Soy for Bone Health | Powerful Tool or Inflammation Bomb??

if you're trying to improve your bone as naturally as possible you've probably looked into soy or isof bones or phytoestrogens there's a surprising amount of controversy in confusion in this space probably because the terminology is confusing but also concerns wrapped around estrogen which is generally misleading but there's also issues then potentially with the addition of soy uh and soy like products into the diet so the question is this does a dietary approach focusing on phytoestrogens or FL bones work for bone and Hormone Health is it safe how much should you consume where should you get it from are there any concerns and the answer is maybe maybe depends and yes as usual there's Nuance in many variables to consider so I'm going to cover this topic in a couple of different videos to keep these digestible today is all about the actual food source of soy and the associated phytoestrogens we will cover supplements mimicking these sources in other videos but today is all going to be just about soy as a tool for phytoestrogens and the potential isoflavones that can be added to Soy because it's kind of hard to separate those in the literature now if you've got a story around phytoestrogens story for osteoporosis I want to hear about it because hearing the stories that we see in our comments on YouTube are actually really helpful in US putting together different topics on things that people want to hear about so give us a little bit of feedback tell us your stories on this topic I'd love to hear about it all right so what are these things and all these crazy words like phytoestrogen and isoflavone so let's just take a step back and let's just talk about the parent group derivative so phytoestrogen is a plant-derived compound with estrogen-like properties we'll just stop there a phytoestrogen is something that comes from plants that has estrogen-like properties meaning that it can mimic some of the activities of the hormone estrogen specifically estradiol in the human body and there's the potential benefits or potential risks associated with activating those estrogen receptors without estrogen right so there's sort of mimicking estrogen in the body now an isoflavone is a type of phytoestrogen so remember phytoestrogen acts like estrogen isoflavone is a subtype of phytoestrogen commonly found in legumes and soybeans are the richest source so that's why we see generally people are going to talk about soy and derivatives of soy the highest levels of isof bones are found in foods such as tofu Tempe soy milk adame there's a couple other different things you could choose my Approach when I see topics like this is to stop listening to the back and forth on social media and YouTube and really just dig into the studies because I want to see what the actual literature says because something like this is likely to have been well studied because of the potential risk so let's look at the research for some guidance on phytoestrogens specifically in soy in this particular video so I wanted to start with this 2014 review paper so this a review paper is nice because it has a little bit of a narrative around it but it gives some background some things that we can discuss and what they talk about in here is that indeed phytoestrogens are strikingly similar in chemical composition to the estrogen that we have in the human body specifically estradi estradi has two different receptors and the phytoestrogens uh in soy can actually activate both Alpha and beta receptors so it can actually work on both sides that estrogen has the potential to work on but it does have a preference for the receptor beta so one over the other and that's actually relevant because estradi will stimulate both and that's one of the reasons why natural estradi is more balanced than other forms of estrogen so a quick review here on those receptors estrogen receptor Alpha is the one that's more prominent in bone it's the one that's also thought to be more proliferative in nature and that's why we need to balance it with receptor beta uh activity but that receptor Alpha activity is important because it will promote osteoblast survival and it will inhibit osteoclasts and that's what we see that estrad does so estrad has a significant impact on bone um estrad beta though less prominent bone really more for balancing Alpha in these tissues and then it has other actions in other tissues despite this in cell Studies phytoestrogens have been shown to activate proteins that build bone we see mineralization of osteoblasts in uh Petri dishes and petri dish studies and we see inhibition of osteoclast in those same studies so you would think that we would see enhanced bone mineral density and Bone formation when using these things in real life but do we so let's look at the second study so this is a 2024 systematic review and meta analysis so it's recent it has 63 randomized control trials reviewed in it that's a lot the intervention group had almost 5,000 individuals in it the placebo group had over uh 4,000 individuals across all of the studies and the goal in all of these studies was to evaluate isoflavone interventions for bone mineral density in postmenopausal women wow so there's a tremendous amount of evidence here but the challenge here is that the interventions are quite varied I'm going to talk mostly and exclusively about the the soy side of this soy isof flone specifically and cut out some of the uh supplement recommendations in here but the results indicated that that soy isoflavone intervention does significantly improve boneal density at the lumbar spine femoral neck distal radius in this specific group which is postmenopausal women but I said this was also this was in soy and in supplements uh what they did too is they showed that if you were to break down what people were doing in the different studies is that the isoflavone intervention by itself it was effective for improving bone mineral density only when the duration was over 12 months and only when the intervention contained a what I will consider like a genesin equivalent I'll explain that but an equivalent of at least 50 milligrams per day so what is genestin well genestin is an isoflavone so when you look at soy isoflavones there actually three major ones in there the soy isoflavones are about made up 50% of genestin so we want to make sure that we're getting 50 milligrams of genestin in the soy isoflavone interventions that we talk about so how much is that when you're talking about actual soy so the whole food source well it's actually not that much like I mentioned in other studies uh in other I'm sorry videos when you're talking about supplements sometimes you can have you know super physiologic doses so lactoferrin is a good example right where you can get 350 milligrams of lactoferrin in a supplement and that would be like gallons and gallons of raw milk so this isn't actually like that so 50 milligrams of genestin would be about a