Dr. Jocelyn Wittstein

So if someone is having side effects or symptoms like breast tenderness or whatever, and they don't have it at 50 micrograms, but they do at 100, you're probably not doing them a disservice to have them at the 50 because...

So if you look at the 14 micrograms versus 25 versus 50 versus 100 in various studies, like the 14 microgram dose over two years increased lumbar spine bone density like 2.5%, which is on par with Avista, you know, similar amount of increase.

If you look at the 25 microgram dose, it does a little more.

If you look at the 50 and 100 microgram doses, you're seeing, you know, a five-ish percent increase as compared to two and a half percent with the Menostar.

So obviously dose matters.

But when you get to the 50 or 100, not that different.

As an orthopedic surgeon, that's my understanding.

There's nuance.

Yes, diets with less inflammation, reduced risk of fracture, you know, you need adequate calcium, magnesium, vitamin D, all those things.

Yeah.

So certainly I don't want to imply that you're never going to need a medication.

Like if you have osteoporosis and, you know, your FRAC score says you have a more than 3% chance of having a hip fracture in the next 10 years, like you should probably be on some osteoporosis medication.

What do all these things do for you?

Lifestyle versus medication or hormone therapy?

I do like to kind of just level things a little bit and think about, you know, what are your returns on investment?

So if we look at...

you know, the timeline for your effort and what you might get out of it.

If you're doing, like, let's say you initiate some impact exercise and, you know, over a six-month period, you might increase your hip bone density by 1%.

That's a six-month investment.

I mean, I think you should continue it, but you've got... So imagine that, 6%, 1%.