Pharmaceutical Industry Websites

The following sites are sponsored by the manufacturers of these pharmaceutical agents:

Archive for the ‘Bone Health’ Category

Calcium and Vitamin D3 Can Help !!

January 21, 2018 @ 9:43 pm
posted by Dr Ginther

Once again we have been treated to statisticians mushing together multiple disparate previous studies to “prove” that calcium alone, or vitamin D alone, or both together in one of many different combinations will not prevent fractures.  All mushed together in a carefully selected meta-analysis, you can prove anything depending on which studies are included.

More important, asking if adding a specific dose of calcium, or vitamin D, or both, will prevent fractures, misses the entire point.  Most studies did not properly account for the nutrients in each day’s diet in individual test subjects – or in individual control subjects, many of whom also consumed the nutrients being studied.

And how can you ethically ask a patient to limit their diet in a way you believe will put them at risk for fractures?  You have to settle for encouraging patients who are inadvertently short on some nutrients to improve their diet.  But then they do not fracture and you cannot prove that they would have if only you had withheld the information!

We help individuals improve their bone health.  One size does not fit all. We do a Complete Bone Health Evaluation.  Then we adjust nutrition and lifestyle as needed for that individual.  In about half of women and three-quarters of men, this is enough.

Jay Ginther, MD

Iowa Bone Club Fall Meeting

October 22, 2017 @ 7:38 pm
posted by Dr Ginther

Iowa Bone Club met for the third time this past Friday, 20 October.  Ritu Munjal, MD was the program chair and hosted the meeting at PCI in Cedar Rapids.

Great program for those attending.  Guest CME topic was hypophosphatasia, which can be a cause of poor bone and increased fracture risk.  Low alkaline phosphatase and elevated B6 are the key labs.  The condition can be made worse by bisphosphonates, and probably other antiresorptives.

Spring 2018 meeting will be Friday 1 June in Spirit Lake.

Jay Ginther, MD

Treat to Target #1 – Which Target?

June 19, 2017 @ 6:30 pm
posted by Dr Ginther

Treat to Target has been standard for chronic diseases like high blood pressure and diabetes for decades.  These are chronic diseases, more common as we get older, that we can control with diet, exercise, and eventually medication.  We cannot cure them.

Bone health joins the Treat to Target club in 2017.  Increased Fracture Risk (Clinical Osteoporosis) is a chronic disease, more common as we get older, that we can control with diet, exercise, and eventually medication.  We cannot cure Increased Fracture Risk, so treatment of some sort is necessary “forever”.

What is our target?  Traditionally it has been maintaining the T-score found at the first assessment.   This does not necessarily make sense, especially if there already are fractures.  The target should be NO NEW FRACTURES.  This is a game changer.

This means that we are aiming for a Bone Mineral Density T-score higher than -2.5 in someone who has not yet fractured.  How we get there requires a new approach to medications, once we have reached the limits of Take Control Naturally detailed in previous posts.

This also means we need to check the VFA for previous Vertebral Compression Fractures, most of which go un-noticed, mistaken for pulled muscles.  (I did that a few years back.)

THE TARGET IS NO NEW FRACTURES.

Jay Ginther, MD

The Bone Health Guidelines are Changing

June 11, 2017 @ 4:58 pm
posted by Dr Ginther

University of Wisconsin hosts biennially the Bare Bones of Osteoporosis Care Symposium.  This year the Wisconsin Bone Club followed the symposium.

Felicia Cosman, MD from Helen Hayes in New York was the guest speaker at both.  She expanded on the new thoughts and guidelines presented at NOF in April.  These were a complete change of approach from just a few years ago.

Treat to Target.  Anabolics first to build bone and then preserve with Antiresorptives.  Reconsider VFA for all first time DXA evaluations.

More detail about these in the weeks to come.

Jay Ginther, MD