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Science Vs on the 49ers Substation: Anatomy of a Hatchet Job
In August, Pablo Torre Finds Out and Science Vs released an episode about my theory that electromagnetic fields from the electrical substation beside the 49ers facility may be contributing to the team’s run of soft-tissue injuries. As the originator of the theory, I was also a subject of the episode. I sat was interviewed by Wendy Zukerman and Rose Rimler of Sciene Vs. I sent them research, connected them with scientists, and spent hours digging through the City of Santa Clara’s and Silicon Valley Power’s records to help clarify critical details. Both Wendy and Rose came off as affable and professional, showing curiosity during the interviews, with Wendy going out of her way to question the “conspiracy theory” framing itself. Then they titled the episode We Solve the 49ers Viral Conspiracy Theory. I was familiar enough with their catalog that I never expected them to agree with my theory, but I did expect them to give it a fair hearing and to deliver their findings honestly. On both counts they came up short. They were not directly dishonest in anything they said, but rather in what they left out, in how what remained was cut, and in the picture painted by those two things in combination. They asked me to recorded the interview on my phone for better audio quality, and I held on to my copy for reference later. That turned out to be a fortuitous decision. Here is the raw audio of my first interview, unedited*. Only my side was recorded, so their questions aren’t on it, but you can generally infer them from the answers, and every claim I make below about what I said can be checked against my statements in this clip. (Note: Wendy had connection trouble at the beginning of the interview and was cutting in and out, which accounts for the false starts.) 0:00 -1:19:13 Audio playback is not supported on your browser. Please upgrade. Science Vs is a fun show. It is pitched at roughly a high-school understanding of science, for an audience that is skeptical, Snopes-oriented, and worried about misinformation. Take a claim circulating online, interview a supporter of the claim, interview consensus scientists, and then tell people which side of the line it lands on. I have listened to their episodes on raw milk, seed oils, 5G and other contested issues in the wellness space. I have problems with all of them, but each at least made an honest attempt to represent the actual range of scientific opinion by talking to credentialed scientists with differing perspectives. Dissenting researchers were heard from, answered, and often given a chance to respond. This episode did not do that. This article is not a relitigation of the science. I have written extensively about that already. This post is for the record. It is simply an accounting of what was wrong with their episode. Contents Is there a power plant next to the 49ers practice facility? — the clearest single example of getting something objectively wrong For the record — a high-level overview of all of the problems with their investigation Draw your own conclusions — why they had to make this episode at all What they left out about childhood leukemia — the exposure threshold, and playing games with statistics to minimize sick children What they left out about the mechanism — the body of literature they refused to cover, and evidence for the mechanism used against it The scientists Science Vs interviewed and did not air — four credential scientists who support myhe theory, recorded and cut, or not even called How they misrepresented me and my case — an answer severed from its question, and three telling edits How you would actually study the injuries — it doesn’t actually matter which team is the most injured, overall The theory: magnetic fields, oxidative stress, and collagen Since the episode never states my theory, here it is below. Those who are familiar with my work can skip this section. Electrical equipment produces magnetic fields, and those fields induce faint electrical currents in anything that passes through them, including people. My argument goes further than induced current. Mitochondria — the structures that generate a cell’s energy — run on continuous flows of electrons and protons, and those flows carry faint electromagnetic fields of their own. Maxwell’s principle of superposition shows that when two fields share the same space, they add together. An external field does not need to be strong to alter an internal field, it only needs to be present. The electron transport chain inside the mitochondria leaks a small fraction of its electrons by design, and those become reactive oxygen species — free radicals, which healthy cells use as signals. External magnetic fields cause the rate of leakage to change, increasing free radicals. When free radicals accumulate faster than the cell’s antioxidant systems can clear them, the result is oxidative stress. Oxidative stress is a recognized driver of chronic illness, including cardiovascular disease, neurodegeneration, diabetes and cancer, and it is in every medical school curriculum. One of its ordinary effects in connective tissue is that it switches on matrix metalloproteinases — MMPs, the enzymes that break collagen apart — while suppressing new collagen synthesis. Tendons are made of collagen. An athlete loading his soft tissue heavily six days a week is already creating oxidative stress in the tendons, so the addition of magnetic field exposure compounds the damage and inhibits repair, making him more susceptible to injury when enormous force lands on a tendon in a fraction of a second. That is the theory. We know that EMF causes oxidative stress, and we know that oxidative stress degrades collagen. The only thing missing is a study showing that direct connection. I have never claimed certainty that the substation is contributing to the elevated injury rate. I do believe it is likely, and I believe it warrants caution, and that a revenue machine like a major NFL team can easily afford to remove the exposure out of precaution. Is there a power plant next to the 49ers practice facility? Here is the clearest single instance of the problem with this episode. It requires no knowledge of electromagnetic fields at all. This story first came to me through Jon Feliciano, a former 49er, in an interview on Willard & Dibs on 95.7 The Game. Asked about why the 49ers are always injured, he said players used to joke that it was the power plant behind the practice fields. Wendy Zukerman corrects him on air. “It’s important to say that it’s not a power plant near the 49ers site.” Torre then asks her to explain the difference between a substation and a power plant. Her answer: a power plant generates electricity and transmits it to a substation, which converts the voltage into something your house can use and sends it on to your home or your business. There are two problems with that. The first is that there is a power plant on that site. The Gianera Generating Station is a natural-gas-fired peaker plant owned by Silicon Valley Power, and it has been there since 1986. I have published aerial photographs of the location from 1987 in which the gas plant is the only thing standing, before the practice facility was even there. I even mentioned the gas plant in my first interview. (Feliciano has since gone on record about this issue, and it is clear he had the substation in mind rather than the gas plant.) The second is that her definition describes a distribution substation, and the facility beside the 49ers is not that. It is the Northern Receiving Station, which takes in bulk power from outside the city’s grid and delivers it to distribution substations. Silicon Valley Power’s own map distinguishes receiving stations from substations, and Rose Rimler even reads the label out loud in the episode when she walks through that map on air. A few minutes before the map segment, Zukerman tells Torre: “like I said, we fact check everything.” Well, maybe not everything. I made a mistake On the morning of July 6th, at 10:20, I sent Rose and Wendy two studies. During the interview I had been asked which human studies show oxidative stress from electromagnetic fields, and I had not been able to name one on the spot. Rose emailed asking for the studies, I quickly searched for a couple, and I wrote that I thought these were the most relevant from that search. Unfortunately, I was busy and did not read either