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00:00 - Intro & Meet Dr Tomasz Forfa 03:00 - Breaking bones in your 30s? 08:00 - Early-onset osteoporosis diagnosis 11:00 - What causes osteoporosis? 16:00 - Bone quality vs bone density 19:00 - Tomasz’s 3-part healing framework 24:00 - Risk factors in men: hormones, diet, lifestyle 27:50 - The role of strength training & LiftMore study 34:00 - Micronutrients: calcium, D, K2 & magnesium 37:00 - Protein needs: 2g per kg target weight 41:30 - Healthy fats & fat-soluble vitamins 43:30 - Testosterone: why it matters for bone health 47:30 - Burnout in medicine & reclaiming purpose 53:00 - Final thoughts on mindset & recovery
Reversing Osteoporosis Naturally: Dr Tomasz Forfa’s Drug-Free Blueprint
Dr Ron Ehrlich [00:00:05] Hello and welcome to Unstress Health, my name is Dr Ron Ehrlich. Today we explore osteoporosis and this is a theme that we haven’t, a subject that we haven’t really… Explored on the podcast before, but we’re also going to explore it from and a slightly unusual perspective because we’re going to explore it from the perspective. Of a man’s, a young man’s experience with osteoporosis. My guest today is Dr. Tom Forfa. He’s a medical doctor and an educator on a mission to bring 1,000 men. Out of osteoporosis by 2026. After successfully reversing his own osteoporosis naturally and drug free. And surprising, as you will hear, is our endocrinologist. It’s interesting to reflect on whether that changed the endocrinologist’s practise or not. But I digress. Dr. Tom has gone from fracturing bones. His story is a rather surprising and shocking one. To competing in his first powerlifting contest. And returning to the potentially. Bone-breaking activities he loves, like snowboarding. Through his work, he addresses the often overlooked challenges Men face for osteoporosis journey. They’re not often associated with this issue. Usually thought I was being. Of a problem that affects women. At a later age and as you will hear Tom’s. First experience was in his late thirties. But he provides practical insights that go beyond conventional therapy. It’s a fascinating story, it’s an inspiring story. I hope you enjoy this conversation I had. With Dr. Tomasz Forfa. Welcome to the show, Tom. Thank you for having me, Ron. Tom . We like to explore, I like to explore two particular themes when I… Talk to medical practitioners. One is the impact that their own health… Has had on their health journey. Personally and professionally. And the flow on effects to the public from that, but also… You know, burnout is a big problem in the medical world, in the health practitioner world, medical world. And I’m really intrigued to hear your personal story, your journey that’s brought you to this point.
Dr Tomasz Forfa [00:02:25] Excellent. I think I’ve had a very unusual journey compared to most health care practitioners, especially… And medical doctors. So I started the usual way, I went through medical school, I did my internship. And then I started looking at different training programmes. But throughout that time I was becoming very kind of disillusioned with the delivery of healthcare. And I was becoming burnt out as well. And ultimately. I… I was… A couple of years into my practise as a doctor, I was travelling, getting a bit of downtime, and I got the letter, the email saying, hey, are you coming back to the hospital or not? And at the time… I was running a business. We were travelling with my wife. And I was able to kind of express all my creativity and live through all my values. In a way that I felt was far more impactful through business and philanthropy rather than. Through through medicine and so I sent in my resignation to the hospital. And I haven’t been back since and that was back in 2014. And I thought I would never kind of be back into the actual practise of medicine. Until I was pulled back around 2020. Not because of COVID, but because of a broken bone, actually. I was riding a bike. And in between COVID lockdowns. And I hit a little pitch, slowly went over the top. Fell over, nothing, shouldn’t have been anything for a 37 year old male. But I broke a wrist. END On its own, well, that’s a little bit weird, but nothing to really be concerned about. But when you put into perspective, that was my third fracture in 18 months. Before that, I had rolled my left ancle and fractured it. I was… Doing a boxing class holding a pad in my chest and I punched it and broke a rib. Ends That wasn’t the only practise that I’d had throughout my life. I’d broken the other ancle in five places from rolling it. Wow. I had broken multiple ribs. Falling over on a snowboard, and again, all these things on their own. Well, okay. I fell over snowboarding on some ice, I broke a rib, so that’s kind of to be expected, but when you paint that whole picture… That’s a lot of fractures.
Dr Ron Ehrlich [00:04:49] But that sounds like at least five or more fractures.
Dr Tomasz Forfa [00:04:53] You know what, I’ve lost count, around 8 or 9, the rest as well, over the years. Incredible. And so it was at that point in 2020 that my GP said, you know what, let’s do a scan of your bones. A DEXA scan. Which is kind of like an x-ray, but it looks at the how much density there is in your bone, how much tissue there is And it turned out that I had what’s called early onset osteoporosis. So essentially I had, I was an otherwise healthy 37 year old male. But I had the bones of a… Post-menopausal lady. Of 65. Which was a bit of a shock to me personally and also to my GP. And at that point, that’s what it was. It was a shock, so… But I thought, you know what? It’ll be okay. I’m a healthy guy. I can work through this. And so I was referred to an endocrinologist, as usually happens in Australia. And he was sitting there scratching his head wondering what is this. I usually see women after menopause there. That they’re frail. And uh And I’m making some stereotypes, some kind of stereotypes here. It is generally associated with women, but there are all sorts of different reasons why it happens. And so he was scratching his head wondering what’s going on, and we did a whole bunch of different tests. And showed up no particular cause for it. There were all these minor little potential causes which I’ve realised kind of stacked up over the years. We did find which was concerning were two crushed fractures in my lumbar spine. And it was at that point that I kind of fell apart. My belief in my body fell apart, I became afraid, what am I gonna break my back? Am I gonna break another bone? And this is what a lot of people experience with osteoporosis, no matter what their age. Thank you. No one really thinks about it. Until you break a bone and you get a scan and they tell you you’ve got this disease in inverted commas. And that creates a lot of fear and uncertainty. Takes that confidence away. We stop doing all the things we love to do because am I going to break something and we’re going to be you know, incapacitated. Am I going to be a burden on my family? And so… It was a shock to me and I… And I was working with a really well-meaning endocrinologist, but he kind of… Pigeon-holed me into a wall. I’ve seen these types of patients. You should take the medication. From the way that I look at things. Medications in my mind are kind of the last resort. If… If even we’re to it. And I thought. Can you just give me six months to figure this thing out? Because something wasn’t quite making sense. For my training in my medical degree, I knew that bones can strengthen. They do adapt. Too pressure, too different stimulus. And it didn’t make, I looked at the medications and as a young guy. There were some limitations at the time. You could only take them for a certain amount of time. And then once you stop, your bones. Don’t stay where they are! They get worse. And now if they go back to where they were, they can even go further than that. Into the, into the red that-
Dr Ron Ehrlich [00:08:16] These medications, Tom, are the bisphosphonates ?
