Posts Tagged ‘antiresorptive’

Happy Birthday Aunt Henrietta

September 2, 2013 @ 2:24 pm
posted by Dr. Ginther

Aunt Henrietta is celebrating her 89th birthday, and 4 1/2 years without a fracture!  This is a major victory for her.  She is one of our many stars!

Despite starting on enough calcium and enough vitamin D over 6 years ago, Henrietta broke one wrist, then the other wrist, and finally a shoulder.  Finally she added osteoporosis medications.  Despite falling all the way down the attic stairs, she has not broken anything since.

Fracture Risk is much more than Bone Mineral Density and t-score.  Bone Health is affected by many medical conditions.  That is why we check blood tests.

Alkaline Phosphatase (alk phos) is the most interesting serum (blood) enzyme because it is produced in liver, bone, intestine and placenta.  High alk phos can mean rapid bone formation.  If Bone Alk Phos is high, we need to determine why.  Most commonly bone alk phos is high in bone healing after a fracture or orthopedic surgery, and will return to normal within 6 months.

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?

Bone Not “Good Enough” = Anabolic Forteo

December 4, 2012 @ 10:40 pm
posted by Dr. Ginther

Bone that has Fractured = Bone NOT Good Enough = Bone which requires the Anabolic, Forteo.  Any fracture, especially vertebral compression fracture, can mean that the bone is NOT Good Enough.  A Falling Bone Mineral Density (BMD) can mean that the bone is NOT Good Enough.

Orthopedic Surgeons see patients because their bone has fractured.  Often this is a Fragility Fracture – a fracture due to a fall from standing height.  I treat osteoporosis because of the patients I saw as an orthopedic surgeon.  My orthopedic training makes Fracture Prevention my #1 goal.