Archive for the ‘Bone Health’ Category

Calcium is responsible for the stiffness and strength in bones. Calcium is what we measure when we measure Bone Mineral Density. Without sufficient calcium intake you cannot have strong bones.

Most people can absorb 500-600 mg Calcium at a time, if taken with food containing Protein.  This only works if your Vitamin D level is high enough.

You need to consume 400-500 mg  in each of 3 meals to  reliably get 1200-1500 mg every day. This is necessary because most people  will pee and poop and sweat out at least 1000 mg of calcium daily.

Calcium is best absorbed when eaten in foods.

You can Take Control Naturally with diet alone.

Milk, Cheese, and Yogurt are all high in Calcium, but amounts can vary.  Check the label to see how many ounces are needed to make at least 200 mg.  (Check “serving size” and remember that “20%” is 200 mg when dealing with calcium.)

Some vegetables are high in Calcium.  One cup of cooked Collards, Black-eyed Peas, or 1.25 cups cooked or finely chopped Kale or Okra each have 200 mg.  4 cups of chopped Broccoli is 200 mg.  Of course you can eat these raw, if you prefer.

If you do not get enough calcium in your diet alone, Calcium Supplements are needed.

Jay Ginther, MD

True in the 1960’s – even more true today.  We expect to live into our 80’ and 90’s.  We expect to enjoy those extra years.  We can, with a little planning and action NOW.

If YOU don’t take care of your body, where ARE you going to live?  That is the real question.  Women start to rapidly lose bone at Menopause.  This is totally natural and used to be unavoidable.  Without action on your part, you could develop Clinical Osteoporosis and Fractures and wind up in a nursing home.  You can avoid these complications of natural aging.

Cedar Valley Bone Health Institute of Iowa offers a Complete Bone Health Evaluation.  DXA, VFA, specific blood tests not usually done in annual check-ups, full history, an examination and full consultation usually take 30 minutes focused on bone health alone.  We can Prevent Osteoporosis if we start early enough.  Prevention is far better than treatment, and ideally should start decades before menopause.

You must be prepared to Take Control of those issues you can control:  Calcium, Vitamin D, Protein, Vitamins & Minerals, and Exercises for Balance, Strengthening and Posture.  Everyone should do these Natural measures for best results, whether taking Osteoporosis Medications or not.  For younger persons and for some individuals over 50, they are enough all by themselves.

More next time about how YOU can Take Control of your future.

Jay Ginther, MD

Diabetes + High BMD = Brittle Bone

August 11, 2015 @ 8:50 pm
posted by Dr Ginther

Patients with poorly controlled Diabetes and high blood sugar levels often have bone with above average Bone Mineral Density (BMD).  This is good?  WRONG !!

High blood sugars lead to glycolization of the Bone Matrix, which is the protein part of the bone – collagen.  This means that glucose (sugar) molecules are incorporated into the collagen protein chains.  This distorts and stiffens the Bone Matrix.

Normally, stiffer is better,  Calcium stiffens the bone matrix, which strengthens the bone.  But too much of a good thing is bad.  Too stiff becomes brittle.  Brittle bones break more easily than “stiff enough” bones.

Persons with diabetes who routinely run high blood sugars fracture more easily than non-diabetics.  Therefore, at the same BMD and T-score, diabetics have a higher Fracture Risk.

We knew that high blood sugars in diabetics are bad for kidneys, eyes and nerves.  Now we know that high blood sugars in diabetics are bad for bones too.

Take Control of Your Future.  If you have diabetes, work with your primary doc to get your blood sugars under control.

Jay Ginther, MD

Several patients have concerns about oral surgery while taking Prolia.  This is not a problem – if you follow guidelines.

Prolia is different from other Antiresorptives.  Prolia does not accumulate in bone.  5 to 6 months after your last dose, Prolia has lost its effect of slowing bone turnover.  Therefore, it is safe to proceed with surgery on bone (including dental surgery) 6 months after your last dose.

Patients worry about OsteoNecrosis of the Jaw (ONJ), but this is very rare.  In fact ONJ virtually never occurs without a tooth extraction or serious periodontal disease.  Even then, it is rare unless you also have cancer,  have poorly controlled diabetes, or are seriously Deficient in Vitamin D3, or Calcium, or Protein intake.

Elective Orthopedic Surgery timing is the same.  If you need a Total Hip Replacement (THR) or Total Knee Replacement (TKR), schedule the surgery for 6 months after your last dose of Prolia.

Any time you plan to have surgery on bone, you should Optimize Your Bone Health First.  Get a Complete Bone Health Evaluation.  Optimize your Vitamin D level (at 40 to 80 ng/ml).  Optimize your Calcium intake in foods and supplements combined (at 400 to 500 mg at all 3 meals daily).  Optimize your daily Protein intake (1 g Protein for every kg body weight).

Sometimes you will also need the Anabolic, Forteo, to increase bone matrix and improve healing.  More about that another time.

Get the best possible result from orthopedic or dental surgery.  Wait 6 months after Prolia, and do your part to optimize your bone health.

Jay Ginther, MD