Best Calcium Supplement for Osteoporosis: 2024 Update & NEW Perspectives on Calcium

welcome back to the Dr Doug show your resource for bone health hormone optimization and Women's Health span through midlife and Beyond so there is a lot of controversy around calcium and osteoporosis and calcium for osteoporosis the challenge here is do we need a supplement do we not need the supplement if so what supplement is it okay if I get calcium through food what about vitamin D what about vitamin k What form how much lots of questions the truth is is that the concern is around the risk of heart attack and stroke so this is a high-risk game and I often get some feedback from people saying oh it's just a supplement oh it's not a big deal but it is a big deal because heart attacks and strokes are a big deal and so we've paid a lot of attention to the detail of studies around calcium uh different formulations and I want to be very clear about this video that if you've watched my previous videos on calcium supplementation um my position has changed a little bit so I've talked to a number of experts I've talked to um some uh industry leaders in the supplement space uh read dozens and dozens of studies so I'm here to present my new position on calcium supplementation and this is a shift It's A New Perspective I want to go through all of it so this is going to be relatively long so I apologize for that but I want you to understand why we're recommending what we're recommending um the changes I'm making based off of the lit lat that I've reviewed in the past um and how I'm looking at those through a different light with the information that I have now so stick around I want to also uh announce that we're going to talk about a partnership at the end of this and uh be some discounts for you that are listening and making it through this video so definitely stick around to the end and if you haven't already subscribed to this Channel please do so so we can help more people to learn more about bone health I'll see you in a minute three 2 1 here we go all right so why all this fear around calcium supplementation I mean the recommendations for calcium go back for decades so why is it that all of a sudden now we're worried about heart attack and stroke with calcium isn't calcium just natural well the thing is around 2010 there was a study that came out by an author uh by the name of Boland and uh Boland released two big studies but the first one from 2010 was a metaanalysis that reviewed 15 randomized control trials so 15 reasonably well-designed studies that looked at calcium supplementation greater than 500 milligrams which is what most people are taking but without vitamin D and that's a really important point in this metaanalysis what they found is that there is a 5.5 % chance of having a heart attack myocardial infarction cardiovascular event in the placebo group and 5.8% in the calcium supplement group so when you do the math on that and you do the statistics you come out with what's called a hazard ratio of about 1.31 which means that you can say that there is a 31% increased uh risk of heart attack with calcium substitutes so just as a reminder absolute risk versus relative risk so we talk about statistics a lot of times drug companies um and anytime you want to make a big impression you will use the relative risk because if you uh especially if you have low numbers the relative risk is going to look significantly bigger versus the absolute risk so you go back and and we know the numbers 5.5 and 5.8 it was actually a 0.3% uh difference between the two groups right so the absolute risk was 3/10 of a per the question we have to ask oursel with absolute risk is is it clinically relevant because 30% sounds clinically relevant and when you look at the numbers um in this case in this meta analysis it included over 8,000 participants there were 143 heart attacks in the calcium group and 111 in the placebo group so that is 32 more heart attacks so is that clinically relevant yeah I mean for me it is so that seems like it's relevant that's a a large number for me and yes that's concerning now some other interesting statistics here is that stroke and death uh overall death did not not reach significance and that these studies were using Rock and synthetic forms of calcium so calcium carbonate and calcium citrate rather than more natural forms or whole food forms and there was not vitamin D included in the formulation which we now know you know two two decades later we now know that vitamin D is is critical for the absorption and utilization of calcium Not only was it not utilized in the rcts the randomized control trials but it also wasn't measured was likely a deficient population we can't control for the the population deficiency uh because we don't know what it was so regardless of those weaknesses in that study this was a big shock to a lot of people a lot of patients a lot of doctors and then the recommendations didn't really change and so what has happened in the past and what still happens now is doctors say well you need 1,200 milligrams of calcium if you're postmenopausal or up to, 1500 milligrams depending on the the recommendation so I'm going to give you, 15500 Mig of uh supplementation that way we don't have to worry about it through food because doctors in general don't talk about food and in America especially we kind of have this feeling that more is better and the challenge here is is more better does that really apply and so Bolan didn't stop there he actually went further and did another study another uh kind of a metaanalysis it's kind of an interesting design here but the second study is another 2011 study the one was 2010 but this is a 2011 study looking at the women's health initiative data now for those that have heard me talk about this let me just let me just mention it quickly so the the Women's Health Initiative was a again a massive trial started in the late 1990s and it is what blew up with the hormone optimization and replacement practices in the early 2000s and it has had uh massive waves uh tsunami sized waves of impact on women's