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Supplements for Osteoporosis

Many calcium supplements include additional vitamins, minerals, and organic additives that have shown to have synergistic and beneficial effects on bone health. The most common additives include:
supplements
  • Vitamin D – Vitamin D is a fat soluble vitamin that is found in food and can also be made in your body after exposure to ultraviolet (UV) rays from the sun. Sunshine is a significant source of vitamin D because UV rays from sunlight trigger vitamin D synthesis in the skin. This important vitamin is often included in combination calcium supplements as it helps the body to absorb calcium. The major biologic function of vitamin D is to maintain normal blood levels of calcium and phosphorus. By promoting calcium absorption, vitamin D helps to form and maintain strong bones. Vitamin D also works in concert with a number of other vitamins, minerals, and hormones to promote bone mineralization. Without vitamin D, bones can become thin, brittle, or misshapen. Vitamin D sufficiency prevents rickets in children and osteomalacia in adults, two forms of skeletal diseases that weaken bones.

    Vitamin D deficiencies are usually the result of dietary inadequacy, impaired absorption and utilization, increased requirement, or increased excretion (loss). A deficiency of vitamin D can occur: when usual intake is below recommended levels , when there is limited exposure to sunlight, when the kidney cannot convert vitamin D to its active hormone form, and when someone cannot adequately absorb vitamin D from the digestive tract.

    The classic vitamin D deficiency diseases are rickets and osteomalacia. In children, vitamin D deficiency causes rickets. Rickets is a bone disease characterized by a failure to properly mineralize bone tissue. Rickets results in soft bones and skeletal deformities. The most common causes of rickets are vitamin D deficiency from a vitamin D deficient diet, lack of sunlight, or both.

    In adults, vitamin D deficiency can lead to osteomalacia, which results in muscular weakness in addition to weak bones.. Symptoms of bone pain and muscle weakness may indicate vitamin D deficiency, but symptoms may be subtle and go undetected in the initial stages. A deficiency is accurately diagnosed by measuring the concentration of a specific form of vitamin D in blood.

    Adults aged 19-50 are recommended to get 200 IU of vitamin D per day. Adults 51 – 70 are recommended to get 400 IU of vitamin D per day. The easiest way to get Vitamin D is through exposure to natural sunlight. In general, 10-15 minutes of exposure to sunlight on exposed skin 3 times a week is enough. The exactly amount varies by individual.

    Americans age 50 and older are believed to be at increased risk of developing vitamin D deficiency. As people age, skin cannot synthesize vitamin D as efficiently and the kidney is less able to convert vitamin D to its active hormone form. It is estimated that as many as 30% to 40% of older adults with hip fractures are vitamin D insufficien. Therefore, older adults may benefit from supplemental vitamin D.

    In a review of women with osteoporosis hospitalized for hip fractures, 50 percent were found to have signs of vitamin D deficiency. Daily supplementation with 20 μg (800 IU) of vitamin D may reduce the risk of osteoporotic fractures in elderly populations with low blood levels of vitamin D.

    Besides natural production through sunlight exposure, Vitamin D is also found in foods such as dairy products (particularly milk), fish, oyesters, and fortified cerals.

    Food International Units(IU) per serving Percent DV*
    Cod liver oil, 1 Tablespoon 1,360 340
    Salmon, cooked, 3½ ounces 360 90
    Mackerel, cooked, 3½ ounces 345 90
    Tuna fish, canned in oil, 3 ounces 200 50
    Sardines, canned in oil, drained, 1¾ ounces 250 70
    Milk, nonfat, reduced fat, and whole, vitamin D fortified, 1 cup 98 25
    Margarine, fortified, 1 Tablespoon 60 15
    Pudding, prepared from mix and made with vitamin D fortified milk, ½ cup 50 10
    Ready-to-eat cereals fortified with 10% of the DV for vitamin D, ¾ cup to 1 cup servings (servings vary according to the brand) 40 10
    Egg, 1 whole (vitamin D is found in egg yolk) 20 6
    Liver, beef, cooked, 3½ ounces 15 4
    Cheese, Swiss, 1 ounce 12 4

    Too much Vitamin D results in toxicity can cause nausea, vomiting, poor appetite, constipation, weakness, and weight loss. It can also raise blood levels of calcium, causing mental status changes such as confusion. High blood levels of calcium also can cause heart rhythm abnormalities. Calcinosis, the deposition of calcium and phosphate in the body's soft tissues such as the kidney, can also be caused by vitamin D toxicity.

    Sun exposure is unlikely to result in vitamin D toxicity. Diet is also unlikely to cause vitamin D toxicity, unless large amounts of cod liver oil are consumed. Vitamin D toxicity is much more likely to occur from high intakes of vitamin D in supplements. The Food and Nutrition Board of the Institute of Medicine has set the tolerable upper intake level (UL) for vitamin D at 25 μg (1,000 IU) for infants up to 12 months of age and 50 μg (2,000 IU) for children, adults, pregnant, and lactating women..
  • Magnesium – Nearly sixty percent of the magnesium in our bodies is found in our bones. Studies suggest that magnesium enhances bone mineral density, and insufficient magnesium levels may interfere with the processing of calcium. RDA is 420 mg for men over 30 and 320 mg for women over 30. Daily intakes over 350 mg are not recommended. RDA is 420 mg for men over 30 and 320 mg for women over 30. Daily intakes over 350 mg are not recommended.
  • Phosphorus – Phosphorus is a component of every cell in our bodies and supports building bone and other tissue during growth. About 85% of the phosphorus in our bodies is found in our bones. In fact, phosphate, a form of phosphorus, makes up more than half of our bone mineral mass. RDA is 700 mg for men and women over age 30. Daily intakes over 4,000 mg for adults up to age 70 and over 3,000 mg after age 70 are not recommended.
  • Vitamin K – Vitamin K helps certain enzymes and local regulators function properly so that we can form the optimal bone matrix or structure for bone strength. RDA is 120 units for men over age 30 and 90 units for women over age 30. No maximum safe intake has been established for vitamin K.
  • Boron – may enhance calcium absorption and estrogen metabolism.
  • Copper – Copper helps certain enzymes and local regulators function properly so that the optimal bone matrix or structure can be formed. RDA is 0.9 mg for men and women over age 30. Daily intakes over 10 mg are not recommended.
  • Isoflavones – Isoflavones have been shown to have a protective effect on bone in animal studies.
  • Zinc – Zinc helps certain enzymes and local regulators function properly which in turn helps our bodies form the optimal bone matrix or structure for bone strength. RDA is 11 mg for boys and men over age 19 and 8 mg for girls and women over age 19. Daily intakes over 40 mg are not recommended.
  • Iron – Iron helps certain enzymes and local regulators function properly so that we can form the optimal bone matrix or structure for bone strength. RDA is 8 mg for men over age 19. The RDA for women is 18 mg between the ages of 19 and 50 and 8 mg over age 50. Daily intakes over 45 mg are not recommended.
  • Vitamin C – Vitamin C helps certain enzymes and local regulators function properly so that we can form the optimal bone matrix or structure for bone strength. RDA is 90 mg for men over age 30 and 75 mg for women over age 30. Daily intakes over 2,000 mg are not recommended.
  • Potassium Citrate – Recent research studies conducted by the University of Basel (Switzerland) have shown that reducing the acidity of your diet can rapidly increase bone mass in amounts that are on par with FDA approved prescriptions medications. Potassium citrate is a base that reacts with acid, thereby neutralizing it. The study’s findings suggest that high acidity levels in western diets are associated with a drop in bone mineral density in postmenopausal women.
vitamins
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