one closely at first. I picked them because they were topically relevant — one on substation workers, one on power plant workers. Neither were great studies, and their problems go past the ones raised in the episode. That was careless on my part. There is context that did not make the episode, though. Before that email I had been on a Zoom call with Rose talking about EMF and oxidative stress, and I pointed her to Dr. Henry Lai at the University of Washington, who has spent years aggregating the literature on this question. His tallies show that roughly 90% of studies since the late 1990s find oxidative effects from electromagnetic field exposure — hundreds of studies, systematically counted. Rose told me she was already aware of his work. So when she asked for studies, I understood her to have the aggregate view already and that she would report anything within that context. Not reading those two carefully was still a mistake, but the larger mistake was assuming the episode would be based on a thorough review of the actual body of literature, rather than on whatever I happened to send that morning. The second email At 1:49 that same afternoon — three hours and twenty-nine minutes after the first — I sent them a second email that I had been preparing for a while. It was a structured document in six numbered sections, written in response to a request they had made two weeks earlier, laying out my entire argument with citations attached to every link in the chain. The episode aired on August 13th, five weeks later, and not a single item from the second email is in it. Here is how it opens: The full email is included at the bottom of this post in Appendix B. Nearly 1,500 words in total. It contains two named mechanisms with the physics behind them. Occupational studies in humans. The literature on oxidative stress and collagen. A section addressing the strongest counter-evidence against my own theory, which I raised myself. And a closing section stating plainly what the theory cannot yet show. My entire argument, in writing, with detailed citations for every claim, provided to them five weeks before broadcast, and none of it made it into the episode. That is the single largest omission, but it is not an isolated one. The whole episode is riddled with similar problems, and the conclusion they came to is not merely a difference of opinion about the scientific evidence. Through omission and through strategic editing, Science Vs misinformed its audience — about what the evidence shows, about what I argued, and about who they spoke to. That is a notable outcome for a show whose stated purpose is correcting misinformation. For the record I am not going to tell you that Science Vs set out to discredit me, or that they had come to their conclusion before they reported the story, or that they used misleading editing to make me look like a man retreating from his own theory. I cannot know what was in anyone’s head, and I am not going to pretend otherwise, either. What I can tell you is what is on the record. They asked me for evidence and aired the weakest thing I sent. They interviewed three scientists who supported my theory and aired none of them. They discussed childhood leukemia without ever saying the exposure level at which it appears. And they took an answer I gave weeks before Ken Karipidis, the one EMF scientist who was put on air, was interviewed, and placed it directly after his critique, where it comes off as a major concession. A friend of mine who has worked as a journalist for thirty years read that last one and called it sleazy. I agree with her. Those are just the four issues that are impossible to defend as pure editorial decision, but they are not the only issues. The most glaring issues stem from what they left out: The exposure level at which the childhood leukemia association actually appears — three to four milligauss, a number the episode never states despite it being much lower than what I measured. The mechanism itself: The episode gets as far as “oxidative stress could weaken collagen,” which leaves it sounding like speculation, rather than a known pathway. The second email, and all the studies in it. Dr. Paul Héroux at McGill, whose work my proposed mechanism rests on, whose contact details I supplied, and who was never called. Dr. Beatrice Golomb at UC San Diego, who runs a research group on oxidative stress and mitochondrial function and has specific expdertice in collagen, interviewed and not aired. Dr. David Carpenter at Albany, the most prominent academic voice on the harm from magnetic field exposure, interviewed and not aired. Dr. Joel Moskowitz at Berkeley, interviewed and not even credited. The specific, testable condition I put in writing that would make me abandon the theory. My own unprompted statement of the theory’s evidentiary gap. My caveats about my own measurements. My ranking of EMF as one factor among several rather than the only one. The new equipment installed at those facilities between 2010 and 2014, and the sharp rise in system load from 2013 onward. But that is not all. What they kept, they selectively edited to serve a narrative that was not served by the raw transcripts of the interviews. A description of thousands of commercial routers in a workplace, reduced to the Wi-Fi in your house. My own acknowledgment, multiple times, that "I'm not a scientist" clipped in an episode that spends considerable energy pointing out that I am not a scientist. And a qualification I volunteered about my own measurements, cut from my answer and delivered later by their EMF expert as a correction. Together their edit produce a portrait of a wellness guy with Wi-Fi phobia and two bad studies, backing away from his theory the moment a “real” scientist looked at it. A practice facility where nothing changed because no new substation was built. Injuries written off as random because the 49ers were not quite the single most injured team in the league over the period in question. That portrait is false even though almost no individual statement made in the episode is. Draw your own conclusions At the top of the episode, Pablo Torre says his show had been flooded with requests to investigate the substation — that it was the thing they were asked to look into over and over again. Neither show went hunting for this story. It arrived from their own audience, in volume, and it could not be waved off. A thread I posted on X reached twenty-two million people. A guy with a gaussmeter and a brand-new Substack obligated a Pultizer prize winning program to spend an hour on a question about player health, that is considered fringe enough that most media operations won’t touch it. Pablo Torre Finds Out could not ignore it. So Science Vs came in and ran a “debunking” operation instead of an investigation. Everything below is what had to be left on the cutting room floor to deliver the “debunking”. They could not ignore it. So they tried debunked it instead. The demand was strong enough to force an episode, and since the episodes release the 49ers have sustained more injuries, including season ending ones, and interest has only grown. Demand from fans and playets is strong enough to force a better investigation from someone else. An omission is not a lie until you find out what was omitted. What follows is the detailed record so you can see the full picture. Draw your own conclusions. I have drawn mine. I am going to keep publishing. A note about Pablo Torre Finds Out After the episode aired I posted publicly, calling out Pablo Torre Finds Out for concerns I had about the integrity of their investigation, and about an interview directly with Pablo Torre which had been offered but never happened. I have since spoken with a producer at PTFO. The offer had rested on a misunderstanding about where things stood between us, and it fell away as the Science Vs part of the production widened past the science. He apologized for the miscommunication and I accepted. The producer also confirmed to me that they did essentially hand off the entire investigation to Science Vs for narrative purposes — so Pablo would be genuinely curious or potentially surprised by their findings — while still taking responsibility for what went out under their name. I appreciated the candor and the accountability, and I am comfortable with where we left things. So this post is not about PTFO. My disagreement is with Science Vs. What they left out about childhood leukemia Childhood leukemia appears at three