Posts Tagged ‘Vitamin D’

It’s the Fractures, Stup..

February 21, 2014 @ 4:36 pm
posted by Dr Ginther

Dr Neil Binkley took this line from politics in his address to the International Society for Clinical Densitometry (ISCD) and International Osteoporosis Foundation (IOF) joint meeting yesterday.  Dr Binkley is known for his blunt style and his ability to go directly to the heart of the matter.

As an orthopedic surgeon, I agree completely that the real issue is Fractures and how to Prevent themA Fracture is a Bone Attack. It is a warning that the patient needs evaluation of their Bone Health.  After a Heart Attack, nearly 100% of patients get an evaluation of their heart health.  After a Bone Attack, barely 20% of patients in the USA get an evaluation of bone health – and that is for life changing hip fractures!  Other fractures are far less likely to get an evaluation.

Punxsutawney Phil saw his shadow today.  Six more weeks of winter.  But NINE more weeks before we can get ANY Vitamin D from the sun in Iowa.  Here the sun is high enough off the horizon only 5 months of the year.  Even in the summer very few Iowans make enough of their own Vitamin D.

In all of 2013 I saw fewer than ten patients with good vitamin D levels from only:  Multiple Vitamins & Minerals, Calcium Plus D Supplements, “Vitamin D Enriched” Milk, and Sunshine combined.  Every other patient needed an additional 1000 IU to over 5000 IU Vitamin D3 supplements daily.

Lies, Damn Lies and Statistics

January 27, 2014 @ 7:05 am
posted by Dr Ginther

Mark Twain and others have said:  ”There are Lies, there are Damn Lies, and then there are Statistics”.  That is the danger when we use Statistics (Meta-Analyses) as a basis for “Evidence-Based” Medicine.  A recent meta-analysis looking at Vitamin D has reached a gaggle of questionable conclusions.  The news media have swallowed it hook, line and sinker, and want you to do so as well.

This meta-analysis re-analyzed 40 old studies which were not designed to track actual 25-hydroxy Vitamin D levels, and used doses of Vitamin D that we now know are too low to be effective.  They looked for diseases which were not specifically tracked, but might be mentioned as incidental findings.  None of these studies individually showed a “statistically significant” finding.  But if you combine enough different studies, the numbers become large enough that “statistical significance” can happen.

Secondary HyperParaThyroidism – Doing Their Job

January 20, 2014 @ 10:25 pm
posted by Dr Ginther

Secondary HyperParaThyroidism is the result of the ParaThyroid glands doing their job.  Their job is to keep the calcium in the blood “just right”.  Too often this requires stealing calcium from the bones.  This is necessary to make up for not absorbing enough calcium every day.  But stealing too much Calcium from bones can cause Fractures.

Most of us need 1200 mg calcium in 3 doses spread across every day.  Older individuals absorb less well and can require 1500 mg.  We also need high enough Vitamin D levels to absorb the calcium.  This usually means 1000 to 5000 units of Vit D3 daily.  Many of us fail to absorb enough calcium daily.  We need Secondary HyperParaThyroidism to keep our blood calcium high enough.