Dr. Michael F. Holick, Ph.D., M.D.
Dr. Michael F. Holick

Arthritis and Vitamin D

Posted by admin on November 27, 2008 under Arthritis, Vitamin D | 17 Comments to Read

Rheumatoid Arthritis and Osteoarthritis

Recent studies have revealed that women who ingest more than 400 IU of vitamin D a day reduce their risk of developing rheumatoid arthritis by as much as 42%.

Vitamin D deficiency has been associated with an increased risk of developing osteoarthritis.  

Merlino LA, Curtis J, Mikuls TR, Cerhan JR, Criswell LA, and Saag KG.  Vitamin D intake is inversely associated with rheumatoid arthritis.  Arthritis & Rheumatism  2004; 50(1):72-77.

Osteomalacia and Vitamin D

Posted by admin on under Osteomalacia, Vitamin D | 3 Comments to Read

Vitamin D deficiency causes a defect in the ability of the body to deposit calcium into the collagen jello-like matrix in the bone.  As a result, the covering on the bone which contains pain sensing nerves is easily deformed resulting in throbbing aching bone pain.  Patients with osteomalacia often complain of achiness in their muscles and bones.  These non-specific aches and pains in the bones and muscles are often misdiagnoses as fibromyalgia or chronic fatigue syndrome.  There have been several studies demonstrating that patients with severe bone and muscle pain and muscle weakness associated with osteomalacia have dramatic improvement in their symptoms when vitamin D deficiency is corrected.  It takes months to years to develop osteomalacia and associated symptoms and it takes three to six months before significant improvement in symptoms results from correcting vitamin D deficiency.  

References:

Holick, M.F.  Vitamin D deficiency:  What a Pain it is.  Mayo Clin. Proc.  2003; 78(12): 1457-1459.

Malabanan AO, Turner AK, Holick MF. Severe generalized bone pain and osteoporosis in a premenopausal black female: effect of vitamin D replacement. J Clin Densitometr . 1998;1:201-204.

Osteoporosis and Vitamin D

Posted by admin on under Osteoporosis, Vitamin D | 5 Comments to Read

Vitamin D deficiency will cause removal of both the calcium and matrix from the bone, and as a result, will cause osteopenia and can precipitate and exacerbate osteoporosis.  Unlike osteomalacia which causes bone pain, osteoporosis, which is porotic bone, i.e., holes in the bones and loss of bone does not cause bone pain unless there is an acute fracture.  Typically this pain resolves as the fracture heals and can be easily distinguished from osteomalacia.  

References:

Bischoff-Ferrari, HA, Giovannucci, E., Willett, W.C., Dietrich, T., and Dawson-Hughes, B.  Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes.  Am J Clin Nutr  2006; 84:18-28.  

Boonen S, Bischoff-Ferrari A, Cooper C, Lips P, Ljunggren O, Meunier PJ, Reginster JY.  Addressing the musculoskeletal components of fracture risk with calcium and vitamin D:  a review of the evidence.  Calcif Tissue Int  2006; 78(5):257-70.

Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, Delmas PD, Meunier PJ.  Vitamin D3 and calcium to prevent hip fractures in elderly women.  N Engl J Med 1992; 327(23):1637-1642.

A 65 year old female with osteopenia

Posted by admin on November 26, 2008 under Case Files | 3 Comments to Read

I was referred a 65 year old white female who on bone mineral density analysis was found to be osteopenic and had a history of 2” height loss.  She entered menarche at the age of 13 and had regular periods until menopause at the age of 52.  She was on hormone replacement therapy and developed breast cancer at the age of 61.  She underwent lumpectomy and radiation therapy, and initially was put on tamoxifen and placed on an aromatase inhibitor for the past four years.  She has limited her calcium intake because of concerns about vascular calcification and kidney stones.  There was no previous history of premature graying (which can increase risk of having osteopenia and osteoporosis) nor was there a history of kidney stones.   Read more of this article »