milligauss. They gave no number at all. 1. They built an EMF ruler, then discussed childhood cancer without it. The sequence on air went like this: First I measured almost 9 mG, then I measured up to 50 milligauss. Torre reacts with concern — “that sounds high.” Cut to Karipidis: the public limit is 2,000 milligauss. Torre reacts again — “What happens at 2,000?” Karipidis explains that nothing happens at 2,000, that safety factors are built in. Then: at more than 50,000 milligauss you get flickers of light in the retina, and higher still, nerve stimulation. The listener now has a ruler (their ruler) to measure these numbers with. Fifty is nothing by their ruler. Then the episode turns to childhood leukemia and states, accurately, that there is a real association — but tellingly, they never give the exposure level at which that association appears. Childhood leukemia appears at three milligauss. They conveniently left that out. The pooled analyses that produced the World Health Organization’s carcinogen classification found roughly a doubling of childhood leukemia risk above three to four milligauss. That is the number that belongs in that segment, and it is more than ten times below the reading that had just been dismissed as trivial. I gave them that number myself, on tape, in the interview. Describing my own threshold, I said my comfort level for long-term chronic exposure is three to four milligauss, but preferably one. 2. Six children in thirteen million. The episode reports that these fields might explain one to four percent of childhood leukemias, then reframes it as a German estimate of perhaps six cases among thirteen million children. Torre, to his credit, is uncomfortable. What never gets explained is why that number is small. Almost no children lives above three milligauss in Europe. Fewer than two children in a hundred, in the Italian data. So even if the risk to those children doubles, the number of additional cases across an entire country stays small — not because the hazard is small, but because hardly anyone is exposed to it. Count the whole population and the few who are exposed disappear. And the reason hardly anyone is exposed is that siting rules keep housing away from transmission lines. In Europe, at least. The Dutch government has a standing precautionary policy against building new homes in any zone where the annual average magnetic field exceeds 4 milligauss — the same number the episode never mentioned. Denmark and Norway treat 4 milligauss as the level that triggers a look at mitigation. That is five hundred times below the ICNIRP figure quoted on air. The United States has no federal equivalent. That is evidence of infrastructure siting policy working. It is not evidence that there is no hazard. It is evidence that we already act as though there is one. If you listen to the raw audio you will hear that my proposed solution is EMF exposure is to build better infrastructure. What they left out about the mechanism 3. They accused me of cherry-picking, and then cherry-picked themselves. On air, Zukerman tells Torre that people who worry about electromagnetic fields dismiss the studies showing null results and collect the ones showing harm, and that this is why you have to be careful not to cherry-pick. They had two papers I had rattled off in a hurry, and a second email containing a carefully chosen set. They ran the two weakest, graded them on air, and presented the result as the state of the evidence for not only my theory, but the whole question of oxidative stress from magnetic fields. That is cherry-picking from my emails. The bigger picture is what they did with the literature as a whole. Zukerman acknowledges it exists, dismisses it, and disposes of it in a single stroke. You can go online right now, she tells Torre, and find scores of studies showing these fields increase oxidative stress. The issue, she says, is that they are not studies in people. Many of them are in people. The occupational studies in my second email are in people. That email had been in her inbox for five weeks. She waved off the literature on a factual claim that the documents in her possession contradict. (I have written separately about the evidentiary standard at work here). The effect was that they essentially baited me: ask the subject to supply the evidence, take the weakest thing he sends, and let that stand as a proxy for the whole argument. Wendy has been doing this show for ten years and clearly knows how to extract what she needs for her desired narrative. 4. They presented the collagen-improvement research as a gotcha, but I had already addressed it. The episode treats the existence of studies showing that EMF can improve collagen as a surprise that undercuts me, but I had pre-emptively addressed that five weeks earlier in the email they ignored. Those studies use measured, high-intensity pulsed dosing. The mechanism by which they work is oxidative signalling. The cell reads a controlled rise in reactive oxygen species as a warning, upregulates its antioxidant defenses, mounts a repair response, and the therapy stops before the system is overwhelmed. The key point is that it induces an oxidative response, which means those studies are actually evidence for my proposed mechanism, not against it. A field that produces a therapeutic effect cannot be biologically inert (which is the implication when they say “Nothing happens at 2,000 milligauss). Chronic ambient exposure is the same pathway with no off switch, and it is most consequential during the evening and while sleeping, when the body is in repair mode and the exposure does not stop. Section 5 of my email is titled What about the study showing improved collagen synthesis. I raised the counter-evidence myself, explained why I did not think it refuted the theory, and wrote that I was disappointed the question had not come up in the interview. That is worth holding against the cherry-picking charge in the item above: the studies they presented as inconvenient for me were studies I had gone out of my way to put in front of them. 5. Section 1 of my email stated a critical argument that was never put to the expert directly responsible for it. My email says the exposure limits exist to prevent acute effects and do not address chronic exposure at all, and that my dispute is with the entire framework. Zukerman gestures at this once. After Karipidis gives the 2,000 milligauss figure, she tells Torre that I would object because those levels do not capture “more subtle effects.” That is not my argument, and “subtle” is doing a lot of work here. My argument is that the limits are built to prevent acute effects — nerves firing, muscles twitching, etc — and were not designed to address chronic exposure at all. In fact, ICNIRP’s own documents state as much themselves. Mine is a structural objection to what the standard measures, reduced as a concern about subtlety, it becomes a matter of degree, rather than a categorical difference. They interviewed Ken Karipidis, vice chair of ICNIRP — the body that writes those limits. He was asked what the limit is, but he was never asked how it applies to chronic exposure. The scientists Science Vs interviewed and did not air 6. They interviewed four officials of the standards body. The episode credits roughly a dozen researchers. Four of them are associated with ICNIRP. Ken Karipidis is the vice chair. Rodney Croft chaired ICNIRP from 2020 to 2024 and led the development of its current guidelines. Dan Baaken is ICNIRP’s scientific secretary. Frank de Vocht sits on the Main Commission. One of them speaks in the episode. Their institution’s position is more than adequately represented — the 2,000 milligauss figure, the safety factors, the assurance that nothing happens below the line. 7. The four who were left out. Dr. Beatrice Golomb is Professor of Medicine at UC San Diego — a physics undergraduate degree, a PhD in biology, an MD. She directs a research group whose stated focus is the relationship between oxidative stress, mitochondrial function and health. That is the mechanism the episode spent its first half dismissing. Her published work includes the fluoroquinolone case series behind the FDA’s black box warning on an antibiotic class that ruptures tendons, where the accepted mechanism is oxidative stress and mitochondrial toxicity — the back half of my chain, already on a drug label. She is in the credits. She is not in the episode. She has told me she finds my theory biologically plausible, and