Tuesday, October 22, 2013

Vitamin D Supplements Do Not Improve Bone Health?

According to a new study published in the The Lancet, adults taking vitamin D supplements did not improve their overall bone mineral density, reports Medical News Today. Researchers from the University of Auckland in New Zealand analyzed data from 23 studies involving 4,082 healthy adults with an average age of 59. They found that adults who took supplements of vitamin D for an average of two years did not see any improvements in their bone health, apart from a small increase in bone density around their femoral neck. “Most healthy adults do not need vitamin D supplements,” said lead author Ian Reid from the University of Auckland.

First and foremost, bone density does not measure bone health. Dense bone is often old, brittle bone as exemplified by all the hip fractures caused by taking biophosphonates, like Boniva and Fosamax. These drugs preserve bone density by keeping the body from removing bone as it ages and preventing the body from forming new bone. Is this any way to treat osteoporosis?

Second, vitamin D has many, many functions in the body. It really is not a vitamin but a hormone. It is necessary for the absorption of calcium from the digestive tract, the first step to incorporating calcium into bone. However, there are many additional factors involved in calcium metabolism. Besides, bone is just a repository for calcium, which is exchanged continually with the blood stream to act as a buffer to control the pH of the blood. The real strength of bone comes from collagen, the protein matrix of bone that holds the calcium.

Third, vitamin D deficiency is epidemic, even in South Florida, where I practice, and the daily sun stimulates production of vitamin D in the skin. In the northern half of the United States, every winter a majority of the population is deficient from lack of adequate sunshine and poor diet. In my practice, it is the most common factor associated with an impaired immune system.

The nutrition board allows practitioners to recommend up to 4000IU per day of vitamin D, without any lab work to identify any deficiency. For supplementation above that level, laboratory testing is recommended.

Finally, the use of the prescription strength 50,000IU dose taken once a week is a dramatic overdose to the body. Unfortunately, many physicians have prescribed this dangerous dosage under the guise of “evidence based medicine”. They fail to understand that the study used a high, weekly dose only to monitor the test subjects. That is, in order to know that they were taking the supplement, they watched them swallow it every week. Daily monitoring just is not logistically feasible. In really, double blind, placebo controlled, crossover studies comprise only 1/3 of an evidence based practice, like mine. Another third is the practitioner’s clinical experience, and the final third (and most important) is patient preference.

Have your vitamin D level checked. The medical norms are 30-100, but I prefer levels above 40. If you are unwilling to test, then just supplement 2,000IU per day. That may not be enough, but it could very well prevent a chronic, life threatening illness.