Sourcing Challenges and Final Recommendations

All right, welcome back to the Dror Doug Show where I am dedicated to educating you that osteoporosis is generally preventable and oftentimes reversible if you are empowered and able to execute with the right information Today we're talking collagen in collagen because a lot of you are using collagen for your bones. Maybe it's for your skin, for your hair, for your nails. You might be wondering whether or not this collagen is doing anything whatsoever for your bones. And that is a really good question to be asking I want to consider in this video, the clinical research that's available and the topic of sourcing because recommendations collagen are actually conflicting when you consider these two angles. The vast majority of products out there do not have good clinical evidence to say that they improve bones. There's only one product that has human randomized control trials. and we'll talk about what that one is. The other challenge then is that many of the products that exist also fail to disclose the source of their collagen. In today's world, that's a big deal because whatever that animal is consuming you're consuming So today in this video, we're going to talk about the actual human data. We're going to talk about the challenges with sourcing of these products and what we're using now If anything at all All right, so before I touch a single study, I want to talk about the biology. because If you don't understand why collagen could be helping bones, we don't really care what the studies say at all Remember, the bone is not just calcium. It's about thirty to thirty five percent by weight Organic matrix, What does that mean The organic matrix is the thing that gets calcified and mineralized by all the minerals and the majority of The organic matrix is actually collagen, specifically type one Cllgen When you look at commercial concrete, they actually put this metal in the middle of it, right? And it's called a rebar. The collagen is like the rebar in concrete. and it allows your bones to be both good under compression, meaning you push on it, but also under tension if you bend it. If you don't have that collagen structure, you don't have that rebar and concrete You've got brittle bone regardless of how dense it is So then this is why quality of bone is not the same thing as quantity of bone because quality requires the bone to have collagen in the right format and the right structure to be able to resist the forces that we put it through naturally So then collagen in theory is reasonable as a tool for bone because it provides two things that we need. Number one, the actual amino acids. It is a protein. so it provides amino acids that we need to build bone. Great But it also provides a peptide signal and you might have seen this in collagen products to say collagen peptides. Well, what is a peptide Pide is just essentially a short protein or a chopped up protein with an amino acid number. I think it's under forty. So people say under forty amino acids Either way, it's a really short protein And these collagen peptides can survive the digestive tract and potentially act as a signal to bone to build more bone, although that's theoretical And that's really important because the supplement industry would have you believe that collagen builds bone be true But the research doesn't really show that. Again, there are only a couple of randomized control trials on humans that have collagen as an intervention anyway Otherwise, we're really just going off of theory. We're going off of potential biology and physiology. But if you've heard me talk recently about these bone turnover markers, if you've been on my channel And you've heard me talk about the ability to look at what's happening with bone metabolism through blood tests, again, bone turnover markers, we can actually start to get a better sense of what's happening with collagen. and this may persuade you to either use it or not. The bone turnover markers that we talk about most frequently are P one and P and CTX If you're new to these things, I'll describe them briefly. I've got longer videos on them. Basically, P one and P is a bone building marker CTX is a bone breakdown marker. We can use these markers together to understand what's happening with bone metabolism. Are we building up more than we're breaking down or are we breaking down more than we're building up So now let's take that into the research So the study that most people cite if they're going to cite anything is this study from twenty eighteen from the researcher Konig K O N IG that's a little oom out over the O, that's the two dots thing. This was published in the journal Nutrients and it's a twelve month randomized placebo controlled trial on collagen Cool, right? It included one hundred and thirty one postmenopausal women with low bone density They had five grams per day of this specific product called forortabone. This is really important because this is made by the company, Jelita. Jileita did fund the study, which again is not wrong. You've probably heard me talk about industry funded research. That doesn't mean it's bad research. We just have to take it for what it is to funded the study. And their product is a specific collagen peptide, although they don't actually say what's specific about it It's called forord to bone. It's a bunch of different commercial products at five grams a day. And I want to show you this graph. So when you look at the bone turnover markers, you actually see what you really would want to see if you're thinking that this is good for bone What you can see here is that P one and P went up. It