Archive for the ‘Vitamin D’ Category
A patient recently insisted on Vitamin D2 instead of D3. She told me that she always uses plant sources because they are “more natural”. Indeed Vitamin D2 (Ergocalciferol) is more natural if you are a cabbage or other plant. But all humans naturally make and use Vitamin D3 (Cholecalciferol). Why not D2? Did God make a mistake designing humans to make and use D3?
Activated Vitamin D3 is a hormone used by our bodies in well over a hundred different functions including absorption of calcium from food, nerve functioning, and our immune system. Vitamin D2 is similar enough to D3 that we can also use it. However, we need much higher doses, and the waste products of D2 build up in our bodies.
We have “known” for years that 25-hydroxy Vitamin D levels over 50ng/ml are “too high” (hypervitaminosis D) and often cause high Calcium levels (hypercalcemia). The Mayo Clinic designed a 10 year study to confirm that causal relationship. It was presented at ASBMR.
NOF and others have called for higher Vitamin D supplementation and higher blood levels. Mayo researchers expected to find many more cases of hypercalcemia related to many more cases of hypervitaminosis D. The numbers of Vitamin D levels above 50ng/ml have doubled during the 10 years. Levels above 80 and 100ng/ml have not increased. The numbers of high calcium levels have not increased. Those patients with the highest Vitamin D levels were not the patients with the highest Calcium levels.
Falls cause Fractures. Preventing falls, or decreasing the number of falls, decreases fractures. How can you do that? Twice daily physical therapy exercises help improve muscle strength, balance and endurance. Eliminating throw rugs and steps helps.
The big news at National Osteoporosis Foundation last month was about fall prevention with Vitamin D3. Lots of new information.
This week I spoke to doctors and nurses who run Pain Clinics. The obvious connection is Vertebral Fractures requiring Kyphoplasty or Vertebroplasty. If you only do the procedure, you have not solved the problem. You must treat the Osteoporosis too, preferably with the Anabolic, Forteo, if you want to avoid further fractures.
Vitamin D is the other connection. Successful treatment of chronic pain often requires enough Vitamin D3 to bring the 25-hydroxy Vitamin D level to at least 40ng/ml. This is not yet widely known. Not all clinics are testing for Vitamin D levels. They should be!