Dr. Douglas Lucas

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736 appearances 1 recordings 1 series first heard Jul 2026 last heard 28 Jul

Dr. Douglas Lucas’s voice in public audio — every appearance, attributed to the second.

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Recordings per month over the last 12 months — 1 in all, peaking in Jul 2026 with 1.

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The Dr. Gabrielle Lyon Show · 5 Hidden Causes of Bone Loss (#4 Is a Shock) - Dr. Douglas Lucas · 28 Jul 2026 podcast

Because if you can't build bone, you inevitably end up with more dense, but potentially more fragile bone.

so there's some research coming out now that i really like the angle of which is looking at the order of these drugs if you're going to need a drug look at the order of the drugs that makes the most sense we know that if you start with an anti-resorptive drug and you suppress bone metabolism then follow it with the drug the anabolic drug that can build bone we know that that doesn't work as well because you've already suppressed the metabolism and these drugs stay in the bone for a really long time

So again, looking at this through bone metabolism, say, oh, well, let's start with an anabolic drug.

Let's actually build up as much bone as possible.

And then if you have to, then switch to something to maintain those gains.

So that's a different way of looking at it.

And this is a totally new perspective that endocrinologists are really just now starting to get on board with.

There really isn't a great one.

So probably CT.

Yeah, which is not a good screening tool and not something we want to do over and over again, right?

So yes, CT can look at strength, and that is good, except that I don't want to expose myself to a CT every year or a couple of years.

So outside of CT, DEXA doesn't look at quality at all by itself.

There is an add-on called TBS, Trabecular Bone Score, and that is a software add-on, so same input, so questionable output, but it can help to stratify at least poor bone quality, better bone quality than average.

And then there are other imaging modalities altogether.

There's an ultrasound device, which is kind of making waves in the wellness space.

And it reports to, and there's a couple of studies supporting the idea of looking at quality with ultrasound, but it's relatively new.

And I think the data is, let's just call it inconsistent.

So it is both, right?

It is both because we have these tools like FRAC's online risk fracture assessment tool that has tremendous data behind it using just the density plus other risk factors to help to extrapolate fracture risk.

So it is important, but it is missing a big piece of the puzzle, which is quality.

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