Osteoporosis, meaning "porous bones," is a condition that weakens your bones and increases your risk for fractures. Approximately 18 percent of women and 13 percent of men over the age of 50 in the U.S. are affected by this condition. Once osteoporosis has occurred, treatment is aimed at preventing falls and improving bone density, although simply delaying further bone loss is also beneficial. Vitamin D plays an important role in osteoporosis management. Your doctor can determine if you need high-dose vitamin D therapy.
Lifestyle
Although vitamin D, calcium and medications are important aspects of osteoporosis treatment, your lifestyle can play a role, too. If you have osteoporosis, your risk for falling and fracturing your hip, wrist or backbone is increased if you use alcohol or sedating medications, such as narcotics and sleeping pills. The American College of Obstetricians and Gynecologists reports that your risk for sustaining an osteoporotic fracture may also be increased if you smoke. Regular exercise improves your balance, enhances calcium absorption and helps build bone mass.
Deficiency
According to the March 2010 issue of "The Consultant Pharmacist," vitamin D deficiency is common among elderly individuals due to inadequate sun exposure, poor dietary intake and decreased cellular vitamin D receptor activity. High-dose vitamin D therapy -- up to 50,000 IU three times weekly -- is often used to correct vitamin D deficiency. However, there is no consensus that high-dose vitamin D is beneficial for treating osteoporosis in people who are not vitamin D deficient.
Safety
A study published in the April 2011 issue of "The Journal of Clinical Metabolism and Endocrinology" demonstrated that vitamin D in doses of 1,600 IU daily or 50,000 IU monthly did not cause toxicity after one year of treatment in elderly adults. However, a study published in "The Journal of the American Medical Association" in May 2010 demonstrated an increased risk of falls and fractures in elderly women who received 500,000 IU of vitamin D annually. In contrast, a different trial showed that seniors who received 100,000 IU of vitamin D monthly for four months exhibited a lower osteoporotic fracture rate.
Considerations
Daily vitamin D doses of 700 to 1,000 IU appear to be optimal for maintaining bone mass in elderly individuals. Concurrent administration of calcium -- 800 to 1,200 mg daily -- is generally recommended by physicians. Higher doses of vitamin D are often used to treat vitamin D deficiency, but the effectiveness, safety and dosing regimen of high-dose vitamin D therapy for osteoporosis have not been adequately established. Your physician can help you determine the best dose of vitamin D for you.
References
- American Family Physician; Practice Guidelines -- ACOG Releases Guidelines for Clinical Management of Osteoporosis; M.J. Neff; March 2004
- American Family Physician; Osteoporosis in Men; S.R. Shobha; September 2010
- "The Consultant Pharmacist"; Vitamin D Deficiency: Appropriate Replenishment Therapies and the Effects of Vitamin D Toxicity; S. Carlton, et al.; March 2010
- "Osteoporosis International"; Rapid Correction of Low Vitamin D Status in Nursing Home Residents; R. Przybelski, et al.; November 2008
- "The Journal of Clinical Metabolism and Endocrinology"; Evaluation of Ergocalciferol or Cholecalciferol Dosing, 1,600 IU Daily or 50,000 IU Monthly in Older Adults; N. Binkley, et al.; April 2011
- "The Journal of the American Medical Association"; Annual High-Dose Oral Vitamin D and Falls and Fractures in Older Women: A Randomized Controlled Trial; K.M. Sanders, et al.; May 2010
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