Dr Tomasz Forfa [00:08:20] There’s a few of them, but bisphosphonates are the first kind of… First line treatment and yes, they are the ones that are usually recommended. Um…
Dr Ron Ehrlich [00:08:33] But. You went to the endocrinologist and… He looked into his he reflected on his 15 years of training. And all his medical knowledge, and of course. The first thing was to reach for the prescription pad. Yeah, that’s uh… This comes back to your first comment about the way healthcare is delivered, really, isn’t it?
Dr Tomasz Forfa [00:08:56] That’s it and If I break up, if I’m in a car accident, I’ll go to the emergency department, give me all the Western medicine. When it comes to chronic issues. And osteoporosis is definitely a chronic issue. Medicine is- is- I don’t want to offend anyone, but it’s hopeless. It really, it really can be. And so. I set my endocrinologist here. Give me six months. And he said, you know what, Tom, you’re a doctor, you’ve got a medical background, I’ll give you that six months. And essentially, he said His kind of prognosis was, Tom, we can only hope it doesn’t get any worse. Here are the medications to hopefully prevent it from getting any worse. All right, we’ll see how this goes. That’s what I dug into what I knew, which was just trying to make sense of why does osteoporosis happen. What is it about? What’s going on here? What kind of research is out there? And also what happens for men. Because osteoporosis is predominantly. A women’s condition. But then there is this certain percentage of men who get it. Who are very isolated when they do. And it is a very isolating situation, almost like. A little bit embarrassing, so I thought this was a women’s condition. Um. And so I was trying to kind of figure out, firstly, how does it happen in women? And then kind of almost specialised into men because it resonated, I needed to fix myself first. And so, I kind of made them, I put into my mind, I kind figure that out in my own mind. And I started implementing. Why are you-
Dr Ron Ehrlich [00:10:37] Well, Tom, before we go into the protocols, because obviously that’s really important, but I do want to set the stage here because. You looked into it a lot, and this is a topic we haven’t really covered on our podcast. So I’d love you to give me some, you know, what are the predisposing factors? What does modern medicine say causes… Osteoporosis. How is it diagnosed? I think that’s interesting. too, because we’re very good at pathologizing things as well. But tell us, how do people get osteoporosis?
Dr Tomasz Forfa [00:11:08] OK, let’s start with the definition of austere process. Essentially, it is. When there’s less bone tissue and the architecture of the tissue deteriorates. Of the bone tissue itself. At which point the bones become more fragile and likely to break and so some small kind of impacts Like if just falling from a standing Position some people sneeze and they break a rib some people shaking hands. It can get that bad And for others, you know, the other impacts, essentially the bones become more Fragile which might seem, well, you know, so we’d break a bone, but the thing is the first boat. Broken bone means you’re like, you’re 80% more likely to get another one. And then there’s the recovery time. Which is a which is a big problem. It often happens in the elderly for so People over 50 usually, for men particularly, there is a one in five chance that a man over 50 is going to have an osteoporotic fracture in the remaining course of their lives. It gets even worse when we have hip fractures. And hip fractures for men, particularly one in five men. Who have a hip fracture will pass away in the first 12 months. Yeah, and so it could have dramatic kind of life expectancy effects and mortality and morbidity. As a result. Now the way that we diagnose Traditionally, the way that we diagnose osteoporosis is we do what’s called a DEXA scan. Which your doctor will refer you for that. And You go, it’s like an x-ray machine and it scans. Your, usually your hip. Your lower back. And your forearm in Australia as well because those are the areas that that break, and if they break, that’s where we’ll… Where we have a lot of them.
Dr Ron Ehrlich [00:12:57] But Tom, when you have people who have… Fractures as you have. There’s clearly an issue going on here, but many, many people… Receive diagnoses of osteo. I think -penia first. And then osteoporosis. What is the reference? You know, you talk about this DEXA scan. What what are they using as a reference to give people that? Diagnosis.
