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Stop - Read This Before You Have Orthopedic Surgery - Nov 2010

clipped from http://www.stopagingnow.com/liveinthenow/article/stop-read-this-before-you-have-orthopedic-surgery

Author = Gale Maleskey, MS, RD
50% of his patients for orthopedic surgery had less than 20ng/ml
He recommends taking 50,000 IU vitamin D weekly until up to 50ng/ml

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Hypovitaminosis D in Patients Scheduled to Undergo Orthopaedic Surgery, A Single-Center Analysis

The Journal of Bone and Joint Surgery (American). 2010;92:2300-2304.
© 2010 The Journal of Bone and Joint Surgery, Inc.
Ljiljana Bogunovic, MD1, Abraham D. Kim, MD1, Brandon S. Beamer, MD1, Joseph Nguyen, MPH1 and Joseph M. Lane, MD1
1 Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021. E-mail address for J.M. Lane: LaneJ at hss.edu
Investigation performed at the Hospital for Special Surgery, New York, NY

Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from the Cohn Foundation and the Weill-Cornell Clinical Translation Science Center (UL1 RR024996-01). In addition, one or more of the authors or a member of his or her immediate family received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from commercial entities (Eli Lilly, Procter and Gamble, Novartis, and Zimmer).

Background Vitamin D is essential for optimal bone health and muscle function. An alarmingly high rate of vitamin-D deficiency in the general population has been reported recently. The purpose of the present study was to characterize the extent of low serum levels of vitamin D among orthopaedic surgery patients.

Methods We performed a retrospective chart review of 723 patients who were scheduled for orthopaedic surgery between January 2007 and March 2008. Preoperative serum 25-hydroxyvitamin D (25OHD) levels were measured. The prevalence of normal (?32 ng/mL), insufficient (<32 ng/mL), and deficient (<20 ng/mL) vitamin-D levels was determined. Logistic regression was used to assess risk factors for insufficient (<32 ng/mL) 25(OH)D levels.

Results Overall, 43% of all patients had insufficient serum vitamin-D levels, and, of these, 40% had deficient levels. Among the orthopaedic services, the highest rates of low serum vitamin-D levels were seen in the trauma and sports services, in which the rates of abnormal (insufficient and deficient) vitamin-D levels were 66% and 52%, respectively. The lowest rate of abnormal vitamin-D levels was seen in the metabolic bone disease service. Patients between the ages of fifty-one and seventy years were 35% less likely to have low vitamin-D levels than patients between the ages of eighteen and fifty years (p = 0.018). The prevalence of low vitamin-D levels was significantly higher in men (p = 0.006). Individuals with darker skin tones (blacks and Hispanics) were 5.5 times more likely to have low vitamin-D levels when compared with those with lighter skin tones (whites and Asians) (p < 0.001).

Conclusions The prevalence of low serum levels of vitamin D among patients undergoing orthopaedic surgery is very common. Given the importance of vitamin D in musculoskeletal health, such low levels may negatively impact patient outcomes.
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Observation by VitaminDWiki

Most patients will probably need 50,000 IU several times per week to get to 50ng/ml in less than 2 months.

See also

as well as lots of charts showing dose-response for vitamin D

Number of weeks a daily dose of vitamin D can be taken before it becomes toxic

Graph of dose vs week
CLICK HERE for VitaminDWiki Toxicity Overview

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