Walking Isn’t Enough: The Best Exercises to Increase Bone Density

In this episode of Hormones and Hope, Dr. Chhaya Makhija sits down with physical therapist and Onero-certified specialist Dr. Robert Pauline to discuss one of the most common concerns among women and aging adults: low bone density.

From osteopenia and osteoporosis to muscle loss, falls, fractures, and strength training, this episode dives deep into how evidence-based resistance training can help improve strength, balance, confidence, and even bone density. 

Dr. Robert shares insights from the groundbreaking LIFTMOR trial, explains why walking alone is not enough to protect your bones, and discusses how properly supervised strength training can completely change the trajectory of aging.

You’ll also hear practical advice on how to safely begin lifting weights, why balance and foot stability matter more than people realize, and how younger generations are already showing signs of poor bone health due to lifestyle habits, low-calorie diets, and inactivity.

Whether you’re in your 30s, 50s, or beyond, this episode offers practical insight into how movement, resistance training, nutrition, and consistency can support lifelong bone health.

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LIFTMOR Trial 

https://pubmed.ncbi.nlm.nih.gov/28975661/

Disclaimer: This podcast is for educational, informational, and entertainment purposes only. It’s not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider for personalized guidance.

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Transcript

SPEAKER_01 0:00

Welcome to a lovely episode on Hormones and Hope. This is your host, Dr. Makija. And today I have a very important guest, especially my uh patients who have low bone density, osteopenia, osteoporosis. You can't miss this episode because I have a guest who is a physical therapist who has a doctorate degree and also is uh onerocertified. You'll get to know more about what this exactly means. But a physical therapist who has a doctorate who is also trained in helping you build your muscle, build your bone strength, and there has been enough evidence that by doing so, we can see improvement in bone density. So without further delay, it's my pleasure to introduce you to Dr. Robert Pauline, who is a physical therapist in Central California. And he's got an amazing clinic called Robert Pauline Hands-on Physical Therapy in Fresno and Clovis, California. I've personally visited, it's a phenomenal place to be. Welcome to Common Podcast where we brought science and helped to help transform your health. I'm your health out of the works. Or you can call me Dr. Cham. Triple Board Certified Endocritic Medicine. Each week we dive into the powerful intersection of clinical medicine and real life lifestyle strategies to help you feel strong. Live longer and show up as the most vibrant self inside and out. So let's get empowered.

SPEAKER_00 1:39

Yeah, we are so honored to work with patients in the Central Valley. I had a a close friend of mine a couple years ago come to me and tell me, I have a problem and I need you to help me solve it. And she announced her menopause and kind of put this problem in my face. It was uh the fact that she was worried about her bone density. She was a drug rep for some of the bisphosphonates and anti-resorptive drugs for many years. So she knew all of the risks and some of the risk benefits to those drugs, and she came to me and said, You're gonna be my guy. And she put this uh challenge in front of me. And it really did sort of turn upside down the way we've been dealing with osteoporosis in the past. So I'm a licensed physical therapist with a clinical doctorate, so it's a DPT, and I'm also an orthopedic certified specialist. I believe that physical therapists are uniquely qualified to uh to work in the space, but it's it wasn't a space that I had been in until Carol, uh my high school friend, came and just challenged me to help her.

SPEAKER_01 2:55

Okay, okay, very cool. Well, I'm excited to have my audience as well as patients hear more about this. And if someone's watching on YouTube, they'll be even um able to meet you if you had to reach out to Dr. Robbie. But you know, before we dive into our usual QA and rapid fire, uh, Dr. Robbie, if you can, in maybe a couple of lines tell us what is this Onero program that we are talking about today before we get into the nuances later on.

SPEAKER_00 3:26

Sure. The Onero program was born out of a study called the Liftmore trial in 2018. A bone researcher set out to try something different for people with low bone mass, and they started treating osteoporosis patients like athletes, and they, under really close supervision and proper training, started doing intense resistance and impact training. This is a high-intensity resistance and impact program that uh carefully screened individuals can participate in. My mantra is to start low and go slow. And so before anybody ever picks up weight, we work on foot stability, balance, strength, get to know their joints, their soft tissues. A lot of our patients have post-menopausal musculoskeletal syndrome, pain in their elbows, knees, hips, or they have a history of back pain. So we start slow and we build up gradually to the point where several of our patients are now deadlifting their body weight. And so it does eventually end up being heavy. And um, that's something that uh is really amazing how the body adapts and how these people who are new to weightlifting can learn the skill and develop the ability to pick up heavy weights.

