2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis.
Arthritis Rheumatol. 2017 Jun 6. doi: 10.1002/art.40137. [Epub ahead of print]
Buckley L1, Guyatt G2, Fink HA3, Cannon M4, Grossman J5, Hansen KE6, Humphrey MB7, Lane NE8, Magrey M9, Miller M10, Morrison L11, Rao M12, Robinson AB13, Saha S6, Wolver S14, Bannuru RR12, Vaysbrot E12, Osani M12, Turgunbaev M15, Miller AS15, McAlindon T12.
Unfortunately they only recommend 600 IU of vitamin D, too much Calcium, and do not mention Magnesium etc needed by bones
Wonder if they fear US patients getting more vitamin D the way the Austrailian patients did 4 years years ago 20X increase in vitamin D sold and 36 percent decrease in osteoporosis business in Australia – Nov 2013
- Search Vitamin D Life for Glucocorticoid 389 pages as of June 2017
- More vitamin D needed if person is taking Glucocorticoids – June 2015
- Category: Drug interactions with Vitamin D has
102 items Overview Osteoporosis and vitamin D contains the following
- FACT: Bones need Calcium (this has been known for a very long time)
- FACT: Vitamin D improves Calcium bioavailability (3X ?)
- FACT: Should not take > 750 mg of Calcium if taking lots of vitamin D (Calcium becomes too bio-available)
- FACT: Adding vitamin D via Sun, UV, or supplements increased vitamin D in the blood
- FACT: Vitamin D supplements are very low cost
- FACT: Many trials, studies. reviews, and meta-analysis agree: adding vitamin D reduces osteoporosis
- FACT: Toxic level of vitamin D is about 4X higher than the amount needed to reduce osteoporosis
- FACT: Co-factors help build bones.
- FACT: Vitamin D Receptor can restrict Vitamin D from getting to many tissues, such as bones
- It appears that to TREAT Osteoporosis:
- Calcium OR vitamin D is ok
- Calcium + vitamin D is good
- Calcium + vitamin D + other co-factors is great
- Low-cost Vitamin D Receptor activators sometimes may be helpful
- CONCLUSION: To PREVENT many diseases, including Osteoporosis, as well as TREAT Osteoporosis
- Category Osteoporosis has
190 items - Category Bone Health has
269 items Note: Osteoporosis causes bones to become fragile and prone to fracture
Osteoarthritis is a disease where damage occurs to the joints at the end of the bonesOsteoporosis category includes the following
190 items in category - see also Overview Osteoporosis and vitamin D - Overview Fractures and vitamin D
- Bone - Health
269 items - Search BMD OR Bone Mineral Density 3250 results as of July 2020
- Search Vitamin D Life for OSTEOPENIA 1740 items as of July 2020
Pages in BOTH the categories Osteoporosis and Meta-analysis
- Osteoporosis Risk varies with Vitamin D Receptor – meta-analysis July 2020
- Osteoporosis 15 percent more likely if poor Vitamin D receptor – meta-analysis Dec 2018
- Fractures reduced with any amount of vitamin D and some Calcium - Cochraine April 2014
- Vitamin D Receptor genes bb and BB and Osteoporosis, esp. for blacks – meta-analysis Nov 2012
- Hip fractures reduced 30 percent with 800 IU of vitamin D – meta-analysis July 2012
- Vitamin D for elderly 800 to 2000 IU - Osteoporosis Canada - Sept 2010
- Hip fractures in India - editorial with recommendation - Sept 2010
- Cochrane review finds that Vitamin D and Calcium treat osteoporosis – Feb 2010
Falls and Fractures category contains the following
219 items in FALLS and FRACTURES - see also Overview Seniors and Vitamin D
- Overview Fractures and Falls and Vitamin D
- Deaths due to falls doubled in just a decade (age-adjusted, perhaps decreased vitamin D) – June 2019
- Preventing Falls in Older Adults – Vitamin D combination is the best - JAMA Meta-analysis Nov 2017
- Falls cut in half by 100,000 IU vitamin D monthly - RCT 2016
- Vitamin D prevents falls – majority of meta-analyses conclude – meta-meta analysis Feb 2015
- Vitamin D and fractures – 24 meta-analyses and counting – Dec 2014
Hip fracture
- Search Vitamin D Life for "HIP FRACTURE" 191 items not in PDF as of July 2020
- A call to action: Vitamin D for hip fracture – Holick July 2020
