Before childbirth, protein, calcium, and other nutrients are directed toward the baby, at the expense of the mother’s health if necessary.  After childbirth it gets worse.  Nursing mothers must supply enough calcium, protein and other nutrients for the child to more than double in size.  Bones are particularly hard hit as the baby’s bones begin to take on more and more calcium.

As an orthopedic surgeon, I knew that pregnant and nursing women take incredibly long to heal fractures.  Any spare calcium is sent to the baby.  And if the mother is not drinking at least as much milk she is producing, there is little calcium left for her.

The sudden drop in estrogen and progesterone which occurs with childbirth results in the mother mobilizing calcium from her bones to her bloodstream in preparation for lactation.  And she will continue to drain calcium from her bones until she stops nursing.

Women need to build up their bones as much as possible to make up for losses during pregnancy and lactation.  This is best done before and after the events.  Gals, get enough Calcium, Vitamin D3, and Protein.

Mothers, thanks for all you sacriufice for your children.

Jay Ginther, MD

Smoking is the biggest risk factor which is completely controlable.  It is very hard to quit.  Most people need the help of pills or patches.

Falls are also a major risk factor for fractures.  They are avoidable.  You can treat low Vitamin D levels, which are a cause of falls.  Balance and strengthening exercises like Tai-chi can also help a lot over time.

Taking Prednisone may be avoidable.  5 mg or more daily for more than a few weeks increases fracture risk.  Switch to medications without Glucocorticoids if you can.

You can avoid being too fat or too thin.  A BMI over 35 or under 19 carries increased fracture risk.

You cannnot avoid the increased risk of being female.  However, one-quarter of all osteoporosis patients are men.

Hormonal ablation therapy for breast and prostate cancer are also a major risk for bone loss and fractures.  Fortunately, some osteoporosis medications actually help treat the cancer.

If you have already had a fracture, you are at increased risk for another fracture.  Multiple previous fractures are a big deal.  If you are shrinking or have a humpback, you have vertebral fractures and are at high risk.

If you have some of the risk factors listed above, you are at risk for osteoporosis and fractures.  Get a complete bone health evaluation, and take action.  You can take control if you act.

Jay Ginther, MD

A mile from Blackhawk Creek, my yard has different soil and wildflowers.  Bloodroots are finishing.  Rue anemonies are peaking.  The grey dogwood is starting.  The redbuds are opening.  Prairie and Grandiflora trilium are up but not quite open. True and false Soloman seal will come later, as will bellworts, wild ginger, and a host of may-apples.  And, of course the daffodils, scilla, crocus, and tulips.

Life is good if you take the time to enjoy it.

Jay Ginther, MD

High blood pressure can hide until the first stroke, or TIA if you are lucky.  High cholesterol can hide until the first heart attack, a minor one if you are lucky.  Diabetes can be overlooked until your eyesight or kidneys fail, or you lose a leg to ulcers.  However, all of these, including Osteoporosis, can be successfully treated before a major problem arrives!!!

Osteoporosis, high blood pressure, high cholesterol, and diabetes are all chronic lifelong diseases.  Many times they can be rendered harmless by changes in lifestyle, and perhaps medications.  You never get rid of the underlying disease, but you can make it harmless by treating it properly.

Proper diet and nutrition are key to controlling all 4 diseases.  If you catch them early enough, diet and nutrition alone can often be all you need for years.  Unfortunately, most of us do not look for and catch them before medications are needed.  We could change that if we looked earlier.

You can Take Control Naturally with diet, nutrition, and exercise, if you start early.  Calcium, Vitamin D3, and protein are key for bone health.  Get a complete bone health evaluation to look for osteoporosis risk and fracture risk.  Specifics about risk factors next time.

Jay Ginther, MD

The drive home was bright, sunny, and warm.  A pleasant change after a cold, wet spring.  Waiting for me were the first daffodils of the season for our yard.  2 days earlier we had leaves and buds, but no flowers.

Evening was a multimedia feast of “The Planets” by Gustav Holst with video of scenes inspired by the music.  (The music has been used as background in a number of films.)  Our local symphony perfomed the music very well, co-ordinating with the video.  Then a reception to view the original artworks (pen & ink, watercolors,  pastels) while talking with the visual and auditory artists over munchies and adult beverages.

