Posts Tagged ‘BMD’

Birthday Disease

December 16, 2014 @ 10:44 pm
posted by Dr. Ginther

“Why did I Fracture?” and “Why do I have Osteoporosis?” are common questions I hear from older women and men.  They are taking Calcium and Vitamin D3, eating a diet with Protein, Fruits and Vegetables, and Exercising regularly.  They are “doing everything right”, and still they have deteriorating bones.  What is wrong?

The simple answer is “Birthday Disease” – too many birthdays.  Increased Fracture Risk (Clinical Osteoporosis) is totally natural as we age.  Women after Menopause, and men after age 70, lose 1-2% of their Bone Mineral Density (BMD), and more of their Bone Strength, every year.

When I was in Medical School, 40 years ago, that was the end of the story.  Many older women (and some older men) became kyphotic (stooped over), fractured and fell, and either died or went to a nursing home for the rest of their lives.  Then, there was nothing we could do to stop it.  Today we can often prevent osteoporosis, fractures and misery.

How Hard Is It To Manage Bone Density?

November 23, 2014 @ 7:57 pm
posted by Dr Ginther

Wrong Question!  What you should be managing is Fracture Risk.  If you only look at Bone Mineral Density (BMD), you miss the chance to decrease Fracture Risk in the overwhelming majority of people.

85% of the women who Fracture have a DXA score of “osteopenia” or even “normal”.  Keeping their bone density at “only osteopenia” does them no favor.  So how can you manage Fracture Risk?

Fractures are NOT FUN.  Not something you want to repeat.  Any fracture is a Bone Attack.  It is a warning that you probably have Bone Health issues that can be improved.  Get a Complete Bone Health Evaluation and work to prevent a second fracture.  Most people can succeed in preventing that second fracture.

I see many individuals who have had a first fracture.  Often the DXA, BMD, and T-score are not that bad.  I even see many who have good DXA test scores.  But they still fractured with relatively minor trauma.  They proved that they have increased Fracture Risk.  Why?

Forteo is a daily shot.  That is a nuicence, but a small price to pay for the only Anabolic, the only osteoporosis medication which will increase bone mass in spongy (cancellous) bone.  Diabetics give themselves a daily shot for the rest of their lives.  Forteo is for only 2 years and uses a tiny insulin needle. 

People worry about the warning that lab rats got Osteosarcoma after being given very high doses of Teriparatide for the equivalent of 70 human years.  We have not seen this in humans, or chimps, or monkeys, or dogs.  Rats have bones that grow all their lives.  We do not give Forteo to growing humans, pregnant women, nursing women, persons with Paget’s Disease or unexplained elevated Alkaline Phosphatase, or persons who have had radiation to their bones.

Remember that you must take adequate Calcium, with food, spread out over 3 meals. You must take enough Vitamin D3 to be able to absorb Calcium.  You must eat enough Protein for your OsteoBlasts to make new bone matrix.