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Archive for December, 2019

Blue Zones Christmas! and New Year!

December 27, 2019 @ 12:34 pm
posted by Dr Ginther

Are you in a Blue Zone?  Don’t know what a Blue Zone is? Read “The Blue Zones” and “Thrive” by Dan Buettner.  Blue Zones are where life is good.

We are visiting our grandkids in California for the Christmas and New Year holidays.  We have 2 north of Sacramento and 2 northwest of LA.  Grandkids are even more fun than your own kids were.

Family is one of the key elements to living in a Blue Zone.

Jay Ginther, MD

 

Improve Bone First – Preserve Bone Second

December 8, 2019 @ 8:19 pm
posted by Dr Ginther

National Bone Health treatment goals are changing for those patients with high fracture risk.  Simply preserving bones already at a too high fracture risk never made much sense to this former orthopedic surgeon.  Now the national leadership is stressing the need to lower fracture risk first, then preserve bones at a lower level of fracture risk.

We now have 3 anabolic medications which substantially lower fracture risk by increasing the thickness and strength of bone structure: Teriparatide (Forteo), Abaloparitide (Tymlos), and Romosozumab (Evenity).  They all decrease fracture risk substantially more than the antiresorptive (preserving) medications alone.  The difference in fracture risk grows for up to 5 years.  After that the difference in fracture risk between anabolic meds followed by preserving meds vs. preserving meds alone remains the same.

Calcium can take up to 3 additional years to collect in newly formed bone matrix.  DXA shows calcium in bone (Bone Mineral Density).   Much of the increased BMD can only be seen on DXA after the anabolic med is completed and the antiresorptive med is started.

All of the anabolic medications must be followed by antiresorptive medication to preserve the gains made by the anabolic.  No medication to grow or preserve bone can work without adequate nutrition in the form of absorbable calcium, vitamin D3, protein and other vitamins and minerals.

Jay Ginther, MD