Colorado Center for Bone Research

The Colorado Center for Bone Research at Panorama Orthopedics & Spine Center is highly regarded as one of the world’s leading authorities on Osteoporosis and other rare metabolic bone diseases, including but not limited to: Paget’s disease; kidney bone disease; osteogenesis imperfecta; adult hypophosphatasia; kidney stones; primary hyperparathyroidism; hypoparathyroidism; and atypical lower extremity fractures in young people and those on bisphosphonates. Working under the guidance and the direction of Dr. Paul Miller, the Colorado Center for Bone Research delivers exceptional care for patients so that they may lead happier, stronger and healthier lives.

The Colorado Center for Bone Research has an approach and care philosophy that rests on three tenets: prevention, diagnosis and treatment. Our goal is to evaluate patients at an early stage to prevent complications of osteoporosis. We also employ top technologies to measure bone density to evaluate our patients.

Dr. Miller personally reads all patients’ bone scans to ensure proper diagnosis and management advice.

Finally, Colorado Center for Bone Research patients are provided the most current treatments and medications, as well as, access to resources and information on nutrition, exercise and drug therapies – all with the intent to improve our patients’ quality of life.

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In addition to treating our patients, we are committed to advancing the treatment of metabolic bone diseases. We participate in national and international clinical drug trials that enhance the care of our patients now and for generations to come. CCBR has been conducting clinical trials since 1987, and has established a track record for excellence in evaluating new drug therapies and treatment options. It is because of this excellence that the Colorado Center for Bone Research at Panorama Orthopedics & Spine Center is on the leading edge of developmental treatments for metabolic bone diseases.

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Dr. Paul D. Miller, MD, FACP is an internationally recognized physician specializing in research on metabolic bone disease. He is widely considered a leading authority on bone biology and the prevention and treatment of metabolic bone disorders, including osteoporosis.

It was during Dr. Miller’s time as a practicing Nephrologist that he developed an intense passion around metabolic bone disease. This interest led Dr. Miller to open the Colorado Center for Bone Research in 1994. Dr. Miller is the Medical Director at the CCBR—which is acknowledged as a top facility for the diagnosis and treatment of metabolic bone disease. He is also an avid researcher and scholar. He focuses on the treatment of osteoporosis in postmenopausal women and he is the principal investigator in a number of clinical trials evaluating the safety and efficacy of current and potential therapies.

Dr. Miler is the author and co-author of more than 300 peer-reviewed publications and has also authored or coauthored over 50 textbooks and chapters. His insights and thought leadership have made him a media resource and sought-after speaker. He lectures widely at regional, national and international levels to physicians and at scientific conferences.

In addition to his research duties and speaking engagements, Dr. Miller is The Founding President of The International Society for Clinical Densitometry and is Emeritus Editor-in-Chief of the Journal of Clinical Densitometry, he serves on the editorial boards of Osteoporosis International, Calcified Tissues Research, Journal of Women’s Heath and the National Osteoporosis Foundation’s Osteoporosis: Clinical Updates Newsletter, and Up-to-Date.He is also a reviewer for the Annals of Internal Medicine, Calcified Tissue International, Journal of Bone and Mineral Research and The New England Journal of Medicine.

Dr Paul Miller

Dr. Miller is one of the Co-Chief Scientists for The National Osteoporosis Foundation, National Bone Health Alliance Bone Turnover Marker Standardization Project, and serves on the Publication Committee for The American Society for Bone and Mineral Research.

Dr. Miller has received The Distinguished Alumni Awards from Gettysburg College and George Washington University, an Honorary Doctorate of Science from Gettysburg College, The Outstanding Internist of The Year from the Colorado chapter of the American College of Physicians, and The President’s Award from The International Osteoporosis Foundation—where he currently serves on the Committee of Scientific Advisors.

Despite the demands on his professional time, Dr. Miller places his highest priority on patient care and humanism. With kindness, compassion and a sense of humor, he works tirelessly with his patients to improve their health and quality of life. It is his passion for medicine and solving complex medical cases that underscore the importance of his work.

