Abstract

Bone Health Facts: Bone and Muscle Aches and Vitamin D DeficiencyAlthough osteoporosis does not cause bone pain, bone which is poorly mineralized (osteomalacia) can cause generalized aching in the bone, as well as muscle pain and weakness. Recent studies have found that a large percentage of patients who presented with muscle aches and bone pain suffered from vitamin D deficiency. Patients who suffer from nonspecific muscle aches and bone discomfort are often misdiagnosed as having fibromyalgia, myositis, or chronic fatigue syndrome. Vitamin D deficiency increases the risk for developing many cancers, including colon, breast, prostate, ovarian and esophageal, and may also contribute to the development of type 1 diabetes, hypertension, congestive heart failure, schizophrenia, and multiple sclerosis. A multivitamin containing 400 IU of vitamin D may not be adequate for all people. Vitamin D deficiencies are becoming more common, due to the lack of vitamin D in the diet, increased use of sunscreen, and diminished outdoor activity. Over 90% of our vitamin D requirement comes from casual exposure to sunlight. Wearing a sunscreen with an SPF of 8 reduces the ability of the skin to produce vitamin D by 95%. “Vitamin D: Important for Prevention of Osteoporosis, Cardiovascular Heart Disease, Type 1 Diabetes, Autoimmune Diseases, and Some Cancers.” By Michael Holick, PhD, MD. Southern Medical Journal, October 2005 Osteoporosis Facts and TreatmentsMore than 1.5 million osteoporotic fractures occur annually in the United States. Although osteoporosis affects both men and women, women are particularly vulnerable to this crippling disease. A 50-year-old white female has a 40% risk of experiencing an osteoporotic fracture in her lifetime. Although calcium and vitamin D supplementation alone do not reduce the risk of vertebral fractures in women with symptomatic osteoporosis, they complement the efficacy of other anti-fracture agents which are often prescribed. Postmenopausal women wishing to reduce their risk for osteoporosis should consume 1000 to 1200 mg of elemental calcium and 400 to 800 IU of vitamin D daily. Fosamax (alendronate), Actonel (risedronate) and Boniva (ibandronate) are approved for both the prevention and treatment of postmenopausal osteoporosis; however, whereas Fosamax and Actonel have been shown to reduce hip and vertebral fractures, Boniva has only been shown to reduce the risk of vertebral fractures. Additionally, potential gastrointestinal side effects require that the patient remain in an upright position and abstain from the consumption of any other food, drink or medication for 30 minutes following the administration of Actonel and Fosamax, and for 60 minutes after taking Boniva. Miacalcin (salmon calcitonin nasal spray) and Evista (raloxifene) offer protection against vertebral fractures, but not hip fractures. Forteo (teriparatide) actually stimulates bone formation and significantly reduces vertebral and nonvertebral fracture risk. This medication is used in postmenopausal women who are at high risk for fracture; however, long-term use (greater than two years) is not currently encouraged. “Review of Treatment Modalities for Postmenopausal Osteoporosis.” By Dr. Ronald Hamdy and colleagues. Southern Medical Journal, October 2005