that she has a recording of her interview. Dr. David Carpenter directed the Institute for Health and the Environment at the University at Albany for decades and is the most prominent academic voice arguing these fields cause harm. Childhood leukemia is the reason these fields carry a WHO classification at all, and Carpenter is the person you call if you want that case made by someone who has spent a career on it. He is in the credits. He is not in the episode. He has told me that when he was interviewed they could not have been less interested in what he had to say. Dr. Joel Moskowitz directs the Center for Family and Community Health at UC Berkeley’s School of Public Health. He told me directly that they interviewed him and that he thought it went well. He does not appear in the episode, and unlike Golomb and Carpenter, he does not even appear in the credits. Dr. Paul Héroux at McGill is the researcher whose work provides the foundation for the oxidative stress mechanism my theory rests on. I gave Rose his email address and phone number. He was never interviewed. They never even called him. 8. “He’s not a scientist.” The episode leans hard on the fact that I am not a credentialed scientist. Zukerman says it. Torre repeats it. “At all.” Having built a segment on that, they then left out the physicist-biologist-physician, the professor of public health, the director of a university environmental health institute, and the McGill researcher whose work the primary mechanism comes from. They spent the episode telling their audience I am not a scientist, and then kept four actual scientists who support the theory off because their argument does not survive otherwise. How they misrepresented me and my case 9. They played my words as a response to an interview I had never heard. Near the end of the hour, Zukerman says she went to me and told me the evidence was lacking. Then she plays me saying I am not wedded to it being an EMF, that I have staked my reputation on it needing more study, and that I am not certain of anything. That segment was placed immediately after Karipidis had finished taking the cherry-picked papers apart. It plays as a man folding under expert scrutiny. Commenters have used it against me since, but it is incorrect. Here is the sequence as it happened. I was interviewed. Karipidis was interviewed weeks later. I was never told what he said, or even who he was. I was never asked to respond to it. I did not know his name until the episode aired. That is not a simple editing decision. That is a quote from one interview, moved to follow a critique from a different interview it was not a response to, so that it would land as a concession. A friend of mine who has spent thirty years as a journalist read that sequence and called it sleazy. She is right. The full passage is reproduced in Appendix A, and it is worth reading. What airs is the preamble. Four paragraphs later I say “to directly answer your question” — and that answer, about what would change my mind if the team relocated, is not in the episode. Neither is the sentence two paragraphs on, where I say the EMF might turn out to be ten percent of the problem. I will say the underlying point again, though, because I meant it and I still do. I am not wedded to my theory that magnetic fields from the substation are contributing to the 49ers injuries. I could be wrong. What I am wedded to is the process of scientific inquiry, and the fact that we should be cautious around these exposures and we need more independently funded studies. 10. Three telling edits. They cut “I’m not a scientist” mid-sentence. What I said: “...and I am not certain of anything. I’m not a scientist. To me, I find the mechanisms compelling. I will go back to the fact that I got into this not because of the 49ers, but because of clients I was working with who suffer from EDS...” What aired: “...and that I am not certain of anything. I’m not.” The clip ends on the first two words of the sentence in which I say I am not a scientist, in an episode that spends considerable energy establishing that I am not a scientist. The full sequence is in Appendix A. They cut my own description of my work. Asked what I do, I said I run a wellness business, that I am focused on writing software to help people navigate environmental stressors, that environmental health is my focus, and that I also do independent journalism and research. What aired is the wellness business and the environmental health, with the software and the journalism removed from my own answer. The software engineering does come up later — narrated by them, as a hacker who grew up to write firmware — but my current work, in my own words, arrives as “wellness guy.” Thousands of commercial routers became home Wi-Fi. What I described: working at a wireless networking company surrounded by thousands of Wi-Fi routers, and a stress-induced health collapse afterward that working in that environment contributed to. What aired: Wi-Fi, the kind you have at home — reinforced by a clip of Christian McCaffrey talking about turning his router off at night. Three cuts, and every one of them makes me seem less credible. That is not a coincidence. 11. I gave them my own caveats and the test that would disprove me. In the first email I wrote that a well-designed chronic, ambient-level exposure study in tendon showing no collagen degradation, run over many months, would undercut my confidence in the theory. That is a specific, testable condition, stated in advance and in writing. There was a second interview, weeks later, which was not used in the episode, but in that I asked again for the falsification criterion to be included. What the episode presents instead is a man saying “we need more study,” which reads as a hedge, an open-ended request for the benefit of the doubt. It is the opposite of a hedge. Section 6 of my second email says, unprompted, that as far as I am aware there is not a single study showing EMF-driven oxidative stress degrading collagen in a human in vivo or in human tendon in a lab. I wrote that because it is true and because it is the first thing anyone should check. Under their standard it becomes the hinge of the entire first half, framed as something they had to surface without my cooperation. I had handed it to them five weeks earlier. And in the interview I said that my 25 to 50 milligauss readings were taken at knee level, and that these fields attenuate quickly, so by the time it reaches your head it is not that high anymore. That did not air either. The qualification arrives later, from Karipidis, as a correction. How you would actually study the injuries 12. They measured the wrong thing. The episode spends its final act on whether the 49ers are the most injured team in the NFL, finds no clean ranking, and lands on “injuries are random”. That is the wrong test. You would define the exposure — measured field levels at the facility — and the outcome narrowly: soft-tissue injuries, not a single MSK injury count that a broken finger and a ruptured Achilles both land in. Then you would compare the 49ers to themselves before and after the exposure changed, and compare that change against every other team over the same window. That controls for league-wide shifts in rules, turf and training load. It is a difference-in-differences design, and it is standard. I sent them that argument on July 28th, in writing, along with the fact that in eleven of the past twelve seasons the 49ers had finished top ten in Adjusted Games Lost. And by the episode’s own reporting, the 49ers are second in games lost to injury over the past decade, with FTN’s Aaron Schatz confirming that once you adjust for starters they come out second worst in the league — after having been one of the healthiest teams for years before that. A finding like that is where an investigation starts, not where it stops. 