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Posts Tagged ‘Bone Mineral Density’

Start with a Complete Bone Health Evaluation

June 24, 2020 @ 6:57 am
posted by Dr Ginther

You just tripped and suffered a minor fracture?  You just started menopause or male low “T”?  You are now on Medicare?  Are you concerned about your bone health?  If not, you should be.  At least concerned enough to check it out.

Don’t just get a DXA.  DXA alone misses 85% of Fracture Risk, especially in older individuals.  You should get a Complete Bone Health Evaluation to catch any problems early.  “Take Control Naturally” with enough calcium, Vitamin D, protein, and exercises every day.

What is a Complete Bone Health Evaluation?

DXA read by an ISCD Certified Clinical Densitometrist is a start.  ISCD certification assures proper reading.

Vertebral Fracture Assessment (VFA) identifies vertebrae which have collapsed, up to 80% of which are not recognized.  (I missed mine.)

FRAX calculates Fracture Risk far more accurately than DXA and Bone Mineral Density alone.

Blood tests include CBC and CMP routinely done for annual check-ups.  We add monohydroxy Vitamin D, PTH, TSH and phosphorous.

History and physical examination focused on bone health and 20-30 minutes consultation solely about bone health, fracture prevention, osteoporosis prevention, or osteoporosis treatment.

A Complete Bone Health Evaluation allows many of our patients to Take Control Naturally with proper nutrition and exercise alone.

Jay Ginther, MD

NOF Tip for 7 May – Calcium Rich Foods

May 7, 2020 @ 7:07 am
posted by Dr Ginther

BMD (Bone Mineral Density) = Calcium in Bone.  If you want strong bone you must get enough calcium.  Calcium in food is best.  Take control naturally with calcium in foods.

Different listings of calcium in foods look different.  They include different foods.  They have different serving sizes.  We have a handout at the office.  The key is to pick out foods that you like well enough to want to eat them.  Then check serving size.

NOF lists 25 common calcium rich foods at https://cdn.nof.org/wp-content/uploads/2017/04/25-TIPS-Calcium-rich-Foods.pdf

Remember to spread out your calcium over multiple meals.  Remember to take enough vitamin D that you can absorb the calcium you consume.

Jay Ginther, MD

Bone Mineral Density is Calcium in Bone

January 11, 2020 @ 11:20 am
posted by Dr Ginther

Why do some patients, who are already on good osteoporosis preventing or treating medications, still have a falling Bone Mineral Density?  Are the medications not working?  Not as well as they should!  Why?  Even the best medications cannot work without enough CALCIUM intake and absorption.

If you want to improve your bones you must ABSORB enough calcium.  This can be a bit tricky.  You need the right kind of calcium, taken in food or with food, and spread out over 3 meals or snacks.  “Calcium” is Calcium Carbonate which requires lots of acid to dissolve.  This often is a problem if you take antacids, have heartburn or GERD, have digestive issues like lactose sensitivity, celiac or IBS, or are just “too old”, which begins at 50.

Calcium in foods is easy to absorb.  Calcium Citrate tablets or Tricalcium Phosphate Gummies require 2 tablets or gummies to total the 400 or 500 or 600 mg on the label.  Adora Chocolates are 500 mg each.  We recommend taking in 1200-1500 mg calcium daily.  That means 400-500mg at each of 3 meals.

DXA does not show bones.  DXA shows calcium.  Calcium stiffens and strengthens bones.  You cannot have good BMD or good bones without enough calcium!  Take control of your bone health with adequate calcium in diet and supplements.

Next time a listing of Calcium in Foods

Jay Ginther, MD

Improve Bone First – Preserve Bone Second

December 8, 2019 @ 8:19 pm
posted by Dr Ginther

National Bone Health treatment goals are changing for those patients with high fracture risk.  Simply preserving bones already at a too high fracture risk never made much sense to this former orthopedic surgeon.  Now the national leadership is stressing the need to lower fracture risk first, then preserve bones at a lower level of fracture risk.

We now have 3 anabolic medications which substantially lower fracture risk by increasing the thickness and strength of bone structure: Teriparatide (Forteo), Abaloparitide (Tymlos), and Romosozumab (Evenity).  They all decrease fracture risk substantially more than the antiresorptive (preserving) medications alone.  The difference in fracture risk grows for up to 5 years.  After that the difference in fracture risk between anabolic meds followed by preserving meds vs. preserving meds alone remains the same.

Calcium can take up to 3 additional years to collect in newly formed bone matrix.  DXA shows calcium in bone (Bone Mineral Density).   Much of the increased BMD can only be seen on DXA after the anabolic med is completed and the antiresorptive med is started.

All of the anabolic medications must be followed by antiresorptive medication to preserve the gains made by the anabolic.  No medication to grow or preserve bone can work without adequate nutrition in the form of absorbable calcium, vitamin D3, protein and other vitamins and minerals.

Jay Ginther, MD