 |
Return Create A Forum - Home |
 |
--------------------------------------------------------- |
|
MS Speaks |
 |
https://msspeaks.createaforum.com |
|
--------------------------------------------------------- |
|
***************************************************** |
|
Return to: DIET AND NUTRITION |
|
***************************************************** |
|
#Post#: 2633-------------------------------------------------- |
|
(Abst.) High-dose vitamin D3 supplementation may decrease bone d |
|
ensity |
|
By: agate Date: August 28, 2019, 11:29 am |
|
--------------------------------------------------------- |
|
Many people with MS (including me) take high doses of vitamin |
|
D3. Other people use high doses of vitamin D3 because it is |
|
believed to improve bone density. Now it seems that the higher |
|
doses might even decrease bone density, according to this |
|
abstract from JAMA (August 27, 2019)--"Effect of high-dose |
|
vitamin D supplementation on volumetric bone density and bone |
|
strength: A randomized clinical trial": |
|
https://jamanetwork.com/journals/jama/article-abstract/2748796 |
|
#Post#: 2641-------------------------------------------------- |
|
Re: (Abst.) High-dose vitamin D3 supplementation may decrease bo |
|
ne density |
|
By: agate Date: September 5, 2019, 8:29 pm |
|
--------------------------------------------------------- |
|
More about this from NEJM Journal Watch (September 3, 2019): |
|
[quote][font=sans-serif][font=arial]SUMMARY AND COMMENT | |
|
GENERAL MEDICINE[/font][/font] |
|
[font=arial]Vitamin D Supplementation: Is More Better? |
|
http://response.jwatch.org/t?r=3963&c=9999&l=2&ctl=6267F:504826E9A16F346EED043E… |
|
Thomas L. Schwenk, MD |
|
http://response.jwatch.org/t?r=3963&c=9999&l=2&ctl=62680:504826E9A16F346EED043E… |
|
/>reviewing Burt LA et al. JAMA 2019 Aug 27 |
|
In a randomized trial, higher doses unexpectedly were associated |
|
with greater declines in bone-mineral density. |
|
The �if some is good, more is better� approach to |
|
supplementation has led to as many as 3% of U.S. adults taking |
|
high-dose vitamin D supplements (≥4000 IU daily). To |
|
address uncertainty about incremental benefit of vitamin D doses |
|
higher than 400 to 1000 IU daily, Canadian investigators |
|
randomized 311 adults (mean age, 62); without osteoporosis and |
|
with normal hydroxyvitamin D (25[OH]D) and serum calcium levels |
|
to one of three levels of supplementation (400 IU, 4000 IU or |
|
10,000 IU) daily. At baseline, mean serum 25(OH)D was 32 ng/mL |
|
(79 nmol/L). Patients with prior high-dose vitamin D use, |
|
disorders of vitamin D metabolism, or high 10-year risk for |
|
osteoporotic fractures were excluded. Dietary calcium intake was |
|
supplemented to recommended levels. |
|
Participants were assessed serially through 36 months. |
|
Bone-mineral density (BMD) and bone strength were assessed at |
|
the distal radius and tibia by high-resolution computed |
|
tomography (a method used in clinical research). |
|
Serum 25(OH)D levels increased significantly for participants |
|
who received 4000 IU or 10,000 IU daily but not for participants |
|
who received 400 IU daily. At 3 years, declines in BMD at the |
|
radius were significantly steeper in the 4000 IU and 10,000 IU |
|
groups (−2.4% and −3.5%, respectively) than in the |
|
400 IU group (−1.2%). A similar pattern was noted in the |
|
tibia. Bone-strength estimates declined in all three groups, |
|
with nonsignificant trends toward lower strength in the |
|
high-dose vitamin D groups than in the 400 IU group. |
|
COMMENT |
|
The authors speculate that this somewhat unexpected finding |
|
might be due to increased bone resorption secondary to |
|
parathyroid hormone suppression. In any case, the findings point |
|
to no benefit for bone integrity � and even potential harm � |
|
with high-dose vitamin D supplementation in patients whose |
|
vitamin D levels are adequate. |
|
Burt LA et al. Effect of high-dose vitamin D supplementation on |
|
volumetric bone density and bone strength: A randomized clinical |
|
trial. JAMA 2019 Aug 27; 322:736.[/quote] |
|
***************************************************** |