didn't go up a ton, but it went up enough to be statistically significant And the CTX essentially held stable in the collagen group. So what does that mean? That means that for the group that took collagen, bone building went up b breakdown stay stable. What does that do for our ratio? That does make it look better. So this is promising. Now in the placebo group, the non intervention group The P one and P essentially stayed the same and the CTX went up. So what does that do to our ratio? It makes it look worse. It makes this look like they slipped into more bone building. Now why did they change at all? I don't know So that's kind of cool, right? You would expect, then, based off of these bone turnnament markers that we would see an improvement in bone density Let me show you what we see. So what you see here then is on the left on the lumbar spine You can see that the placebo group is in gray, the forer bone group is in blue and you can see that indeed, their lumbar spine bone mineral density did go up. In fact, they went from just a little bit below osteoporosis to above osteoporosis Not a huge shift, but again, statistically significant And you can see that the placebo group got a little bit worse, which is what you would expect to see in twelve months over the course of that time in a postmenopausal osteoprotic group, you would expect them to get worse Now the femeral neck data looks even better, right? So the femeral neck data Essentially, they started the same. and you can see that again, placebo got a little bit worse over the course of the next twelve months. And you can see this pretty, I don't only use the word dramatic, but significant improvement and femeral neck bone mineral density in the intervention group with collagen So this is pretty good data, right? I think that many people are taking colleagen f bones because of this study. But here's something that most people are going to miss. And it's not that it's industry funded That just is what it is. Maybe there's bias there and maybe there's not. But there's actually something missing here that we need to talk about So remember when we look at research, we always need to ask questions. We need to ask questions about who They were studying, is this person like me? For example, if I'm thinking this is interesting for me But who are we studying in this study and what condition are they in So we have some information here, right? We already said they their postmenopausal low bone density. you can see that their bone density was a little bit below osteoporosis. So this is actually a group that started with osteoporosis, which is actually pretty rare in the research. All right, so let me just talk about these absolute numbers of bone turnover markers. And we're going to talk about how we look at these numbers a little bit here because this is really, really important. All right So let's just talk about the for bone group, the group in blue So you can see that they started with a P one and P of thirty three. That's pretty low. Let's tred with a CTX of eighty one. That's pretty darn high. So this is an interesting group, right? Because actually I think I have this calculated here. The ratio is forty one And If you've heard me talk about the numbers and the ratio, our goal is to get you between That's kind of like one hundred thirty and two hundred somewhere in that range forty one is really suppressed bone turnover. So what's interesting here is you have a group of women who are in a really suppressed bone turnover state, like really suppressed. And this is a relatively important group to study, sure But the question you need to ask yourself as a consumer is am I in this group? Does this represent me So you know, most of our Austio collllective members, for example don't have bunk turnover this low, right? They're actually at a much better starting point. So then would college be good for them? Well, we've got some data on that. All right, so we've got another study to look at. Now this one was in twenty twenty from the Journal of Musculoskeletal and Neuronal Interactions Using for to bone again, same collagen, same five gram dose, in postmenopausal women. But three big differences here. Number one, these women had osteopenia and osteoporosis, so low bone density, not actually a T score of less than negative two five The spine T score averaged negative one point three Their baseline turnover was four times better. P one and P was on average sixty, CTX was on average thirty eight, not eighty one Right? orr three hundred and eighty, not eight hundred and ten. That's a ratio of one hundred and fifty seven. That's actually meeting our threshold and criteria for healthy bone turnover And these women were also given calcium and vitamin D, and then the quote unquote placebo group or the control group were given calcium and vitamin D as well. So this is a very different study, a very different group. What they see? Well, the bone turnover markers don't even look the same Right? P one and P actually went down. Now is it because they started so high I don't know But had a thirteen percent drop in the building biomarker Now CTX also went down. that much The ratio It's not the same. So what does that mean? Does that mean that there is no benefit Not necessarily Maybe it's because they had a better starting point and they didn't actually need it So if you're actually in a good starting point, maybe collagen isn't going to be the answer to help you to maintain bone loss So I prepared this little graph just to help demonstrate how significant these numbers are. What you see here is on the left, We have the bone turnover ratios from