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Posts Tagged ‘Complete Bone Health Evaluation’

National Osteoporosis Prevention Month

May 5, 2017 @ 10:40 pm
posted by Dr Ginther

May is National Osteoporosis Month.  That should be National Osteoporosis Prevention Month.  Or perhaps National Bone Health Optimization Month.

Click on the helpful link to National Osteoporosis Foundation to learn more.

Take Control Naturally by following the posts from earlier this year.  And get a Complete Bone Health Evaluation.

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

True in the 1960’s – even more true today.  We expect to live into our 80’ and 90’s.  We expect to enjoy those extra years.  We can, with a little planning and action NOW.

If YOU don’t take care of your body, where ARE you going to live?  That is the real question.  Women start to rapidly lose bone at Menopause.  This is totally natural and used to be unavoidable.  Without action on your part, you could develop Clinical Osteoporosis and Fractures and wind up in a nursing home.  You can avoid these complications of natural aging.

Cedar Valley Bone Health Institute of Iowa offers a Complete Bone Health Evaluation.  DXA, VFA, specific blood tests not usually done in annual check-ups, full history, an examination and full consultation usually take 30 minutes focused on bone health alone.  We can Prevent Osteoporosis if we start early enough.  Prevention is far better than treatment, and ideally should start decades before menopause.

You must be prepared to Take Control of those issues you can control:  Calcium, Vitamin D, Protein, Vitamins & Minerals, and Exercises for Balance, Strengthening and Posture.  Everyone should do these Natural measures for best results, whether taking Osteoporosis Medications or not.  For younger persons and for some individuals over 50, they are enough all by themselves.

More next time about how YOU can Take Control of your future.

Jay Ginther, MD

You have started taking Osteoporosis Medication.  You think you have entirely eliminated your Fracture Risk.  Then, WHAM – you have a Fracture!  What went wrong?

It is time to re-evaluate.  There are many possible reasons for your fracture.

First, all osteoporosis medications gradually become effective over months.  Therefore, if you fracture within the first few months, there has not been enough time for it to become fully effective.

By two to three years, all osteoporosis medications Decrease Fracture Risk by 1/2 to 2/3.  That is very good, but not perfect.

Second, you need to be sure you are getting enough Absorbable Calcium in 3 doses of 400-500 mg In Foods or With Foods – every day.  You need to have a high enough Vitamin D level to absorb the Calcium.  You need Magnesium too – a Multiple Vitamin and Mineral (taken with a full meal) should be enough.  You also need Protein (1gram per kg of body weight).  If you had Secondary HyperParathyroidism, it must be resolved.

Third, Bisphosphonate pills are sometimes not absorbed adequately.  When they work, we actually absorb less than 1% of the drug taken.  If this is a problem, Reclast or Prolia can get around the absorption issue.  Of course, skipped doses do not work at all.

Fourth, there may be other issues causing fragility.  A Complete Bone Health Evaluation will usually identify Diabetes, HypoThyroidism, Colitis, Irritable Bowel Syndrome, Lactose or Gluten sensitivities, etc.  These need to be fixed too.

Finally, your Osteoporosis may be too severe to be ideally treated with Antiresorptives.  Very low BMD and T-scores, multiple Fragility Fractures, Vertebral Fracture Deformities (especially multiple) are all indications that you probably should start with the Anabolic, Forteo, to build up your Bone Matrix enough that a Antiresorptive can then be the best treatment.

Fracture while on medication?  Time to re-evaluate.  Then modify your program if needed.

Jay Ginther, MD