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Archive for the ‘Bone Health’ Category

ASBMR 2019

September 18, 2019 @ 8:49 pm
posted by Dr Ginther

American Society for Bone & Mineral Research Annual Meeting 2019 starts tomorrow.

Jon Hennings, ARNP and I will be there hoping to see and hear  the latest studies about the new medications Tymlos and Evenity.

We always learn a lot.

Jay Ginther, MD


FDA approved clinical trials are a well established way to gain access to medications not yet available to the general public.  Most people have heard of individuals taking experimental treatments for cancers or HIV or Ebola on the news.  But there is another type of FDA trials to which we now have access.

Osteoporosis medications are first tested and approved for postmenopausal women only.  Men are 20-25% of the individuals with osteoporosis.  However, approval for men takes a separate clinical trial.  Therefore, often men have to wait an additional 3-5 years for access to a medication we know should work but has not yet been officially approved for men.

Participating in the clinical trial for men allows men with osteoporosis access to the new medication years earlier – and at no cost.  The anabolic medication Tymlos (abaloparatide) is currrently conducting a national clinical trial for men.  The intake process is detailed to be certain that only those men likely to benefit and not be harmed are included.

Cedar Valley Bone Health Institute of Iowa and North-East Iowa Medical Education Foundation are a test site for the clinical trial of Tymlos (abaloparatide) for Men.  You may qualify.  The qualification testing is all at no cost to the patient.

If you are close enough to Waterloo, IA to come in every 3 months for testing, contact us at 319-233-2663 (Shari) or 319-272-2539 (Kayla) to apply for the clinical trial.

For a bone health evaluation and treatment plan for men or women call 319-233-2663.  If you are a man needing anabolic medication we will also proceed to evaluation for the clinical trial.

Jay Ginther, MD

Evenity is a Really Different Anabolic

August 8, 2019 @ 6:42 pm
posted by Dr Ginther

We now have a third anabolic medication to build new bone.  Evenity is really different from the other anabolics, Forteo (teriparatide) and Tymlos (abaloparatide).  Forteo and Tymlos are daily shots based on the human hormones PTH and PTHrP.  Evenity is an antibody to the human hormone sclerostin.

Sclerostin controls bone formation by telling osteoblasts to stop making new bone, and telling osteoclasts to gobble up old bone.  This results in  stable bone turnover remodeling (until menopause decreases control over the osteoclasts and they go wild).  Evenity suppresses sclerostin.

Evenity markedly increases new bone matrix formation within the first month.However, the ability of Evenity to increase new bone formation diminishes month by month until it is mostly gone by one year.  Therefore, it has been approved for use for only one year at a time.  Like Forteo and Tymlos, Evenity must be followed by an antiresorptive to preserve the increase in bone.

Evenity also suppresses bone resorption by the second month.  This is a less dramatic action, but it continues at the same level to the end of the year.  The net result is a significant increase in bone matrix by the end of the year, in the same general order of magnitude as Forteo and Tymlos.

Evenity is a monthly shot into the subcutaneous fat on the back of both arms by a healthcare professional.

There is a possibility that Evenity may increase cardiac events in persons who have had a recent stroke or heart attack.  This was found in only one of the 3 clinical trials of Evenity.

Preauthorization is required for insurance to cover Evenity.  Most insurances will probably cover it within the first 3-12 months.  More next time.

Jay Ginther, MD

Top 10 Reasons

June 10, 2019 @ 6:08 pm
posted by Dr Ginther

Copy for BTrue Magazine July 2014 Issue


Top 10 reasons to check your Bone Health


 10.        It’s all downhill after age 30.  You reach your maximum bone mass by about age 30.  Then you start to lose bone mass every year.  After Menopause it is 1 to 2 percent bone loss every year.  That adds up fast.

9.         You are active and want to stay active.  Weak bones can get stress fractures during sports or fun activities like dancing.  Don’t get caught doing the wrong knd of break dancing.  Strong bones require enough Calcium, Vitamin D, and Protein, as well as regular exercise.  See our recommendations at

8.         Fractures “Suck”.  A fracture is not fun.  You could be in a cast or on crutches for months.  That really sucks.

7.         Most Iowans are low on Vitamin D.  Unless you are taking extra Vitamin D all year long, you are probably too low to absorb calcium well.  We can only get Vitamin D from the sun 5 months of the year and then only at mid-day.  Find out how much extra you need by testing.

6.         “Milk does your body good”  Milk is optional.  Calcium is not optional.  You need about 1200 mg of calcium daily in divided doses with meals.  In food is best.  Supplements with food also work.  Look up foods providing calcium on

5.         Babies steal from your bones.  During pregnancy and nursing, your baby comes before your bones.  You will steal calcium from your bones to build a healthy baby.  Try running after a toddler with weak bones!

4.         A fracture is a Bone Attack.  It is a warning that you may have problems with bone density or bone quality.  Someone with one fracture is 2 to 5 times as likely to have a second fracture.  Bummer.  A complete bone health evaluation can identify opportunities for improvement.  Avoid that second fracture by fixing the problems.

3.         A bone density exam (DXA) involves less radiation than a flight to LA and back.  DXA is safe and much more comfortable than a mammogram, pelvic or prostate exam.  Our machine rotates, so you don’t have to.

2.         Osteoporosis is much easier to prevent than treat.    Starting to build or preserve your bones while young is relatively easy and does not require medication.  Trying to salvage serious osteoporosis after a major fracture is harder for you, and usually requires medication.

1.         60 minutes for a DXA/VFA and Complete Bone Health Evaluation can save you years of misery.  Start early to prevent that hip fracture at 70.  Or that wrist fracture at 50.  Or that foot fracture at 30.  They can really cramp your style.

A Complete Bone health Evaluation includes DXA, VFA, FRAX, CBC, CNP, TSH, PTH, 25-hydroxy Vit D level, and a consultation solely focused on bone health.  In seven years I have never seen a patient who did not have at least one bone health issue which could be improved.

Jay Ginther, MD