Vitamin D and Fracture Risk Reduction with 2000 IU of Vit D

August 20, 2012Vitamin D and Fracture Risk Reduction with 2000 IU of Vit D Reference:  New England Journal, July 5th 2012 Lead article in the New England Journal!  That’s impressive, considering the NEJM is the de facto lead medical journal in the English language.  Dr. Bischoff-Ferrari has done a series of meta-analysis over the years on Vitamin D, the last one being on falls and their reduction with the use of Vitamin D back in 2004. So this is one of her main interests, passions and core skill sets.  She likes pooling data from many studies and parsing out the details of what happens when you collect lots of data from multiple sources.  It’s a good tool as you get to statistical significance on findings you might not achieve in any single study on its own. Her findings?  Following 31,000 people, average age of 76 and 91% women, they found 1111 hip fractures.  That’s a lot!  What they found was a “By quartiles of actual intake, reduction in the risk of fracture was shown only at the highest intake level (median, 800 IU daily; range, 792 to 2000), with a 30% reduction in the risk of hip fracture)” What does this mean?   “Only at the highest level of intake” did they find helpfulness from Vit D.   2000 IU a day was the highest they could find.  From prior newsletters of ours, you should be able to find that 2000 IU of Vit D will get the average Caucasian researcher in Antarctica to a blood level of 29 ng.  That’s NOT enough to exceed our “minimum” of 32 ng.  Winter in Switzerland, and in Milwaukee, is like Antarctica.  We get no sunshine and no D for 6 months.  2000 IU a day will get many of us to “just enough”, but not all of us, and not consistently.  This study demonstrates the possibility, and we are beginning to see standard science proving it. Why is this important?  For women over age 65, the risk of falls and fractures are as big a cause of premature mortality as anything else. Cancer and heart disease get all the billing because there are such strong advocacy groups for those conditions, but falls and fractures edge them out in risk frequency.  If you are a women, this is your fate if you don’t do something different.  We now finally have a study that is raising the bar from the 800 IU the Institute of Medicine recommended to 2000 IU.  This is big.   But it’s not enough.  It takes more than that to get the average person to a level of 45-60 ng consistently.  Most folks need 3000-5000 IU daily dose after a 300,000 loading dose over a couple of weeks to get to a sufficient level. And why is this safe?  Your body makes 1000 IU a minute in good sunshine when you are young, up to 20,000 IU a day.  And the normal human body, with adequate sunshine balances out around a level of 55 ng.  No toxicity here. WWW.  What Will Work for Me.  For all the frail elderly in my world, I’m advocating for a level of 55-60 and checking blood levels.  I see many “misses” because folks don’t get a loading dose and it takes 6-12 months for them to get to sufficient.  And then, because falls and fractures don’t happen to everyone, they don’t see an immediate helpful effect.    It takes consistency, encouragement and life time commitment to keep it. Then, when you fall in the bathroom in the middle of the night and DON’T break your wrist, back, hip……send me a thank you card.

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