the Konig study, right? So you've got the control group in the orange, you've got the intervention group in the red compared to then the ratios in the twenty twenty study, right? So now you have blue and the green, blue being the intervention group with Fordab bone. in the green being in the control and you can see how big a difference these are, right So healthier starting point. What was the benefit of collagen? There wasn't much. So then does that mean that collagen's only good if you have osteoporosis and not if you don't? Well, not necessarily, because we can see the same bone turnover marker ratios in people with and without osteoporosis. We see it in women with good bone density who are losing bound and we see better ratio in women sometimes who have osteoporosis who are improving their bone density I think it has to do with what needs to be done, not necessarily what your T score is And then I have a little summary here of some additional research and I'll link to all of these, but I've got one, two, three, four, five different studies here all looking at bone turnover markers and collagen Now these are not fortabone. These are actually different forms of collagen, different types of collagen picture here is None of them really seem to show anything not a significant increase or decrease in the bone turnover markers or the ratios. Maybe one of them had bone mineral density There was not a really interesting or significant finding in any of these studies. So again, the only study that really shows it is the Konic study from twenty eighteen with Fordabone. And this was in a population who was in a relatively bad starting point So then the last part here is sourcing You could make an argument that you want to follow the research and I only want to use collagen from Jelita because the research shows that it works That's totally reasonable. But something we always have to remember with animals or plants. is that However they're raised will impact not only the nutrients, but also the potential toxins. When it comes to animals we consonsuming when it comes to collagen, the hide and the bones, the hide and the bones can bioacumulate pesticides, herbicides, heavy metals, antibiotics. whatever, growth hormones, solvents from processing, all these things can be in the actual collagen and it bioocacumulates, meaning it actually gets built up in there. so you're actually getting a bigger dose of it. We see this in other supplements, especially protein powders with heavy metals because it can build up in animals and then it's processed and then it's further intensified in the actual supplement. In my opinion, we need to get it from a clean source and it needs to be tested. Jileita talks about where they get it from They talk about their suppliers come from meat processing industry with veterinary inspection complying with EU regulations. That doesn't mean anything to me. They don't talk about farm level sourcing transparency. They don't have a certificate of analysis showing for any kind of heavy metal, pesticide or solvid residue testing on the finished collagen product. There was a twenty twenty study that looked at colloagen supplements and found sixty four percent contained arsenic, thirty seven percent contained lead, thirty four percent contained mercury seventeen percent contained measurable cadmium And this was across major brands So now we have a challenge. What are we going to use Are we going to use the product that has I'm not saying it's bad, but it's an unknown source with no third party testing, no certificate of analysis or Do we use a product that doesn't have the research behind it, but is sourced better And the last thing I'll say about the Fordabone product is they describe it as a quote unquote specific bioactive peptide. They don't actually say what that means. They've never actually disclosed what the amino acid sequence is or why it's special or not special. So I don't really know what makes this different But I do know that I don't know where they source it from. So What are we doing now? Well, if people want to take a product with forward bone in it, that's fine. And we have products, we use full script, different manufacturers, products that we recommend to people that have forward bone in it because many people want to follow the research. I'm a fan of following the research But I'm also a fan of eating clean and eliminating as many contaminants in our food source as we can. And this is an area of concern for me. So some of the products we talk about like NBI products, for example, They get it from manufacturers that are very specific about where they procure their animals how they're raised, what they're exposed to and have a third party testing for heavy metals and other contaminants and provide a CTA to the manufacturer. CTA means a certificate of analysis. So for me, that's where I'm putting my money, a product that doesn't have the research behind it to show that it works But I can't say that it's any different than the product that does have the research behind it And I can verify the sourcing So I hope that makes sense. I know there's a lot of discussion around collagen. I personally use it. I do recommend it to all of our clients and patients because I think it's good for our health. I think it is something that is valuable for skin, hair nails probablyro for bone probably for other things too. It's a source of protein, it's a source of amino acids and it's easy to consume. I put mine in coffee with some cream and it's absolutely delicious. So I hope that helps. Remember that life is about making memories while we're strong enough to make them