Osteoporosis (cont.)
Vitamin D
An adequate calcium intake and adequate body stores of vitamin D are
important foundations for maintaining bone density and strength. However,
vitamin D and calcium alone are not sufficient treatment for osteoporosis. They
are given in conjunction with other treatments. Vitamin D is important in
several respects:
- Vitamin D helps the absorption of calcium from the
intestines.
- A lack of vitamin D causes calcium-depleted bone (osteomalacia), which
further weakens the bones and increases the risk of fractures.
- Vitamin
D, along with adequate calcium (1200 mg of elemental calcium), has been shown in
some studies to increase bone density and decrease fractures in older
postmenopausal, but not in premenopausal or perimenopausal women.
Vitamin D comes from the diet and the skin. Vitamin D production by the skin is dependent
on exposure to sunlight. Active people living in sunny regions (Southern
California, Hawaii, countries around the equator, etc.) can produce most of the
vitamin D they need from their skin. Conversely, lack of exposure to sunlight,
due to residence in northern latitudes or physical incapacitation, causes
vitamin D deficiency. In less temperate regions such as Minnesota, Michigan, and
New York, skin production of vitamin D is markedly diminished in the winter
months, especially among the elderly. In that population, dietary vitamin D
becomes important.
Unfortunately, vitamin D deficiency is quite common in the
United States. In a study of hospitalized patients in a general medical ward,
vitamin D deficiency was detected in 57% of the patients. An estimated 50% of
elderly women consume far less vitamin D in their diet than is recommended.
The Food and Nutrition Board of the Institute of Medicine
has recommended the
following as an as adequate vitamin intake:
- 200 IU daily for men and women 19 to 50 years old,
- 400 IU daily for men and women 51 to 70 years old, and
- 600 IU
daily for men and women 71 years and older.
But if a person already has
osteoporosis, it is advisable to ensure 400 IU twice per day as usual daily
intake, most commonly as a supplement alongside prescription osteoporosis
medication.
An average multivitamin tablet contains 400 IU of vitamin D.
Therefore, one to two multivitamins a day should provide the recommended amount
of vitamin D. Alternatively, vitamin D can be obtained in combination with
calcium in tablet forms, such as Caltrate 600 + D (600 mg of calcium and 200 IU
of vitamin D) and others. Adequate calcium and vitamin D are critical for bone
health.
Adequate levels of calcium and vitamin D are essential for optimal bone health, especially
in addition to any prescription osteoporosis medication. Chronic excessive use of
vitamin D, especially above 2000 units/day, can lead to toxic levels of vitamin
D, elevated calcium levels in blood and urine, and may also cause kidney stones. Since
various dietary supplements may also contain vitamin D, it is important to
review vitamin D content in dietary supplements before taking additional vitamin
D.
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