Bone density improved by monthly 50,000 IU of vitamin D for 6 months – RCT Jan 2021

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Effect of vitamin D therapy on bone mineral density in patients with diabetic nephropathy; a randomized, double-blind placebo controlled clinical trial

Journal of Diabetes & Metabolic Disorders (2021) https://doi.org/10.1007/s40200-021-00737-y
Gayani Liyanage, Sarath Lekamwasam, Thilak Weerarathna & Chandrani Liyanage

Purpose
Diabetes compromises bone strength resulting increased risk of osteoporosis. Objective of this study was to determine the effect of vitamin D given to patients with early diabetic renal disease on BMD and BMC.

Methods
Patients with diabetic nephropathy were recruited. Treatment group received 50,000 IU of vitamin D3 intramuscularly and the control group was given an equal volume of distilled water (0.25 mL) monthly for six months. Baseline BMD, BMC in the total body, lumbar spine and proximal femur were measured by DXA. After six months measurements were repeated. When trial period was over, a randomly selected subgroup of patients (25 from each group) was followed up for further six-months and measurements were repeated.

Results
Selected patients were randomly assigned to two groups. After six months, the treatment group total body BMD, total body BMC and BMDs of spine, femoral neck and total hip regions increased by 2.0%, 2.2%, 1.8%, 2.1% and 2.6% (P < 0.05 for all within-group differences), respectively. In the Control group, BMD or BMC of any region mentioned above did not change significantly during the initial 6 months (P < 0.05 for the between-groups differences). After 6 months of stopping treatment, a statistically significant reduction of total BMD and BMC was observed in the treatment group (P = 0.009).

Conclusion
This study showed that treatment with high dose vitamin D significantly influences total body BMC, total body BMD, BMDs of spine, femoral neck and hip among patients with diabetic nephropathy.

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Each of the following have been found to increase bone mineral density

1. Enough of a good form of vitamin D for 6+ months (this study)
2. Additonal vitamins and minerals which help grow bones (Magnesium, Calcium,silicon, etc)
3. Stress on bones(exercise) to tell the body to increase the bone strength

Note: Bone Strength is a much better indicator of Bone Mineral Density, but is rarely available

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Poor guts need different forms of vitamin D

Guesses of Vitamin D response if poor gut

Bio	Form	Speed	Duration
10	Injection ($$$) or Calcidiol or Calcitriol	D - Slow C -Fast	Long
10	Sun/UVB	Slow	Long
10	Topical (skin patch/cream, vagina)	Slow Fast nano	Normal
9	Nanoemulsion -mucosal perhaps activates VDR	Fast	Normal
9?	Inhaled (future)	Fast	Normal
8	Bio-D-Mulsion Forte	Normal	Normal
6	Water soluble (Bio-Tech)	Normal	Normal
4	Sublingual/spray (some goes into gut)	Fast	Normal
3	Coconut oil based	Slow	Normal
2	Food (salmon etc.)	Slow	Normal
2	Olive oil based (majority)	Slow	Normal

10= best bioavailable, 0 = worst, guesses have a range of +-2
Speed: Fast ~2-6 hours, Slow ~10-30 hours
Duration: Long ~3-6 months, Normal = ~2 months

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Falls and Fractures category contains:

• 258 items in FALLS and FRACTURES
• Vitamin D and Calcium cost-effectively reduce falls and fractures – April 2019
• see also Overview Seniors and Vitamin D
  • Overview Fractures and Falls and Vitamin D
  • Overview Fractures and vitamin D
  • Muscles and Vitamin D - many studies

Falls

• Fall prevention - Vitamin D is one of the ways - umbrella review Jan 2024
• Deaths due to falls doubled in just a decade (age-adjusted, perhaps decreased vitamin D) – June 2019
• Preventing Falls in Older Adults – Vitamin D combination is the best - JAMA Meta-analysis Nov 2017
• Falls cut in half by 100,000 IU vitamin D monthly - RCT 2016
• Falls reduced by a third if achieved 40 ng level vitamin D– RCT Sept 2018
  • Note: It took 6 months to get to that level. Most trials last only 3 months
• Vitamin D prevents falls – majority of meta-analyses conclude – meta-meta analysis Feb 2015
• Falls reduced by Vitamin D: 13 percent reduction if more than 700 IU – review of 38 trials – Aug 2022

Left hand column section as of Nov 2024

Fracture

• Hip fractures are predicted by 10 factors – low Vitamin D is the biggest – Aug 2023
• Vitamin D and fractures – 24 meta-analyses and counting – Dec 2014
• Low trauma bone fractures in seniors – considering Vitamin D loading dose for all, without testing – Nov 2019
• Vitamin K (any amount and any kind) reduced bone fractures by 24 percent – meta-analysis – May 2019
• 77+ Hip fracture items in VitaminDWiki title   Click here for details examples:
  • Risk of Hip fracture cut in half if Vitamin D was prescribed - Aug 2023
  • Call to action: Vitamin D to prevent of treat hip fracture (50,000 weekly for 8 weeks, then bi-weekly) – Holick July 2020

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Injection category listing has 65 items

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• Healthy bones need: Calcium, Vitamin D, Magnesium, Silicon, Vitamin K, and Boron – 2012
• Calcium from plants might be OK – Dec 2016
• Vitamin D monotherapy for just 3 months did not improve bone turnover – Oct 2012
• Silicon or silica as a vitamin D co-factor
• Hypothesis: increased bone mineral density needs protein, Ca, Mg, Vitamin D and K
• Osteoporosis treatment with denosumab is helped by Vitamin D and Calcium – 2017

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Bone - Health category contains:

314 items in Bone - Health category
See also

• Overviews: Osteoporosis,  Fractures,  Rickets  Dental   Hair
• 16 articles are in both Bone and Magnesium categories
• 29 articles are in both Bone and Vitamin K2 categories
• 18 articles are in both Bone and Sports categories
• 8 articles are in both Bone and Meta-analysis categories
• 25 articles are in both Fractures and Meta-analysis categories
• Healthy bones need: Calcium, Vitamin D, Magnesium, Silicon, Vitamin K, and Boron – 2012
• VitaminDWiki pages with BONE MINERAL DENSITY or BMD in title 25 pages as of Feb 2023
• Hearing loss is associated with soft bones in ear
  • Perhaps prevented and treated by Vitamin D
• See also Overview of Rickets and Vitamin D   Overview Osteoporosis and vitamin D

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VitaminDWiki -Weekly, Monthly Vitamin D are typically better than daily - many studies