SPEAKER_01 4:58

Yeah, absolutely. As endocrinology and you know, in in this lifestyle medicine world too, we've been focusing on uh muscle, on building it and uh more strength training also for insulin resistance, for reducing the diabetes complications or even getting diabetes into remission. And of course, the other metabolic uh conditions that also we see an improvement. But the other aspect is, you know, with the era of uh weight loss medications, even though we've had it for 20 years, but you know, with the media bringing it in, if there is significant weight loss, there is going to be more bone loss or lean body mass loss. So in these patients, they have to like really be trained in regards to how to work on your muscle, how to improve the strength, and also build that extra muscle fiber so that you don't lose muscle and don't lose bone and don't have future uh low bone density. So, what discussion we're gonna have, I feel it's gonna be in the realm of lots of other conditions and health rather than only individuals or people uh dealing with low bone density.

SPEAKER_00 6:04

Yeah, absolutely.

SPEAKER_01 6:05

So, Dr. Robbie, we'll start with a rapid fire. This is just more fun for one-liner or one-word answers, and then uh we get to really learn about the strength training or how you approach uh patient care in terms of uh helping them to get stronger. You ready?

SPEAKER_00 6:22

Let's go.

SPEAKER_01 6:23

Number one, true or false, low bone density is only a concern for older women.

SPEAKER_00 6:29

False. I'm uh as an older man, I'm offended.

SPEAKER_01 6:33

I love that answer. All right. Number two, can strength training actually improve bone density and not just maintain it?

SPEAKER_00 6:41

Absolutely.

SPEAKER_01 6:43

Walking. Walking alone is enough to prevent osteoporosis.

SPEAKER_00 6:46

Big fat false.

SPEAKER_01 6:48

Thank you very much. Number four, does improving muscle strength and balance significantly reduce fall risk?

SPEAKER_00 6:56

Yes.

SPEAKER_01 6:58

All right. And one myth about low bone density or osteoporosis, false aging that you wish people would stop believing.

SPEAKER_00 7:07

That it's a normal part of aging. It's not normal.

SPEAKER_01 7:10

Sweet. Absolutely. Yes. We get younger with you, Dr. Robbie. So you have the miracle mantra here. I love it. I love all the answers and uh completely 100% with you on those. Okay, so where do we want to start? You told us about the Onero program, but can we get into more details about the lift more clinical trial? And I can give you some background. You know, we have patients with um, you know, uh osteopenia or osteoporosis, and many individuals with severe osteoporosis. And we have certain ways to prevent. We have uh guidelines telling us that weight-bearing exercise or, you know, working on strength training will help you to build bone. We have hormone replacement therapy to prevent osteoporosis uh in individuals who have low bone density in women. And then we have medications, pharmacological medications, which either you build bone or you just preserve what you have. There are always questions that what can I do naturally? Which is, you know, always a question from patients that can help me. And this is where I stumbled upon, I think it was Bone Health Osteoporosis Foundation, where they talked about the liftmore trial. And that intrigued me. That's how I went through uh this website or Nero program and discovered that you were uh one of the certified uh teachers in our neighborhood, and that's how we met. So, can you break it down in terms of if you want to start with the actual trial, like what was done to see the results for those patients, and then about how you approach your patients?

