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Start with Dietary Calcium

April 13, 2013 @ 11:35 pm
posted by Dr. Ginther

Once again we are warned of the dangers of calcium supplements.  Once again those studies cited prescribed supplements without regard to total calcium intake, including diet.  What matters is total calcium intake, including diet.

I prescribe a lot of Calcium Citrate for my patients.  I would prefer not to.  Dietary Calcium is more easily digested than supplements, and appears to hold fewer dangers than Calcium Carbonate or other calcium supplements.  Unfortunately, we have lost our taste for calcium rich foods.  There are tasty choices.

Post # 200

April 12, 2013 @ 10:59 pm
posted by Dr. Ginther

This is post # 200 in a little over 2 years.  Our audience has grown.  Last month we averaged over 200 visitors and 600 pages daily.  We had a total of 1911 unique internet addresses visit during March.  April is running over 250 visitors daily.  We must be filling a need for easily understood Bone Health information.

Thank you for your interest.

Jay Ginther, MD

GIOP From Steroid Inhalers & Injections

April 6, 2013 @ 10:54 pm
posted by Dr. Ginther

Glucocorticoid Induced OsteoPorosis is more common than we thought.  Individuals with Rheumatoid arthritis, fibromyalgia, and other inflamatory diseases often need Prednisone and other steroids (glucocorticoids).  3 months of Prednisone 5 mg or more daily induces GIOP.  3-6 months of Prednisone at over 2.5 mg daily can also lead to GIOP.  And both of these are total lifetime dose.

Many inhalers for asthma and COPD also contain steroids.  Steroids suppress OsteoBlasts, the cells that make new bone to replace resorbed bone.  A year or more of inhalers is thought to be the threshhold for ill effects.

Now we are finding out about “Cortisone” (glucocorticoid) Injections into knees and other joints.

Beware of GIOP

April 1, 2013 @ 5:55 am
posted by Dr. Ginther

GIOP is Glucocorticoid Induced OsteoPorosis.  Cortisone, Prednisone, and many Inhalers for Asthma or COPD are glucocorticoids.  Therefore, Glucocorticoid Induced OsteoPorosis is a particularly aggressive form of osteoporosis that affects all ages, not just older adults.

Glucocorticoids suppress OsteoBlasts, the cells that make new bone.  Even the normal rate of bone turnover required for good bone maintenence and repair of microcracks becomes a problem when new bone formation is suppressed.  Persons with GIOP have a rapid decline in bone quality and strength.  What can be done?