and hormone sense but some of the things that they also did during the Women's Health Initiative include a calcium and vitamin D study so 36,000 of those women and the Women's Health Initiative also did a prospective study on uh calcium and vitamin D that was controlled so there was a placebo group and they used 1,000 milligrams of again a rock calcium calcium carbonate and 400 IU of vitamin D so that's not a lot of vitamin D the original publication in 2006 did not show an increased risk of uh cardiovascular events with calcium and vitamin D but as usual the devils in the details so I've actually reviewed that study and my takeaway was hey vitamin D added to the calcium even if it's a rock form of calcium reduce the risk but Bolan took a look at this a different way and Bolan said well look if you look at the details of the study and he actually got additional data that I didn't have access to so I Adit I don't know if I would have picked up on this or not but when you look at the details of the study and you look at the number of people that were reporting already being on calcium 46% of those participants of those 36,000 people were already taking calcium and over half of them were already taking vitamin D and they were allowed to continue their own supplements despite what they had been recommended or what they had been given as part of the study so they may have already been on calcium and vitamin D and then given a placebo and you can imagine that is going to negatively impact your outcome right so now we don't know uh What uh the results are actually showing so Boland took those data he excluded those people and did a subgroup analysis now you have to be careful with subgroup analysis because this always exposes potential bias but I think at this one it's legitimate because you're looking at the group that didn't have calcium and and vitamin D already on board and probably didn't continue to take it we don't really know and then he looked at some other studies some two more recent randomized control trials that used uh calcium carbonate and vitamin D so I actually looked those studies up and he must be really good at getting data that's not published because neither of those studies uh actually reported on heart attack and stroke or death in their publication so he must have been able to get some data that that I didn't have access to because I couldn't find those data but when he did the subgroup analysis of the Women's Health Initiative he did see an increase in heart attack so does that nail the coffin on calcium and vitamin D should we just put this one to bed and not use it I don't think so we're not going to get away with that that easily so the following Year in 2012 Dr Heeney who's who was unfortunately he's he's passed but Dr Heeney was a brilliant calcium researcher so did a lot of research on calcium and he looked at these studies and he applied what's called called The Bradford Hills criteria uh and these are specifically for this a statistical way to look at data and really looked at these and said look these are not well done studies there is no control for the risk factors associated with heart attack there's no real physiological mechanism that makes sense here and there's no reason that we should change our recommendations in other words don't listen to the outcome of these studies we have better studies to talk about uh we don't need to change our recommendations and so that was published in 2012 um but here's the physiological consideration that I hear all the time so what he said is there's no like there's no way that this makes sense like why would calcium consumption increase the risk of heart attack how would it do that but here's what I hear people say well I took a calcium supplement and now I have calcification in my arteries kateed coronary either way and they assume that the calcium supplementation is the cause but what we have to remember is that calcification of the arteries is a process that's been going on use quotes here for those that aren't watching this but naturally in quotes um forever as as long as we know as long as we've been able to do studies on arteries we know that they do get calcified that is with or without calcium supplementation so we don't necessarily need to stop our calcium supplementation if we start to see calcium in the arteries however we do know that plaque development calcium developing in the arteries is potentially something that could lead to um worsening disease it could lead to heart attack and stroke that gets into the whole area area around uh stable versus unstable plaque and heart disease and Etc and we don't need to go there but just know that calcification of the arteries is not necessarily causal from calcium supplementation they can exist they can coexist they could be unrelated there's a lot of ways to look at that so I hope that makes sense that we don't there isn't really a good explanation of why this would happen other than if there is excess calcium in the blood and you'll see why this is important later but if there is excess calcium in the blood because of one reason or another not enough vitamin D not enough vitamin K uh inappropriate form whatever could the calcium be going to the arteries it could uh but we again we don't really see strong evidence that that's the case but there is definitely more to this story before we get to that if you haven't been to our master classes on osteoporosis or women's hormone optimization take a look in the description on YouTube uh or if you are listening to this in a podcast go to Dr douglas.com and you can find those free resources these master classes we run about every two weeks on those two topics it's basically how we put it together for people for our patients uh and an opportunity for you to ask questions again totally free all right so what does the newer data say about um about calcium about vitamin D since 2012 what's happened well in 2015 this is our fourth study in 2015 there's a meta analysis again of randomized control Trials of 63,000 postmenopausal women pretty big there are studies looking at just