SPEAKER_00 8:51

Sure. I hope it's okay to just take just a little side route and talk very briefly about anabolic resistance. You mentioned earlier in metabolic syndrome, we see insulin resistance. As we age, we see anabolic resistance or just the body's sort of resistance to growth. We sort of believe that breakdown happens slowly over time, and we have these metrics as far as how much muscle mass you can expect to lose over time. And so one of my biggest hurdles is going to be anabolic resistance. And there's certain ways to signal growth in the body. You mentioned a couple of them: nutrition, medication, the lifestyle activities, and then obviously exercise. And so when we're taking somebody and trying to create an environment for them to grow something, whether it's muscle mass or bone mass, you have to get a really clear picture of where they're starting. And so the Lyftmore trial did a very good job of screening out complications because they didn't want to have to deal with people with arthritis or back pain or you know, prior history of fracture. And so the Lyftmore trial is a group of very healthy women and a few men who happen to also have low bone mass. So the inclusion criteria in the study really screened out for some of the things that I deal with every day. And so I'm very cautious to say, okay, this worked for these 49 women or 49 participants, so it's going to work for all my patients, right? So the Lyftmore trial had 101 participants, 49 lifters, and 52 in the control study. The control were people who were advised to walk and lift light weights for 30 minutes, two to three times a week. The participants in the study were supervised and taught some very specific compound movements. And these would be very similar to Olympic weightlifting. And they were taught how to do them safely, supervised every session. This was not a learn how to do these lifts and go do them on your own. They had eyes on them in groups up to eight people, and they lifted weights for about a half an hour twice a week for eight months. And they really wanted to do a year, but the study had some limitations in funding, and so they did eight months and then retested uh bone mass, they retested muscle mass, and then some functional measurements for balance and fall risk. And just across the board, they saw remarkable improvements in every one of those domains. Also, because the control group lost over eight months, they lost a little bone, they lost a little muscle because what they were doing was not building, and so just over time they lost. And so you you have some high percentages, but you have to remember that it's also the those numbers of improvement account for the loss in the control group. So when somebody goes and gets their DEXA scan and they say, well, this this trial showed 3% improvement in the lumbar spine. Why did I only have one or two percent improvement? You're comparing yourself to yourself, not yourself to a control group. So we have to just help patients sort of have a realistic expectation of what they might expect to happen with their testing. But we typically see um significant improvements in balance, single-limb stance, tandem walking, functional reach, sit-to-stand. Uh, we see improvements in those uh measurements regularly, and we're not running off and getting repeat DEXA scans every six months. Like that's just not how how you work clinically. But those that have had repeat DEXAs have shown significant improvement. One of our most favorite um lifters had a 7.5% improvement in her lumbar spine and hip. Uh, she is on an anti-resorctive drug, but had been on that for a long time, and her numbers had kind of been pretty flat. And so it was maintaining, but I kind of ran off with that response. Is there any element of the lift more trial you want me to double-click on?

SPEAKER_01 13:39

No, that's pretty robust in terms of the way you describe. And I really loved what you said about the realistic uh expectations and the the you know, the aging process of the muscle and the bone. You don't use as much. There is sarcopenia bound to happen, especially in the 70s, 80s, 90s. And same thing with bone. We tend to lose bone after we've achieved our peak bone mass in our early 20s. And though, and you know, that cannot be prevented, but it can slow down with what you're sharing with us. And, you know, if someone has, say, no bone loss and they're getting uh, you know, day one bone density, and again in two years, but they are building muscle, they've improved their balance, they're you know, performing like uh what you were mentioning about strength training, and they don't have any bone loss on bone density, that itself is positive because they did not lose anything relevant to the age. Yeah. So the realistic expectations and you know, educating the patients in terms of what they're going to accomplish was uh very well um said. And uh can you share any um other patient experience that you've had in terms of how do you start? Like say I'm 65-year-old female and I've just learned that I have either osteoporosis or severe osteoporosis in the spine, and you know, numbers are kind of similar in in the hips. And, you know, I'm going to be on a specific medication, but you're trying to help them start. They only are good with walking and maybe taking care of, you know, daily home chores, climbing stairs. But other than that, they've never been to the gym, they've never worked out, they've never lifted anything heavy. How would you start someone on this journey?

