Optimal Use of Vitamin D When Treating Osteoporosis

Curr Osteoporos Rep. 2011 March; 9(1): 36–42.
Published online 2010 November 27. doi: 10.1007/s11914-010-0041-0.
Joop P. W. van den Bergh,1,2 jvdbergh at hetnet.nl., Sandrine P. G. Bours,3 Tineke A. C. M. van Geel,4 and Piet P. Geusens5,6
1Department of Internal Medicine, VieCuri Medical Centre Noord-Limburg, P.O. Box 1926, 5900 BX Venlo, The Netherlands
2Faculty of Health Medicine and Life Science, Department of Internal Medicine, Maastricht University Medical Centre/Nutrim, P.O. Box 616, 6200 MD Maastricht, The Netherlands
3Department of Internal Medicine, Subdivision Endocrinology, Maastricht University Medical Centre, Maastricht, P.O. Box 616, 6200 MD Maastricht, The Netherlands
4Faculty of Health Medicine and Life Science, Department of General Practice, Maastricht University Medical Centre/Caphri, P.O. Box 616, 6200 MD Maastricht, The Netherlands
5Faculty of Health Medicine and Life Science, Department of Internal Medicine, Maastricht University/Caphri, P.O. Box 616, 6200 MD Maastricht, The Netherlands
6Biomedical Research Center, University Hasselt, Hasselt, Belgium

Inadequate serum 25-hydroxyvitamin D (25OHD) concentrations are associated with muscle weakness, decreased physical performance, and increased propensity in falls and fractures. This paper discusses several aspects with regard to vitamin D status and supplementation when treating patients with osteoporosis in relation to risks and prevention of falls and fractures. Based on evidence from literature, adequate supplementation with at least 700 IU of vitamin D, preferably cholecalciferol, is required for improving physical function and prevention of falls and fractures. Additional calcium supplementation may be considered when dietary calcium intake is below 700 mg/day. For optimal bone mineral density response in patients treated with antiresorptive or anabolic therapy, adequate vitamin D and calcium supplementation is also necessary. Monitoring of 25(OH)D levels during follow-up and adjustment of vitamin D supplementation should be considered to reach and maintain adequate serum 25(OH)D levels of at least 50 nmol/L, preferably greater than 75 nmol/L in all patients. PMCID: PMC3026680

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See also VitaminDWiki

• Wrist fracture is also associated with vitamin D inadequacy – Feb 2011
• National Osteoporosis Foundation on Vitamin D - more than 30 ng - 2010 800 to 1000 IU daily for elderly
• Vitamin D for elderly 800 to 2000 IU - Osteoporosis Canada - Sept 2010
• Lowest cost osteoporosis treatment was vitamin D and Calcium – Oct 2010
• Half of orthopedic surgeries had vitamin D less than 32 ng – Dec 2010
• Noticed bones heal faster when more than 60 ng of vitamin D
• Low vitamin D before orthopedic surgery – dark skin 5X more likely – Oct 2010
  • suspect not just dark skin, but those also at risk of being low on vitamin D: sunlight, elderly, medical problems, etc.
• Hip surgery followed by 100000 IU, then 1000 IU of vitamin D daily – June 2010
• Upper body bones fractured along with hip when extremely low on vitamin D – Sept 2010
• Low cost co-factors for vitamin D More than Calcium is needed for healthy bones
• Vitamin D and Fracture Prevention – June 2010
• Vitamin D and calcium for the prevention of fractures
• Cochrane review finds that Vitamin D helps prevent fractures– downloaded Feb 2010
• Osteoporosis reduced by 800 or more IU of vitamin D - July 2010
• Both Calcium AND vitamin D needed to prevent elderly fractures – Sept 2010
• Would there be fewer stress and bone fractures with vitamin D?
• 4000 IU Vitamin D intervention helped elderly bones – March 2010
• 890 IU of vitamin D and 1200 mg Calcium improved bone density – July 2010
• Calcium and just 900 IU of vitamin D can improve Bone Density – July 2010
• 400 IU of Vitamin D Magnesium and Calcium helped Twin bones – Feb 2011
  • 400 IU is the least amount of vitamin D - wonder how low of vitamin D needed if take all of the co-factors
• Hip fractures in India - editorial with recommendation Sept 2010
• 75 percent of hip fractures associated with vitamin D deficiency - Jan 2011