calcium or calcium vitam D together and there was no effect of calcium or calcium and vitamin D on heart attack uh or stroke so that's good except that there still was a trend that existed for calcium alone so you still you kind of get this subtle signal right that maybe something's going on and then in 2016 this study called Mesa Mesa stands for multi-ethnic study of atherosclerosis now this is something that U this is a great study there's a lot you can take away from this but one of the things they did in this study was they looked at coronary artery calcium scores so these are the CT scan that looks at the heart looks for calcium in the coronary arteries the arteries that give bleed blood for the heart and it followed people for 10 years and so it showed that after 10 years that there was a slight increase in Risk if you were on a calcium supplement and they didn't divide out calcium and calcium and D together that I'm aware of but they also found in this cuz they were looking at at food intake they also found that calcium from food was actually protective against developing coronary calcification so that's interesting they even went so far as to divide calcium intake into quintiles so five different groups the highest quintile of consumption had the lowest incidence of subsequent coronary artery calcium formation isn't that interesting so there must be something or there may be something a better way to say that about the form of calcium are you getting it from food versus are you getting it from supplementation so so then there's another study more recent from 2021 because this was a review study and it looked at calcium and vitamin D studies and again uh sort of went through all the details of the analysis and said look there's no reason to be concerned there is a subtle signal but if you need it you need it and we shouldn't change what we're doing so overall what's the takeaway here the takeaway is that calcium alone does show a very small signal for increasing um heart attack but that does doesn't mean that we shouldn't use it that means we need to understand more about it and so there's some interesting data I want to review with you my remaining questions then are are there differences in the different forms of calcium and should we be restricting or promoting whole food sources of calcium or just getting calcium all through diet so let me dig into what I've recommended previously so I have some older videos they're still on if you want to watch them uh they just have a a card that leads to this video because I want people to get the most updated version um but previously I was recommending calcium in the form of MCHC or microcrystalline hydroxyapatite complex also sometimes called oine hydroxyapatite complex or ohc basically what this is is ohc MCHC is calcium in the form of um hydroxyapatite complex which is the basically the formulation that you see calcium in Bones so it is essentially Ground Up Bones now one of the cool things that you can do when you are grinding Up Bones is if you preserve the protein matrix you can actually get some anabolic protein effects from the The Matrix itself so there is a product an ohc product that is unfortunately not available in the US but actually has several studies behind it so natural sources of ohc um have been shown in this study seven that we have here is a a 2021 um observational cohort showing that ohc is far superior to to calcium carbonate again the rock form of calcium um and prevented bone loss and that's cool it's a key Point here is that it prevented bone loss it didn't improve bone mineral density but it it prevented uh bone loss um and I think the deal is again it's a whole food source it's your body knows what to do with it um and those additional proteins are going to have an impact um on bone metabolism and it's not a rock so it's better um but like I said all of those ohc studies are on a product that is not available in the US so if you look this up you can look it up online you can see it called osteopor OST Osan uh Osteo genon um a couple other different names there and there is a similar product that is available in the US called stimukal now in the past I've recommended products from gerro uh orthomolecular has an MCHC product as well um and the gerro products in particular use stimukal now why did I recommend this in the past I I recommended stimukal because it has a similar formation it is in the hydroxyapetite form it contains micronutrients it contains collagen um it is similar in formulation to the ohc but if you look at the studies on it there are no good human studies there are no bmd or fracture reduction studies so we're making a leap and assuming that the MCH is going to work the same way as the ohc if it comes uh in the form that it was coming in in stimukal now stimukal does have some studies and I bring this one up so this is study eight I bring this one up because this actually is really important to demonstrate the difference between rock salt versus Whole Food forms of calcium and blood and so if you look at this graph uh this is a graph from the study itself and what they did is they compared uh styal to again calcium carbonate and calcium citrate and you can see that there's three lines there the lower line is the um the calcium in blood levels with the uh stimukal which is the MCHC product versus the other two which are much higher and that probably why we're not overloading the tissues with calcium with a whole food source as we are with a Rock Source or a synthetic Source uh through um calcium citrate so um I think that's great and that helps us to be confident about using certain types of calcium over others however we don't have data to say that this product will specifically improve bone mineral density slow bone loss reduce fracture risk Etc uh they also had some interesting studies that showed that uh there was an impact on growth factors and cyto kindes with this product versus others so again stimukal better than Rock calcium better than synthetic calcium but is it the best now when I was doing my initial research on um MCHC um I had