Life is good, if you take the time to enjoy it.  Do so.  A few minutes every day is good.  A rare full day is even better.

Jay Ginther, MD

Lectures focussed on bringing new knowledge into clinical practice.  The emphasis was on what we can do for individual patients.  That is how we practice – helping one individual person achieve better bone health at a time.

This year the theme was teamwork.  A coordinated program involving doctors, nurses, nurse practitioners, physician assistants, physical therapists, dietitians, all working in a single coordinated effort works the best.

We learned more about what can be done to improve bone health without medications.  We studied the very limited data about “natural” substances and how they may work.  We reviewed the data from clinical trials of pharmaceutical medications involving tens of thousands of human patient years.  We learned more about how each pharmaceutical medication works compared to other meds and compared to the natural disease process.

We debated the “ideal levels” of calcium and vitamin D3.  People are all different.  Even the same person has different needs at different ages.

I will be discussing the topics covered at the symposium over the next weeks.  The really good news is that each year we know more and can do more to prevent osteoporosis, to decrease fracture risk.  And we can do more to treat osteoporosis too.

Jay Ginther, MD

As an orthopedic surgeon, my goal is always Decreasing Fracture Risk.  In the USA we sometimes seem to have forgotten that real goal.  We focus too much on DXA t-scores.  We should focus on the patient.  We should treat “Clinical Osteoporosis”.  The patient deserves a complete Bone Health evaluation.

We cannot just take a medicine and forget about our bone health for the rest of the year.  Calcium is basic – in at least 3 doses daily – best in foods or Calcium Citrate.  Vitamin D3 is essential.  Enough protein is essential.  Back extension exercises can make a major difference in avoiding humpback (kyphosis).  Stopping smoking can be a huge help.

Do what you can to Take Control Naturally.  Remember:  If you don’t take care of your body, where are you going to live?

Jay Ginther, MD

I prescribe a lot of Calcium Citrate for my patients.  I would prefer not to.  Dietary Calcium is more easily digested than supplements, and appears to hold fewer dangers than Calcium Carbonate or other calcium supplements.  Unfortunately, we have lost our taste for calcium rich foods.  There are tasty choices.

See previous posts for a listing of calcium rich foods and Adora Premium Chocolates.  There is a reason why many peoples around the world have consumed milk, yogurt, cheese, collards, kale, black-eyed peas, okra, whole sardines, almonds and brocolli for hundreds of generations.  They supply the calcium needed for strong bones.

Remember that fresh is often better than processed food.  Excessive salt in many processed foods directly harms bones leading to osteoporosis.  This is covered in previous posts “Lower Your Salt – Save Your Bones” and “Salt Free in a Salty World”.

Take Control Naturally with enough dietary calcium.  At least 1000 mg daily, and 1200-1500 is better if you need to make up for years of neglect.  However, if you cannot eat enough calcium in your diet, you do need supplements. 

Remember, in order to absorb calcium from food or supplements, you need enough Vitamin D3.  A 25-hydroxy Vit D level of 40 or above is enough for everyone.  Check your level.  It’s probably lower than you realize.

Jay Ginther, MD

Thank you for your interest.

Jay Ginther, MD

Many inhalers for asthma and COPD also contain steroids.  Steroids suppress OsteoBlasts, the cells that make new bone to replace resorbed bone.  A year or more of inhalers is thought to be the threshhold for ill effects.

Now we are finding out about “Cortisone” (glucocorticoid) Injections into knees and other joints.

Recent studies of bone turnover markers have revealed that OsteoBlast function (new bone formation) is suppressed for about 2 weeks after a “cortisone” injection into a knee for arthritis.  Mild effects have also been found after shoulder injections and after Epidural Steroid injections for Spinal Stenosis.

Apparently a single injection is not a big deal.  More than 3 injections in a single year, or more than 10 injections in a lifetime, can be a problem.  Many men receive multiple injections.  Just like many men are on steroid inhalers.

Glucocorticoid Induced OsteoPorosis will eat away your bones by blocking their renewal.  What can you do?  Read my last post about GIOP.  Obtain a complete bone health evaluation.  You may need the assistance of medications, but you can take control of your future!

Jay Ginther, MD