Vitamin D, Osteoporosis and CalciumVitamin D and Osteoporosis 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! 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
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. 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. |
