The Journal of Clinical Endocrinology & Metabolism September 24, 2013 jc.2013-2121
John F. Aloia, Ruban Dhaliwal, Albert Shieh, Mageda Mikhail, Shahidul Islam and James K. Yeh
Winthrop University Hospital, Bone Mineral Research Center, Mineola, New York 11501
Address all correspondence and requests for reprints to: John F. Aloia, MD, Winthrop University Hospital, 222 Station Plaza North, Suite 510, Mineola, New York 11501. E-mail: jaloia at winthrop.org.
Context: Bone health is influenced by the intake of both calcium and vitamin D.
Objective: Our objective was to evaluate the influence of calcium and vitamin D supplementation on PTH and bone turnover.
Setting, Patients, and Design: At an ambulatory research center, 159 postmenopausal healthy white women participated in this double-blind, placebo-controlled parallel, longitudinal factorial study that began in December 2008 and ended in April 2011. It was 6 months in duration.
Interventions: Subjects were randomly allocated to 4 groups:
- 1) double placebo,
- 2) calcium (1200 mg daily) plus placebo,
- 3) vitamin D3 (100 μ g) plus placebo, and
- 4) vitamin D3 and calcium.
Serum and urine were collected fasting and 2 hours after a calcium load at baseline and at 3 and 6 months.
Main Outcome Measures: Serum PTH, cross-linked C-telopeptide (CTX), and procollagen type I N-terminal propeptide (P1NP) were measured.
Results: Before study medication, a calcium load resulted in a decline in PTH and CTX and an increase in urinary calcium excretion. Serum CTX and P1NP declined over time with calcium supplementation but did not change with increased vitamin D intake. There was a decline in PTH in the vitamin D groups in the fasting state compared with placebo. Suppression of PTH was greater after a calcium load in the vitamin D groups. A calcium load decreased PTH and CTX and raised urinary calcium.
Conclusions: Fasting PTH declines with vitamin D supplementation. PTH declines after calcium intake.
Supplementation of the diet with 1200 mg calcium/d reduces bone turnover markers, whereas supplementation with up to 100 μ g vitamin D3/d does not.
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- Overview Osteoporosis and vitamin D
- 8X higher Osteoporosis risk if high level of vitamin A, vitamin D important too – Feb 2013
- Vitamin K-2 (180 ug MK-7) helped both bone density and strength – RCT March 2013
- European Osteo group recommends 20-50 ng of vitamin D – Jan 2013
- Korea proposes vitamin D of 20 ng, but notes 20ng increases osteo by 50 percent – Oct 2012
- Vitamin D, K2, Magnesium, etc increase bone density when taking together– Jan 2012
- National Osteoporosis Foundation on Vitamin D - more than 30 ng - 2010
- 6500 IU vitamin D not improve bone density without co-factors – Jan 2012
- Skeletal health needs at least 30 ng of vitamin D – German paper – March 2011
- Vitamin D Alone Ineffective for Postmenopausal Osteoporosis Medscape review of this study