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#Post#: 2633--------------------------------------------------
(Abst.) High-dose vitamin D3 supplementation may decrease bone d
ensity
By: agate Date: August 28, 2019, 11:29 am
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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":
HTML 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
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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?
HTML http://response.jwatch.org/t?r=3963&c=9999&l=2&ctl=6267F:504826E9A16F346EED043E5354BB0B99D2B71D9A95FA21D3&?query=etoc_jwgenmed&jwd=000100983645&jspc=[/font]
Thomas L. Schwenk, MD
HTML http://response.jwatch.org/t?r=3963&c=9999&l=2&ctl=62680:504826E9A16F346EED043E5354BB0B99D2B71D9A95FA21D3&<br
/>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]
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