half a cup of soybean about two cups of tofu depending on the type of tofu could be around a gallon to a gallon and a half of soy milk or about gram per gram for soy protein so if you're actually eating soy protein by itself 50 grams is probably around 50 gram although it's a little variable so I'm going to cover genesin as a supplement in another video but first I want to get into the research looking at the soy isof flavor themselves before I do that if you're having a hard time putting all this together please consider joining our free Master Class if you haven't done this already it is free it's an hour long I go through how we put together a bone health program and answer questions for 10 to 15 minutes depending on how quickly I go thousands of people I think at this point probably tens of thousands of people have found this to be helpful in their own Journey because it just puts everything together in one place and it allows you at least to Kickstart moving forward on your own program also exposes you to some other free resources so again again if you haven't done it I would encourage you to do that on YouTube you can look for the link in the description um of this video and if you're listening to this on a podcast you can go to Optimal human health.com and you can find the link there all right now this next study is really cool because it actually Compares soy isoflavones to estradi specifically as a form of estrogen and also to abys phosphinate in actinal or risedronate so this is a really cool comparison now unfortunately the study is really small so I think they had 11 individuals in this study um and they had four different isoflavones and actinal and estrad so that's six things 11 people I don't know how they did that but it can't be more than two people per intervention um so obviously really really small study but it's worth looking at because this would be a really cool study to do on a bigger scale and what they found is that the um urinary bone resorption markers is what they were looking at with the bis phosphinate and with estral went down by 22 and 24% respectively so a couple of important points here one is we're looking at the impact of the drugs in urine which is okay that's a way to measure it um and estrad outperformed although not significantly but outperformed the bis phosphinate um so I think that's kind of cool the isof bones did actually reduce the net bone resorption but only by 9% so we'll call that a modest impact in a very small sample size and a pretty darn short study so not particularly helpful um in in a big scale because we don't really know like what would happen over the long term and what if you had more individuals so hard to draw a lot but it is kind of a cool study showing that it has the potential these isoflavones have the potential to be most impactful and the soy isoflavone by the way was the most impactful of all the other ones in there um so that's really helpful but we certainly need more data than that and fortunately we have it so this next study is a 2011 randomized control Trail on 225 individuals so thankfully we have more people so this study was looking specifically at the soy isoflavone in doses of 80 to 120 milligram per day I'll explain what that means um they also had a placebo group so that's great and they were looking at volumetric bone mineral density so this kind of a different way to look at bone mineral density and strength now a soy isoflavone like I said is about 50% genestin so 80 milligrams is a little under our that genestin equivalent of 50 and 120 is at 60 so a little bit over there's also not a lot of difference between those two groups so if I could go back and redesign this study for them I would have made that shift a little bit bigger but they did the study for three years which is cool that's a long study for a supplement especially with over 200 individuals the outcomes were pretty Technical and not easy to read but it was helpful because it did separate out some things that you would usually look at some some typical bone mineral density things but also some other things that might be more indicative of bone strength rather than just bone density by itself so again this is kind of a cool study now what's interesting in the results are that there was bone lost for both interventions meaning that the phytoestrogens the isoflavones at these doses did not stop bone loss however the longer a woman was out from the onset of menopause the more powerful the phytoestrogens were also the bigger their rate of bone turnover as measured through urine markers the bigger that measure the more impactful the phytoestrogens were and this kind of makes sense right so if you are going to um hit and activate the estrogen receptors a little bit the people that are at the most risk are probably going to see the most benefit so that does make sense now remember too that these women were not on hormone replacement therapy so these estrogen receptors were begging for estrogen and they were able to get a little bit of a an activation through the phytoestrogens uh but certainly not as much as you would get through estral so then what about the concerns and there is a study that actually does a good job of talking about some of the concerns around soy and then we'll sort of extrapolate from there so this last study I want to talk about is a 2017 randomized control trial again on 200 postmenopausal women so great audience reasonable number for a supplement or dietary trial and what they did is they looked at changes in bone turnover markers with soy supplementation for six months so it's pretty good six months long we'll take that too what they did though is they randomized 15 grams of soy protein now I mentioned soy protein is about G for gram uh the equivalent of genistin again varies quite a bit but that's an assumption and then they also added 66 milligrams of soy isoflavone so that's one intervention soy protein and soy isoflavone and then the other group was just soy protein on their own and so that would be a little bit um about half of that genestin equivalent of 50 milligrams versus probably about the same as what they recommended in that initial study so you've got again half and then probably recommended but the the recommended is through both supplementation and soy by itself so keep that in mind so when you compare the intervention group that had more of a genestin equivalent there was a reduction in CTX but there was also reduction in P1 and P now if you're not familiar with those biomarkers CTX is a a blood biomarker that looks at osteoclast activity osteoclast are the cells that break down bone so when we're working on bone health with our patients we want CTX to come down not too low but we want it to be relative low because we want to break down bone but not too quickly we also want to push P1 and P up but these biomarkers are linked so generally we're not going to see CTX go down and P1 and P go up it happens but that's usually not