New product- Fosamax Plus.
in [Osteoporosis]
|
From: John Que on 17 Apr 2005 23:48 Yes, Larry we've disagreed before. (You top posted so I top posted.) I suppose you may have a case in subjects with sarcoidosis, leukemia or lymphoma. Be it known that Ronald Vieth, Michael F. Holick, B. Dawson-Hughes, B.W. Hollis, C. L. Wagner, C.M. Weaver, and J.C. Fleet generally seem to agree with my position. Recall that if you live in Brazil and get out in the sun, your serum 25 (OH) vitamin D3 levels will be similar to a person who is taking 4000 IU (100 mcg) and not get any meaningful sun. Many people don't get strong enough sun to yield meaningful amounts of vitamin D3 due to work schedules, smog, dark skin, seasons, and confinement. In younger adults an exposure of 15% of skin area for 1/3 a minimal erththemal dose yeilds 1000 IU (25 mcg) during the summer. A whole body exposure for 10 to 15 minutes in the midday sun of summer yeilds a dose of 15 000 IU (375 mcg). On the other hand in the late fall depending on latitude such an exposure to the midday sun will yeild no meaningful amounts of vitamin D3. In the elderly, the synthesis of vitamin D3 can be cut by 75%. Understand also that while a normal serum calcium level can not be used to diagnosis a vitamin D deficiency, it can be used to used to check for hypervitaminosis as the serum calcium would be elevated in such a case. An as far as a good endocrinologist goes, I suggest if one is educated, one is better off reading up on the topic themselves and getting their lab results from a lower cost GP at least at times. Endocrinology isn't rocket science ;-) And good ones occur at a rate of about 1 in 10 at best, IMO, on the basis of a position poll among other things. The body DOES NOT accumulate sufficient stores to maintain sufficient 25 (OH) vitamin D3 to yield enough 1,25 (OH)2 vitamin D3 to prevent a rise in PTH and the liberation of calcium from the bones. Serum levels of less than 80 nmol/L of 25 (OH) vitamin D3 have an inverse relationship to PTH levels. Indeed, some have suggested even this value is too low for fully reducing PTH levels. Granted, I've seen the threshold for sufficiency set at 50 nmol/L and even lower by some. And finally it takes 4000 IU (100 mcg) in a lactating woman to render her beast milk an adequate source of vitamin D. Or it would seem 20 minutes in the sun with 10 minutes exposure for both sides in a Bikini swim suit. It would be foolish to take 4000 IU of D per day and also get sun. If one is going to take a fixed supplement dose all year round a 1000 IU is a reasonable dose. The use of a 4000 IU dose per day makes sense in the circumstance of a Seattle winter or shut in. Further there are other chemicals important to bone heal such as vitamin K, boron, and magnesium. --JQ "Social norms bear only a tangential relationship to either truth or reality." "Larry" <larry(a)nospam.net> wrote in message news:2Au8e.2383$ZQ1.1810(a)fe11.lga... > Just a word to the wise. It is my opinion (and I think I've expressed it > here before) that it is not a good idea to blindly take large doses of > Vitamin D (or anything for that matter). A good endocrinologist can > order tests to see if your body needs vitamin D supplementation and if > so, how much. Your body is supposed to get plenty of it by itself from > sunlight during months that are not winter months. > > Larry E. > > John Que wrote: > > "osteoporosis advisor" <info(a)osteoporosis-advisor.com> wrote in message > > news:1113517978.786273.66820(a)l41g2000cwc.googlegroups.com... > > > >>There was an earlier post about vitamin D and I so I thought the > >>folowing information would be of use. Merck & Co., Inc. has announced > >>that the U.S. Food and Drug Administration (FDA) has approved FOSAMAX > >>PLUS D(TM) (alendronate sodium/cholecalciferol), a single once-weekly > >>tablet containing 70 mg FOSAMAX(R) (alendronate sodium) and 2800 IU > >>vitamin D3, representing seven days worth of 400 IU of vitamin D. (The > >>recommended intake of vitamin D is 400-800 IU daily). FOSAMAX has been > >>demonstrated to reduce the risk of both hip and spine fractures in > >>postmenopausal women with osteoporosis and is now the only > >>bisphosphonate with the added benefit of a weekly dose of vitamin D. > >> > >>Maintaining adequate levels of vitamin D is necessary for the > >>development of strong bones because