Dr Tomasz Forfa [00:13:23] Okay, so. When you get a DEXA scan, you’ll get what’s called a T-score. And a T score is essentially comparing you. To a healthy 25 year old person of your gender and ethnicity. Now, there is a whole lot of controversy about the use of these scores in itself, but let me just give you the definitions first. So anything, if you’ve got anything negative one and. Higher? So negative point negative point five or in the positives you’re normal but when it goes to negative one to negative two point five you have what’s called osteopenia. Which is almost like pre osteoporosis, if you will. It’s weakening of the bone, but not to the extent where the statistics showed that you’re very likely to break something. Which is essentially from that 2.5. Onwards. And and oftentimes Now people will come to us with your negative threes negative 3.5 and it gets scarier the further it goes because you’re essentially your bones are more and more fragile, the lower that number is. And so that’s… The traditional kind of way. And if there are any medical professionals watching this, that’s how they would think about it. There is a shifting. A shifting tide. Looking at the bone quality. Which the research is showing is far more important. Than bone density. So just to differentiate those things, the T score looks at the density, so how much bone tissue is in your bones? Um, no, it doesn’t look at. How that’s structured. So a great example. What I heard recently is from an American doctor called Dr. Andy Bush, and he compared a pencil to a piece of chalk. Now if you drop, if you think about a piece of chalk, it is dense. There is a lot of. Stuff in there, a lot of chalk in there. Tightly packed. If you did a scan of it, it’d be very dense. A pencil. Is not as dense. But if you were to drop both of them… From a standing height, which one would break? The chalk the pencil will be okay because the pencil has a better micro-architecture and structure of the different fibres. And that’s what the research now is, and kind of where the tide is going, is showing that it’s far more important is the bone quality And the microarchitecture of the actual bone. But it’s going to take some time before that tide kind of shifts and before And it’s- and it’s People like yourself, Ron, who are bringing on people to talk about this that are going to shift that. That tide, which is really exciting.
Dr Ron Ehrlich [00:16:04] I mean, I mean I think what you’ve described in your own personal journey and people who break ribs by coughing or shaking hands. Is really concerning and the statistics around hip fracture. Are really concerning statistics, but… There is a bigger picture here about how we do, in fact, pathologize. …Growing old… By comparing bone. To a healthy 25-year-old. So I… Who am now in my late 60s. You know, sure as eggs, I would say. Would be have a different bone quality to a a person who is 25. If the answer to that preventatively, I put up inverted commas. For those listening to this on a podcast. On audio. Um, you know, would be a wonderful segue into a lifelong. A prescription of a drug that I may never even need to use. And I know you’re going to be talking about. Prevention and all of that, which is great. But I can see I’m I know this anyway, but I can see why you may have been a little disillusioned the way medicine was being Yeah, yeah, what are your thoughts about that as a putting aside the extreme cases of fracture and your own experience. Do you feel like we may be… Gathering, you know, diagnosing, over diagnosing this condition. It’s very real, it’s a real problem, but…
Dr Tomasz Forfa [00:17:35] Yeah, I think there’s two sides to this story, Ron. I totally understand where you’re coming from and that’s kind of my… I don’t I don’t see osteoporosis as a disease. Traditionally, inverted commas, I see it more like a. Condition of bone deterioration that we can adjust. When we look at a medical… Doctor. They’re doing the best that they can with the time that they’re given, the information that they have. The fact that they are being judged by a body of their peers. And all these different factors that… And also the patient who comes to them. Who says, you know what? I don’t want to do all this. Exercise and this food, is there a pill? They’re going to give you that, and that’s kind of the… The general kind of that the people that generally see a doctor, a medical doctor. It kind of fit into that category. The people kind of listening to you Ron and people like yourself, they’re more proactive with their health, they are more interested, they taking ownership of it. And yeah. The frustration for me is when someone in that position goes to a doctor and says I don’t want to take the medications, at least not just here, what else can I do?” And they’re like, well… You’re on your own, Tom.
Dr Ron Ehrlich [00:18:51] Which Tom brings us back to. You being given six months by your endocrinologist. And I’m intrigued. I’ve got a feeling I might know. That this worked out well, otherwise we wouldn’t be talking, but tell us what happened, tell us what happened. You’ve got six months.
Dr Tomasz Forfa [00:19:07] This thing doesn’t make any sense. I kind of conceptualised it in my own head what I needed to do. And it comes down to kind of a triangle of three components. Number one, we need to remove the obstacles to strengthening both. And this is any of the medical conditions that might be. Or hormonal imbalances that might be leading or contributing to it. Once we need to address that, we also then need to. Trigger bone growth and this is what I started to do. It turned out that I had no particular reason causing my osteoporosis, so it’s what’s called. Idiopathic. Or as one of my professors in medical school used to say, the idiots don’t know the pathology. So they got idiopathic. Um, and so I had the green light to build bone in my in my opinion And so, it became about… Triggering bone growth. So bone doesn’t spontaneously grow. It’s like a muscle. If we don’t exercise the muscle, it’s not going to grow. If we don’t exercise and put pressure on the bone. It’s not gonna strengthen even if we remove the causes of osteoporosis. We need to put pressure on that bone through specific and correct exercise. Which is doable no matter what, how weak or fragile your bones are, and the research is very clear on this. That’s one thing. The other thing is actually giving the bones the fuel or the building blocks they need. And it’s not just as simple as calcium and vitamin D, although they’re very important. There are a whole lot of other vitamins and then also what’s often missed and particularly in the elderly populations. Protein It’s interesting. Um… I know Ron, you’ve had people on before who have spoken a lot about the high-carbohydrate, low-fat, and protein diets, which is… Complete Uh, yeah. Potentially dangerous for people’s health. I’ll put that lightly out there that way, mate. It’s very important to shift the way that we’re eating to increase the amount of protein we’re having good fats and carbohydrates only depending on kind of our activity levels and what we’re doing. And then adjusting as we go and getting checks on a regular basis and this is where the medical kind of profession is yet to catch up as well. I’m DEXA scans, it takes two years before you can have your next one. But there are better ways to kind of test your bone along the way. That’s important to test and adjust and work with some professionals to help you to implement. That’s what I did. Through the right exercise, through the right fueling of my bone, giving it the right kind of… Macro and micronutrients, removing the obstacles. I then had a DEXA scan. I was a little bit sneaky in that I got it done six months rather than the two years. And the results had improved in only six months. I was out of. Osteoporosis, into osteopenia. And I went back to my endocrinologist and I slid the results across the table. And with a big smile on my face and kind of… Expecting a well done and understandably he was very kind of reserved and conservative in his response. Did he?
