Dr. Alan Whitfield

9g Collagen with Calcium, D3, K2 and Magnesium

If you've taken a calcium pill every morning for years and still lost an inch, I want you to see what a 91-year-old farm widow showed me in her kitchen. Her bone fought my drill like a 40-year-old's. The 63-year-old two rooms down had taken calcium for 12 years, and her screw spun. Let me back up. I'm Dr. Alan Whitfield. I'm an orthopedic trauma surgeon, 26 years. I still take the 2am calls. When an older woman's hip breaks in our county, she usually ends up on my table. I already know what her chart will say. It always says the same thing. Her name was Vivian Toller. She was 63. She came in the same week in March as the farm woman, two rooms down the hall. Age 51. Menopause. Patient asks about her bones. Doctor's notes: take calcium. Walk. Age 55. Patient takes a calcium tablet twice a day. Joins a walking club. 4 miles, 3 mornings a week. Doctor's notes: doing great. Age 58. Wrist fracture. Caught herself in a wet parking lot. Cast, 6 weeks. Age 61. Bone scan shows thinning. Doctor's notes: increase calcium. Keep walking. Age 62. Lower back ache that won't quit. Down an inch in height. Doctor's notes: probably arthritis. Age 63. Patient does not walk into the next appointment. She stepped down from the walking club's van in a church parking lot. A step of maybe 14 inches. Her friends in their matching blue shirts heard the crack before she hit the asphalt. Everything right. 12 years of everything right. If any line of that chart sounds like yours, keep reading. Her films explained every line of it in under a minute. The femoral neck snapped clean across, like a breadstick. That's the van step. 2 vertebrae collapsed onto each other like wafer cookies somebody leaned on. That's the lost inch. And bone that had been thinning for years without one day of pain. That's the scan nobody answered except by saying the same word louder. Calcium. I took Vivian to the OR at 7 the next morning. There's a smell when you cut bone. The saw whines, and the air fills with something like burnt hair and a dentist's office. After 26 years I can tell you what kind of bone I'm in by the pitch of the saw. Vivian's bone barely made the saw work. When I drilled for the first screw, the bit dropped through her like stale cake. I seated the screw and turned it, and turned it, and it never bit. It spun in the hole like it had been driven into wet sand. Gloria, my scrub nurse of 11 years, handed me the next size up before I asked. She knows the sound of a spinning screw as well as I do. The bigger screw barely held. So when I got paged that Thursday night for a 91-year-old woman who'd fallen off a hay wagon, I knew exactly what I was going to find. 91 is nearly 30 years past Vivian. Her name is Hattie Brennan. Widow. She and her husband ran a 60-cow dairy outside town for 54 years. Her grandson runs it now. She still feeds the calves every morning. She'd been climbing down off the back of the hay wagon at dusk with a bucket in one hand. Her boot caught the step. She dropped about 4 feet onto the concrete floor of the barn and landed square on her left hip. 4 feet. Onto concrete. Holding a bucket. At 91. Vivian broke hers stepping off a van. Before surgery Hattie looked at me over her glasses and said, "Is this going to take long? The calves don't know I'm in here." The saw pitch was wrong. Higher. It labored. Gloria looked up at me over her mask. When I drilled for the guide pin, the bit bit. It climbed. I had to lean my weight into it, the way I do in a 40-year-old roofer who came off a ladder. I seated the first screw and turned it, and it grabbed, and it kept grabbing, and it locked down so hard I felt it in my shoulder. Her bone fought me. "Read me her age off the board," I said. Gloria read it. "Ninety-one." I keep a notebook in my desk drawer. I've kept it since 2004. Every patient over 50 I operate on after a minor fall, the age, and what the bone felt like under my drill. For women over 80, almost every line says the same 2 words. Wet sand. Hattie's line says: fought the drill. There is no other line like it from a woman her age. It made no sense. I couldn't let it go. Vivian didn't get to go home. 3 weeks after surgery, at the rehab center, she got up at 3 in the morning to use the bathroom without pressing the call button. She'd never bothered anyone in her life. Her other hip broke between the bed and the door. She lay on the tile until the 5 o'clock rounds. She never stood on her own again. She caught pneumonia in the eighth week. She died 11 weeks after the van step, in a bed by a window. Her walking club had left one of their blue shirts folded on the chair beside her. Her husband told me she'd done her 4 miles the morning she broke. About 1 in 5 people over 65 who break a hip are dead within a year. About half of the ones who live never get back the life they had. Nobody told her. I gave that same one-word answer to my own mother. "Calcium, Mom." She took it every morning for 30 years. At 79 her hip broke while she reached into a kitchen cupboard, and I operated on her myself, and her screw spun too. So the farm woman wasn't a curiosity to me. Hattie went home to the farm. Her grandson put a railing on the porch steps. She told him it was ugly. 6 weeks later I did something I'd never done in 26 years. I drove out to a patient's house to ask her a question. Gravel lane. A red barn with the paint gone pink. She was on the porch in a barn coat, her walker parked beside her like a dog she didn't much like. "I figured you'd come," she