it helps increase the intestinal > >>absorption of calcium. Vitamin D insufficiency is associated with > >>reduced calcium absorption, bone loss and increased risk of fracture. > >>Patients at increased risk for vitamin D insufficiency (e.g., those who > >>are nursing-home bound, chronically ill, over the age of 70 years) and > >>with gastrointestinal malabsorption syndromes should receive vitamin D > >>supplementation in addition to that provided in FOSAMAX PLUS D. > >> > >>FOSAMAX PLUS D is indicated for the treatment of osteoporosis in > >>postmenopausal women. For the treatment of osteoporosis, FOSAMAX PLUS D > >>increases bone mass and reduces the incidence of fracture, including > >>those of the hip and spine. FOSAMAX PLUS D is also indicated to > >>increase bone mass in men with osteoporosis. > >> > >>FOSAMAX PLUS D, like other bisphosphonate containing products, should > >>be used with caution in people with certain stomach or digestive > >>problems. FOSAMAX PLUS D should not be used if the patient has certain > >>disorders of the esophagus that delay emptying or if the patient is > >>unable to stand or sit upright for at least 30 minutes. In addition, > >>FOSAMAX PLUS D should not be used in patients with severe kidney > >>disease or low levels of calcium in their blood, in patients who are > >>allergic to FOSAMAX PLUS D or in patients who are pregnant or nursing. > >>FOSAMAX PLUS D alone should not be used to treat vitamin D deficiency. > >> > >>Many physicians and patients frequently are unaware of the importance > >>of vitamin D in bone health. Given its effect on calcium absorption, > >>vitamin D insufficiency is an important medical concern for patients > >>with osteoporosis, as it can lead to bone loss and an increased risk of > >>fracture. > >> > >>Vitamin D is obtained from two sources: sunlight and diet. The skin > >>manufactures the majority of the body's vitamin D after direct exposure > >>to sunlight but as adults age the ability to make vitamin D through the > >>skin diminishes. Avoiding sun exposure or using sunscreen can also > >>limit a person's production of vitamin D. Vitamin D can also come from > >>the diet but there are limited dietary sources that contain the > >>nutrient. Good dietary sources include fatty fish (e.g., salmon), > >>vitamin D fortified milk and orange juice. However, for many people, > >>dietary sources alone are not enough. For example, one must drink four > >>eight ounce glasses of milk to receive 400 IU of vitamin D. > >> > >>According to an analysis published in 2004 and based on the Third > >>National Health and Nutrition Examination Survey (NHANES III), a > >>majority of Americans are not consuming enough vitamin D. The study > >>estimated that over 70% of women age 51-70 and almost 90% of women over > >>70 are not getting an adequate intake of vitamin D from food and > >>supplements. This analysis was based on the adequate intake, as defined > >>by the National Institute of Health's Institute of Medicine, of 400 IU > >>per day for women age 51-70 and 600 IU per day for women over 70 years. > >>Other organizations, such as the National Osteoporosis Foundation > >>(NOF), recommend vitamin D intake of up to 800 IU per day. As a > >>treatment for osteoporosis in postmenopausal women, FOSAMAX PLUS D > >>offers 2800 IU vitamin D, representing seven days worth of 400 IU of > >>vitamin D. > >> > >>I now routinely check 25-OH Vit D levels and if below 30ng/ml would > >>suggest treatment. I use the repalacement regime as devised by Michael > >>Holick MD. > >> > >>Adrian > >> > > > > > > Several comments. > > > > First the Fosamax contain too little vitamin D if > > it is seen as the sole source of supplemental vitamin D. > > I'd suggest 5600 IU (140 mcg) per week would > > be the barebones minimum as a maintenance > > dose and 7000 IU (175 mg) per week is a reasonable choice. > > Perhaps they are assuming concurrent use of a multiple vitamin > > and being ultra-conservative? > > > > Personally I agree with Vieth that 4000 IU per day during the darker > > months of the year or for living entirely indoors 4000 IU all year round > > is a better choice. > > > > 30 ng/ml is right around 80 nmol/L. > > Reasonable. > > Far better than waiting until 40 nmol/L. > > > >
From: John Que on 17 Apr 2005 23:56 Hmmm......an unfinished version of my posting got on to the usenet.
