Osteoporosis and the importance of Vitamin D

The recent front page of the New York Times featured an image not of the contentious political landscape but surprisingly of bone. Specifically, a series of CT scans showing the progression of spinal osteoporosis over an 8-year period. The accompanying article discussed the growing concern and patient refusal to take osteoporosis medications due to rare by potentially severe side effects.

What is Osteoporosis?

Osteoporosis is a condition that primarily affects older women where decreased bone strength increases the risk of a fracture or broken bones. Conventional treatment recommends pharmaceutical drugs whose action is to prevent decrease in bone density or actually increase the growth of new bone. One of the rare side effects of these medications is a spontaneous thigh bone or jaw fracture. A large majority of Americans are concerned enough about this potential side effect that they are seeking alternative ways to help maintain and strengthen their bones.

As integrative practitioners, who are also conventionally trained, we respect that there is time and a place for the use of these medications. There are also many other interventions patients can do to help keep their bones healthy. One of the key ways to do this is to ensure adequate Vitamin D.

What is Vitamin D and why is important for osteoporosis?

Vitamin D is a fat-soluble vitamin that is synthesized in our bodies through exposure to sunlight. It actually behaves as a hormone in our body, playing a role in many key processes. Every cell has a Vitamin D receptor and we are just beginning to learn of its significance!

Vitamin D is important for osteoporosis treatment and prevention because it promotes calcium absorption, bone growth and helps to keep calcium in the bone. Vitamin D works in the gut to help increase the absorption of calcium from the foods we eat. It then plays a role in making sure calcium stays in the bones and is not released into the serum. It is also essential for osteoblasts and osteoclasts- cells in charge of bone growth and remodeling, to function properly. As you can see, Vitamin D is essential for bone health.

How do you know if you are getting enough Vitamin D?

Many Americans are deficient in Vitamin D. This is due to many factors- our lack of exposure to sunlight, use of sunscreen, distance from the equator and genetic variants that decrease our ability to absorb and synthesize Vitamin D. This level can be easily assessed by checking a serum 25(OH)D concentration. The optimal range for Vitamin D concentration is 50-80 ng/ml.

How to increase Vitamin D levels?

Unfortunately, vitamin D is not readily available in food sources. It is fortified in some milk products but in minimal concentrations. The best way to increase levels is by supplementation of Vitamin D3. The optimal dose would be dependent on your lab value but can range from 2000 IU to 10,000 IU daily. It is best to work with a knowledgeable practitioner to avoid taking too much Vitamin D which can very rarely cause increased serum calcium levels.