13. I did a lot of substation research for the episode that was never aired. I had reported that the substation next to the facility was expanded in 2014. That was wrong, and Rose Rimler and I sorted it out together. They gave me credit on air, which I appreciated, but framed it as a concession on my part to something they had found. In fact I had been investigating it myself, was uncertain before they asked, but was waiting for clarification from Silicon Valley Power. The uncertainty centered around a substation named “Esparanca” that was proposed right behind the facilities as part of the stadium construction, but now appears to never have been built. I spent days in Silicon Valley Power’s records, and did eventually reach Silicon Valley Power for confirmation and indentified the mistake myself. I also gave them highly detailed documents on what we do know about those facilities: new equipment installed between 2010 and 2014, and load growth across the system with an inflection around 2013–2014, with the Northern Receiving Station carrying the highest capacity in the system and sitting closest to the data center corridor. None of that is in the episode. I have a separate piece about it coming out soon. *I cut 2 seconds from the raw audio to remove personal information that had no connection to anything in the episode. Appendix A: the passage the clip was taken from This is the sequence from my first interview, in full. The episode uses one fragment of it. It’s tricky because my understanding is that there’s something like a 15-year half-life on collagen remodeling issues. They’re going to get a new crop of players. What I really need, though, is for the injuries to be broken down so we can see the soft tissue injuries. Right now, they’re categorized as MSK injuries, but let’s say we can actually identify them more specifically. Is that right? He was able to do that? Oh, cool. I wasn’t able to find that information. Interesting — I didn’t know that data existed. I tried so hard to get it, and I didn’t know it was available. Maybe you could connect me with that person. That would be amazing. I’m not wedded to it being an EMF, honestly. I’m not. I would say that, to a certain extent, I’ve staked my reputation on the fact that it needs more study. It’s important to look into it, and I am not certain of anything. I’m not a scientist. To me, I find the mechanisms compelling. I will go back to the fact that I got into this not because of the 49ers, but because of clients I was working with who suffer from EDS, Ehlers-Danlos Syndrome, a tendon hypermobility issue. This condition is documented to be partially caused by oxidative stress. I’ve worked with them to mitigate their EMF exposure and have seen people improve. I think it’s a bigger story. In a way, the 49ers represent an occupational cluster with specific exposure risks. If someone would conduct a study on this, I believe we could learn a lot. Perhaps we would discover that it’s like, okay, maybe it’s 10% of the problem. I don’t know the exact number, but I think either way, conducting the study would provide valuable insights. To directly answer your question, it’s challenging for me because it’s part of a bigger story. If the 49ers move and stop having injuries, I might conclude that it was related to the substation. However, if they move and still experience injuries, I would want to analyze the nature of those injuries. Are they primarily soft tissue injuries? I don’t think it’s necessarily a case closed, but the story might lose traction at that point regardless. Three things are worth noting. The aired fragment stops immediately before the sentence in which I say I am not a scientist — the cut described in item 10. It also stops four paragraphs before the words “to directly answer your question.” What the episode plays is the throat-clearing. The actual answer, about what would change my mind, never airs. And two paragraphs in, I say the EMF might turn out to be ten percent of the problem. That is the ranking the episode says I never gave. Appendix B: the full email, July 6th, 1:39 PM Hi Rose, You asked me to send you some studies a couple of weeks ago. I apologize for the delay. I have been incredibly busy. I also wanted to give you a chance to dig in yourself, and get your own perspective before I influenced you too much with mine. That said, I do want to make sure that the actual argument is abundantly clear, so here it is! One note before I begin, there are really two separate questions here: Does the substation cause the soft-tissue injuries? That was my specific claim, and what the podcast is about. Is the theory biologically sound? Can 50/60 Hz fields at these levels do anything biological below the safety limits? Question two is why people have been calling me a conspiracy theorist. The regulatory and advisory bodies (ICNIRP, etc) maintain that anything below their exposure limits is biologically inert, and that position is broadly accepted within the mainstream, but the actual science paints a different picture. To defend my theory I’ve had to defend a much larger claim: that the advisory bodies have the biology wrong. I can’t honestly answer question 1 without first addressing that. Here’s is a simplified outline of my theory, with links to studies: 1. Advisory body thresholds for biological effects The ELF magnetic-field limits (ICNIRP’s ~2,000 mG public / 10,000 mG occupational) exist to prevent acute effects from exposure. If a magnetic field is strong enough, it makes nerves fire and muscles contract. Muscles twitch. You can see faint flashes of light in your vision. People can even feel tingling or even a shock. That happens due to Faraday’s law, which states that a time-varying magnetic field induces an electric field inside the body via the creation of Eddy currents.The standards assume that those currents do nothing below the twitch threshold. They do not consider chronic effects at all. My argument is that they are biologically active and do have chronic effects. 2. There are multipe ELF-EMF mechanisms for inducing oxidative stress. This is basic biophysics. Below are the two primary mechanisms. Simplest first. Dr. Paul Héroux of McGill has the most intuitive explanation, which rests on Maxwell’s principle of superposition: because Maxwell’s equations are linear, two sets of electromagnetic waves sharing the same space simply add together. In the interview I pictured a pebble dropped into a pond, sending out clean ripples. Then a boat motors past at distance, sending larger waves, and where they meet the ripples, the two add together and the original pattern gets distorted. In our cells, the mitochondria run on continuous currents of electrons and protons that carry their own faint electromagnetic fields. An external field from a substation, by the principle of superposition, adds to those internal currents and shifts the pattern. The electron transport chain in the mitochondria leaks a fraction of its electrons by design as reactive oxygen species (ROS), which act as signalling molecules in a healthy cell. Distorting that field increases that electron leakage, creating oxidative stress. A tiny electromagnetic interference results in a large downstream effect. https://www.sciencedirect.com/science/article/pii/S2405844025006474 The more complex pathway is Dimitris Panagopoulos’s Ion Forced-Oscillation / Voltage-Gated Ion Channel (IFO-VGIC) mechanism. Weak, polarized, low-frequency fields force the ions (calcium, potassium, sodium) next to an ion channel’s voltage sensor to oscillate; because that force scales with the inverse cube of the distance involved, fields far below the stimulation threshold can still force the channel open, disrupting the cell’s ion balance and driving ROS overproduction (Nitric oxide and superoxide interact and produce peroxynitrite, a highly unstable cytotoxin that breaks down into free radicals). https://www.researchgate.net/publication/366088934 https://www.spandidos-publications.com/ijo/59/5/92 https://www.mdpi.com/1422-0067/22/18/10041 https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1585441/full https://pmc.ncbi.nlm.nih.gov/articles/PMC3772193/ 3. Evidence of oxidative stress, in vivo, in humans from ELF-EMF There are many studies, and the strongest are occupational, which applies to the 49ers situation. 