From: John Que on 18 Apr 2005 00:18 The "apparent references" come from the views and papers of top scientists in the field of vitamin D research. You seem to assume that I don't have a wall of books off to my right. If one live is sunny California, I agree the chance of needing a vitamin D supplement is greatly reduced provided they get out in the sun without sunscreeen. People can operate on some general rules of thumb. They don't have to test for everything. Clearly, though if one has unlimited resources it is best. And remember one of my Docs agrees with me as to the dose. Though I am sure he'd order a test a drop of the hat. As I pointed out to you my calcium serum level is in the normal range. I've given this some thought and I am not just "spouting off". I rather more conservative than you make me out to be. I only take my dose of D during the darker months of the year or if I've spent all day out of the sun which is rare. "Larry" <larry(a)nospam.net> wrote in message news:dwF8e.2591$ZQ1.1187(a)fe11.lga... > John, > > You can spout off as many apparent references as you want to support > your position to overdose on vitamin D. I know people who take 1000s of > mgs of vitamin C per day and think it does them some incremental good > but don't understand that the human body just excretes it all out. But > ... as with any substance that you take into your body ... especially in > quantities ... it makes good common sense to seek the opinion of your > doctor. Some osteoporotic people need vitamin D supplementation, some > don't. Some osteoporotic people need calcium supplementation, some > don't. Some heart patients need to take statins, some don't. And to > think that you can derive the best answer for your body by reading > references on the internet is sheer silliness. > > Vitamin D happens to be a component that can be tested for in the serum. > There is absolutely no good reason to assume that you need it without > being tested to make that determination and without seeking out the > advice of a qualified physician. > > That is my opinion. You are certainly welcome to yours, and I respect > that. But I think it is wrong to encourage people to blindly ingest > substances into their body over the internet ... when it makes much > better sense to seek out the opinion of a physician. If you don't like > his opinion ... seek out another and another. If you can find one that > recommends such high levels and only having one (or however many) > satisfies you, go ahead and have a party if you must. > > Larry E. > > John Que wrote: > > Yes, Larry we've disagreed before. > > (You top posted so I top posted.) > > > > Be it known that Ronald Vieth, Michael F. Holick, > > B. Dawson-Hughes, B.W. Hollis, C. L. Wagner, > > C.M. Weaver, and J.C. Fleet generally seem to > > agree with my position. > > > > Recall that if you live in Brazil and get out in > > the sun, your serum 25 (OH) vitamin D3 > > levels will be similar to a person who is taking > > 4000 IU (100 mcg) and not get any meaningful sun. > > Many people don't get strong enough sun > > to yield meaningful amounts of vitamin D3 due > > to work schedules, smog, dark skin, seasons, > > and confinement. > > > > In younger adults an exposure of 15% of > > skin area for 1/3 a minimal erththemal dose > > yeilds 1000 IU (25 mcg) during the summer. > > A whole body exposure for 10 to 15 minutes > > in the midday sun of summer yeilds a dose > > of 15 000 IU (375 mcg). On the other > > hand in the late fall depending on latitude such an > > exposure to the midday sun will yeild no > > meaningful amounts of vitamin D3. In the > > elderly, the synthesis of vitamin D3 can be > > cut by 75%. > > > > Understand also that while a normal serum calcium level > > can not be used to diagnosis a vitamin D deficiency, > > it can be used to used to check for hypervitaminosis > > as the serum calcium would be elevated in such a > > case. > > > > An as far as a good endocrinologist goes, I suggest > > if one is educated, one is better off reading up > > on the topic themselves and getting their lab > > results from a lower cost GP at least at times. > > Endocrinology isn't rocket science ;-) > > And