Dr Ron Ehrlich [00:22:20] Did he dismiss it as a placebo? I don’t know how that could be.
Dr Tomasz Forfa [00:22:27] I’ll tell you what, Ron, with the amount of work I did, those bones, there was only one way they were going to go and that was to get stronger.
Speaker 3 [00:22:34] Yeah.
Dr Tomasz Forfa [00:22:35] Right. But he said, I’ll throw you a party, Tom, once they’re back to normal. And, uh… Only recently, my hips are back to normal now. So, but my lumbar spine, I’m right on the edge. Right on the edge of normal.
Dr Ron Ehrlich [00:22:48] It’s interesting those three things, obstacles, trigger for growth and building blocks. Um, I’m just still intrigued coming back to, and I think what you’ve done is truly inspiring and, you know, shame on the endocrinologist for not embracing it as part of his own treatment protocol, but leaving that aside. The obstacle is an interesting one because. The as you were telling me your story and I’ve got some familiarity with nutritional. Environmental medicine, something that came to my mind. Was two things. One would have been Well, three, actually. One would have been a gluten intolerance, not necessarily celiac. But a gluten intolerance, the second would have been. Poor vitamin D. Levels and that would have been around the sunshine. Area there. And the other one could have been magnesium, but, but… What was your gluten situation there? I mean, you weren’t celiac.
Dr Tomasz Forfa [00:23:49] Yeah, so for myself I- I f- Figured out that there were a number of It was a stacked up a number of potential kind of causes that Individually They’re okay, but all together They led to osteoporosis. So I was gluten intolerant and I still am. I had a scope done. To make. To confirm that I’m not celiac but I am intolerant. And so for many years, I would start the day with, you know, I think it was like eight wheat bicks or something. Just just, and then I was just inflamed all day. To add to that, in my 20s and 30s, I was against milk. I was against dairy for whatever reason, right? And so I didn’t get much calcium, which is. Thanks also. Uh, uh. Yeah, milk, dairy is our main source of calcium, so I wasn’t getting much of that, plus I was really… I was inside, like you said, a lot. I was preparing for it. Studying. A medical degree in hospitals low by. I’ll see ya. Pushing myself, exerting myself, a lot of stress, and that can contribute as well. My testosterone levels were not below normal, but on the cusp of low. All right, just on the cusp. And this is something that a lot of men experience. Especially as they get older. Testosterone does protect uh, a bone. Um. And so for me, adding all those up, it’s the perfect storm. For osteoporosis. But generally speaking, in terms of the risk factors for osteoporosis. That the main one is your gender? Uh, so, women. As soon as… The menopause arrives and the oestrogen levels drop. It’s a high- high probability that they will develop. Weaker bones because the the oestrogen protects. And when there’s less of that, there’s more bone turnover and breakdown. Then there are other risk factors like smoking, alcohol. Stress levels then there’s also glucocorticoid steroids, different types of medications can contribute to it. I have for the for the gentleman, the big one that we see if they have prostate cancer and they go through. The hormone treatment for prostate cancer, which drops their testosterone levels. They often- You know, treat the cancer, but they end up with… Broken bones and osteoporosis. Yeah, so there is a whole range of risk factors. But the so we.
Dr Ron Ehrlich [00:26:29] You said obstacles for you I mean when yeah if you’re looking for the obstacle but when you add up all of those obstacles, that starts to paint a picture of a high-risk individual. Who’s obviously genetically predisposed to express it in this way, others might’ve expressed it in a different way.
Dr Tomasz Forfa [00:26:51] Yeah, potentially. I mean, there’s no osteoporosis in my family. My mom is very proud of the fact that she has no osteo process in her late 60s. And my dad and no one else, but… Yeah, definitely that if you put that picture together. And this is where my kind of personal mission comes in other than. Firstly, I want to make osteoporosis a truly reversible drug-free condition. Right and then secondly all
Dr Ron Ehrlich [00:27:15] Music to our ears, Tom. Music to our ears. And secondly,
Dr Tomasz Forfa [00:27:20] I want the medical pro-
Dr Ron Ehrlich [00:27:20] profession to say it that way as well. Well, gee, I’m not as optimistic there, but this is why we do this podcast and this is why we talk to people like you. The triggering of the growth, I mean, gee whiz, I’m just so impressed by. What you’ve achieved, what you achieved, and you mention irrespective of your particular fitness or age levels, what were some of the things you did that worked? Bearing in mind you were 30 something at the time, late 30s at the
Dr Tomasz Forfa [00:27:50] What did you do? So, first step was to… Get me moving because I was in a very deconditioned state. I was, you know, a young man. However, I hadn’t been looking after myself in the previous few years. I just had a child running a business and just all the pressures I’d given up on. Looking after myself and just But I worked with an exercise physiologist to try and get me moving and it started with really basic things like getting my core working, so bending over with a broomstick along my back. A really basic thing. I’d previously fractured both ankles with no rehabilitation. So I couldn’t hop on one foot. And so we started to rehabilitate some of these problem areas. Many of the men we speak to, they might have bulging discs, bad knees, hips, backs, whatever it is. We need to firstly. Start to address those. Those problem areas. Then we need to start to put on some pressure on those bones with some weight-bearing exercise. So strength, we kind of broken it down into progression. Stages, progression states. Firstly, are those foundations where we address those problem areas? And start to build the core strength. Secondly, we start to work on just general strength and weight bearing. And so that we are starting to pressure on the bone, moving the limbs and the different joints. And that in itself can start to get things, can stop the bone loss. And then we start to really step it up and this is where it gets exciting where the bone starts to really grow when we have more heavy exercise and impact exercise. The impact of things like hopping on one foot. Box jumps if we can do it, hill drops, so putting pressure and kind of like sending a see a bit of a pulse through the through the bones to give him that trigger to say, hey, you know, this person’s serious, we need to start. Strengthening the bone. There are studies being done on this. There’s a great one called the Lift More. Trials. Done by an Australian professor. Professor and Dr. Belinda Beck from Griffith University. She is a world leader on this stuff. And where she took… And women from different levels of osteoporosis. And put them through this high impact resistance training. Who’s with us since training. For a course of f- 12 weeks and found that the bones The results were amazing as good as some of the medications and that’s that’s kind of my interpretation That wasn’t what what they’re very they’re, very conservative in there Discussions on this, but I was very excited by those trials and then they did the same for men Um, and so The evidence is just building and building that you can and we should be first port of call for those patients who are willing to do it as well. Is that exercise.