said. "You looked at me funny in there." She sat me at her kitchen table. The kitchen smelled like my grandmother's on a Sunday. Rich and savory and old. "Mrs. Brennan, your bone fought me like a young man's. I've got 2 notebooks of hips in my desk, and none of them felt like yours. What do you do?" She laughed. "You think I've got a secret." She took her walker the 3 steps to the stove and lifted the lid off a big dented pot on the back burner. A blue speckled enamel stockpot, scorched black around the bottom. Under the steam I could see beef knuckles the size of my fist, chicken feet, a curl of pig skin. "That pot," she said, "has been going on the back of this stove since 1958." Not the same pot. She's worn out 3. But the fire under it has hardly gone out in 68 years. Knuckles and shanks from the fall steer. Chicken feet. Pig skin, tails, the joints nobody else wanted. She simmers it all day, low, strains some off, tops it up, and starts the bones over. Every morning since she was 24, she has ladled a cup of it into her coffee mug and drunk it before she goes out to the calves. "My mother kept one on the stove all through the Depression," she said. "You town people eat the meat and throw out the part that holds the animal together. My mother said that's backward. The meat is for your muscle. The pot is for your frame." She set a chipped white mug of it in front of me. When it cooled, it went to jelly at the edges. I want to be careful here. I can't tell you that pot is why her bone fought my drill. She's one woman. She's carried buckets every day of her life. She may have her father's bones. A 91-year-old dairy farmer is not a study. But I had 2 notebooks of hips and one line that didn't fit. And the one thing she did every morning that no woman in my notebook did was simmering 3 feet from my chair. The jelly at the edge of that mug was the thing I'd been trained to understand and had stopped thinking about. When I was a resident, Walter Brandt, the bone pathologist who trained me, put 2 chicken leg bones on the conference table every July. One had soaked a week in vinegar, which dissolves the mineral and leaves the frame. He'd tie it in a knot. It bent like rubber. The other he'd baked for hours, which burns the frame out and leaves the mineral. Clean and white. He'd squeeze it, and it crumbled to chalk. The bone that bends is collagen. About 90 percent of the organic structure of bone is collagen. Calcium gets laid down on that frame like concrete poured over rebar. Vivian took calcium for 12 years. Concrete. Nobody asked about the rebar. The scan measures mineral. That's what it's built to see. It doesn't tell you much about the frame. And what comes out of knuckles and feet and skin after 12 hours on a stove? Collagen. The frame of the animal, broken down into glycine, proline and hydroxyproline. Hattie has been drinking it every morning since Eisenhower. Bone is alive. Most of the skeleton gets replaced about every 10 years, out of what she ate this morning. And the body makes less collagen every year as it ages, faster after menopause. Less frame, at the exact age a woman is told to take one mineral tablet and walk. Calcium helps build and maintain strong bones. It was never wrong. It was one ingredient. Without enough vitamin D she absorbs only a small fraction of it. K2, the MK-7 form, activates osteocalcin, a protein that helps bind calcium into bone. About 60 percent of her magnesium is in her bones. Her body needs vitamin C to form collagen and copper to link the fibers. And protein, at every meal, first. Collagen isn't a complete protein. It doesn't replace a protein-rich meal. Hattie eats eggs from her own hens and beef from her own steers. The pot is on top of that. Then load. Hattie has carried a full bucket twice a day since Truman. The next Saturday I tried to make Hattie's pot. 5 pounds of beef knuckles and a bag of chicken feet. The butcher asked if I had a dog. My wife, Diane, watched me set her biggest stockpot going at 7 in the morning. By noon the house smelled like a tannery. At 9 that night I strained out 6 cups of something cloudy. Diane looked at the grease on the backsplash, then at me. "We are not doing this every week, Al." She was right. Hattie has a farm. I have a pager. So I tried the shortcuts. Grocery store broth cartons. Not one told me how much of anything was in a cup. The calcium aisle. 40 bottles, not one gram of collagen. A pink collagen tub from the beauty aisle, built for skin, with no minerals. A "joint" pill with a knee on the front and a sprinkle of collagen on the back. I'd already bought Diane a calcium, a D, a magnesium and that pink tub that month. She'd started a weekly weight-loss shot in March, her doctor runs it, and she was eating less than I'd ever seen. She made it to Thursday with the bottles. When I mentioned bone broth in clinic, one patient looked at me like I'd asked her to churn butter. "Doctor, I work two jobs." I had the answer and no way to hand it to anyone. A few days later I was at the scrub sink at 6:40 in the morning, telling Gloria about the knuckles and the tannery smell and the bottles. She'd been in the room for Hattie's screw. She'd been in the room for Vivian's. She'd been in the room for my mother's. She listened to all of it. Then she looked at me over her mask like I was slow. "Doc, you think I'm boiling chicken feet? I stir a scoop into my coffee. Have for 2 years, since my sister broke her wrist." "A scoop of what?" After the case she went to her locker and came back with a plain bag. DensiaPlus. I'm a skeptic by trade. I read a label the way I read a film, looking for what's missing. So I read it against everything I'd just relearned, standing in the hallway in my scrubs. 