Vitamin D and Osteoarthritis
In an effort to reverse osteoarthritis, some people are turning to Vitamin D as the fountain of joint youth. Yes, vitamin D is very important for bone, cell and vascular health. Vitamin D unlocks the power of calcium and adds a boost to the immune system as well. But, is Vitamin D supplementation enough to stop the effects of aging? Maybe not, however supplementation is critical for preventing problems of Vitamin D deficiency. Severe deficiency leads to osteomalacia and Rickets. Mild deficiency may lead to a number of more common conditions like vascular disease, cancer and pain. All of the vitamins are very important to keep the entire body running smoothly including joints.
Many researchers have looked at the association between low Vitamin D levels and osteoarthritis. Yet the question remains: Does a low vitamin D level lead to joint deterioration? One recent study evaluated the impact that a two year supplementation program had on symptoms of knee osteoarthritis. After two years, pain and function did not improve despite “normalizing” Vitamin D levels. However, the targeted level (> 30 ng/ml) and length of treatment (2 years) may not have been adequate enough. Higher levels of Vitamin D may help those with mild OA over a longer period of time. Although the relationship between Vitamin D and osteoarthritis remain unclear, those with osteoarthritis should at least have the vitamin D levels checked.
Some have studied the impact that Vitamin D may have on joint replacement in cases of end-stage osteoarthritis. Low Vitamin D levels may increase the risk of poor surgical outcomes. Intuitively, this makes sense because Vitamin D is so critical for bone health and healing. The interface between the implant and the bone has a much better chance of solidifying if Vitamin D levels are within normal range. Because of this potential impact on surgical outcomes, those planning to replace an arthritic joint with an implant should have the Vitamin D level checked.
Even if one does not have osteoarthritis, making sure the Vitamin D levels are normal may help prevent osteoarthritis in the future. Vitamin D may not be the fountain of joint youth, but it is certainly worth a pound of cure. Vitamin D is not going to cure osteoarthritis, nor is it going to insure that joints will not deteriorate. However, Vitamin D is receiving some well deserved attention because too many have been deficient for too long. Vitamin supplementation is a necessary part of preventative medicine.
In my practice, I use 60 ug/ml as a target level for the 25-hydroxyvitamin D (25(OH) D) concentrations (the real Vitamin D level). Those who are below 30 ug/ml are loaded with 8000 IU per day of Vitamin D3 for one month; followed by supplements between 1000 to 2000 IU per day depending on the response. At your next appointment, talk to your doctor about your vitamin D level. Your joints might be glad that you did. To learn more see Pam Flores’ interview with Dr. Davis about Vitamin D. You will be very enlightened.
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.