looked at and actually previously used the algae Cal products so algae based calcium and I I went away from it for reasons that I'll talk about in a minute but I came back to it recently because I did a talk for uh osteostrong um and Al Cal and Osteo strong have a relationship and so I was doing this supplement talk with um with osteostrong for their members and there was um uh a representative from alal was there and so we uh you know just politely talked about the differences and and um calcium and we agreed on basically everything but it was a little bit uncomfortable because I had previously said I am going to recommend using this MCHC product over an algae form and so after we got done with the talk we actually hopped on another Zoom call we were chatting about you know kind of my my process and how I got there and I got to sit down with the CEO of alal uh because I I told him that when I reviewed the studies I had there were some things that I couldn't make sense of uh and I couldn't get the answers so I just went with the product that I could get the answers that I was looking for so I actually went through those concerns with him and it was really really helpful and it's changed my mind about how I view the algae uh form of calcium that they use and the products that alial sells so I'm going to go through sort of uh these studies they have some great studies on their we website uh uh that are specifically on alal so I'm going to go through these and um I'm going to show you what I initially saw um and then what I learned about the study that has helped me to change my recommendation on um calcium products all right so before we get into the this first study let me just give you a little bit of background about algae based calcium so algae is a whole food source of calcium it is going to be better tolerated than Dairy for a lot of people now you guys know that I'm I'm a fan of dairy but we know that many people don't tolerate Dairy they don't tolerate the lactose or the Quine or whatever and the challenge I have is that I tell people and I see a lot of other people on the internet YouTube Etc telling people get your calcium through through food and I agree with that we should get our calcium through food but if you don't tolerate Dairy it's not that easy and getting a calcium through a supplement that also gives you the other minerals that you also need um is going to provide you with some value likely now what's interesting about the um the mchd products is that the the ground up bone yeah it did have calcium in it uh but it didn't have some of the other things that I was always adding so it's basically creating like a multi-mineral out of multiple products um algae is naturally A multi-mineral and vitamin product the algae and I apologize if I get this wrong if I say this wrong but lithothamnium Super positum Algae um that's the first time I've ever said that it's 93% mineral and 7% organic material so it is most mostly a multi-mineral product and it's about 30% calcium about 2 to 4% magnesium and the rest are just trace minerals so it's kind of cool that it is this natural multi mineral in this very specific ratio that includes calcium so I sat down with the nules from alicen and he gave me a breakdown of the research um sort of the pathway that they went to develop the product and it's really interesting what it takes to create a company like that and so one of the first things they did was to look at the the upper limit recommendations of calcium they were trying to decide how much is enough you know people are getting 12250 milligrams of calcium carbonate is that too much is that enough should it be more should it be less the upper limit recommendations of calcium in both the US and Europe are around 2400 milligrams from all sources so that includes food now interestingly this is not why they did this but the dose that they came up with from a calcium perspective of alic Cal happens to include 2400 milligrams of minerals of that 720 Mig of that is calcium again it's a whole food form of calcium so when they were going through the process of figuring out what to do with this calcium one of the other things that they did was to compare the algae form of calcium to calcium citrate and carbonate in bench studies so in vitro and they were looking at what it does to the cells what it does to the Bone and it increased alkalin phosphatase which is a bone uh turnover marker and it uh increased calcium deposition but decreased oxidative stress and so this was kind of a cool finding that warranted then human trials so there are three studies that I'm going to talk about this first one is our ninth study for today and this is the alal um kind of open label cohort study so they uh this is not blinded it's not controlled but they had 158 participants and they used one of two different forms the 158 people uh used the first form and then they switched to the second form followed them each for 6 months and then annualized the results and so you have what they report in there is ma PC or mean annualized percentage change both of the products had strontium in it so we'll have to keep that into consideration we look at the results but when you look at these results it is significant that um there was when compared to Baseline um about 0.5% increase uh in group one and a 2.18% increase from group two now you'll see in these studies that there's kind of different formulations of the alal product and they were kind of manipulating the the recipe as they went to try to find the biggest impact and I'll show you in the next study the one that is the biggest impact and while that first one wasn't clinically significant when you look at the expected bone loss it becomes clinically significant with about a little over 1% and a little over um actually almost 3% in group two so both statistically significant at that point that's the first time any calcium bone health product has shown an improvement in bone mineral density so that's a really good finding but some of the weaknesses of this study are that they didn't actually follow these people for 12 