More About Dr. Miller

Dr. Paul Miller is a highly sought after research specialist, not only does he treat patients with metabolic bone diseases as they progress through the different stages of their lives and diseases, but he also researches new ways to help treat and in the future cure these ailments. Dr. Miller is the principal investigator for all major clinical drug trials centered around medications to treat osteoporosis. He works with companies in both the United States, Europe and Asia to help develop and test newest cutting-edge medications that can help strengthen bone and even grow new bone.

As he follows his patients through these trials, he treats each one with the best evidence-based medicine and clinical experience in an effort to develop more effective treatments for metabolic bone diseases. Some areas of recent focus for Dr. Miller include clinical trials, outcomes, and side effects in the following medications:

New anabolic agents that help stimulate bone formation, improve bone quality and help heal fractures.
Anti-resorptive medications which help slow the break down of bones.
- Calcitonins which are hormones that help build bone density of the spine.
- Bisphosphonates which help slow the break down of bone by improving bone density in the spine, hips and other bones, and reducing bone turnover.
Hormone therapies like parathyroid and estrogen which can help in protecting bone and increasing bone density.

As Dr. Miller manages and monitors each of his patients at the Colorado Center for Bone Research, he may order DXA scans for vertebral fracture assessments to look for asymptomatic TBS (trabecular bone score – a partial measurement of bone quality) or bone biopsies to better diagnose and monitor the markers of specific diseases. These procedures are all performed right at Panorama Orthopedics & Spine Center’s Imaging Center or Golden Ridge Surgery Center.

In order to improve the field of metabolic bone disease treatment, Dr. Miller works with the National Osteoporosis Foundation, American Bone Health, and many other foundations and publications to maintain national and worldwide reference databases. Specifically, Dr. Miller maintains a national reference population database for biochemical markers for bone turnover.

Through his extensive research Dr. Miller is able to offer solutions to symptoms, as well as, monitor the progress of each patient’s disease. Dr. Miller specializes in the research, diagnosis and treatment of the following metabolic bone diseases:

Osteopenia and Osteoporosis
Paget’s Disease: bone regenerates more quickly and leads to weak and misshapen bones
Rare and Renal Bone Diseases
- Tumor Induced Osteomalasia (Oncogenic Osteomalacia): Difficult to locate tumors exist that emit FGF23 which impairs phosphate reabsorption and leads to low levels of vitamin D
- Hypophosphatasia: Genetic disease that affects the mineralization of bones and teeth, causes soft bones due to the lack of bone absorption of calcium and phosphorus.
Low Trauma Bone Fractures: due to extended exposure to bisphosphonates there exists reduced healing and increased fracture risk
Osteomalacia (rickets, adult rickets): softening of bones usually due to severe vitamin D deficiency
Hypoparathyroidism: Leads to decreased calcium and increased phosphorous levels in blood
Hyperparathyroidism: Converse to hypoparathyroidism, the hormone that regulates the calcium and phosphorus levels in blood is overproduced leads to illness, fragile bones, kidney stones, etc.
Osteogenesis Imperfecta – Bones that break easily with little or no apparent cause

Dr. Miller’s research and clinical trials are the perfect complement to the work done by the Orthopedic team at Panorama Orthopedics & Spine Center. Patients who have fractures that are not healing, spontaneous fractures or fractures related to osteoporosis are now able to benefit from the expertise of Dr. Paul Miller at the Colorado Center for Bone Research. His expertise and access to the newest clinical drug trials allow patients to receive the most advanced and complete treatment for their condition.

Dr. Miller is a strong advocate for an overall healthy lifestyle to help manage, prevent, and treat metabolic bone diseases. The Colorado Center for Bone Research at Panorama Orthopedics & Spine Center is a central resource for patients to learn more about changing their lifestyles to have healthier bones. As bone ages it changes and with those changes, people are at a higher risk for fractures – the number one cause of fractures is falls. Dr. Miller has, therefore, created the following suggestions and materials for his patients to understand how to create a more bone friendly lifestyle, it is our hope that these materials will help you feel better and do more.

