Peanut brittle might be a fun treat. However, living with brittle bones isn’t any fun at all. While it is also commonly called frail bones, doctors refer to it as osteoporosis. Brittle bones affect older women more than anyone else. Not that long ago, lack of calcium was blamed for it, but now more finger pointing is directed at a lack of vitamin D for this health issue.
That has led to new popularity of adding vitamin D supplements as the solution for many health problems, with calcium barely getting a whisper of press, even though they both need to work together for best results. Because the human body manufactures vitamin D from the sun, vitamin D has even earned its nickname as the sunshine vitamin. It has been added to a list of potential health aids to also prevent or treat other medical concerns like depression, heart disease and colon cancer.
As with any health issue, there are official standards the medical community looks to for patient care. The National Institute of Health (NIH) recently released updated recommendations that adults in all life stages should now receive from 600 to 1,000 of IUs vitamin D each day, with no more than 2,000 IUs, depending upon their blood test results. This is an increase of about double the old recommendations the NIH set back in 1997.
New Studies Confusing Issue of Vitamin D for Older Women
But the sunshine vitamin’s star status might be fizzling out with new doubts about bone health benefits of certain vitamin D dosing in older women. In several studies, women about age 70 and up, with healthy baseline vitamin D levels were given a once-a-year 500,000 IUs dose over a four year period. The hope was that a yearly dose might help prevent winter time drops in vitamin D levels, as well as being more convenient for patients.
The control group of women in the same age range took smaller doses on a daily, weekly, or monthly basis, in the study done by Minneapolis VA Medical Center and University of Minnesota. Researchers found the women given a one-a-year 500,000 IU vitamin D dose by mouth fell more often and broke more bones than women of the same age range given any of the smaller doses.
“Our study did not find higher vitamin D to help lower brittle bone risk,” said team leader of the study, Kristine Ensrud, MD, professor of medicine and epidemiology. “In fact, higher levels of vitamin D were associated with increased likelihood of frailty.”
Ensrud’s team also found a surprising trend in over 4,000 other women in the study who started with healthy baseline vitamin D level in their study. At the end of that four and a half year research, the team learned that the women who developed levels of vitamin D which were lower than the NIH recommended dose also had higher odds of brittle bones or death.
Their results parallel those of the Vital D study by a team at the University of Melbourne in Geelong, Australia, led by Kerrie Sanders, PHD. The primary conclusion was that a single dose of 500,000 IUs caused falls and fractures. Another important conclusion found was that lower daily doses of up to 2,000 IUs of vitamin D for people whose blood tests show they are low on vitamin D.
Studies done so far have not completely resolved vitamin D deficiency questions, or even the definition of what exactly is a mega-dose. If patients’ blood tests show a deficiency in the sunshine vitamin, doctors are not prescribing 500,000 IUs daily, anyway. This high amount was limited only to the controlled tests. More studies are definitely needed to resolve the issue of supplemental vitamin D benefits and risks.
What Can Older Women Do Right Now?
Regular outdoor sun exposure of 15 minutes without sunscreen and eating vitamin D enriched foods can allow the body to produce its daily needs for the sunshine vitamin. Some of these foods are salmon, sardines, milk, orange juice and breads. However, older women are at a higher risk of osteoporosis than much of the population, and even in the southern United States during winter, there is just not enough sunshine each day for adequate ultraviolet exposure. Both these points make it very important not to just assume good eating habits and a daily morning walk keep bones strong and healthy.
Keeping up with regular physical exams and blood tests with the doctor is the first step in determining whether a supplement is necessary. Doctors now routinely check vitamin D levels using the annual blood test to tell if sunshine and vitamin D enriched foods have not been enough to keep vitamin D levels to a healthy level for those patients. Clues are also provided on what amount of daily vitamin D supplement the doctor might suggest. There is usually a follow-up blood test after a few weeks of taking the supplement to make sure it is a helpful, appropriate dose.
The Bottom Line
Like most things, one size does not fit all. Vitamin D has proven benefits in preventing rickets, heart disease, depression, and also in preventing osteoporosis, but too much or too little of any good thing can be harmful. Daily habits of eating vitamin D enriched food, greeting the sun, and regular exercise, in combination with annual blood tests and other health evaluations by the doctor can prevent many health issues, including brittle bone disease. Some people need supplements and some do not, to be decided on an individual basis no matter what age or gender.
Low and High Vitamin D Levels in Older Women, from the Endocrine Society, 12/06/2010
Falls, Frailty Linked…, from MedPageToday, 11 May 2010
New Guidelines Double…, from AAP Newsroom, 13 Oct 2008
Vitamin D Benefits, Side Effects…, by Lynn Pritchett, 08 Aug 2009
Vitamin D, from the Mayo Clinic, update 08 July 2010
Vitamin D Benefit-Risk Analysis, from the Council on Responsible Nutrition, 14 Oct 2010
Vitamin D: Office of Dietary Supplements, from the National Institute of Health (NIH), 2010
Calcium and Vitamin D Important at Every Age, from the National Institute of Arthritis and Musculoskeletal Skin Diseases (NIAM), 2010