good ones occur at a rate of about 1 in 10 > > at best, IMO, on the basis of a position poll > > among other things. > > > > The body DOES NOT accumulate sufficient > > stores to maintain sufficient 25 (OH) vitamin D3 > > to yield enough 1,25 (OH)2 vitamin D3 to > > prevent a rise in PTH and the liberation of > > calcium from the bones. Serum levels of > > less than 80 nmol/L of 25 (OH) vitamin D3 > > have an inverse relationship to PTH levels. > > Indeed, some have suggested even this value > > is too low for fully reducing PTH levels. > > Granted, I've seen the threshold for > > sufficiency set at 50 nmol/L and even > > lower by some. > > > > And finally it takes 4000 IU (100 mcg) > > in a lactating woman to render her > > beast milk an adequate source of > > vitamin D. Or it would seem 20 > > minutes in the sun with 10 minutes > > exposure for both sides in a Bikini > > swim suit. > > > > --JQ > > "Social norms bear only a tangential > > relationship to either truth or reality." > > > > > > > > > > "Larry" <larry(a)nospam.net> wrote in message > > news:2Au8e.2383$ZQ1.1810(a)fe11.lga... > > > >>Just a word to the wise. It is my opinion (and I think I've expressed it > >>here before) that it is not a good idea to blindly take large doses of > >>Vitamin D (or anything for that matter). A good endocrinologist can > >>order tests to see if your body needs vitamin D supplementation and if > >>so, how much. Your body is supposed to get plenty of it by itself from > >>sunlight during months that are not winter months. > >> > >>Larry E. > >> > >>John Que wrote: > >> > >>>"osteoporosis advisor" <info(a)osteoporosis-advisor.com> wrote in message > >>>news:1113517978.786273.66820(a)l41g2000cwc.googlegroups.com... > >>> > >>> > >>>>There was an earlier post about vitamin D and I so I thought the > >>>>folowing information would be of use. Merck & Co., Inc. has announced > >>>>that the U.S. Food and Drug Administration (FDA) has approved FOSAMAX > >>>>PLUS D(TM) (alendronate sodium/cholecalciferol), a single once-weekly > >>>>tablet containing 70 mg FOSAMAX(R) (alendronate sodium) and 2800 IU > >>>>vitamin D3, representing seven days worth of 400 IU of vitamin D. (The > >>>>recommended intake of vitamin D is 400-800 IU daily). FOSAMAX has been > >>>>demonstrated to reduce the risk of both hip and spine fractures in > >>>>postmenopausal women with osteoporosis and is now the only > >>>>bisphosphonate with the added benefit of a weekly dose of vitamin D. > >>>> > >>>>Maintaining adequate levels of vitamin D is necessary for the > >>>>development of strong bones because it helps increase the intestinal > >>>>absorption of calcium. Vitamin D insufficiency is associated with > >>>>reduced calcium absorption, bone loss and increased risk of fracture. > >>>>Patients at increased risk for vitamin D insufficiency (e.g., those who > >>>>are nursing-home bound, chronically ill, over the age of 70 years) and > >>>>with gastrointestinal malabsorption syndromes should receive vitamin D > >>>>supplementation in addition to that provided in FOSAMAX PLUS D. > >>>> > >>>>FOSAMAX PLUS D is indicated for the treatment of osteoporosis in > >>>>postmenopausal women. For the treatment of osteoporosis, FOSAMAX PLUS D > >>>>increases bone mass and reduces the incidence of fracture, including > >>>>those of the hip and spine. FOSAMAX PLUS D is also indicated to > >>>>increase bone mass in men with osteoporosis. > >>>> > >>>>FOSAMAX PLUS D, like other bisphosphonate containing products, should > >>>>be used with caution in people with certain stomach or digestive > >>>>problems. FOSAMAX PLUS D should not be used if the patient has certain > >>>>disorders of the esophagus that delay emptying or if the patient is > >>>>unable to stand or sit upright for at least 30 minutes. In addition, > >>>>FOSAMAX PLUS D should not be used in patients with severe kidney > >>>>disease or low levels of calcium in their blood, in patients who are > >>>>allergic to FOSAMAX PLUS D or in patients who are pregnant or nursing. > >>>>FOSAMAX PLUS D alone should not be used to treat vitamin D deficiency. > >>>> > >>>>Many physicians and patients frequently are unaware of the importance > >>>>of