Thursday, January 24, 2008

Medication Failure and Vitamin D

It happens: women are put on osteoporosis medications and don't seem to respond. The reasons are varied, but a somewhat common one has recently come to light.

Adequate vitamin D in your diet does two things: it is necessary for the absorption of calcium and it is necessary for the final step in bone hardening. It was discovered recently that some women are poor absorbers of vitamin D and need more than the formerly recommended 400 units a day. In fact, the National Osteoporosis Foundation has changed their recommendation on vitamin D intake from 400 to 1000 units daily. Poor vitamin D absorption has certainly been one of the causes of medication failures. The other is tied to lack of weight bearing exercise. Medication slows the breakdown of bone, but the ideal scenario for improved density is adequate calcium and vitamin D, and weight bearing exercise to stimulate the osteoblasts. Other vitamins also play a role, but the good news is that if you are eating your veggies and fruit, you are getting them. The AMA also currently recommends that all adults take a multi vitamin daily. Isn't it nice to know that the heart healthy diet is also good for your bones?

Not all primary care physicians, many of whom treat osteoporosis, are aware that some people are poor Vitamin D absorbers. If you are diagnosed with Osteoporosis and have been taking calcium and D faithfully, ask your physician to do a simple blood test for your Vitamin D3 level.
Avoid waiting 2 years for a repeat bone scan that shows no improvement before having your D level checked. If you are diagnosed and are just starting calcium and D, ask your physician to do a blood test in 3 months to check your D3 level.

This vitamin D absorption problem has got the endocrinologists just a bit at odds with dermatologists. Fifteen minutes of sunshine (northern sunshine in the winter doesn't count), just on your hands and face, is adequate Vitamin D intake. So wait just a little while before putting on your sunscreen, and take advantage of the best way to get your D.

2 comments:

Kathryn Mackel said...

I just got back from my bone density test, and now I'm starting to accept I've got to pay attention.

Question...do you take a vitamin D supplement in addition to the Multi-vitamin?

Janice Freeman said...

I take calcium and vitamin D together, and a multi. You should have your D3 checked, because they sometimes find low D in women with Fibromylgia. When I get home I'll send you a few exercises, it's easy when you do the right ones, and they are not hard. It is NOT true that walking alone will maintain density in the hips, you'd have to walk 20 miles a day!