Gains in Bone Mineral Density with Resolution of Vitamin D Intoxication
Publication: Annals of Internal Medicine
Volume 127, Number 3
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Abstract
Background:
Vitamin D intoxication is associated with the mobilization of skeletal calcium.
Objective:
To ascertain how the resolution of vitamin D intoxication affects bone density.
Design:
Case series.
Setting:
Referral service for metabolic bone disease in a tertiary care teaching hospital.
Patients:
Four patients with osteoporosis who were each using several nonprescription dietary supplements and were found to have fasting hypercalciuria.
Intervention:
Discontinuation of use of dietary supplements.
Measurements:
Serial measurement of serum levels of 25-hydroxyvitamin D, ratio of fasting urinary calcium to creatinine, and bone mineral density for 3 years.
Results:
Discontinuation of use of dietary supplements resulted in the normalization of serum levels of 25-hydroxyvitamin D, the normalization of the ratio of urinary calcium to creatinine, and a mean annual increase in bone mineral density (±SD) of 1.9% ± 0.6%.
Conclusions:
Occult vitamin D intoxication was detected in patients who were using dietary supplements that contained an unadvertised high level of vitamin D. Resolution of vitamin D intoxication was associated with a rebound in bone mineral density.
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References
1.
Slemenda CW, Christian JC, Williams CJ, Norton JA, Johnston CC Jr. Genetic determinants of bone mass in adult women: a reevaluation of the twin model and the potential importance of gene interaction on heritability estimates. J Bone Miner Res. 1991; 6:561-7.
2.
Silverberg SJ, Gartenberg F, Jacobs TP, Shane E, Siris E, Staron RB, et al. Increased bone mineral density after parathyroidectomy in primary hyperparathyroidism. J Clin Endocrinol Metab. 1995; 80:729-34.
3.
Parfitt AM. Hormonal influences on bone remodeling and bone loss: application to the management of hyperparathyroidism [Editorial]. Ann Intern Med. 1996; 125:413-5.
4.
Diamond T, Vine J, Smart R, Butler P. Thyrotoxic bone disease in women: a potentially reversible disorder. Ann Intern Med. 1994; 120:8-11.
5.
Ooms ME, Roos JC, Bezemer D, van der Vijgh WJ, Bouter LM, Lips P. Prevention of bone loss by vitamin D supplementation in elderly women: a randomized double-blind trial. J Clin Endocrinol Metab. 1995; 80:1052-8.
6.
Zerwekh JE, Sakhaee K, Breslau NA, Gottschalk F, Pak CY. Impaired bone formation in male idiopathic osteoporosis: further reduction in the presence of concomitant hypercalciuria. Osteoporos Int. 1992; 2:128-34.
7.
Kanis JA, Melton LJ 3d, Christiansen C, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J Bone Miner Res. 1994; 9:1137-41.
8.
Vanderschueren D, Gevers G, Dequeker J, Guesens P, Nijs J, Devos P, et al. Seasonal variation in bone metabolism in young healthy subjects. Calcif Tissue Int. 1991; 49:84-9.
9.
Clemens TL, O'Riordan JL. Vitamin D. In: Becker KL, ed. Principles and Practice of Endocrinology and Metabolism. Philadelphia: Lippincott; 1990: 417-23.
10.
British Pediatric Association. Hypercalcaemia in infants and vitamin D [Letter]. Br Med J. 1956; 2:149.
11.
Berth-Jones J, Bourke JF, Iqbal SJ, Hutchinson PE. Urine calcium excretion during treatment of psoriasis with topical calcipotriol. Br J Dermatol. 1993; 129:411-4.
12.
Pouilles JM, Tremollieres F, Ribot C. Prevention of post-menopausal bone loss with 1 α-hydroxy vitamin D3. A three-year prospective study. Clin Rheumatol. 1992; 11:492-7.
13.
Jacobus CH, Holick MF, Shao Q, Chen TC, Holm IA, Kolodny JM, et al. Hypervitaminosis D associated with drinking milk. N Engl J Med. 1992; 326:1173-7.
14.
Holick MF, Shao Q, Liu WW, Chen TC. The vitamin D content of fortified milk and infant formula. N Engl J Med. 1992; 326:1178-81.
15.
Fraser DR. Vitamin D. Lancet. 1995; 345:104-7.
16.
Henney JE. Combating medical fraud. N Y State J Med. 1993; 93:86-7.
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Published In
Annals of Internal Medicine
Volume 127 • Number 3 • 1 August 1997
Pages: 203 - 206
History
Published in issue: 1 August 1997
Published online: 15 August 2000
Keywords
Copyright
© 1997 American College of Physicians.
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Gains in Bone Mineral Density with Resolution of Vitamin D Intoxication. Ann Intern Med.1997;127:203-206. doi:10.7326/0003-4819-127-3-199708010-00004
Gains in Bone Mineral Density with Resolution of Vitamin D Intoxication. Ann Intern Med.1997;127:203-206. doi:10.7326/0003-4819-127-3-199708010-00004
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Questions regarding levels of 25 OH D and 1, 25 OH D and PTH
Dear Sirs: In re: your article Gains in Bone Mineral Density with Resolution of Vitamin D Intoxication
John S. Adams, MD, and Gene Lee
1 August 1997 | Volume 127 Issue 3 | Pages 203-206 in Annals of Internal Medicine.
Thank you for your interesting article. However, I would appreciate if you could answer questions for me:
1) What was the level of Vitamin D consumed? Two sententences, as below, are confusing.
"No patient knowingly consumed more than 1200 IU of vitamin D daily or took other medications known to alter skeletal metabolism."
"Some of these products were advertised as containing as much as 3600 IU of vitamin D3 per daily dosage"
2) What were the measured levels of 25 OH D3 and 1,25 OH D3 and 25 OH D2?
3) What was the measured level of Parathyroid Hormone?
4) Was was the animal extract product?.
5) What was the level of Calcium measured?
Thank you for your attention to my questions.
Barbara Zeitlin Kravets CCN LDN
[email protected]
Conflict of Interest:
None declared