vitamin D in bone health. Given its effect on calcium absorption, > >>>>vitamin D insufficiency is an important medical concern for patients > >>>>with osteoporosis, as it can lead to bone loss and an increased risk of > >>>>fracture. > >>>> > >>>>Vitamin D is obtained from two sources: sunlight and diet. The skin > >>>>manufactures the majority of the body's vitamin D after direct exposure > >>>>to sunlight but as adults age the ability to make vitamin D through the > >>>>skin diminishes. Avoiding sun exposure or using sunscreen can also > >>>>limit a person's production of vitamin D. Vitamin D can also come from > >>>>the diet but there are limited dietary sources that contain the > >>>>nutrient. Good dietary sources include fatty fish (e.g., salmon), > >>>>vitamin D fortified milk and orange juice. However, for many people, > >>>>dietary sources alone are not enough. For example, one must drink four > >>>>eight ounce glasses of milk to receive 400 IU of vitamin D. > >>>> > >>>>According to an analysis published in 2004 and based on the Third > >>>>National Health and Nutrition Examination Survey (NHANES III), a > >>>>majority of Americans are not consuming enough vitamin D. The study > >>>>estimated that over 70% of women age 51-70 and almost 90% of women over > >>>>70 are not getting an adequate intake of vitamin D from food and > >>>>supplements. This analysis was based on the adequate intake, as defined > >>>>by the National Institute of Health's Institute of Medicine, of 400 IU > >>>>per day for women age 51-70 and 600 IU per day for women over 70 years. > >>>>Other organizations, such as the National Osteoporosis Foundation > >>>>(NOF), recommend vitamin D intake of up to 800 IU per day. As a > >>>>treatment for osteoporosis in postmenopausal women, FOSAMAX PLUS D > >>>>offers 2800 IU vitamin D, representing seven days worth of 400 IU of > >>>>vitamin D. > >>>> > >>>>I now routinely check 25-OH Vit D levels and if below 30ng/ml would > >>>>suggest treatment. I use the repalacement regime as devised by Michael > >>>>Holick MD. > >>>> > >>>>Adrian > >>>> > >>> > >>> > >>>Several comments. > >>> > >>>First the Fosamax contain too little vitamin D if > >>>it is seen as the sole source of supplemental vitamin D. > >>>I'd suggest 5600 IU (140 mcg) per week would > >>>be the barebones minimum as a maintenance > >>>dose and 7000 IU (175 mg) per week is a reasonable choice. > >>>Perhaps they are assuming concurrent use of a multiple vitamin > >>>and being ultra-conservative? > >>> > >>>Personally I agree with Vieth that 4000 IU per day during the darker > >>>months of the year or for living entirely indoors 4000 IU all year round > >>>is a better choice. > >>> > >>>30 ng/ml is right around 80 nmol/L. > >>>Reasonable. > >>>Far better than waiting until 40 nmol/L. > >>> > >>> > > > > > >
From: Larry on 18 Apr 2005 09:09 John, It doesn't matter. You are trying to dole out a prescription for ingesting substances into ones body over the internet. That is (with all due respect) quackery. You are advocating the taking of these decisions into ones own hands, and that can be dangerous ... in some cases even life-threatening. No one says that you have to go to a doctor to determine whether to take a common multiple vitamin, or a 500mg dose of vitamin C every day. But you are advocating dosages of vitamin D much higher than is the US MDR. No, you cannot operate on general rules of thumb that are provided by a person over the internet who claims to have done some research and quotes doctors that just happen to seem to agree with his ideas. Everyone is different, and if you know what's good for you, you'll stop making these recommendations. Because if some harm happens to come to someone, and they can locate you, you are leaving yourself open for suit. And frankly, it really doesn't matter whether you have a "wall of books" or not. If one tries hard enough, one can find examples on the internet to support almost any medical opinion. You can quote examples of abstracts from PubMed or wherever. But PubMed almost never contains the bona fide results of large or even medium-scale clinical trials or studies which are normally required to