9 grams of collagen peptides. Studies on collagen peptides commonly use 2.5 to 15 grams a day, so that's a real amount, not a sprinkle. The same building blocks Hattie simmers out of her pot. Calcium, for the mineral. Magnesium. Vitamin D3, so the calcium gets absorbed. Vitamin K2, the MK-7 form. Vitamin C and copper, which the body needs to form and link collagen. Zinc and boron. One unflavored scoop. It disappears into coffee. Hattie ladles a cup of her pot into her coffee mug every morning. This went into the same kind of mug. It's the modern version of Hattie's pot. Without the knuckles, the butcher, or the 12 hours. I want to be straight with you about what that means and what it doesn't. I'm not telling you a scoop does what Hattie's pot did, because I can't tell you what Hattie's pot did. Nobody can. I'm telling you it's the closest thing I've found to her morning that a person with a job can actually keep doing. I ordered that night. I take it every morning. I'm 58. I have seen the other side of the van step. Diane has taken it since June. She hasn't missed a morning, because it isn't a pill. It's just her coffee. She eats her eggs first now, before anything else on the plate. She keeps cottage cheese in the shop refrigerator. She lifts with me in the garage twice a week, light at first. Her doctor signed off on it, and her doctor runs anything she's prescribed. I'm not touching that. The stockpot went back in the cupboard. The bottles went in the trash. Gloria still takes hers. She practices getting down to her garden bed and back up every weekend, because she's seen what the floor does. I made the residents on my service read Vivian's chart, the one I showed you at the top of this story. Then I made them tell me what was missing from it. The first 2 got it wrong. The third one said, "Nobody asked what her bones were being built out of." That's the right answer. In September I drove back out to the farm with a bag. Hattie was in the barn with the calves when I pulled in. She came out slow on her walker, wiped her hands on her coat, and took the bag from me. She opened it, sniffed it, and frowned. "That's it? No knuckles?" "No knuckles." "Hm." She put it on the windowsill next to her coffee can. Then she went back out to the calves. Her pot was still going on the back burner. I don't expect she'll turn it off for me. I tell the women in my clinic about her now. Not the pot. The idea. Count the frame, not only the mineral. Eat protein first. Lift something. Practice getting down to the floor and back up. Feed the part of the bone the scan can't see. Some of them go home and look it up. Some come back at the next visit and tell me the scoop in their coffee still tastes like coffee. A couple of them have started their own pots on the weekend. I tell them that's fine too, as long as they eat their eggs first and keep the pot from becoming the whole plan. I don't know what their next scan will say. Neither do they. But I know what their skeleton is getting every morning, and before I met Hattie I couldn't have told you. I still think about Vivian in that bed by the window with a blue shirt folded on the chair. 12 years of calcium and 4 miles a morning, and nobody ever asked about the frame. And I think about the one line in my notebook that says: fought the drill. If you've taken a calcium pill every morning for years and that is the only thing anyone has ever told you about your bones, I'm telling you more. If you've lost an inch and your back aches in a way you've decided is just age. If you've already broken a wrist catching yourself, and you were told it was the ice. If you get up off the floor in stages. A hand on the table, a hand on the couch, a push. If you've been told your scan is "a little thin" and to keep taking your calcium. If your mother shrank, or broke a hip, or ended up folded forward with that curve at the top of her back. If you did everything right, every morning, for years, and nobody ever asked what your bones were being built out of. Bone loss has no symptoms, and the break is often the first sign. About 1 in 2 women over 50 will break a bone because of bone loss. You don't need a farm. You don't need a pot on the stove since 1958. You need to stop feeding your skeleton one word. If your doctor has you on anything, keep taking it. Your doctor makes those calls. This isn't instead of anything. It's the part nobody wrote on Vivian's chart. DensiaPlus is 9 grams of collagen peptides with calcium, magnesium, vitamin D3, vitamin K2 (MK-7), vitamin C, zinc, copper and boron. One scoop a day, stirred into coffee, tea or water. That's the whole routine. Right now it's up to 70% off: buy 2 bags, get 1 free, or buy 3, get 2 free. Every bag comes with a 90-day money-back guarantee, empty or full. Feed the frame. Dr. Alan Whitfield, 58, orthopedic trauma surgeon P.S. If you take a blood thinner like warfarin, talk to your doctor before starting anything with vitamin K, this included. Calcium can affect how some medications are absorbed, so ask your doctor or pharmacist about timing. Keep taking everything you've been prescribed. P.P.S. Hattie's bag is still on her windowsill next to the coffee can. Her pot is still on the back burner. She says the bag is for "town people." That's me, and probably you. P.P.P.S. Up to 70% off: buy 2, get 1 free, or buy 3, get 2 free. 90-day money-back guarantee, empty or full.