SPEAKER_00 15:20

Yeah, it's a lot of fun to take a brand new lifter or someone who's just found out about an osteoporostic diagnosis and bring them in and just sort of wrap our arms around them and help them to see that we have a plan and that we are one piece of a comprehensive approach to their bone health. I don't try to play family physician, I don't try to play endocrinologists or even nutritionalists, right? Uh I just I'm happy to play my role. And so one of the first things I do is have people take their shoes and socks off. I want to see what I'm working with. If they're gonna pick up some weight, I need to get to know their feet. And so I get to know their feet, their big toe. They don't know what I'm maybe I shouldn't spoil it here on this podcast. But when they stand up and down out of a chair, what does their big toe do? Is it sticking up in the air like a little antenna, or is it to the ground and providing stability? I'd like to see how their knees move. Do their knees come together? Do they have strength to get out of a chair? Is there pain getting up and down out of a chair? So one of our very, very first tests is how many times can you stand up and down from a standard chair in 30 seconds? If you're under 10, you're in trouble. Usually our 60-year-olds, between 60 and 65, somewhere between between 10 and 15, sit to stands is normal. If they're over 15, I think, okay, I can move this person along a little bit quicker. Then we look at single-limb stability. How do they stand on one leg? Under 15 seconds, they're in trouble. Over 30 seconds, I can probably move this person along a little bit quicker. Then I look at heel-to-toe walking over the course of six meters. If they're under 20 seconds, I'm thinking I can work with this person and move them quicker. If they're over 20 seconds and they have stumbles and a lot of missteps, then we're gonna have to start a little lower. And then I look at a functional reach test. How far can we reach over their base of support without losing their balance? Under 12 inches, we start a little bit lower, over 12 inches, we move a little bit further. And uh obviously that is after a very thorough medical screening. We'll look at their medication history, I'll look at their supplements and see what they're taking, how often, their compliance. I'll talk about nutrition. If they're not tracking, we'll ask them to start tracking protein intake. And then we talk about their orthopedic history, surgeries, injuries, chronic pain. I will probably palpate in the usual areas where uh where problems exist: elbows, hips, knees, feet. I'll look at the spine, looking at uh any potential uh modifications we have to make if they're kyphotic. We measure kyphosis with a really simple test, and we get a really thorough baseline. I'll often get a body mass index and measure lean mass using bioelectrical impedance and just get a really solid uh starting point. So that's the first visit, sometimes first and second visit, depending on how long their medical history is. So that's my true starting point. And um then in subsequent visits, we really start to reintroduce people to their feet. We like to put our feet in tight oven mitts and ask them to do complex things like walking and stabilizing. Our shoe wear in this country is mostly horrible. I do have some various patients who come in in a barefoot-style shoe, and they're always going to perform way, way better than people in their Nikes or underarmors or other traditional shoes. So we typically will have people start several of their exercises barefoot, if possible, if there's a complex history there at the foot, and then we work we work with that and we work around it. And then we're teaching a very important concept called the extensor moment of the spine. How to maintain a spinal neutral while hinging at the hips. So we we really get to know their body awareness and give them lots and lots of visual feedback. We we move with PVC pipes for weeks before we ever pick up their first weight. And a lot of it is slow, but people appreciate that. It's very refreshing when people aren't frustrated at the slow process. They they almost always thank me for taking my time and not rushing it along. So the beginning stages are technique, technique, technique, body awareness, stability training, and we start to introduce a lot of balance activities in that early stage as well.

SPEAKER_01 20:55

This is very important that you mentioned, you know, I'm from India, and that's where we learn yoga. And uh, you know, while I was here, Fresno, you probably know Audrey Tan, but she used to be my yoga teacher for a long time. And uh the concepts of you know, your foundations and you know, making sure there is enough room in between your toes, and you know, how do you make sure that you're able to wriggle every toe and your balance and you know, how are you standing, your posture? You know, when we grow up, it's like, what the heck? This is not exercise, it doesn't feel right. But over time, as I became a physician, and then of course, things coming back, and now I am learning it over and over again, that these simple foundations are technically simple, but they're the ones which are helping us ground. And then you're building on the, you know, the actual strength part of it, but the posture, the stability that you talked about, because that's going to help us prevent fractures, prevent falls. But you know what? I thought while you were expressing all this that this is not just needed for the that 65 year old female that we were talking about. I feel Each adult, every person uh needs that exposure and understanding and expertise that can someone assess me how I'm grounded when I am standing? And I see most of them are not. And I so agree with what you mentioned about us wearing closed boots and limiting that or worsening our foundations. So, do you talk to your young adults about this?

SPEAKER_00 22:24

Oh, yeah, for sure. In fact, the the being certified in Onero has really changed the way I even work with young athletes. One of my favorite uh young ladies that I have had the privilege of working with after an ACL injury, she's 15 years old now. She's been with me for about a year. She had a complex ACL rehab and was still very weak eight months later. We're teaching her these same principles, and she is now doing compound lifts with symmetry, she's jumping and there's impact. Uh, she wasn't going back to a sport, but we're treating her like an athlete and um absolutely uh translates into the young. You know, you you mentioned uh that there's a peak for bone development. I would love to hear you speak a little bit more about how a young teenager, especially maybe one at risk for osteoporosis, what they might do as as an adolescent to build the most bone, so they're starting off at the highest possible lean mass. Any thoughts on that?