Dr Ron Ehrlich [00:30:52] Hi, Dr. Ron here, and I want to invite you to join our unstress health community. Now like this podcast, it’s independent of industry. And focuses on taking a holistic approach. To human health. And to the health of the planet, the two… Are inseparable. There are so many resources available with membership, including regular live Q&As. On specific topics with special guests. Including… Many with our amazing Unstress Health Advisory Panel. Now we’ve done hundreds of podcasts all worth listening to with some amazing experts on a wide range of topics. Many are world leaders but with membership We have out unstressed. Podcast series. Where we take the best of several guests and carefully curate specific topics for episodes. Which are jam-packed full of valuable insights. Join the unstress health community. If you’re watching this on our YouTube channel… Click on the link below or just visit on unstresshealth.com to see what’s on offer. Join Now! I look forward to connecting with you. The flow on effects of exercise, I mean, we’ve done programmes on SLEEP! And the flow-on effect of that, of a better night’s sleep is huge. Uh… The flow on effect on mental health I have an exercise, are huge And here we are on blood sugar, another one, huge. And here we are, another one on osteoporosis. There’s really very little down, I’m trying to, very little downside. I’m trying to visualise you having broken. Ankles hopping around on one. Leg that on that must have been You must have done little hops, very little hops.
Dr Tomasz Forfa [00:32:42] Oh, I didn’t go to Hoppik. It started with just balancing on one foot. It was very… Very basic stuff, and then slowly when I was able to stand on one foot, I think we then… Progressed to. I can’t remember exactly what it was, but it was very progressive. Steady kind of now I’m standing on, I don’t know if you know what a BOSU ball is like, it’s like a half a half of It’s a flat surface with a ball underneath. I’m standing on one foot. On that with balancing weights and so but that’s probably it started off with me literally bending over with a broomstick along my back. That was as good as I can do. And so that’s. Really important for people to understand. We need to start slowly. And work with a professional to make sure that you’re doing things that are that are adapted to your needs. But are headed in the right direction so that we are. Putting the right kind of pressure on the bones. To to give them the signal to grow.
Dr Ron Ehrlich [00:33:44] I mean, that’s a… And here we are. You know, four or five years after you. Being diagnosed, I’m guessing. I’m hoping that your endocrinologist has put on a party for you. As the, uh, as. What is the I’m just intrigued because your numbers must be looking very good What’s the endocrinologist’s comment on this?
Dr Tomasz Forfa [00:34:08] Well, I’m waiting until my lumbar spine is back to normal and then I’m going to reach out. But I haven’t been back to see him for a little while. Look, he did his best, and it’s not him in the bit personally, it’s the way that the process that that… Kind of the expectations and the limitations and the. Process, the system is set for doctors that… I can see why they don’t do anything else, it’s really…
Dr Ron Ehrlich [00:34:37] Now, you mentioned triggering growth and this importance of well-designed, well- Curated exercise. But the building blocks. What about the
Dr Tomasz Forfa [00:34:49] Okay, so the building blocks… The way that I think about it is, you know, it’s like a… Like a construction site where we’re building a house. You can have all the workmen there ready to go, but if they don’t have the bricks, the wood, the timber… They can’t get it done. And so. For the bone. There are a couple of key requirements. Firstly is calcium. And this is irrespective of if we’re deficient in calcium on our blood tests. Because how we Osteoporosis is often caused by the removal of calcium from the bones. And so the body needs a constant supply of it. Because, uh… Because the body will do whatever it takes to maintain that normal blood calcium level. It’s so much so that it will draw the calcium out of your bones. Right, because there is this. The bones are like a reservoir. And a storage facility for calcium, and not just the… Structural support and other minerals as well like magnesium. Is really important. So calcium supplementation is really important. Vitamin D, which gets the calcium out of your guts. And into the bloodstream is important. Magnesium supports it in doing so as well. Then we need vitamins like vitamin K2, which puts it kind of into your into the sense of the calcium from the bones, sorry, from the blood. Into your bones. And Yeah, there are a couple of other vitamins that, you know, that are a bit more controversial, or my personal opinion is I like to keep it simple. I feel like that. Like there are the two approaches I call it the Spartan approach versus the kitchen sink. I want the stuff that’s… Gonna work and I’m sure it’s gonna work and it’s going to work for me. And I’m not just throwing things in just because people say that we should throw them in. I’m like, let’s see what actually works. And so I’d like to keep it simple for us. And that’s the kind of the micronutrients, the macronutrient… Protein is the biggest one. There have been studies done on men who… And women too, who exercise. And don’t take protein, extra protein, whether whey protein or hit a particular amount. Versus those that do. And the results that. From those who are exercising with the right amount of protein. Their bone results are far better. And so it’s very, very promising there.
Dr Ron Ehrlich [00:37:15] Well, I know this has been a moving movers, excuse the pun, but a movable feast. Hear about protein levels. Over time… And I know that the levels of protein are said to be what is an appropriate. Level of protein for a person to aim for. Okay, yes.