our goal because that would be unrealistic in all people um so that the fact that we see both come down is expected but what really matters and what we measure for our patients is the ratio between P1 and P over CTX how quickly are you building bone versus how quickly are you breaking down bone it's it's hard to measure that in this study so I can't really tell what the impact was on the P1 and P over CTX ratio all we know is that it reduced both which is um kind of good it might be the right move it's just a little bit hard to tell but the intervention that had more genestin equivalent was more impactful significantly than the one that had less so take that for what it is they also looked at additional uh biomarkers and there was benefit from again the higher isoflavone intervention in metabolic markers and in blood pressure over the soy protein by itself now here's where the risk comes in so what they noticed though is that TSH or thyroid stimulating hormone which is uh one of the labs that you can get to look at thyroid some doctors make this the only lab they looked at thyroid function with but uh they looked at TSH freet T4 which is kind of the storage form of thyroid hormone and then free T3 which is the true active form and so when you look at all three of those together you can get a sense of what's going on with the thyroid now what they noticed here is that TSH went up up and free T4 went down but free T3 was unchanged so what does that mean what they published on is that they had worsening thyroid function and that was concerning for them I don't know that I would necessarily look at that the same way and I don't know necessarily that that's clinically relevant without talking to the patient around symptoms and you know are they actually seeing some changes in how they feel uh with the TSH up and the free T4 down with the free T3 unchanged my guess is that actually they would feel the same so then let's talk about some of these potential risks because soy is not without risk so could soy actually negatively impact the thyroid and the answer is yeah so soy is known as a goitrogen but how much soy would it take to actually cause a negative impact on the thyroid that's what a goitrogen is by definition so soy does contain these little goitrogen substances that can interfere with thyroid function by inhibiting the body's ability to use iodine but again the question is how sensitive are you and how much would it take and so is this really an issue with soy at at normal dosing levels but if you consumed it every day as your source of protein yeah it certainly could be and maybe that's what they were seeing is that there was enough to actually get uh the start of that kind of a risk another thing that's in soy that's concerning for a lot of us is these things called Fates or phytic acid so Fates can bind to minerals like calcium and zinc and magnesium and iron in the gut and it can reduce their absorption now if you were to process the soy particularly through fermentation uh then you can reduce the impact of the Phat but again if you're consuming raw or uh tofu then this could actually be an issue and the amount of calcium that you think you're getting you may not actually be absorbing so that could be an issue for some people and phytic acid can bother some people I think more than others there's also some potential allergen issues associated with soy so particularly in children now I think this might probably be more related to uh soy being used in highly processed foods and and kids having uh you know poorly designed diets so I don't know how big of an issue that's going to be in our adult population certainly something to consider though if you just don't feel good after you eat soy that's something to consider as well the estrogenic effect is actually what we're going for in soy but there are populations that probably wouldn't do well using a lot of soy as their protein Source again because of this estrogenic effect and so younger populations younger women it can mess with their cycle and especially young men especially if they are also at risk of having lower testosterone for various reasons the enic effect can actually really imbalance a young man's uh testosterone balance especially if they're already at risk so just something to consider too for different populations and then lastly um these Proteus Inhibitors that you might hear about as antinutrients soy does have those as well although as long as you're cooking it and processing it appropriately you can probably process most of those things out of there if they do end up in there though they can't inhibit the enzymes that you need for protein digestion so that can be a challenge especially if you're already on a limited protein diet so the last thing here would be genetic modification actually it's the second to last thing genetic modification or GMO I think is an issue and soy is GMO almost globally in the United States it's actually hard to find soy that's not GMO it's also hard to find soy that doesn't have exposure to pesticides or glyphosate so soy can be pretty toxic from that perspective and so you have to make sure if you're going to consume it it's got to be organic it's got to come from a reliable source U and that can be hard to find you know so soy as a a mass-produced soybean and source of protein is probably pretty toxic and unfortunately something that most people need to avoid so a soy that answer right can soy actually help improve bone health and and for me I don't think it's the answer I think it's an answer it's a tool just like we have you know hundreds of tools that we use but it's probably not the best one in this group of phytoestrogens and isoflavones our team doesn't particularly love or recommend soy as a food to eat on a regular basis a little bit of soy is probably not going to hurt you but there are other ways to leverage this so we'll do follow-up videos on genestin on flax seed on other phytoestrogens because again there are probably better options than soy as soybean edamame Tempe soy soy milk Etc there are probably better options and something that you could easily take as a supplement to get the benefits potentially of phytoestrogens make sure that you're subscribed to this Channel and sign up for notifications if you want to be notified when these videos come out if you like this video as a review of the food product of soy and the phytoestrogens associated with it you might want to consider this video on estrogen levels uh this is something that I think a lot of women really need to know about if they're on replacement because not all estrogen replacement is the same and then this video on incorrect beliefs around HRT is a nice complement to that because there's a lot of misinformation around there uh out there rather around um HRT and hormone replacement therapy and estrogen so remember that an osteoporosis diagnosis isn't the end but deciding to reverse it is is a beginning I'll see you in the next video