SPEAKER_01 23:40

Yeah, yeah. See, yeah, I'm an uh adult endocrinologist, but I can tell you about pediatric bone age too. You know what in this era, what we're seeing is our adolescent age group, uh both uh girls and boys, there is this trend of being pin. There's a trend of you know, eating disorders which is dramatically increased. And I see more and more boys, like 16-year-old, 18-year-old, presenting with these or being referred to me for these symptoms, some other hormonal disorder that they are getting evaluated by me. But when I'm digging into the deep depths, it's like low caloric intake. And all of these individuals, after looking at their biochemical evaluation or labs, I get a bone density scan for that young adult. And I'm surprised to see, you're not surprised, but I would say shocked to see that they've probably been in that low caloric deficit for a few years during their building period. And that's leading to, you know, that abnormal bone density. It's also called as female athlete triad, which we were seeing only in women. Again, athletes, runners, their energy expenditure is higher than the caloric intake, and that's where we see low bone density. But now I've started seeing in the last eight, nine years more boys. And this is also wetted by, you know, I've had a few interviews with psychiatrists, ADHD specialist, a pediatrician actually interviewed on our podcast from San Francisco, and she's been noticing that trend as well. So in those individuals is what I think it's a lot of is is the caloric deficit rather than true hormonal abnormalities, which can happen, which is a disorder and can be treated. But that caloric intake versus energy expenditure has caused poor bone development. So they cannot reach their peak bone mass at that age. The second one is the lifestyle. So, like at UCSF, that is a pediatric clinic, and even at Valley Children's, you know, the the rates of obesity is a massive, especially the incline and incidence in uh young kids or kids and adolescent age period. And they're getting diagnosed with early onset type 2 diabetes, obesity, you know, complications related to it, high blood pressure at age 12, 13. And obesity itself is a risk for low bone density. So two uh separate extremes, technically, right? One is a low caloric deficit, the other is uh the lingering obesity because of our environment, lifestyle, biology, but both of them impact the peak bone mass.

SPEAKER_00 26:16

Yeah. I think it's super important that we teach the maybe the grandmas and grandpas that might be listening to you just how important it is for their children to develop as much bone mass as they can in their in their growing years. I see a lot of single sport athletes, you know, kids that started swimming at a young age, and that's all they do, be at a disadvantage if uh if the land training isn't there or the resistance training is not there. So it has been fun to incorporate some of these principles into our rehab for these young athletes that I see.

SPEAKER_01 26:55

Yeah, that's impressive. Because they're getting their foundation laid and they're getting stronger. So, Dr. Robbie, if a duration, right? Like because we started with the lift more and the Monero program and why it's important to just get started, but with the right expertise rather than doing it yourself in terms of understanding your posture balance, building muscle. What do you tell your patients or your clients when they're under your supervision, learning to get better in terms of their strength, their probably weights and their lifting heavier as they go along? I wanted to ask you to clarify this because a trial was eight months, but this is something lifelong. So how do you have those conversations with your patients?

SPEAKER_00 27:41

Yeah, I just make sure they understand on day one what my intentions are. My intentions are to have a long-term supervised program. We'll hopefully take it as far as the health insurance will allow. And then when people find value in it and they want to continue, we have monthly memberships. But this really is a program. It's really surprising how much troubleshooting we have to do, even eight months a year into the program. I have people that come in after a vacation or after, you know, cleaning the garage, and we have to modify everything for a couple of weeks and make sure that they're, you know, allowing recovery time. And so being under the direct supervision of a physical therapist accounts for all of those little hiccups in life. When you have a long long-term relationship to exercise, you get really good at modifying and figuring some things out. And that's hard to do. Most people just stop. And so there is that long-term element, and it is a technical program, and so you should plan on having eyes on you and um somebody there to program, to modify, to advance when you're ready. Not when you think you're I had one of our uh favorite lifters, she was so excited, like gung ho, and she wanted to progress, but she was not getting adequate protein intake. And I said, I am not adding weight to your deadlift until you get your you hit your protein goals for four weeks in a row. Because I'm gonna be breaking down and you're you're not gonna be replenishing and rebuilding. And so she hit her protein goals, and we we've added weight to her deadlift. There's a lot of people who are motivated by that number, and we do have to pull in the reins a little bit sometimes. These are motivated people who are trying to do something that takes a lot of work, and so the they kind of self-select into this program, and they're usually go-getters. I've got a couple that are uh maybe they wouldn't describe themselves as that, but after a while they get a taste of that accomplishment, that confidence that comes as you build a new skill. So it is a supervised program. Our intention is not to show you what to do at the gym. It is to have eyes on you, to be part of a long-term relationship and program. And they form these bonds, and the lifters uh and the participants have become friends, and they try to it's a lot of fun to see these uh participants interact and just support each other. It's a beautiful thing when they're there supporting each other.

