Page 1 of 3 123 LastLast
Results 1 to 15 of 38

Thread: Vitamin D?

  1. #1
    Join Date
    Jun 2008
    Posts
    107

    Vitamin D?

    What is known in terms of Vitamin D deficiency and scoliosis? This is what I have found, but just wondering what any one else knows.

    In a 2005 study: osteopenia is suggested as an important risk factor for curve progression. They found that 27% to 38 % of girls with idiopathic scoliosis also had osteopenia. Here is the title:Osteopenia: a new prognostic factor of curve progression in adolescent idiopathic scoliosis.

    In a 2008 study, girls with scoliosis who progressed during brace treatment versus those who did not, had higher rates of osteopenia (along with other factors). The study concluded that "Osteopenia might be an independent risk factor in the curve progression during brace treatment." Here is the title: The role of initial bone mineral status in predicting the early outcome of brace treatment in girls with adolescent idiopathic scoliosis

    In another 2008 study, it concluded "Low bone mineral status in adolescent idiopathic scoliosis" (this is also the title of the study, although it does not conclude whether or not which the causative factor).

    Lastly, a 2003 study concluded: "Inadequate calcium intake is a significant determinant on generalised osteopenia in Hong Kong Chinese adolescents with idiopathic scoliosis." (also the title)

    I found all of these studies (all done in China) on one particular website that was pondering the role of Vitamin D deficiency in scoliosis, since Vitamin D is a key factor in bone mineral density and calcium uptake. Regardless of the legitimacy of this website, all the studies can be found there: http://www.easy-immune-health.com/vi...scoliosis.html
    (I have yet to read the entire studies, but looked at the abstracts).

    Have any of you, adults or kids, been tested for osteopenia, osteoperosis, or Vitamin D? And, if osteopenia is indeed present in upwards of 38% of AIS, why are orthopedists not testing for it (at least the 4 we went to did not- no one has ever suggested it). My daughter has not been tested for osteopenia as of yet, but was just tested for Vitamin D and is deficient (19). I also understand that Vitamin D deficiency is higher in higher latitudes, as is the prevalence of scoliosis (while this could be related to other factors, I still find it curious).

    Just wondering any one else's thoughts on all of this. Always looking for an answer.

    Brooke

  2. #2
    Join Date
    Apr 2009
    Posts
    1,244
    Hi Brooke - I've not been tested for vitamin D deficiency, but knowing that this vitamin requirement is very important for the very young, and for the aging - has found me doing some lay-research. Good find - your article.

    Absorption of calcium, magnesium, and zink appears dependent upon D - which in turn seems dependent upon B12 - which is dependent upon B1, B6, and Folic Acid. At least that's how I think I remember my research. As a result I supplement with all these.

    I'm currently trying to put together a better diet plan that would provide all these things in a more natural way - which has led me to some interesting discussions on genetic engineering of our food sources ;-)

    The sunshine vitamin D - can we really get enough just from the sun? I don't know - especially nearing 70: http://www.berkeleywellness.com/html...tured0103.html

    All supplements should be taken with caution - for example one can get too much D. Here's a pretty good in depth article:
    http://www.merck.com/mmpe/sec01/ch004/ch004k.html

    Important Note: If we choose to supplement our diets with vitamins - then it may be important to keep the family practitioner aware of this as many can have an effect on other prescription drugs. My family doctor has a program in his blackberry that can tell him how any one vitamin supplement may interact with a given prescription. A good example is vitamin K - it can't be used with blood thinners, and large amounts in natural forms (like collard greens) should be avoided (if one is on blood thinners), as my brother's doctor says anyway.

    Looking forward to others who may weigh in on this.
    Last edited by mamamax; 02-06-2010 at 02:16 PM. Reason: Added note

  3. #3
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,317
    Quote Originally Posted by bas2101 View Post
    In a 2005 study: osteopenia is suggested as an important risk factor for curve progression. They found that 27% to 38% of girls with idiopathic scoliosis also had osteopenia.
    Did only the girls with osteopenia progress?