Dr Tomasz Forfa [00:37:37] It’s going to be different than the recommendations.
Dr Ron Ehrlich [00:37:40] That’s all right. Listen, forget the recommend the recommendations tell you to stay out of the sun. And take bisphosphonates if you’ve got…
Dr Tomasz Forfa [00:37:48] Osteoporosis, and eat carbohydrates.
Dr Ron Ehrlich [00:37:49] Carbohydrates. So forget about the recommendations. This is what we’re interested in health. Okay. This isn’t about a business model. This is about a health model.
Dr Tomasz Forfa [00:37:59] So two grammes per kilogramme. Interesting. Weight of target body weight. So that’s target. So if we’re trying to lose weight, what’s that target weight? If we’re trying for a lot of the osteoporotic men want to put on weight and women as well want to and lean body weight here. Okay, this is where people get a little uncomfortable because we don’t want to put on weight, that’s just extra energy we want. Muscle mass, lean mass, so we want to put on, so I want to eat. Uh, two grammes. Of protein per kilogramme per day, which is a significant amount. That is compared to what people are usually getting in. And the keys in how to actually do it and spacing it out throughout the day and then. Supporting, having, making sure that you have the rights kind of. Foods and preparations that you can. Do that. And that The way that we think about it is, let’s do that for this kind of acute two to four. Year period of time where we’re. Getting the bones back. And then we can reassess You know, is that required at that level? Is that, or can we adjust it at that point?
Dr Ron Ehrlich [00:39:05] I mean, I think that people may miss that very important. Uh, caveat that you put on the target body weight, it’s not your body weight at the moment. If you’re grossly overweight and you’re thinking Two grammes and I’m- You know, a hundred kilos. My God, that’s a lot of protein I have to eat. No, if your ideal weight was seventy five kilos. That’s what you have two grammes of not not your yeah yeah that’s it that’s that’s a really important
Dr Tomasz Forfa [00:39:32] yeah that’s it that’s a really important point that is the key and then the other thing to add to that is Let’s say you weigh, you’re going for 75 kilogrammes. And so that means. 150 grammes of protein. That doesn’t mean 150 grammes chicken. No, that’s just the whole protein, the protein component of your meal. So just to kind of keep it, again, I like to keep things simple for me. I think 30% of the cooked weight of meat is protein. And if I kind of generalise that, it kind of hits that about that time. If I’m eating. You know, uh-uh-uh. At a 90. Gramme. You know, if I’m eating, let’s say 100 grammes of chicken. Cooked chicken, 30 grammes of that is protein. And if we’re going for 150 grammes, that’s you know, five times that serving in the day. That so it’s really important to get the protein in the morning. And lunch. At dinner and then snacks in between, potentially protein shakes. That kind of thing.
Dr Ron Ehrlich [00:40:35] Mmm, mmm. No, no, that’s that’s quite a it is. It’s a bit like when we’re measuring carbohydrate, you know, I mean, people say low carb. What does that mean? Well, in my book, it means somewhere around 70 grammes a day. Is achievable, sustainable. What does that mean? Well, it means you’ve got to spend about a week or two, not the rest of your life. A week or two measuring out. What it is you’re eating to educate yourself, because after two weeks, believe me, you’ve got a pretty good idea of what you’re reading. You drive yourself crazy. So the same goes for the adequate protein. What about fat? We hear a lot about fat and. You know, apparently, I mean, we’ve done programmes on. On the importance of fat soluble vitamins. Like A, D, E, and K, A,D, E and K. To absorb minerals. We need fat soluble… Vitamins to absorb minerals. But what about fats? Where should we be looking for fats?
Dr Tomasz Forfa [00:41:35] So, the way that I eat my fats is… Firstly, through natural sources as much as possible, so avocados. Virgin olive oil. Um… I’m also I’m not against animal fats either. I think I think the tide is turning on on some of the saturated fats in animal So, so through. Fish and I love a steak that every now and then that’s great too. Some coconut oils as well, it’s just a limited amount, and it’s more so about the So firstly, it’s the type of fat, so it’s staying away from seeds and processed. OILS That stuff. Really. Yeah, we want to stay away from that and the more natural. The better. The amount is also important as well. And understanding where it’s kind of sneaking into our foods as well… So, uh. The way that we kind of… Can try and conceptualise it is a thumb piece of fat with dinner or lunch. And Oftentimes if you have enough proteins if you’re having the right amount of carbs. You only be able to stomach so much fat. It really fills you up. And so you probably won’t be having too much of it if you’re kind of structuring your meals. In a very purposeful way.
Dr Ron Ehrlich [00:42:57] You’ve also mentioned testosterone, and we’ve done… We had Dr. Rob King on, who’s a men’s health specialist. And, um, and he. Talked about testosterone levels. And I had to admit that in all of my, you know, whenever I’d seen my doctor. Very rarely. Had the box been ticked to check my, check my not even my vitamin D because, you know, the Australian government doesn’t want you to. Won’t support that that wasteful thing of checking someone’s vitamin D. But testosterone is another one. What? How does how does how do men? Improve their testosterone levels.
Dr Tomasz Forfa [00:43:36] Yeah, I hear where you’re coming from there on when I asked to get my testosterone checked my GP looked at me and said Tom You look like a man You’ve got that. I don’t think we need to check your testosterone levels.
Dr Ron Ehrlich [00:43:48] And you say, and isn’t that great that the doctor had been at medical school in five years and diagnostically could pick that up really well. I mean, you’ve got to hand it to them for that lecture, right? You’ve got a hand there for the medical education. It’s really knows how to identify gender, which is quite a challenge. And now in this day and age, but that’s a different programme. Go and tell us.