SPEAKER_01 30:36

Yeah, you're building a community also, you know, that's so important.

SPEAKER_00 30:41

I feel like the fly on the wall sometimes when they're all together and having having a good time.

SPEAKER_01 30:46

Yeah, no, that's that's amazing. Any last-minute wisdom, thoughts, insights that you would want to give to the audience, including our male audience.

SPEAKER_00 30:59

Yeah. You know, I've seen the extremes in my family. My mother passed away at an early age, and because of her cancer treatments, she had fragility fractures in her pelvis. And I saw just how that really impacted her quality of life there at the end. And then my grandmother, her mom, is still alive at 102. And I see just how important um her bone health is. She's fallen many times and has not fractured, thank the Lord. And um, so seeing these extremes, I think we do have a lot that's not in our control. Mom didn't have the ability to uh to lift during her cancer treatments, uh, but my grandmother has stayed very active and uh learned a lot from her. We have a lot of control um in many cases. And um getting the right help and having the right coaching, someone that's trained perhaps in this Oneero program, or perhaps in other ways. This is not the one and only way to build muscle mass and bone density. Uh, it just happens to be one of the best uh research methods, and that's where I I want to be. That's my space. But consistency is probably the secret sauce, and uh not treating yourself like you're fragile. Even we have had patients with fragility fractures just standing on the pickleball court and the femur broke. Long, long history, complex history, but she's here and she's moving and squatting and lifting, and it took a long time to get to know her well enough to even put a little bit of weight on her back. But now she's lifting 22 pounds across her back and shoulders and doing amazing. Big shout out to Linda.

SPEAKER_01 32:58

Yeah, impressive.

SPEAKER_00 33:00

A lot is within our control. Get the proper help, the supervision, try not to DIY your bone health. Talk to the experts like Dr. Chaya, find someone that can help you with an adequately dosed exercise program. We under-exercise, and for years I exercise these people afraid, more covering myself and not wanting to hurt somebody because we've all heard the stories of the lady who broke a rib when she coughed, you know, or putting on compression socks broke her spine. I have people coming through. Over the years, I've been a little reluctant to load these folks. But the Onero training really gave me the confidence and the screening, gives me a lot of a lot to go off of so that we can make an appropriate dose program uh based on their starting point and where they want to go.

SPEAKER_01 33:58

Yeah. You know, the funny thing is I just recorded a a podcast on, you know, dose escalation for a certain medication. And here you go, you're talking about, you know, the exercise part of it, but it's also a dose escalation of the weights or the training or the movement that you're helping your patients and then building on it. And it needs the expertise. It cannot just be done, do it yourself or DIY, like you mentioned. So these are all gems. Thank you so much. If you can share your website or your phone number contact, uh, you know, we have lots of individuals listening who reside in Fresno Clovis. That would be really helpful for them too.

SPEAKER_00 34:36

Yeah, you are a bit of a celebrity here in the Central Valley, Dr. Chaya. Anybody I talk to in the space, they know you and they respect what you're doing. Thank you for being an expert and for staying in the Central Valley. We hope we can keep you here for a long, long time.

SPEAKER_01 34:52

Oh, absolutely. It's it's my community. And now we have, you know, we we know each other. So we build on prevention, we build on making everyone stronger. I think it's what, Robbie Pauline.com for your website. Okay.

SPEAKER_00 35:05

Correct. I'm just why Robbie with a why, Robbie Pauline.com. And um we're located here in uh Fresno on Willow and Herndon. Our phone number is 559-257-3991. Drop in, say hi, take a tour, come and watch. We've got a pretty open door policy if you want to just come and see what's happening here.

SPEAKER_01 35:29

There you go, people. You get a special invitation. So check it out. Really wetted, and uh, I love evidence-based science at professionals like Dr. Robbie. So I really appreciate all the insights today and uh hope we can help more patients and collaborate more. Thank you so much.

SPEAKER_00 35:45

Thank you, Dr. Chaya. Much appreciated. Thanks for your support and interest in what we're doing.

SPEAKER_01 35:51

Of course, likewise. Thanks for hanging out with me on Hormones and Hope. If you've loved this episode, do me a favor, hit subscribe, share it with someone you care about, and drop a review if you're feeling generous. Want more tools to support your hormones and health? Head over to unified endocrine care.com. We've got free guides, resources, and more waiting for you. Until next time, stay curious, stay kind to your body, and keep your hormones happy.