validate the viability of medications. All PubMed is, is a venue to publish opinions, theories, and in some cases ... the results of studies on small groups of people. Larry E. John Que wrote: > The "apparent references" come from > the views and papers of > top scientists in the field of > vitamin D research. > > You seem to assume that I don't have > a wall of books off to my right. > > If one live is sunny California, I agree > the chance of needing a vitamin D > supplement is greatly reduced provided > they get out in the sun without sunscreeen. > > People can operate on some general > rules of thumb. They don't have to > test for everything. Clearly, though if one has > unlimited resources it is best. > > And remember one of my Docs > agrees with me as to the dose. > Though I am sure he'd order > a test a drop of the hat. > As I pointed out to you my > calcium serum level is in the > normal range. > > I've given this some thought > and I am not just "spouting off". > I rather more conservative than > you make me out to be. I only > take my dose of D during the > darker months of the year or > if I've spent all day out of the > sun which is rare. > > > > > "Larry" <larry(a)nospam.net> wrote in message > news:dwF8e.2591$ZQ1.1187(a)fe11.lga... > >>John, >> >>You can spout off as many apparent references as you want to support >>your position to overdose on vitamin D. I know people who take 1000s of >>mgs of vitamin C per day and think it does them some incremental good >>but don't understand that the human body just excretes it all out. But >>... as with any substance that you take into your body ... especially in >>quantities ... it makes good common sense to seek the opinion of your >>doctor. Some osteoporotic people need vitamin D supplementation, some >>don't. Some osteoporotic people need calcium supplementation, some >>don't. Some heart patients need to take statins, some don't. And to >>think that you can derive the best answer for your body by reading >>references on the internet is sheer silliness. >> >>Vitamin D happens to be a component that can be tested for in the serum. >> There is absolutely no good reason to assume that you need it without >>being tested to make that determination and without seeking out the >>advice of a qualified physician. >> >>That is my opinion. You are certainly welcome to yours, and I respect >>that. But I think it is wrong to encourage people to blindly ingest >>substances into their body over the internet ... when it makes much >>better sense to seek out the opinion of a physician. If you don't like >>his opinion ... seek out another and another. If you can find one that >>recommends such high levels and only having one (or however many) >>satisfies you, go ahead and have a party if you must. >> >>Larry E. >> >>John Que wrote: >> >>>Yes, Larry we've disagreed before. >>>(You top posted so I top posted.) >>> >>>Be it known that Ronald Vieth, Michael F. Holick, >>>B. Dawson-Hughes, B.W. Hollis, C. L. Wagner, >>>C.M. Weaver, and J.C. Fleet generally seem to >>>agree with my position. >>> >>>Recall that if you live in Brazil and get out in >>>the sun, your serum 25 (OH) vitamin D3 >>>levels will be similar to a person who is taking >>>4000 IU (100 mcg) and not get any meaningful sun. >>>Many people don't get strong enough sun >>>to yield meaningful amounts of vitamin D3 due >>>to work schedules, smog, dark skin, seasons, >>>and confinement. >>> >>>In younger adults an exposure of 15% of >>>skin area for 1/3 a minimal erththemal dose >>>yeilds 1000 IU (25 mcg) during the summer. >>>A whole body exposure for 10 to 15 minutes >>>in the midday sun of summer yeilds a dose >>>of 15 000 IU (375 mcg). On the other >>>hand in the late fall depending on latitude such an >>>exposure to the midday sun will yeild no >>>meaningful amounts of vitamin D3. In the >>>elderly, the synthesis of vitamin D3 can be >>>cut by 75%. >>> >>>Understand also that while a normal serum calcium level >>>can not be used to diagnosis a vitamin D deficiency, >>>it can be used to used to check for hypervitaminosis >>>as the serum calcium would be elevated in such a >>>case. >>> >>>An as far as a good endocrinologist goes, I