Dr Tomasz Forfa [00:44:09] Okay, so so Increasing testosterone LEVELS. It’s, we have to understand. Kind of how how they build. So firstly, how you said He mentioned. Uh, FATS. And yep. Fats are the building blocks for hormones. So we need to get in the right amount of. Good fats. And secondly, we need to start taking exercise, heavy kind of lifting exercise stimulates. Testosterone improvements and growth. Supplementing with ZINC is also, it’s a secret kind of a men’s supplement. It’s not spoken about in the women’s osteoporosis space. Men require zinc. And that, you know, classically speaking, when you think of… You know, the oysters being, you know, this aphrodisiac because they’re the… The biggest source of zinc, but I mean other than oysters it’s best probably to supplement. Now, the testosterone space, if you Google search how to increase it, it is a… All kinds of crazy things. Come on out there. But we really wanna keep it simple and keep it kind of healthy and based on what’s been shown. It is very. Limited in terms of other than… A hormone replacement therapy, which is often. It might end up being something that some men go for. But there are Definitely things that we can start doing. Improving sleep is another one. So they’re kind of the four main areas that we talk about. Right kinds of fats, the right kind of exercise which in itself triggers it. Zinc supplementation. Good sleep, even napping during the day has been shown to boost men’s testosterone levels, funnily enough. It’s a good quality slate. And starting with that. Is a great way to go.
Dr Ron Ehrlich [00:46:07] Another example, I think, I’m sorry if I sound like I’m having a go at some public health measures that are touted. You know, a precursor to testosterone is cholesterol. You need healthy cholesterol. You need cholesterol. To have healthy testosterone levels which kind of puts the statin, lower cholesterol to as low as you can get. I once heard a heart specialist. Not one that we’ve had on this programme. That’s Dr. Ross Walker who annually comes to see us. On the programme. But I’ve heard one heart specialist say… I just cannot get my… Patients low enough, the lower the better. The lower the bit. So can you imagine what that’s doing to people’s testosterone? Wow, that’s, uh, you almost. We almost should have a minute’s silence after a statement like that.
Dr Tomasz Forfa [00:47:00] I can’t help myself but have a minute’s smile.
Dr Ron Ehrlich [00:47:02] Yeah, that is extraordinary, isn’t it? But there’s a few things there because we don’t we really don’t test for testosterone. And yet it’s so critically important for so many different levels, it’s kind of. Almost a parody of your high testosterone levels. But we need testosterone as men.
Dr Tomasz Forfa [00:47:19] Yeah, and it needs to, it can’t just be, low normal is also. A potential problem. If you have symptoms… You then. Essentially have low testosterone. All right. And any of the… The symptoms, if we put it that way, of ageing has often been put. Have now started to be shown to be caused by low testosterone levels in men. And so it is very important and part of my mission, as I was saying, was changing the way that that medical practitioners are thinking about osteoporosis. Particularly in men. And I want them to be thinking about the risk factors and the potential causes of it. And low testosterone. Particularly if someone’s had prostate cancer, for example, if there are very specific reasons for it. Then testing for that, that should be part of the normal workout. And almost like the screening process for, if a man over 50 has come in. With a broken bone. Let’s start screening for osteoporosis. And potentially even earlier if we’re thinking about you know, the risk factors and what’s going on here. We have a lot of men coming to us who are younger. Who are frustrated because… They don’t know what’s going on. The doctor kind of threw up their hands not sure what to do and just take the medications. And they’ve They’ve proactively started to kind of take ownership of their health and say, you know, what’s going on here? And it comes together, what we kind of start to realise is that there are all these different things that add up. That’s all. That we need to be thinking about. And I empathise for the doctors because there are a lot of things they need to be thinking about at the same time. Probably far more serious, but at the same time, you know. Over the next 10 years, osteoporosis is going to become a big topic as people get older and they keep breaking bones. And as you said, the system’s set up. The risk factors fall further, breaks the bones, and it’s just gonna become big.
Dr Ron Ehrlich [00:49:25] And it’s so interesting, too, and I want to ask you about mindset as well. But, you know, Doctor, you had this burn out. And we’ve done programmes on burnout. Characterised by the acronym. D.I.E. Disengaged. Feeling disengaged, ineffective and exhausted. So if a doctor is thinking that, and I’m not surprised really because writing out prescriptions and on a revolving door of patients coming in for the next prescription. Must be very. Dis, what is it, disengage. In effect, feeling ineffective and quite exhausting, so. I mean, mindset and motivation are key, aren’t they, here? What do you say to people? I mean, what is. How do we get started on that? What is how do we engage with that? For medical professionals or for patients? Well, your background is medical profession, but I’m saying for your patient, you know, for patients. Who are facing this. With the alternative. Go down this way or go down this The difference is in your mindset. How do we change that?
Dr Tomasz Forfa [00:50:32] Burn out. Is a very interesting topic. And I think that, so I’ve previously spoken to doctors about burnout. Put together some education for them about it. And a lot, a lot. It’s part of. It’s seen as a normal part of medicine. You get burnt out, you kind of recover. And you get back to it and you kind of go through these periods of burnouts and then coming back in And now different people kind of address this in different ways, different doctors. But in the last five years, there has been more conversation about it more. More openly talking about, and I used to refer to it as high-functioning burnout. Where they’re still getting, pushing through, getting things done, but they’re feeling miserable and I think that’s kind of what you were trying to get to there was it’s very unfulfilling to be Just churning through. And frustrated. Unfulfilling and tiring and there is this this kind of Over being overworked and overstimulated and not enough downtime And one of the things that we spoke to doctors about… You know, I once put together a programme where I was saying to doctors, all right, if you’re so burnt out, let me show you another way. Here’s what I did. I… Left medicine and I started my own business and I kind of took my experience with with with medicine and kind of turned it into something that gave me a-a-a a life that didn’t lead to burnout. But what I realised is that they don’t want to leave medicine. They love. Looking after patients. They want to do good for their patients, they want to look after They just want to find a- and what a way to do it so that they’re not. Burning the candle on both ends. And so one of the things. That are offered. And I don’t want to- Simplify because there is a lot more there could be some depression kicking in at this point all sorts of other kinds of mental conditions, but. That that’s where it becomes difficult with with medicine because If you are in any way impaired… You can’t practise. We shouldn’t practise. And so it’s a very sensitive topic, but in terms of Preventing burnout and going to that extreme then there are things we can do like taking a break inserting activities that we enjoy. Making sure that we’re looking after ourselves in terms of sleep. and exercise, it’s very easy, particularly in a hospital system, just grab whatever is there. And it’s usually in a carbohydrate laden. Foods from the cafeteria or things that are easy on the go. There’s a lot of pressure to keep working and working and And not take breaks. Breaks are important because it does kind of rejuvenate. Um, uh, uh. And one of the medical professionals that I’ve spoken to if they do take a holiday and it seems a little simplistic and I don’t want to oversimplify it.
