Archive for the ‘Evaluation and Screening’ Category

Determining the correct 25-hydroxy Vitamin D level is still a work in progress.  In the 8 years I have been attending meetings, we have made considerable progress.  NOF 2007 was the first time any society proposed an intake above 400 IU daily and a 25-hydroxy Vit D level of more than 20 ng/ml.

At the 2015 U. Wisconsin “Bare Bones Symposium” the latest recommendations were discussed.  I have summarized them here.

Take Vitamin D3.  D3 is Cholecalciferol (what we make in sunshine).  Vitamin D2 is Ergocalciferol (what plants make and use).  D3 works much better in people than D2 becuse it is the right stuff.   It lasts 5 times longer and the assay is more accurate.

Test for 25-hydroxy Vitamin D level and aim for between 40 and 80 ng/ml.  At 40 ng/ml over 98% of people can absorb and utilize Calcium fully.  You want to have some margin of safety since lab test results vary by at least 20%.  If you are seriously deficient, we give 50,000 IU of D3 every M, W, F based on your level and size, to correct the level quickly.

If you do not want to test your level, and you are the “average person” of 154# or 70 kg, you should take 3800 IU daily.  This should achieve the 40 ng/ml level – eventually.  If you are very deficient, this could take a year or more.  If you are larger than the old average, or you have digestive issues, you will need more.

Finally, some cancer researchers believe that 70 ng/ml is better for preventing and treating cancers.  If they are right, you should go for the higher level.  If they are wrong, you have done no harm by going for the higher level.

Take Control of your Bone Health.  Take enough D3.

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 ( 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

Happy Mother’s Day

May 8, 2015 @ 9:09 pm
posted by Dr Ginther

What can you do for your mother?  Mother’s Day is when you thank your mother for all that she did for you.  Seriously?  That is too much to accomplish in just one day with flowers and a meal.  Perhaps you can do something that could improve the rest of her life!

Your mother is getting older every year.  We all do that.  Perhaps she is shrinking or developing a humped back (kyphosis).  We can prevent that!  Perhaps she has fallen and broken a bone.  We can often prevent that too!

Over the last 20 years the world has changed.  We now know how to prevent bones from deteriorating.  We can improve bone health and prevent fractures.  The sooner we start, the better we can preserve your mother’s independent lifestyle.  Your independence too, if you are her caregiver.

Without attention to their bone health, half of all women over age 50 suffer at least one fracture.  We can prevent nearly 2/3 of those fractures.  A Complete Bone Health Evaluation tells us in what areas you have opportunities for improvement.

We start with enough Calcium in foods and supplements, enough Vitamin D3 supplements, enough Protein, Multiple Vitamins & Minerals and balance exercises.  Sometimes medications.

Your mother sacrificed her bone health for you before and after your birth.  She gave you a lot.  Give back to her.  And if you must give chocolates, try Adora Chocolates with a whole meal’s Calcium in each.

Check out your mother’s bone health.  Yours too.  Then take Control of both your futures.

Jay Ginther, MD

ISCD 2015

March 3, 2015 @ 7:37 pm
posted by Dr Ginther

Driving to Chicago in February was cold and snowing.  But it was hot indoors at the ISCD (International Society for Clinical Densitometry) Annual Meeting and Position Development Conference (PDC).

While no new technologies were introduced, the PDC evaluated the scientific studies of several recent innovations.  Most are best done in research centers.  One recent innovation could make it to clinical centers.  Trabecular Bone Score (TBS) is a software addition to DXA that adds information about the quality of bone by re-analyzing the L1, L2, L3 vertebrae.

We have discussed how adding Vertebral Fracture Assessment (VFA) to a DXA Bone Mineral Density (BMD) improves Fracture Risk calculation.   TBS has the same potential.  The main issues blocking TBS are software cost, added time, and the fact that all insurances (including Medicare) currently do not pay for it.

We also attended presentations about patient treatment issues.  Fracture Prevention is much more than just checking a T-score with DXA.  National experts shared their knowledge of medical issues that can strongly influence Bone Health and Fracture Risk.  More about these sessions next time.

You can Take Control of your Future with action to decrease your fracture risk.

Jay Ginther, MD