months they did an annualization after 6 months so it's probably pretty accurate but it'd be good to know what 12 months looks like and also they reported on whole body bone mineral density rather than spine and hip and this just was uh this was kind of a a failure in the development of the protocol where they didn't really recognize the importance of spine and hip over a whole body uh there's lots of studies showing that whole body and Spine and hip are going to be closely related U but again it would be good to see spine and hip specifically to know if there's going to be an impact on one versus the other um and then of course there's strontium in both products so we can't say that it's the algae by itself because there's also strontium um in the product as well so good thing we have more studies so the second study um published in 2011 which is our 10th study today um also had three groups now this one's a little bit different because this one had U three groups three different formulations and one of the formulations didn't include strontium they also had some lifestyle components that went along with this so there's some um recommendations around nutrition and exercise and they uh wore a podometer so that's obviously going to have an impact on their U activity level and so there were three groups like I said there were 125 in the first group 51 and then 35 uh so it got smaller as it went on um and then this is where things got confusing for me so if you follow this study uh and you look at this initial um group so if you look at table one here you can see that there's three groups um and then if you look at fig fure two you can see how the groups do what I couldn't make sense of is why the group that had the least amount of stuff in it so didn't have strum didn't have vitamin D didn't have vitamin k um and also didn't have the the Fitness and Nutrition recommendations outperform the other two I couldn't make any sense of that this one of the things that I I sat down and talked with Dean about um and it turns out that there was actually an error in the publication that they couldn't get corrected and so um this is one of those unfortunate things that happened and research but it makes sense so now if you flip that around and you make group The what they have listed as group three group one and then move the other two over now it actually all makes sense so what you see then is that the group group one had the least amount of stuff in it group three had the most amount of stuff in it and uh the results of the increase in vul density are um linearly related to those uh increases in different content so group or plan one rather was 12 months of the alal alone it's an older version so there's a newer plan here um plan two had um plan two and three had different versions again with more things added to it um and so you can see then in figure two that plan a increased boneo density 1.3% from Baseline uh Plan B 2% and plan C 4.1% from Baseline um now these were all statistically significant from Baseline alone and definitely when compared to expected losses so these are really big changes uh with just the supplementation and again plan one didn't include strontium or lifestyle Rex so I think we can safely say that the the algae by itself this multimineral calcium rich product is going to have a positive impact on bow and no density without strontium and that that was really important for me to make that understanding because I couldn't make sense of that before and so when you look at at the the other plans as they move forward so plan two then had the algae Cal more D vitamin K2 was MK4 uh and then plan three had even more vitamin D more magnesium K2 is mk7 Vitamin C Boron and lifestyle and so you can imagine how like that's going to increase when you start adding each of those things which we know make an impact so now all of a sudden this all makes sense um and so I can see then that that there is a reason to potentially use this over the MCHC product the third thing that alal did is to do a long-term follow-up so what they did with this study was to take um 172 alal customers and they reached out to say hey we see that you have a dexa scan um on file we would love for you to get a new dexa scan and some of these people were seven years out so they got data on out to seven years so 172 total people data out to 7 years and what you can see in this figure that there's pretty much a 1% per year uh continual increase and that is great the only downside of this study I would say is that I'd love to see the groups be larger uh and obviously I think there's some bias potentially in this because they are long-term alal customers they're likely committed they're probably doing other things too but still it shows that you can continue to improve bone over time even up to seven years um the product that these patients were using were also included strum um so there's um again some confounding variables there and I would love to see that study done a little bit differently um to continue to see what potentially the algae by itself could do but I know they could do that because a lot of people want to see that increase in bmd so how has that changed our practice and the truth is is that has changed our practice so again we were recommending the you know the gero products the orthomolecular products um but having to put a lot of different things together to get what we wanted and one of the things we always struggle with is capsule fatigue uh you know recommending too many things trying to get the things that we want for people's bone and for health optimization in general so this is a way for us to put all these minerals in one place uh and it helps us to pair down our capsules but also to give people a product that we know has human evidence that can support increasing increasing bone mineral density simply from the algae itself so I think that's great we still recommend people get their calcium from food and for those that can consume Dairy they don't necessarily need a calcium product but knowing what that that upper limit is it's probably not