Archive for the ‘Bone Health’ Category

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

Keep Your Dad Fracture Free For Fathers’ Day

June 19, 2015 @ 10:04 pm
posted by Dr Ginther

Do better than another shirt or tie for Fathers’ Day.  Make sure your Dad stays Fracture Free!  What?  Men don’t have Osteoporosis or Fractures.  But they do!

25% of all Osteoporosis patients are Men.  Each year 80,000 men have hip fractures.  Over 30% of those men die of complications of their hip fractures.

1/4 of all Men over 50 will Break a Bone due to Poor Bone Health (Osteoporosis).  More Men over 50 will Break a Bone than will have Prostate Cancer.

Many diseases and some medications increase fracture risk.  So do many modern lifestyle errors.  The good news is that simple measures can Decrease Fracture Risk.

Enough Absorbable Calcium spread out through the day.  Enough Vitamin D3 to achieve a 25-hydroxy Vitamin D level of at least 40.  1 gram of Protein for every kilogram of body weight daily.  Multiple Vitamins & Minerals.  Balance and Weight-bearing exercises daily.

Go to the National Osteoporosis Foundation website (www.nof.org) or click the link at your right.  Read The Man’s Guide to Osteoporosis.

Get a Complete Bone Health Evaluation.  Fix potential problems.

Take Control.  You can Avoid Fractures.

Jay Ginther, MD

Kids Learn About Bone Health

June 4, 2015 @ 9:45 pm
posted by Dr Ginther

The Imaginarium (Children’s Science Museum) at the Grout Museum in Waterloo, IA is teaching bone health this summer.  Good choices for bone health during growing years are the best way to avoid future problems and osteoporosis.

“The Bone Zone” is a special exhibit from Purdue University Department of Nutrition now through 5 September.  Interactive exhibits teach interesting facts about bone, and guide participants to healthy choices for bone health.  The target audience is K-8, but adults learn a few things too.

You can learn about Calcium content of foods.  Fortuneteller “Madame Ulna” will tell your bone future based on activity choices.  You can compare the strength of a human femur to equally strong wood, concrete and steel.

Cedar Valley Bone Health, Cedar Valley Orthopedics, and Cedar Valley Medical Specialists, PC sponsored the exhibit.  As sponsors we brought our kids and grandkids to a special opening.  “The Bone Zone” is really cool.

Take your kids and grandkids to the Grout Imaginarium this summer.  They’ll have a great time, and great bones.

Jay Ginther, MD