Posts Tagged ‘Bone Health’

“I want to treat my bone health entirely naturally – without any “artificial” medications.”  That might be possible if you are among the less than half of all women not destined to suffer one or more fragility fractures without medication.  Your odds are certainly better if you take all the measures outlined over the past weeks.

Years ago Osteoporosis was rarely a problem.  100 years ago most people died before age 65.  200 years ago most people died before age 40.  We live too long to avoid the natural decline in bone health.  (I would rather live long and deal with medications).

When I was in medical school (45 years ago) we lived entirely naturally in terms of bone health.  Most woman, and some men, became stooped forward with “humpback” kyphosis until they fell, broke a hip and either died or were shipped to a nursing home forever.  There was nothing we could do to prevent that.

Now we know a bunch of natural things we can do to postpone that scenario, but we cannot prevent it entirely in many people without adding medication.  Adding medication may be “cheating”, but I would rather stay active and enjoy life.

Take Control Naturally as long as you can, but evaluate your bone health periodically and add osteoporosis medication when your fracture risk rises.

Jay Ginther, MD

So how do you find out what aspects of your bone health are pretty good already, what will be easy to fix, and what will take some real work?  Start with a Complete Bone Health Evaluation.

DXA is about 1/3 of the story and should include both hips and spine.  When you are as old as I am, the spine probably is too arthritic to be really accurate, but helps complete the picture.  If you have had a total hip replacement, you should use the non-dominant forearm.

VFA will pick up many persons at increased fracture risk who are missed by DXA alone.  You should ask for VFA, especially if you or a parent have kyphosis (humpback) or have lost height.

The FRAX calculation picks up different individuals at high fracture risk.

Blood tests should include CBC, CMP, TSH, PTH, and 25-hydroxy Vitamin D as a start.  Further testing may be needed.

A medical history and examination focused on bone issues is a critical part of the full consultation.  We allot a minimum of 30 minutes for discussion.  Often a follow-up visit is needed to be sure both we and our patients are clear on the whole picture.

DXA alone misses over half of the individuals who need to improve their bone health.  Get a Complete Bone Health Evaluation.

Jay Ginther, MD

Smoking is a major risk factor for fractures.  Smoking suppresses the osteoblasts (the cells that make new bone).  The osteoclasts (cells that eat away bone) then can easily outdo the osteoblasts, and you lose bone mass.  Lower bone mass = more fractures.

Stopping smoking altogether is the best for your bone health.  That is really tough to do.  E-cigarettes have not proven less harmful to bone.  Nicotine patches help only if they eventually lead to less nicotine intake than with smoking.

The damage smoking does to your bones (and lungs, and heart) is dose related.  Therefore, cutting way down is almost as good as quitting, and often much easier to do.

Especially if you are trying to heal a fracture, stopping smoking, even for a few weeks, is really important.  1 ppd smokers are 5 to 10 times as likely to not heal a fracture.  The same is true for infection rate after surgery.

Steroid Inhalers also suppress osteoblasts and bone formation.  Unfortunately many cannot get off their steroid inhalers, even after they quit smoking.  Major bummer.

Take Control Naturally of your bone health.  Stop Smoking.  Or at least cut way back.

Jay Ginther, MD

 

 

The purpose of good bone health is to prevent fractures.  Most fractures happen as a result of a fall.  If you do not fall, you decrease your fracture risk.  How do you prevent falls?

Regular exercise will strengthen your muscles.  Strong muscles are part of the solution.  But you also need good balance.  Good balance requires exercises to strengthen the muscles required for balance.

Balance exercises have been used for centuries to keep people limber and free from falling, and thereby, free from fractures.  They are often taught in group sessions, but can be performed alone on any flat surface.

Tai Chi and Yoga are the best known ancient balance exercises.  Daily, or at least 3 times weekly, sessions of 20-30 minutes will gradually improve your balance and prevent falls.

Less interesting, but easier to do anywhere, is simply walking on your toes for several minutes.  More challenging is walking on your heels, like a penguin.  If you can do that for 2 minutes straight, you have great muscles, strong ankles, and are unlikely to stumble, even on uneven ground.

Take Control Naturally by working on your Balance.  Remember that proper nutrition is necessary for strong muscles and bones.

Jay Ginther, MD