115 power-plant workers vs. 145 office controls. Serum malondialdehyde (MDA, the standard lipid-peroxidation marker), superoxide dismutase, and catalase were all significantly higher in the exposed group, and the markers rose with increasing field exposure. https://journals.sagepub.com/doi/abs/10.3233/WOR-203244 A follow-up where they reversed the oxidative stress in power plant workers. A double-blind randomized controlled trial: 91 power-plant workers given vitamin E, vitamin C, both, or placebo for 90 days. The antioxidant groups showed reduced lipid peroxidation and raised antioxidant capacity versus controls. https://pubmed.ncbi.nlm.nih.gov/32191586/ A spot-welder study: 46 welders occupationally exposed at 50 Hz, showed significantly altered red-blood-cell antioxidant enzyme activity and concluded ELF-MF “might act as an oxidative stressor… even at the recommended levels of exposure.” https://pubmed.ncbi.nlm.nih.gov/18504600/ A substation-specific study found oxidative stress and DNA damage https://pubmed.ncbi.nlm.nih.gov/24460415/ 4. Oxidative stress degrades collagen This half isn’t controversial at all. Oxidative stress activates the matrix metalloproteinases (MMPs) that break collagen down and suppresses its synthesis. Here are three example studies: Siwik et al. 2001: Oxidative stress raises MMPs and lowers collagen synthesis in cardiac fibroblasts. https://pubmed.ncbi.nlm.nih.gov/11121376/ Fisher et al. 2009: Collagen fragmentation drives oxidative stress and elevates MMP-1 in aged human skin. https://pmc.ncbi.nlm.nih.gov/articles/PMC2631323/ Varani et al. 2006: Decreased collagen production in oxidatively aged skin. https://pubmed.ncbi.nlm.nih.gov/16723701/ 5. What about the study showing improved collagen synthesis I’m glad you asked this question, and I’m bummed we didn’t get to it in the interview because it is a great question, and very important to understand. Superficially it may appear to be a refutation of my theory, but I would argue that it actually supports the underlying argument. That study used a short, high-intensity pulsed dose: therapeutic-PEMF, the same type of field used clinically to stimulate bone and tissue healing. The reason this works is because it triggers the very same biological pathways that can lead to oxidative stress. The exposure still stimulates ROS production, but done at a controlled dosage, for a limited duration it has a different effect. The cell reads the ROS as a warning signal and it upregulates its antioxidant defenses, and mounts a repair/proliferation response. The therapy is then stopped before the cell gets overwhelmed. That is essentially a hormetic response: a small dose of a stressor producing a beneficial adaptation. Two things follow: At the very least, this means the field is biologically active, which by itself undercuts the regulatory claim that these fields are inert below their thresholds. There is a wealth of literature on PEMF (pulsed EMF) bone regeneration and calcium channel signalling (which is the second mechanims in section one). Here is one. https://www.nature.com/articles/srep13856 At best, it leads us straight to my actual concern, which is that under chronic, chaotic and unregulated exposure, the cell’s antioxidant capacity gets overwhelmed, resulting in oxidative stress. There are plentiful examples of things that are beneficial at controlled doses, but harmful at uncontrolled doses. Excecise is one obvious, uncontroversial example. Botox is perhaps a more interesting example. 6. What about a study that shows EMF causing collagen degradation in humans? As far as I am aware there is not a single study showing EMF-driven oxidative stress degrading collagen in a human, in vivo, or in human tendon in a lab. There are studies involving isolated fibroblasts though, which secrete collagen. The most relevant one showed that human fetal scleral fibroblasts exposed to 50 Hz ELF-EMF showed a significant decrease in collagen synthesis and that MMP-2 expression was upregulated, which is the exact mechanism I described in section 2. https://pmc.ncbi.nlm.nih.gov/articles/PMC3626379/ That’s it! Thanks again for the interview. Best, Peter Anthony Cowan Environmental Health · Wellness Tech · Researcher & Journalist Publisher & Editor, Living Energy Bio: petercowan.comSocial: X · Instagram · TikTokApp: sunlightis.lifePhone: [redacted]
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The Strange New Politics of AI. Plus. . .
It’s Thursday, September 17. This is The Front Page, your daily window into the world of The Free Press—and our take on the world at large. Today: Douglas Murray asks, why do we allow terrorists to die of old age? The American nonprofits backing Hamas. A conversation with Dara Horn and Coleman Hughes. And much more. But first: inside the unlikely coalition warning that AI may kill us all. Last week, an AI researcher named Jacob Coxon made headlines around the world after saying that he had resigned from Anthropic because he believes AI might cause human extinction—and his co-workers do, too. Unlike the rest of us, potentially, the story just won’t die. The Pro-Human Assembly, a conference held Tuesday in Washington, D.C., about the existential dangers of artificial intelligence, couldn’t have come at a better time—or with a more eclectic coalition. The Archbishop of San Francisco was there. So was Steve Bannon, screaming about the Chinese. Bernie Sanders did a quasi-dramatic reading of messages posted to an online forum by rogue AI agents. Ashley Judd paraphrased a graphic Andrea Dworkin quote for reasons that remain a mystery to me still. It was odd. People in the AI industry have talked openly about the possibility of this technology causing human extinction for years, but it hits differently in the wake of the Hugging Face incident. If you don’t know what that is, all the more reason to read my dispatch today. As the doomers see it, the best-case scenario is a future in which humans are basically kept as pets: well cared for, but with zero autonomy. The worst-case scenario, obviously, is the everyone dies thing. What should be done? I heard lots of ideas but no easy answers. There are currently zero federal regulations on AI, which is sort of strange even to think about. After all, we regulate microwaves, and the people running the microwave industry have never once refused to rule out the possibility that their products will end all human life on Earth. What I saw in D.C. left me even more convinced that you would be hard-pressed to find anyone who believes nothing should be done. You know, except for President Trump. — River Page River Page • Tech and Business [ The AI Doomers Have a Plan to Save Us. I Went to Find Out What It Is. ](https://www.thefp.com/p/the-ai-doomers-have-plan-save-bernie-sanders-bannon) Read story How Robert Kraft Made Macklemore a Martyr—and How to Better Fight Antisemitism On Monday, New England Patriots owner Robert Kraft and a group of other NFL owners banned Macklemore from performing at their stadiums after the rapper delivered a “Free Palestine” speech while opening for Ed Sheeran. 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Read his latest column on what that failure says about our unpreparedness for the era we are now living in. Read story The Editors • U.S. Politics [ When Nonprofits Support Terrorists ](https://www.thefp.com/p/when-nonprofits-support-terrorists) A newly declassified CIA brief from 1998 found that Osama bin Laden used nonprofit shell organizations—including U.S.-based Islamic groups—to fund his terror plots. Today, a similar story is unfolding as multiple organizations on American soil present themselves as nonprofits, taking advantage of tax-exempt status while seeking to advance the ideological mission of terrorist groups like Hamas. Read our editorial on the latest evidence of this dangerous trend—and why there’s no excuse for making the same mistake the CIA revealed 28 years ago. Read story Simon Sebag Montefiore and Bari Weiss Live in New York For decades, the Middle East has shaped American foreign policy and loomed large in the public consciousness. 