    If the progressive cases were all over the map then this is an incidental finding and not predictive of progression.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  4. #4
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,317
    In a 2008 study, girls with scoliosis who progressed during brace treatment versus those who did not, had higher rates of osteopenia (along with other factors). The study concluded that "Osteopenia might be an independent risk factor in the curve progression during brace treatment." Here is the title: The role of initial bone mineral status in predicting the early outcome of brace treatment in girls with adolescent idiopathic scoliosis
    Marfans patients are also known to not respond to brace treatment. Any study that doesn't control for at least that and probably other connective tissue disorders is questionable at best.

    Also, how did they control for the brace restricting movement and possible causing or contributing to osteopenia?
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  5. #5
    Join Date
    May 2009
    Posts
    3,729
    vitamin D deficiency is quite common in older adults..especially where they are not out in the sun alot...like northeast in winter! that is according to my hormone doctor, who put me on vitamin D tablets...

    i wonder...since lack of calcium can be a factor in osteopenia... i wonder if, since most calcium capsules come with "built in" vitamin D...i wonder if lack of calcium is related to lack of D which is related to oseopenia in many cases...??

    i hope someone is making it clear to teen girls just how important calcium is ....& if they dont eat right ( i fear many teens do not)....that they take calcium supplements even at a young age!

    i have osteopenia...surgeons have told me they can still do fusion surgery on me, should i/when i decide to go ahead with it....

    note...hormone specialists are very good about testing for vitamin D...but it is not special, so any doctor can test for it if you ask them to! and bone densitiy is an important test for older females...younger ones too, if there is a question...


    jess
    Last edited by jrnyc; 02-06-2010 at 09:52 PM.

  6. #6
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,317
    Quote Originally Posted by jrnyc View Post
    [COLOR="RoyalBlue"]vitamin D deficiency is quite common in older adults..especially where they are not out in the sun alot...like northeast in winter! that is according to my hormone doctor, who put me on vitamin D tablets...

    i wonder...since lack of calcium can be a factor in osteopenia... i wonder if, since most calcium capsules come with "built in" vitamin D...i wonder if lack of calcium is related to lack of D which is related to oseopenia in many cases...??
    I was listening to the doctor channel on satellite radio and they could not say enough about supplementing with Vitamin D. It's all upside.

    i hope someone is making it clear to teen girls just how important calcium is ....& if they dont eat right ( i fear many teens do not)....that they take calcium supplements even at a young age!
    Our pediatrician told my girls to take calcium supplements. They did is for a while. I just recently by coincidence got them some more and asked them to take them.

    i have osteopenia...surgeons have told me they can still do fusion surgery on me, should i/when i decide to go ahead with it....

    note...hormone specialists are very good about testing for vitamin D...but it is not special, so any doctor can test for it if you ask them to! and bone densitiy is an important test for older females...younger ones too, if there is a question...
    I think osteoporosis at least has some hereditary component. For example, my mother's family at least seems to have significant bone and we have no known case of osteoporosis.

    Good post, Jess
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  7. #7
    Join Date
    Jun 2008
    Posts
    107
    The 2008 study found that girls with progressive AIS had higher rates of osteopenia, among other factors. They are suggesting that osteopeina be added as 1 of 5 factors in progression prediction.

    This is what they found: "All growth potential factors, curve-related factors, and the Z-score bone mineral density at the femoral neck on the convex-side hip and at all sites on the concave-side hip were significantly associated with curve progression (p < 0.05 for all). In contrast, the Z-score bone mineral density at the spine (chi square, p = 0.062), Z-score bone mineral density at the trochanter on the convex-side hip (chi square, p = 0.177), and a family history of scoliosis (chi square, p = 0.750) did not show a significant association with curve progression."

    There is more to the study if anyone is interested.