suggest >>>if one is educated, one is better off reading up >>>on the topic themselves and getting their lab >>>results from a lower cost GP at least at times. >>>Endocrinology isn't rocket science ;-) >>>And good ones occur at a rate of about 1 in 10 >>>at best, IMO, on the basis of a position poll >>>among other things. >>> >>>The body DOES NOT accumulate sufficient >>>stores to maintain sufficient 25 (OH) vitamin D3 >>>to yield enough 1,25 (OH)2 vitamin D3 to >>>prevent a rise in PTH and the liberation of >>>calcium from the bones. Serum levels of >>>less than 80 nmol/L of 25 (OH) vitamin D3 >>>have an inverse relationship to PTH levels. >>>Indeed, some have suggested even this value >>>is too low for fully reducing PTH levels. >>>Granted, I've seen the threshold for >>>sufficiency set at 50 nmol/L and even >>>lower by some. >>> >>>And finally it takes 4000 IU (100 mcg) >>>in a lactating woman to render her >>>beast milk an adequate source of >>>vitamin D. Or it would seem 20 >>>minutes in the sun with 10 minutes >>>exposure for both sides in a Bikini >>>swim suit. >>> >>>--JQ >>> "Social norms bear only a tangential >>> relationship to either truth or reality." >>> >>> >>> >>> >>>"Larry" <larry(a)nospam.net> wrote in message >>>news:2Au8e.2383$ZQ1.1810(a)fe11.lga... >>> >>> >>>>Just a word to the wise. It is my opinion (and I think I've expressed it >>>>here before) that it is not a good idea to blindly take large doses of >>>>Vitamin D (or anything for that matter). A good endocrinologist can >>>>order tests to see if your body needs vitamin D supplementation and if >>>>so, how much. Your body is supposed to get plenty of it by itself from >>>>sunlight during months that are not winter months. >>>> >>>>Larry E. >>>> >>>>John Que wrote: >>>> >>>> >>>>>"osteoporosis advisor" <info(a)osteoporosis-advisor.com> wrote in message >>>>>news:1113517978.786273.66820(a)l41g2000cwc.googlegroups.com... >>>>> >>>>> >>>>> >>>>>>There was an earlier post about vitamin D and I so I thought the >>>>>>folowing information would be of use. Merck & Co., Inc. has announced >>>>>>that the U.S. Food and Drug Administration (FDA) has approved FOSAMAX >>>>>>PLUS D(TM) (alendronate sodium/cholecalciferol), a single once-weekly >>>>>>tablet containing 70 mg FOSAMAX(R) (alendronate sodium) and 2800 IU >>>>>>vitamin D3, representing seven days worth of 400 IU of vitamin D. (The >>>>>>recommended intake of vitamin D is 400-800 IU daily). FOSAMAX has been >>>>>>demonstrated to reduce the risk of both hip and spine fractures in >>>>>>postmenopausal women with osteoporosis and is now the only >>>>>>bisphosphonate with the added benefit of a weekly dose of vitamin D. >>>>>> >>>>>>Maintaining adequate levels of vitamin D is necessary for the >>>>>>development of strong bones because it helps increase the intestinal >>>>>>absorption of calcium. Vitamin D insufficiency is associated with >>>>>>reduced calcium absorption, bone loss and increased risk of fracture. >>>>>>Patients at increased risk for vitamin D insufficiency (e.g., those > > who > >>>>>>are nursing-home bound, chronically ill, over the age of 70 years) and >>>>>>with gastrointestinal malabsorption syndromes should receive vitamin D >>>>>>supplementation in addition to that provided in FOSAMAX PLUS D. >>>>>> >>>>>>FOSAMAX PLUS D is indicated for the treatment of osteoporosis in >>>>>>postmenopausal women. For the treatment of osteoporosis, FOSAMAX PLUS > > D > >>>>>>increases bone mass and reduces the incidence of fracture, including >>>>>>those of the hip and spine. FOSAMAX PLUS D is also indicated to >>>>>>increase bone mass in men with osteoporosis. >>>>>> >>>>>>FOSAMAX PLUS D, like other bisphosphonate containing products, should >>>>>>be used with caution in people with certain stomach or digestive >>>>>>problems. FOSAMAX PLUS D should not be used if the patient has certain >>>>>>disorders of the esophagus that delay emptying or if the patient is >>>>>>unable to stand or sit upright for at least 30 minutes. In addition, >>>>>>FOSAMAX PLUS D should not be used in patients with severe kidney >>>>>>disease or low levels of calcium in their blood, in patients who are >>>>>>allergic to FOSAMAX PLUS D