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Since Russia's full-scale invasion in February 2022, Ukraine's defence sector has expanded several-fold, becoming a significant source of military innovation, especially in unmanned systems, counter-drone technologies, electronic warfare and AI-driven combat systems. But finding the funds and personnel to scale up and to reach international markets remains a challenge.Spurred on by the demands of the front-line, Ukrainian defence companies say they can develop a minor component in a couple of weeks, or major hardware or software solutions within a year. This is several times faster than the usual development cycles in the sector. Tencore, founded in 2024, is now one of Ukraine’s largest providers of unmanned ground vehicles, well exceeding the production of NATO members in this category. Odd Systems, a Ukrainian combat cameras developer founded in 2023, launched its first thermal camera in 2024. Less than two years later, it is developing the fourth generation of the product, one that has evolved into a full vision system.According to Michael Singer, managing partner at Verne Capital, a venture capital fund supporting defence companies in Europe, this speed is down to the short feedback loop between the developer and the end user. “Ukrainian companies develop technologies in close interaction with soldiers and military units, test them under real combat conditions and rapidly incorporate feedback into the next generation of the product,” he says. “Sometimes we need to react to feedback and deploy an upgrade within hours,” says Polina Tymchenko, the spokesperson for Himera, which develops electronic warfare-resistant walkie-talkies. “It means that, as a company, you have to have a higher tolerance for risk, and also design your products in a way that fosters those quick changes.”Getting a product deployed by a combat command involves no paperwork other than a purchase order, says Perry Boyle, co-founder and chief executive of Mits Capital, a Ukrainian-US investment group focused on attracting capital for Ukraine's defence tech sector. “New weapons can be developed and deployed based largely on handshakes.”Nevertheless, the speed of development is largely subject to the level of funding, says Iryna Sukhomlyn, head of business development at RMachine, a developer of unmanned ground systems. “Financial support needs to start much earlier, particularly at technology readiness level 3-5, not only when most of the technological risk has already been removed,” she says.In 2025, Ukrainian defence tech companies attracted about $129 million in investment, with the true figure likely higher given the share of undisclosed security-sensitive deals, according to a report published by the Kyiv School of Economics. These investments were primarily concentrated in the AI and software segment, as they are considered a lower financial risk.Scaling production is a major barrierAccording to Iryna Supruniuk, business development director at Odd Systems, proving a defence product in Ukraine is not the end of the development process, but the beginning of a continuous evolution, since operational requirements change rapidly. “Continuous iteration remains our highest priority,” she says.It's also when production must scale up, which represents a major hurdle. “Scaling production requires capital, manufacturing capacity, components, certification, procurement access and reliable supply chains,” Singer says. Scale-up is also hampered by demographic pressures, especially a shortage of young specialists needed to expand engineering teams. Companies have reported struggling to replace specialists lost due to Russian attacks, mobilisation and emigration. In order to meet this scale-up challenge and finance arms production, begun allowing defence technologies to be exported, assuming it has an excess capacity. It has also announced the creation of ten defence and weapons export centres across Europe by the end of 2026.According to Singer, a technology that has demonstrated its value under real combat conditions has a fundamentally different credibility than a product that has only been tested in a laboratory or training environment. But combat validation alone doesn’t automatically create an international business. “Companies still need access to foreign defence ministries and procurement organisations, international certification, financing for production scale-up and, in many cases, local industrial partners,” he says.Already in 2026, the EU has signed several agreements with Ukraine that aim at joint defence technology development and production. These include allowing Ukraine to join the European Defence Fund, signing a financing agreement under the European Defence Industry Programme, and setting up the EU-Ukraine Drone Alliance.For Singer, it is important that European defence companies don’t just see their Ukrainian partners as technology suppliers, but rather as potential innovation partners. “Ukrainian companies bring speed, operational experience and an exceptional ability to iterate. European partners can provide industrial capacity, capital, established supply chains and access to European procurement markets.”Procurement possibilitiesWhen it comes to exports, the procurement and compliance processes involved require time, taking months or even years, and money. In other words, resources that small defence tech companies need if they are to improve and scale up their technologies. According to Sukhomlyn of RMachine, if the priority is to rapidly increase available defence capabilities, then the processes need to reflect that urgency. “If Europe wants defence innovation at wartime speed, its administrative processes also need to operate much closer to wartime speed,” she says, highlighting a need for support with certification, market access and mutual recognition of relevant testing. “Otherwise, we risk having excellent technology available but spending years making it administratively eligible to be purchased.”Related articlesRussia widens targeting of European research centresEU must support research managers in central and eastern Europe, says Visegrad fund headThis is a lesson Europe’s defence sector would do well to learn, Singer says. “Defence innovation needs to be organised around the speed and requirements of the end user, not around the speed of the bureaucracy.”Supruniuk says the European defence sector should rethink the balance between quality and quantity. “In many cases, a good-enough system available in thousands of units creates greater operational value than a perfect system available in dozens.”“For decades, everyone has been looking for that all-powerful, exquisite system that can protect everyone,” adds Tymchenko. “We see in crime that only scalable, dedicated, affordable solutions can actually defend democracies.”
EU membership bid gives boost to Moldova’s fledgling R&D landscape
Moldova’s push to join the EU is having the spillover effect of helping to improve the country’s R&D landscape, which in recent years has suffered from fragmentation, decreasing personnel and a lack of research infrastructure.The country became an EU candidate country in 2022, alongside Ukraine, and officially began accession negotiations in 2024. With a pro-EU government, Moldova has been actively carrying out reforms to align with EU standards. This has helped accelerate the development of R&D, said Igor Chiosa, acting head of the Research and Innovation Policy Directorate at Moldova’s Ministry of Education and Research. “Our R&D landscape is moving up, and we are more and more involved in the European Research Area,” he said. “The support we receive from the EU is very important, not only financially, but also because of incentives, consultation and capacity building.”The R&D landscape in the former Soviet republic is still relatively underdeveloped, despite attempts at improvement going back to a 2004 law on science and innovation and later reforms in 2017 and 2018. But the system remains in a “precarious situation” and “in the process of contraction,” according to an assessment carried out by the government for the current National Programme for Research and Innovation, which runs from 2024 to 2027. The analysis highlights in particular the declining number of researchers and PhDs, which has been continuously falling, as well as limited research funding. This is around 10 times lower than the EU average and “insufficient to maintain a level of research activity that supports higher education and meets the needs of the economy.” The mechanisms for allocating research funds are also described as inefficient, as well as the general fragmentation of the landscape, with research and innovation activities being carried out in 67 different places. The lack of strategic vision for research infrastructure is also noted. The strategy sets out to address these issues and is being fuelled by reforms linked to EU accession. Moldova now has a regulation on open science and gender equality. There is also a new support mechanism for technology transfer offices and a business-academia roadmap. In 2025, the country also became the first Eastern Partnership country to approve a Smart Specialisation strategy, which will coordinate its R&D efforts to focus on strengths, within a European context. “We’ve done a lot in terms of normative acts,” Chiosa said. Horizon Europe successMoldova is also seeing more success in the EU’s flagship R&D programme, Horizon Europe. The country has now won nearly €15 million in funding, already double the amount won under the previous programme, Horizon 2020, and more than the €10 million target set by