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Osteoporosis Message Board


Osteoporosis Board Index


Pika B-Hi!I hope you are doing well. I am glad you chimed in. If I hadn't already read about this phenomenon , that age reduces ability to sythesize D , I would have thought you would absolutely have no possibility of a vitamin d issue living in Arizona and getting daily sun exposure.Do you recall what your d level was at when tested?
Have you finished your forteo treatment yet? Have you made a decision about your next move?One angle I am now pursuing is the hormone situation. I am 55 and yes , there have been changes. But, of course, it is an issue with men as well I believe. I just wanted to put the idea out there. I think I previously mentioned in my research I saw that doctors at the Univer of Oregon are very focused on male osteoporosis and the role of male hormones. I believe one of the lead medical doctors is Orlow or Orloff, probably it would be an easy search but let me know if I could help you at all ,if you have any interest. Not that I would see you would want to go to Oregon , but maybe you would be interested in reading about their research projects.
osteoblast: I don't recall exactly what my Vitamin D level was, but I recall that it was [B]not[/B] close to the borderline. I still have 3 months of Forteo to go, and will decide on my next treatment at that time (and after next DEXA). But I would rather break free of prescription medication.

Another Vitamin D note: If taking Vitamin D supplements, remember that Vitamin D is fat-soluble, so it should be taken with some sort of fatty food. If a person takes Vitamin D on an empty stomach, or just with orange juice, coffee, etc., the body will not absorb much of the D.
I did a quick web search and found one hopeful article: Response to Teriparatide in Patients with Baseline 25-Hydroxyvitamin D Insufficiency or Sufficiency. The results of this study indicate that Forteo built just as much bone whether or not the patient had the recommended amounts of Vitamin D-25 in the blood. :)
Pika B- I need to look at the article. I have read at Mayo Clinic that vitamin d deficiency causes rickets in children with growing bone, and osteomalacia in adults. So, how could a vit d deficient status allow quality bone growth while on forteo. Did the article pose the question that while the bone growth was not inhibited that it may not be of a good quality or as good a quality as it may have been with adequate vit d level??
Hi Osteo: Here's the article PikaB mentioned. You can also find it by typing in the entire title name he lists and it pulls up numerous other sources for the same study. I wondered the same thing, but this has been an issue with me for a long time but with my calcium levels. If my calcium level is elevated wouldn't it pull the calcium from the bone, into the blood, leaving the bone at higher risk for fracture, thus making the Forteo less effective, and according to my Min Met dr the answer was no. I still don't completely understand how elevated or low vitamin and minerals affect the remoldeling process, especially in the case of [U]elevated[/U] levels, I understand your reasoning when the vitamin is low. Read it and see what you think.

Pika-Hope you don't mind me stepping in;)



[url]http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=17911178&cmd=showdetailview&indexed=******[/url]

Well it looks like you will have to type in the title of the article since the above link is truncated :( But the one I read is from PubMed-National Institute of Health
PikaB-Thank you for the follow up. I saw an expert in the osteo field, he is mostly involved in research, and he said that the flaw with the dexa is that it didn't test quality. He said bone quality testing is the next development in the diagnostic field and it isn't too far out that it would be available. I didn't ask the time frame. When thinking quality , I am sure it is multifactorial, but vit d seems to one of the critical components if not the most critical given that with rickets and osteomalacia vitamin d administration is the treatment. Of course , there could be other issues with rickets and osteomalacia- it wouldn't always be so simple in ,for example, cases where a person could not use the vitamin d that is taken in- celiac etc. What I don't understand is why forteo users are expected to have the 19%increase in d 1,25 and 19%decrease in d25. What is going on with the metabolism of vit d?
[QUOTE=osteoblast;3354848]PikaB-Thank you for the follow up. I saw an expert in the osteo field, he is mostly involved in research, and he said that the flaw with the dexa is that it didn't test quality. He said bone quality testing is the next development in the diagnostic field and it isn't too far out that it would be available. I didn't ask the time frame. When thinking quality , I am sure it is multifactorial, but vit d seems to one of the critical components if not the most critical given that with rickets and osteomalacia vitamin d administration is the treatment. Of course , there could be other issues with rickets and osteomalacia- it wouldn't always be so simple in ,for example, cases where a person could not use the vitamin d that is taken in- celiac etc. What I don't understand is why forteo users are expected to have the 19%increase in d 1,25 and 19%decrease in d25. What is going on with the metabolism of vit d?[/QUOTE]


