoidance of which could be detrimental to your health. Legitimate practitioners use alternative therapies when it is safe, along side conventional therapy when necessary.

If you must buy your therapy from your practitioner, it is important to understand why. Many providers may have their favorite company that provides a homeopathic or herbal product that they trust. Oftentimes, this may be the only way to get these products, as they are not carried in most retail drug stores. You could ask your provider for websites to compare costs. Legitimate CAM practitioners will not have much of a personal stake in selling you therapies, they are providing you with the needed tools.

A worrisome sign regarding lack of legitimacy is the need to travel outside the country, as the medical practitioner has been banned from practicing within your country.

If you find yourself frustrated with conventional medicine, feeling that it is not addressing your needs; you may want to try an integrative practitioner. You will be wise to be aware:

  • that you may not have insurance coverage for this and will need to pay cash.
  • the recommended therapies take time to take effect and will most likely require a change of lifestyle
  • ask the integrative provider about their training and participation in their professional organizations
  • contact your state medical regulatory board or medical licensing organization
  • most importantly, go with your personal feeling after meeting with the practitioner regarding your comfort level with the provider and the treatment recommended.

Integrative and alternative medicine has an important role in your health in that it focuses on the total body and your psychological and emotional  well being. You may find that your regular provider is actually open to incorporating some of these practices, ask your provider what you can do to get better results.

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Willpower, Decisions and Habits p2

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How can you strengthen will power? What can you do to improve the brain? Is lack of willpower a character flaw? Can will power be conserved? Where can I learn more? What can I do right now to improve my willpower tomorrow?

These and other questions are answered in this 27 minute video. Get out a pen and paper and take some notes – one one side write points Anne makes and on the other side write what you are going to do to implement what she reveals.

Visit our Squidoo lens to find out how you can support us financially by buying the books we mention in this video. Thanks so much and please leave comments! Need one on one help? Click on the link above to hire Anne as your coach for creating better habits.
OK, Here is the discussion!



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Last week there was quite a bit of discussion in the various new media groups regarding osteoporosis and medications. The short version pushed by the news media was that medications for osteoporosis can cause fractures of the thigh bone.

While these sorts of fractures can occur and are no laughing matter, this simplification is not exactly accurate.

Our bones are made up of many living cells, some that make bone and some that break down old bone. This is meant to be a balance that maintains our bones as healthy with new, strong bone. Estrogen helps to stimulate the bone making cells; Vitamin D helps us to absorb the calcium we need for these bone making cells to make strong bone. As we move through menopause, the lower levels of estrogen cause these bone making cells to slow down. Meanwhile the bone destroying cells continue at their steady rate, breaking down the old bone. What you end up with is more in the loss column and less is the new column; like a business that pays out more in bills than it takes in as revenue.

Moving on to the medication for osteoporosis; drugs like Fosomax, Reclast, Actonel to name a few. This class of osteoporosis medications work by slowing down the destruction phase of bone remodeling, allowing a balance between destruction and formation to be achieved once again.  When these medications were first released, they did represent a tremendous help to many women with osteoporosis. After all, there was not much treatment available other than supplements and vitamins. These medications were felt to be life changing for women at risk for a hip fracture. What has come to life, however, is the knowledge that these drugs can affect bone in different parts of our bodies, differently.

When taken for more than 5 years, some women are at risk for a fracture in the thigh bone. This is normally an area not affected by osteoporosis, unlike the wrist, spine and neck region of the upper thigh nearest the hip. For reasons yet unknown, the mid portion of the thigh is weakened by these medications in a very low percentage of women; thus resulting in painful fractures. Additionally, in rare instances, these medications have been shown to decrease blood flow to the jaw bone, resulting in osteonecrosis or bone deterioration.

When reading or listening to reports such as this, it is no wonder we are hesitant to start medication. After all, we can’t feel osteoporosis until it is too late and we sustain a fracture.

What do we do?

Don’t stop your medication until you talk with your medical provider. Discuss your risks of osteoporosis and make sure you understand all that you can do to improve your bone density. You are most likely safe to take these medications for 5 yrs, then stop to let the bone destroying cell have a chance to get rid of old bone.

Get your bone density study done at a reputable radiologic facility with an approved DEXA scanner.

Do weight bearing exercise daily, this stimulates bone making cells.

Get the proper amount of calcium and Vitamin D to make sure the bone you are making is strong bone.

When you listen to the lay press discuss these issues, make sure you understand that while they feel they are relaying important information to consumer; they are also selling stories. Talk with your medical provider before assuming the worst case scenario.

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