the government. Chiosa said the priority has shifted now to winning more research-centred projects, rather than those related to support and capacity. Moldova is also targeting further involvement in large European projects. Last year, it joined the EuroHPC Joint Undertaking giving Moldovans access to Europe's supercomputing network. The country is also a member of Danubius-RI, a European research infrastructure focused on river and sea research. Despite these efforts, Moldova’s research capacity is still shackled by its limited R&D budget, which equates to 0.23% of its GDP. This is around half of what its neighbour Romania spends, which is the lowest in the EU. According to Chiosa, the research budget is increasing year-on-year, jumping by €6.34 million between 2024 and 2025. But this doesn’t show up when looking at it as a proportion of GDP. “Of course, it’s difficult,” he said. “That is why we are putting more emphasis on collaboration between business and academia, as well as participation in Horizon Europe, to try to diversify our sources of funding.”A World Bank loan of €30 million, plus a grant of €7.8 million, was agreed in 2025 to support the modernisation of Moldova’s universities. As part of this, a call was launched this year to provide universities grants of up to €900,000 to develop their research infrastructure. Moldova is also collaborating closely with Romania, with which it shares a common language, funding 100 joint projects in 2023 and 2024. This support has been instrumental. “They are helping with sharing their expertise, inviting us into consortia, and lots more,” Chiosa said. Looking forward, Moldova is eagerly anticipating joining the EU. “We are looking closely at what the EU is doing and will shape our future national programme in research innovation accordingly.”EU accession “blocked at a technical level”Moldova is aiming to join the EU by 2028, but despite its swift and eager efforts to meet the accession criteria, there remain obstacles outside of the country’s control. For a country to join the EU, it must have certain legislation in place and meet specific standards in various areas. This is categorised into six thematic clusters containing 33 chapters. Moldova and the EU have so far opened two of the clusters, numbers one and six. The first covers fundamental laws, such as the judiciary, security and financial legislation. The sixth covers external relations. The remaining four clusters are still unopened. This includes the third cluster, on competitiveness and growth, which contains the chapter on science and research.Related articlesQ&A: Albania’s ambition to become a ‘moderate innovator’Data corner: Horizon success rates are droppingThe European Commission has confirmed that these clusters are ready to be opened, with an official saying that the Commission is encouraging EU governments, who have the final say, to move forward on the matter. However, both clusters two and three remain blocked by the EU Council’s working party on enlargement and countries negotiating accession to the EU, a different official, representing the Council, confirmed.This working party is set to meet several times in the coming weeks, with a Council meeting scheduled for mid-October in which enlargement, and Moldova’s bid, will be discussed. But there is no certainty that these talks will lead to progress. According to the Council source, it is “completely impossible to foresee if and when the file will be unblocked,” citing the sensitivity of the matter. Moldova’s situation is particularly complicated. One factor is that it borders Ukraine and is increasingly embroiled in Russia’s war, with drone incursions occurring more often on its territory. Another is Transnistria, a Russian-backed breakaway state that lies within the territory of Moldova. It is unclear how the EU would be able to accept Moldova into the bloc while this situation remains unchanged. While there is no direct reason to delay opening cluster three with Moldova, as it covers matters unrelated to security, it could be that the EU is reluctant to speed through accession negotiations without first resolving broader, geopolitical issues.Chiosa is confident that, if and when the chapter on science and research is opened, Moldova will be able to finalise it quickly. It doesn’t require any legislative changes and is only a matter of proving certain standards, which Chiosa believes Moldova is well prepared to do. “We hope that chapter 25 on science and research will be one of the first chapters opened and closed,” he said.
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I am at the Australasian Menopause Society meeting and we had a fantastic lecture on Bone Health on Day 2, called, “Everything you need to know about bones - except the boring bits!” Spoiler alert, there were no boring bits. The lecture was given by Dr. Amanda Beech, who is a senior staff specialist in Obstetric Medicine and Endocrinology at the Royal Hospital for Women, where she is director of the Bone Density Unit. I want to summarize my top 10 take-aways for you. Share Osteoporosis is a disease of low bone mass, disruption of bone microarchitecture, and fragility of the skeleton. It is a silent disease…until someone develops a fracture. The diagnosis of osteoporosis is based on either fragility/minimal trauma fractures or a T-score of less than -2.5 on a DXA (Dual-Energy X-ray Absorptiometry) or bone scan. It is important to recognize that about 50% of minimal trauma fractures occur when women have low bone mass (often referred to as osteopenia), but not osteoporosis. This tells us that bone strength is more complicated than a number on a DXA report. I am going to add a little here that wasn’t in the talk (one can only include so much in 25 minutes), as many women might read the above paragraph and think, “Shouldn’t we be treating everyone with low bone mass if this is when 50% of the fractures occur?” Many fractures happen for women with low bone mass because there are so many women with low bone mass –it is a statement about the population on a whole, not about the fracture risk of low bone mass. For you as an individual, bone density is only one component of fracture risk and many women with lower bone mass will not have a significantly elevated fracture risk. This is why individualized risk assessment matters. Subscribe We build bone in our teens and twenties, and by the time we are about thirty we have reached peak bone mass. This is why, when we discuss risk factors for osteoporosis, it is important to consider factors that might have affected us in our teens and twenties when we were actively building bone, such as nutritional restriction/energy imbalance. It is important to ask women about a history of eating disorders, and for those with such a history, getting a bone scan in perimenopause or at age 50 is likely warranted. (This image below isn’t from the talk, but is similar to one that was). Bone mass is relatively stable until about two years before the final menstrual period, and perimenopause marks a time of rapid bone loss for women. Using urinary markers of bone loss we know that the time of significantly accelerated bone loss starts about 1 year before the final period and ends about 2 years after the final period. The Study of Women’s Health Across the Nation (SWAN) shows that over the menopause transition women lose an average of 10.6% of the bone at their lumbar spine and 9.1% at the femoral neck While this wasn’t covered in the lecture, I want to add that the rapid bone loss during perimenopause is clearly related to more than estradiol, because during this time estradiol levels can be erratic and not uniformly low. Bone loss during perimenopause is likely a multi-hormone event. For example, rising FSH (follicle stimulating hormone) tracks with bone loss better than estradiol, and there is evidence that FSH may act directly on bone. While decreased estrogen matters, there is clearly more going on. FSH and bone is an active area of research. Subscribe Screening for osteoporosis was recommended fairly broadly before age 65, and was taken from the “Practitioner’s Toolkit for Managing Menopause,” from Monash University. Here is a screenshot from the toolkit that was used as a slide: I am going to add a little bit more about body weight here for clarification. Low body mass (typically 152.1 lb): 0 points (risk neutral) 60–69 kg (132.3–152.1 lb): 3 points (adds some risk)
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