going to harm them to have it on board if it's coming from Whole Food likely going to reduce the amount of calcium in Blood and it's a good buffer that also gives them the other minerals that go along with it if people don't end up on a calcium product for us we are putting them on a multi-mineral because I feel like those minerals are really important all right so then when I sat down with Dean one of the other things that I wanted to ask him was hey you guys have this money back guarantee tell me a little bit more about how this works and so I was surprised to see it because when you again listen to most doctors they will tell you just outright osteoporosis is not reversible and yet you have the supplement company that says hey take our product and if you don't see an improvement in your dexa in six months we'll give you your money back wow uh so I was surprised and I wanted to figure out okay how often does that happen and so what he told me is that they have about 100,000 clients and they've only refunded uh about six people per year which is really really low um so it just goes to show that the the product is likely going to improve your bone maneral density and also that osteoporosis is reversible now I think that um again there's bias in there because those are people that are um you know probably doing other things too I don't think that the supplement alone is probably going to do everything for everybody it might be all some people need U but that's why we created a comprehensive program that I um that I think most people are going to need to get all of the lifestyle the rest of the supplements through the lens of Health span potentially hormone optimization a and replacement so I think all of that plays a role so I'm going to do another video on what would now be my three favorite supplements for osteoprosis but I'll just give you a sneak peek in that which is what we're basically doing now is we're adding the um alal plus we're also adding the vitamin D complete which gives you a little bit more D vitamin A E and K2 as both mk7 and MK4 uh as well as a little bit of K1 so it gives you a nice uh complex of the fat Sol vitamins so I'll talk more about that in another video I'll also talk more about St team in another video too cuz I know there's going to be a lot of follow-up questions on that so uh welcome to ask your questions but I'm going to to do an updated video on strontium uh because I'm sure they're going to come out of that then my last Point here is on um one of the questions I get around algae which is what about contamination aren't our oceans contaminated and the answer is yes they are contaminated um but I talked to Dean about this and they do um they test every batch the areas where the algae is grown is very well protected um they're testing everything and all of the um levels are going to fall within all the safety standards from the uh what is it the US pharmacopia also the American urbal Products Association so these things are very very tightly regulated another interesting thing he told me is that the alic Cal powder itself is certified organic now the product isn't because some of the minerals can't be made organically so algae Cal is uh the capsules don't necessarily say it on the bottle but the powder is and that's really I think important um and then additionally if you really wanted to look this up there was a study this will be our last study that I'll I'll point out here study 12 is a study um that alal also funded that looked at toxicology studies and what it could potentially do to the body so again really really well studied product uh more so than most supplements that's for sure so congratulations on making it to the end of this video um the fact you got here tells me that you are very committed to your health so kudos to you for that um if you made it to the end of this video you also get to hear about our bonus so we are now partnering with alic cal um from an optimal bone health and optimal human health perspective to be able to offer to our YouTube uh subscribers and viewers a 10% discount so if you want to look in the description for the unique code to get 10% off of your first purchase uh from alal you can take a look and do that and again if you haven't subscribed please do so helps us to reach more people who are looking to improve their bone health and that's all I have for you today so friends remember you are created for greatness so seek optimal not average don't be afraid to be extraordinary because you are and that's what it takes uh a few uh other couple announcements are really just one if you've already done the master classes the the bone health and the the health I'm sorry hormone optimization master class and you're looking for more the next steps might be the health span nation which is where you can ask me and my team uh questions through a weekly Zoom as well as have access to our um content Vault and our community our really cool Community who are supporting each other and helping each other to optimize their health uh that's Health span Nation um and then our bone foundation's course um is our our free comprehensive course it's like the master class blown out into I don't know how many talks right now 16 or or more um different talks in a workbook to go along with it and again that is totally free health span nation is not more information on the Dr douglas.com website or you can look for the links in the YouTube video see you next time this presentation is for General informational purposes only does not constitute the practice of medicine nursing or other professional health care services including the giving of medical advice no Dr patient relationship is formed the use of this information and the materials linked to this presentation are at the user's own risk the content in this presentation is not intended to be substitute for professional medical advice diagnosis or treatment users should not disregard or delay obtaining medical advice for any medical condition they have and they should seek the assistance of their Health Care Professionals for any such conditions