Osteoporosis is the most common bone disease in humans and it literally means “porous bones.” It is characterized by decreased bone strength and an increased susceptibility to fractures. Bone strength is a measurement of your bone density and bone quality. The clinical diagnosis of osteoporosis is made when an individual falls from standing height and sustains a fracture.

A DXA scan is the standard test to measure bone density and bone health. Colorado Center for Bone Research has two DXA’s on-site at Panorama Orthopedics & Spine Center (one from each manufacturer of DXA machines, since the two machines can give different results.) This test is simple and painless and can assess the health of the bones.

The World Health Organization’s technical definition of osteoporosis is when bone mineral density (BMD) is less than or equal to -2.5 or greater at the hip or spine, as measured by a DXA scan.

This value is termed a T-score. Osteopenia, the precursor for osteoporosis is defined as “low bone mass,” in which the patients T-score is between -1.0 and -2.5. A normal T-score is defined as being above -1.0. Always talk with your doctor to discuss and interpret your results.

Additional information may be found at The National Osteoporosis Foundation website.

To learn more about osteoporosis, osteopenia, and other bone health, please consult these resources

Your diet and the foods you eat affect your bone health. You can greatly improve your health by incorporating foods and supplements that build bone strength so that they will support you throughout your life.

The key players in your diet for bone health are calcium and vitamin D. These are essential nutrients for building bone density and healthy teeth. Because your body can’t manufacture its own calcium, getting it from your food and drinks is important.

Dr. Miller recommends the following doses of Calcium and Vitamin D:

Calcium: 1500 – 2000 mg daily
Vitamin D: 1000 – 2000 IU daily

* Please note – Dr. Miller often recommends that women older than 50 years of age take greater amounts of calcium and vitamin D on a daily basis than the amounts recommended by the National Osteoporosis Foundation.

It is in recent years that research has shown the importance of vitamin D levels and the role they play in allowing the body to absorb the calcium. Recent data shows that many people are vitamin D deficient even when they are getting regular sunlight exposure and drinking milk. Men and women alike need both calcium and vitamin D to maintain strong bones.

Dr. Miller may also suggest that patients increase their vitamin D intake above the National Recommended Allowance due to the growing evidence that suggests it can benefit overall health having higher vitamin D levels than the minimum level necessary for calcium absorption.

Dr Miller has provided more information on nutrition for strong bones. Please review the following resources to help you better understand the role calcium plays in bone health.

Exercise doesn’t require new clothes or expensive equipment. You can walk the dog more often, park farther away from the store, find a friend to exercise with you and increase your exercise tolerance gradually. Aerobic exercise is one that gets the heart beating faster than normal and keeps that rate for 20 minutes. Some exercises are better than other for your bones.

At Colorado Center for Bone Research we recommend that patients practice gentle yoga, pilates and other exercise programs aimed at improving bone density, flexibility, posture, balance, skeletal alignment, aerobic fitness and muscle size.

In addition to exercise, preventing falls is important for any one with osteopenia or osteoporosis. A person with osteoporosis is more susceptible to a fracture when a fall occurs, especially in the hip, spine or wrist. Consider that nine out of 10 hip fractures in older Americans are the result of a fall.

Dr Miller has provided several resources to help you learn more about exercise and fall prevention.

There is no cure for osteoporosis, but there are steps you can take to prevent, stop or slow its progress. In some cases, with some of the new medications available today, you may even be able to improve bone density and reverse the disorder to some degree.

Getting enough calcium and vitamin D, as well as, appropriate exercise are essential to the bone health of everyone. This includes people treated with an osteoporosis medication. Dr. Paul Miller specializes in finding the right blend of lifestyle modifications and medications to keep your bone health at an optimal level.

Today, thanks to clinical drug trials, we are fortunate to have many new advancements in the medications available to treat osteoporosis and strengthen bones. There are two distinct categories of medications that are used at the Colorado Center for Bone Research:

Antiresorptive agents also known as the bone strengtheners are the medications available that can help to make the bones stronger – some of the drugs in this category include Fosamax, Bonita or Evista.
Anabolic agents – this is the newest class of medications that are available to help grow new bone and strengthen the bones

Please see the article here to learn more about osteoporosis medications.

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