One last thing about Vitamin D

As you know, the last few blogs have been evolved; the value and importance of having your vitamin D3 checked.  There have been a number of articles in the media noting that vitamin D does everything from treat cancer to reduce heart disease to even grow hair! (Just kidding)  Obviously these claims are not my area of expertise and I would certainly take a lot of pause until one looks at the evidence-based studies on these areas and check with your internist

What we do know is that vitamin D is absolutely essential for good bone health.  We are just scratching the tip of the iceberg in terms of its effects.  I cannot tell you how many patients coming in to my office with knee pain that are middle-aged men that I get vitamin D levels on, are dramatically low. The Bay Area has one of the lowest Vitamin D levels in general in the country.  Women on the other hand, are generally within normal limits and that may be because they are a lot more conscious about taking vitamins and calcium supplements.  For men, I urge you to take at least 1-2000 mg a day especially if you have darker skin since you do not tend to absorb this well. Get a level checked to see where you are and how much you need to take.

An interesting article in the British Bone and Joint Surgery looked at outcomes of total hip replacement and its relationship to vitamin D levels.  What was surprising is that patients with low vitamin D levels preoperatively did not have as good outcomes as those with normal vitamin D levels.  So this is an exciting area of study and we look forward to more articles looking at how we can improve your bone health, improve your outcomes with surgery, and in any way stay out of our office is in the first place!.  That would be a good thing.

-Lesley Anderson, MD

More on Vitamin D

More on Vitamin D.  A study put out by the Hospital for Special Surgery in New York reinforces the alarmingly high rate of low vitamin D in patients scheduled for orthopedic surgery.  In a chart review of 723 patients, they found that 43% of all patients had low vitamin D levels, and of those, 40% had severely low levels.  The highest rates of low vitamin D levels were seen in patients in Sports Medicine Services as well as who had trauma or fractures.  Over one half of patients (52%) had low vitamin D levels in patients undergoing sports related surgery!  The highest rate was in patients between age of 18 and 50 years and it was significantly higher in men (5X higher). In patients sustaining fractures, 66% had low vitamin D levels.  In individuals with darker skin tones (Blacks and Hispanics) were over 5 times more likely to have low vitamin D levels when compared with those with lighter skin tones (White and Asians).

Bottom line:  Get your vitamin D level checked.  If you are a runner and have had arthroscopic surgery, I am routinely recommending, particularly in men, to have your vitamin D levels checked and corrected because we are seeing an increasingly high number of stress fractures and bone bruises that occur when patients go back to high-level sports that involved running, jumping, or pounding.  We do not know for sure whether the low vitamin D levels correlate with the reason why one develops this.  On the other hand, it seems like it could be very likely.  You should be taking at least 1000 mg of vitamin D3 tablets a day and I recommend you take it as a supplement unless you drink four cups of milk a day.

Lesley J. Anderson, MD