Hi Osteo: This really won't help your situation much but there are some forms of ostemalacia and rickets that are vitamin D resistant. :confused:

I was thinking about this, and wondered if you read the article that Pika posted and also if you'd thought of phrasing your search query differently? I was looking this up myself and haven't been all that satisfied with the results so far, but I will continue to look. But it occured to me that since our PTH levels effect calcium, d 25, d 125, and phosphorous the same way, could you try rewording you search query by substituting the word Forteo for parathyroid gland. Since Forteo has only been around for 5 years there aren't as many studies on it as there are on the effects of parathyroid disorders (high/low readings/adenomas etc) and cal, D, and phosphorous levels. You might be able to find out more if you knew how the parathyroid gland does the exact same thing that Forteo does. Just a thought. But I still feel better knowing that the patients in that trial who started off (baseline) with low D 25 didn't have any decrease in remodeling or suffered any increases in fx's after 19 months with out of wack D. Of course we wouldn't know the quality of the bone that was being made with low D, but evidently it was good enough to prevent fx's, and increase bmd. We still have to treat these problems, in some cases, but I'm glad they "even did" a study about the effects of low D25 with the coadministration of Forteo, who knew the medical community was even thinking about this! Thanks again Pika...good job finding it~~

I'll let you know if I finding an explanation, and I've been looking, but all I can find is what I mentioned above about the metabolism effects of the PTH gland on those vits and minerals. So even if you weren't taking Forteo we still know this can happen via a malfunctioning PTH gland.

An example of a query off the top of my head might be "metabolism of vitamin D and Calcium with Forteo" and then replace Forteo with "the Parathyroid gland," putting that query in your search engine instead. I'm sure you can come up with a better query than that, I can't think anymore tonight bad neck/headache pain.

Talk to you later to give you the latest news, not all that interesting though about the vit D 25:)
DesertBloom - Merry Christmas to you as well!!Sorry to hear about the ear ringing- we are alike in this too it seems. I have had low level ringing , buzz in ears for several years. I think it is connected to being hypothyroid. Other hypo people say they have it too.
Maybe Umass will come back and let us know the connection between d1,25 , d25 , vitamin d high dosing, and calcium level.And, also pth.Yes, I understand your feeling of being caught about the high dose and possibly pushing the calcium. It is not an easy situation. Your 1,000 iu's is not that much of a dose, but I understand your concern. I always thought that instead of a one day 50,000 dose, for my system it would be better to spread it out in the week. I went to the 10,000 iu's becuase it is usp and in an oil suspension. When I saw the big expert who now referred me to the local rheum , he looked over a year of labs and there was quite a bit- I put it into a chart for him. He said not hyperpara and not hypercalcemia. But who Knows!!!He did say the high doses of d would have pushed it but he didn't see it. I still have the way elevated ntx. That bugs me too. Esp. reading cosman saying exuberant bone turn over numbers were not as good as so so turnover numbers that with evista yielded higher bmd. I recently had a 24 hr. urine that came out -out of range high side by 2 points. The endo said I think it is the forteo, lower your calcium Right now I am getting total cal. of about 800 a day. Only taking the 250 in the multi and otherwise it is dietary. What is your total cal intake now? I have a script to do a serum calcium in the next week or so. I am going to try to get this conundrum clarified early this yr. -here's hoping for Jan. Of course I will keep you updated, please do the same. Maybe between us there will be some light shed on this .On your calcium level-what are you most concerned with the urinary or the serum?
Do you know which should be of the most concern? Hope you feel better soon:) I am thinking that our questions are crystallizing somewhat and maybe we are not too far off from the answers.

p.s. more on bioid. in the next few days. I have a book I want to look at and quote from - Dr. Mehmet Oz . He likes the bioid but from the regular pharm- is what I gathered from the book.





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