Vitamin D, Osteoporosis and Calcium

Vitamin D and Osteoporosis

The key is to have the proper levels of calcium and vitamin D in your body. When there is enough vitamin D, the body can absorb the calcium you need from food and supplements. The parathyroids will shut down, and stop pulling it from the bones. Once the parathyroid hormone is no longer depleting the bones of calcium, the body can begin to put it back into the bones.

It may never return to a completely normal level, but you can change the direction so that instead of decreasing bone density, it actually begins to increase!

UPDATE: July 17,2012

I am here to give you hope today. My husband just had his latest Dexa Scan. The results are fabulous! His spine had been the weakest part, originally diagnosed as ADVANCED OSTEOPOROSIS. Advanced osteoporosis means the bone density is more than 3 standard deviations from normal. His L4 vertebrae was (T score) -4.3 standard deviations from normal in 2008 according to the Dexa Scan. L1-L3 vertebrae ranged from -2.5 to -3.2. on the T score of standard deviations.

The doctor put him on Fosamax in an effort to slow the bone loss. (This type of medication works by slowing the breakdown of bone) He was on it for about a year, but after hearing about cases where people developed dead bone in their jaws, he stopped taking it. He had been off of it for over a year before he began the vitamin regimen with D3, sublingual K2 and Calcium. So any old bone would have been removed.

He started this vitamin regimen, including the K2, which was when the bone loss reversal began, about 4 years ago. His current Dexa Scan shows all of his vertebrae, including the very low L4, have come up in bone mass to a T score of -2.4 to -2.6. The diagnosis now is BORDERLINE OSTEOPOROSIS. -2.5 is the cutoff between Osteopenia and Osteoporosis.

This is a massive reversal! His Endocrinologist had told him that she did not ever expect his bone mass to increase. But it did, and by nearly 2 standard deviations in the L4 vertebrae! So I believe that those with this hormonal form of bone loss caused by Celiac Disease and low vitamin D CAN regain their bone mass with this vitamin regimen. I have to believe, it happened to us! To understand T Scores and Dexa Scan see here

The important things to be aware of is that the vitamin D and calcium levels in the body need to be at optimal levels. The parathyroid needs to stay shut off. And, there are some other minerals and vitamins needed to ensure that the body uses the calcium to rebuild bone mass.

These include magnesium, zinc, boron, and vitamin K2. Vitamin K2 is usually produced in the intestines by the natural intestinal flora. So here again, we can see why people with celiac disease have a hard time with bone density. K2 is available in supplement form, and can be used even if you haven't healed your intestine completely, as long as you don't have a condition that requires you to be on blood thinners like coumadin or you don't have sarcoidosis. My husband uses this D and K supplement

Vitamin D Tests and PTH Tests

How can you find out if this is the cause of your osteoporosis? You need to ask your doctor, or preferably an endocrinologist, to test your:

blood calcium level

25-OH-D (cholecalciferol)

If these are low, then also the Intact PTH or(parathyroid hormone). Make sure to get and keep a copy of all results.

Some doctors will want to run the 1-25-OH-D (calcitriol) because it measures the amount of active D3 in the body. To get a look at overall vitamin D status however, this is not helpful. The half-life is too short. The 25-OH-D measures the D that is available to the body and has a much longer half life.

Usually it is best to start with a general metabolic panel to see where your blood calcium is. If it is in the lower end of the normal range then it will be worthwhile to check for the vitamin D level. If that is also low, then you can ask for an Intact PTH and blood calcium test.

If your blood calcium is above 10, then you might want to make sure you don't have primary hyperparathyroidism.

For best results the PTH sample should be frozen. Hormones degrade quickly, and this will prevent degradation. The test can still be run if the sample is not frozen, but then the result needs to be adjusted for the rate of decay with a mathematical formula.

My husband's test results from the lab he had to use due to insurance varied widely except when the sample was frozen AND we made sure it was the only blood sample they had for testing at the time. It took us a long time to figure out what was happening, and now we insist the sample be frozen and that it be sent alone.

They can do a calcium test on the blood after it is thawed, and if it's the only sample they have, then they will.

The Test Results

If your blood calcium is low, and the parathyroid test comes back ambiguous, or at the top of the normal range, you should be suspicious that it may actually be elevated.

This happened to my husband, and the doctor insisted that his problem was that his kidneys were leaking calcium. This type of problem is associated with poor kidney function in general. My husband was sent to a kidney specialist who tested his kidneys for their function in several ways. He told my husband his kidneys were functioning better than most.

So we did not accept the explanation of the kidneys leaking calcium.

It was the 4th endocrinologist who finally recognized that his bone loss had a hormonal pattern. This reinforced our belief that his elevated parathyroid level was causing the osteoporosis. His vitamin D dose has since been increased until it shut down his parathyroid glands. The PTH level must still be checked periodically to make sure it has stayed shut off.

My husband's bone mass quit dropping according to the 2008 dexa scan for bone mass. His last bone density dexa scan (in late 2009) showed not only no further decrease, but an actual increase in bone density.

This was only possible once the parathyroid glands had shut down.

So if you get an ambiguous result on the parathyroid level, keep trying to get an answer. Insist that the sample be frozen and sent alone. Without an accurate result you can't know if this is the problem or not.

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