or in patients who are pregnant or nursing. >>>>>>FOSAMAX PLUS D alone should not be used to treat vitamin D deficiency. >>>>>> >>>>>>Many physicians and patients frequently are unaware of the importance >>>>>>of vitamin D in bone health. Given its effect on calcium absorption, >>>>>>vitamin D insufficiency is an important medical concern for patients >>>>>>with osteoporosis, as it can lead to bone loss and an increased risk > > of > >>>>>>fracture. >>>>>> >>>>>>Vitamin D is obtained from two sources: sunlight and diet. The skin >>>>>>manufactures the majority of the body's vitamin D after direct > > exposure > >>>>>>to sunlight but as adults age the ability to make vitamin D through > > the > >>>>>>skin diminishes. Avoiding sun exposure or using sunscreen can also >>>>>>limit a person's production of vitamin D. Vitamin D can also come from >>>>>>the diet but there are limited dietary sources that contain the >>>>>>nutrient. Good dietary sources include fatty fish (e.g., salmon), >>>>>>vitamin D fortified milk and orange juice. However, for many people, >>>>>>dietary sources alone are not enough. For example, one must drink four >>>>>>eight ounce glasses of milk to receive 400 IU of vitamin D. >>>>>> >>>>>>According to an analysis published in 2004 and based on the Third >>>>>>National Health and Nutrition Examination Survey (NHANES III), a >>>>>>majority of Americans are not consuming enough vitamin D. The study >>>>>>estimated that over 70% of women age 51-70 and almost 90% of women > > over > >>>>>>70 are not getting an adequate intake of vitamin D from food and >>>>>>supplements. This analysis was based on the adequate intake, as > > defined > >>>>>>by the National Institute of Health's Institute of Medicine, of 400 IU >>>>>>per day for women age 51-70 and 600 IU per day for women over 70 > > years. > >>>>>>Other organizations, such as the National Osteoporosis Foundation >>>>>>(NOF), recommend vitamin D intake of up to 800 IU per day. As a >>>>>>treatment for osteoporosis in postmenopausal women, FOSAMAX PLUS D >>>>>>offers 2800 IU vitamin D, representing seven days worth of 400 IU of >>>>>>vitamin D. >>>>>> >>>>>>I now routinely check 25-OH Vit D levels and if below 30ng/ml would >>>>>>suggest treatment. I use the repalacement regime as devised by Michael >>>>>>Holick MD. >>>>>> >>>>>>Adrian >>>>>> >>>>> >>>>> >>>>>Several comments. >>>>> >>>>>First the Fosamax contain too little vitamin D if >>>>>it is seen as the sole source of supplemental vitamin D. >>>>>I'd suggest 5600 IU (140 mcg) per week would >>>>>be the barebones minimum as a maintenance >>>>>dose and 7000 IU (175 mg) per week is a reasonable choice. >>>>>Perhaps they are assuming concurrent use of a multiple vitamin >>>>>and being ultra-conservative? >>>>> >>>>>Personally I agree with Vieth that 4000 IU per day during the darker >>>>>months of the year or for living entirely indoors 4000 IU all year > > round > >>>>>is a better choice. >>>>> >>>>>30 ng/ml is right around 80 nmol/L. >>>>>Reasonable. >>>>>Far better than waiting until 40 nmol/L. >>>>> >>>>> >>> >>> >>> > >
From: John Que on 18 Apr 2005 21:49
As to vitamin D, the December issue of the American Journal of Clinical Nutrition is devoted to the topic. How would you suggest I wording my opinion such that it not be seen by you as "prescribing"? You seem to have "legal mind." not a "'science mind." JQ "Larry" <larry(a)nospam.net> wrote in message news:6kO8e.2133$V02.1032(a)fe08.lga... > John, > <snip> ..> Because if some harm > happens to come to someone, and they can locate you, you are leaving > yourself open for suit. > > > If one live is sunny California, I agree > > the chance of needing a vitamin D > > supplement is greatly reduced provided > > they get out in the sun without sunscreeen. > > > > People can operate on some general > > rules of thumb. They don't have to > > test for everything. Clearly, though if one has > > unlimited resources it is best. > > >> > >> top posted so I top posted.) > >>> > >>>Be it known that Ronald Vieth, Michael F. Holick, > >>>B. Dawson-Hughes, B.W. Hollis, C. L. Wagner, > >>>C.M. Weaver, and J.C. Fleet generally seem to > >>>agree with my position. > >>> <snip> |