Vitamin D Deficiency Leading to Rapidly Aging Bones and Fractures

vitamin D-SunA study was recently published in the journal, Science Translational Medicine, titled “Vitamin D Deficiency Induces Early Signs of Aging in Human Bone, Increasing the Risk of Fracture”. In this study, samples of iliac crest bone were collected from 30 people, half who had vitamin D levels below 10 and half above 20 micrograms per liter (which they defined as normal).  The study showed that vitamin D deficiency not only reduced mineralization, but also increased the aging of the bone.

Vitamin D is essential for normal absorption of calcium in your diet. When it is low, the body will draw calcium from the bone, resulting in loss of bone mass (osteomalacia). This is accompanied with bone pain, muscle weakness, and the increased risk of bone deformity (rickets in children) and fracture.  I have recently had two young adult women in their 20’s and 30’s who were fit runners have a spontaneous fracture of the femur (one of the strongest bones in the body) that was due to low vitamin D levels.

I am seeing increasing numbers of children with bone pain and muscle weakness and they are low in vitamin D levels. 

One thing to be aware of is the two different methods used by labs to report vitamin D levels: 

 

Table 1: Serum 25-Hydroxyvitamin D [25(OH)D] Concentrations and Health* [1]

nmol/L**

ng/mL*

Health status

<30

<12

Associated with vitamin D deficiency, leading to rickets in infants and children and osteomalacia in adults

30–50

12–20

Generally considered inadequate for bone and overall health in healthy individuals

≥50

≥20

Generally considered adequate for bone and overall health in healthy individuals

>125

>50

Emerging evidence links potential adverse effects to such high levels, particularly >150 nmol/L (>60 ng/mL)

* Serum concentrations of 25(OH)D are reported in both nanomoles per liter (nmol/L) and nanograms per milliliter (ng/mL).
** 1 nmol/L = 0.4 ng/mL    (from NIH fact sheet)

 

This study actually used micrograms/L which is the same as ng/mL. 

I like to think of getting vitamin D levels to optimal range rather than just having barely enough.  Optimal would be 50-80 nmol/L or 20-40 ng/mL (micrograms/L).

In my clinical experience, measuring thousands of vitamin D levels, we have found that of the people living here in Oregon (Pacific NW of the USA), less than 10% are in the optimal range and over 50% of children tested are deficient. To achieve these optimal levels, my experience is that teenagers and adults need to take 5000 IU a day of Vitamin D3, newborns to 40 lbs (20KG) should take 1000 IU Vitamin D3, and for children from 40-120 lbs between 2000-4000 IU a day.  If you take this much for over a year, get your vitamin D level tested to make sure it is not getting your level too high, since vitamin D is fat soluble and can, in rare cases, get too high.  I have yet to see a single case where vitamin D levels exceeded my optimal levels using this range of dosing.

 

Government Fact Sheets About Vitamin D

Read the review of the study here

  

Dr. Paul

 

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