Dr Ron Ehrlich [00:53:33] No No….
Dr Tomasz Forfa [00:53:34] The holiday does make a big difference changing the work environment as well understanding their own limitations and what is what is the right kind of work and the right way that they do work, but also. Looking after those foundations of sleep. FOOD! And exercise. And uh and building kind of this. Way that they do life. And understand their own, almost like a thermometer of burnout. Because I don’t think that’s. We’ll ever get, we’ll potentially get to a point where we don’t, we’re not kind of pushing that burnout level because a lot of doctors are. High achievers. They want to do this. They add things to their plate. We’ve talked to doctors before and taken a whole bunch of things off their plate and saying… How you got this extra time? They feel it just like that with other activities because they love to be busy. They’ve got all these ideas and things they want to do. And so. Being able to understand their own kind of. SIGNS! And the different symptoms that they’re experiencing. To go, okay, I need to pull back on this. I need kind of slow down on that. And having someone in their life is very important to who understands that as well. And can be. Almost like their mirror, you can say, hey. Hey Tom, you’re kind of going a bit, you haven’t been sleeping as well as you used to. Let’s kind of look back at your days and have you been eating regularly? Have you been exercising, have you taken time out? What kind of tasks are you doing that are kind of overdoing it for you and just kind of Getting that. Navigating through life by knowing where those limitations are. And then working within those and also sometimes, and again, the high achiever thing comes in. We wanna test our limits. We want to kind of see where we can go because we want to keep growing and improving and so Understanding that if we do push those limits, there will be a period of… Recovery that has to come up, and almost forgiveness for yourself that we can’t keep pushing. We do need to kind of stop and rest at times as well. So I kind of went on a bit of a rant there on. No, no, no.
Dr Ron Ehrlich [00:55:46] I think that is actually a great note for us to finish on, Tom, because it’s a great message not only for the medical profession. But for anybody who is trying to overcome. A diagnosis of a chronic. Preventable and reversible. Chronic disease, which you’ve outlined for us today. So thank you. So much for joining us.
Dr Tomasz Forfa [00:56:09] Thank you for having me, Ron. This has been fantastic.
Dr Ron Ehrlich [00:56:13] Well, isn’t it interesting that we have recurring themes? On this podcast, we’ve spoken to many people. With the supposedly reversible, irreversible Type 2 diabetes. Irreversible, that is, until the doctor themselves… Experiences it, explores alternatives, specifically. A low carb. Diet? And miraculously. What was previously thought of as irreversible. Is now reversible. And here we have another story. Are osteoporosis. Often thought of as irreversible, but here we have… Dr. Tom very clearly demonstrating that through a whole range of Accessible. Convention, not unconventional at all. Um. Treatments or lifestyle. Choices of exercise and nutrition. That he was able to reverse that, much to the surprise of his Endocrinologist, but one I’d be fascinated to know. What impact that surprise had on the endocrinologists. Own professional journey. This is such an interesting story because… When I was listening to Tomasz’s history The first thing that came to my mind is to why did this occur? And although he initially felt that there was no obvious reason why. The first thing that came to my mind was that perhaps. He had a. Gluten intolerance. Now whether that was strictly The celiac, which is complete. Loss of the villi. Which help you absorb your nutrient in your gut. You can have something called non-celiac. Gluten intolerance, which means you also don’t absorb your nutrients. As well. And I became aware of this because of. Some patient, despite. A good diet are much more susceptible to tooth decay than those. That are not looking after their teeth, perhaps as well as they could or should. And yet don’t appear to have any decay. And why is that, Will, when the teeth are laid down? In the first five, 10, 15 years of life. When all of the permanent crowns of. Of the dentition are laid down. If you have an intolerance to absorbing your nutrients efficiently. Then that will affect the hard tissues in your body, like teeth. Tooth quality. And here we have bone quality as well. Um, so there is a reason. And it takes me back to one of my mentors saying to me. That if you ask your patients. The right questions and you understand their answers. Then you will uncover the story. That they tell. So this is. Oh, this was a great story. I’ll have links to Dr. Tom’s. Whole programme where you can get a free report in the programme. Uh… And uh… I think it’s an inspiring story. I hope this finds you well, until next time, this is Dr Ron Ehrlich. Be Well. Feeling stressed? Overwhelmed? It’s time to un-stress your life. Join the Unstress Health community and transform stress into strength. Build mental fitness. From self-sabotage to self-mastery. And together… Let’s not just survive. But thrive. Expert led courses, curated podcasts. Like-minded community and support and much more. Visit UnstressHealth.com .com This podcast provides general information and discussion about medicine, health, and related subjects. The content is not intended and should not be construed as medical advice or as a substitute for care by a qualified medical practitioner, if you or any other person As a medical concern, he or she should consult with appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences and conclusions.
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