- Risk factors for death after hip fracture surgery – 7 of the 8 are associated with low vitamin D – Aug 2020
- 3.5 X higher risk of death 2 years after hip fracture surgery if low vitamin D – Jan 2020
- Hip fracture recovery best with home exercise plus Vitamin D – RCT Dec 2018
- Hip fracture 58 percent more likely if low vitamin D – meta-analysis March 2017
- Fracture risk 40 percent higher risk if low Vitamin D - June 2019
- 1 in 3 died after hip fracture but only 1 in 14 if add Vitamin D and exercise – RCT April 2017
- Drugs that may harm bone (vitamin D needed) -April 2016 - which contains the following
GLUCOCORTICOIDS
Glucocorticoids are used to treat many medical conditions, including allergic, rheumatic, and other inflammatory diseases, and as immunosuppressive therapy after solid organ and bone marrow transplant. They are the most common cause of drug-induced bone loss and related secondary osteoporosis. Multiple effects on bone Glucocorticoids both increase bone resorption and decrease bone formation by a variety of mechanisms.1 They reduce intestinal calcium absorption, increase urinary excretion of calcium, and enhance osteocyte apoptosis, leading to deterioration of the bone microarchitecture and bone mineral density.2 They also affect sex hormones, decreasing testosterone production in men and estrogen in women, leading to increased bone resorption, altered bone architecture, and poorer bone quality.3,4 The bone loss is greater in trabecular bone (eg, the femoral neck and vertebral bodies) than in cortical bone (eg, the forearm).5
Download the PDF from Vitamin D Life
OBJECTIVE:
To develop recommendations for prevention and treatment of glucocorticoid-induced osteoporosis (GIOP).METHODS:
We conducted a systematic review to synthesize the evidence for the benefits and harms of GIOP prevention and treatment options. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence. We used a group consensus process to determine the final recommendations and grade their strength. The guideline addresses initial assessment and reassessment in patients beginning or continuing long-term (≥3 months) glucocorticoid (GC) treatment, as well as the relative benefits and harms of lifestyle modification and of calcium, vitamin D, bisphosphonate, raloxifene, teriparatide, and denosumab treatment in the general adult population receiving long-term GC treatment, as well as in special populations of long-term GC users.RESULTS:
Because of limited evidence regarding the benefits and harms of interventions in GC users, most recommendations in this guideline are conditional (uncertain balance between benefits and harms). Recommendations include treating only with calcium and vitamin D in adults at low fracture risk, treating with calcium and vitamin D plus an additional osteoporosis medication (oral bisphosphonate preferred) in adults at moderate-to-high fracture risk, continuing calcium plus vitamin D but switching from an oral bisphosphonate to another antifracture medication in adults in whom oral bisphosphonate treatment is not appropriate, and continuing oral bisphosphonate treatment or switching to another antifracture medication in adults who complete a planned oral bisphosphonate regimen but continue to receive GC treatment. Recommendations for special populations, including children, people with organ transplants, women of childbearing potential, and people receiving very high-dose GC treatment, are also made.CONCLUSION:
This guideline provides direction for clinicians and patients making treatment decisions. Clinicians and patients should use a shared decision-making process that accounts for patients' values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies.© 2017, American College of Rheumatology. PMID: 28585373 DOI: 10.1002/art.40137
American College of Rheumatology Guidelines finally include Vitamin D – June 2017Printer Friendly PDF this page! Follow this page for updates1654 visitors, last modified 07 Jun, 2017,
- Category Bone Health has