    I cannot access the bracing study, so I do not know if they factored in bracing as a causative/contributing factor to osteopenia. They are however also suggesting osteopenia be added as 1 of 5 factors in predicting whether or not an AIS patient will progress during bracing. These were the results:

    RESULTS: There were 16 girls (21%) with a progressed scoliosis and 61 girls (79%) with a non-progressed scoliosis, respectively. In the girls with a progressed scoliosis, higher ratios of subjects were found with pre-menarchal status (chi(2) = 9.628, P = 0.004), lower Risser grade (chi(2) = 4.565, P = 0.037), main thoracic scoliosis (chi(2) = 4.009, P = 0.045), a larger curve (chi(2) = 1.685, P = 0.194), as well as osteopenia (chi(2) = 3.828, P = 0.050), as compared with those with a non-progressed scoliosis. During brace treatment, besides pre-menarchal status, a larger Cobb angle, and a main thoracic scoliosis, osteopenia (OR = 5.362, P = 0.022) was identified as the risk factor in curve progression in AIS girls, as revealed by the multiple Logistic regression analysis. CONCLUSIONS: Osteopenia might be an independent risk factor in the curve progression during brace treatment. The analysis of initial BMD status before bracing may help to predict the outcome of brace treatment.

    The 2007 Saudi Arabian study concluded that scoliosis causes osteopenia/osteoporosis in AIS patients compared to their siblings, although I don't understand how they determined it as causative rather than the result of osteopenia.

  8. #8
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,317
    Quote Originally Posted by bas2101 View Post
    The 2008 study found that girls with progressive AIS had higher rates of osteopenia, among other factors. They are suggesting that osteopeina be added as 1 of 5 factors in progression prediction.

    This is what they found: "All growth potential factors, curve-related factors, and the Z-score bone mineral density at the femoral neck on the convex-side hip and at all sites on the concave-side hip were significantly associated with curve progression (p < 0.05 for all). In contrast, the Z-score bone mineral density at the spine (chi square, p = 0.062), Z-score bone mineral density at the trochanter on the convex-side hip (chi square, p = 0.177), and a family history of scoliosis (chi square, p = 0.750) did not show a significant association with curve progression."
    Okay I have a general question about this study and studies like it. Did they do these measurements on girls who had progressed versus girls who still have smaller curves or did they do the measurements on all girls and note LATER that the ones who progressed had these particular bone scores?

    This is a critical question in my opinion.

    And all this smacks of the issue of just adding in terms that happen to increase the fit of a curve. That is, the other factors (Rissser, T versus L curve, chrono age, menstrual status, etc.) might explain 75% of the relationship but just by coincidence these other bone factors happen to increase the fit a few more percentage points. When you start getting up past 3 or 4 factors in something like this, it's very hard to say anything one way or anything as I understand this.

    The 2007 Saudi Arabian study concluded that scoliosis causes osteopenia/osteoporosis in AIS patients compared to their siblings, although I don't understand how they determined it as causative rather than the result of osteopenia.
    Good point.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  9. #9
    Join Date
    Jun 2008
    Posts
    107
    It appears that they tested all the girls' bone density first, and then indicated who progressed later.

    As far as it being just one more factor to consider in the mix, I am sure there are others that could pop up too. But, still, I wouldn't want to overlook its potential significance. And, if osteopenia/osteoporosis is a factor in AIS in upwards of 38% of patients, why is this not addressed in general, as in, why is there no attempt to treat it, or even to find out who has it and who doesn't? I certainly want to know if my daughter has it to prevent it from being a problem in the future-surgery or not.

  10. #10
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,317
    I suspect that if there is a very high correlation with more robust indicators like Risser, chrono age, mentrual status then it added nothign to the predictive power of who will progress.

    As to whether it is treatable in children or whether it ever rises to an issue in surgery in children I don't know. May not be an issue. I would think if it was correlated with pseudoarthrosis or other complications it would be studied more. Maybe it will be but as I understand this, the state of the instrumentation is that 95% of kids will avoid pseudoarthrosis even WITHOUT physical restrictions in the post op period. If you restrict them all then the rate approaches zero. Given that, it doesn't seem like there is any room for osteopenia to be an issue at all in surgery in kids. Of course delaying surgery into adulthood it might become a major factor in pseudoarthrosis. Who knows.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  11. #11
    Join Date
    Jan 2010
    Location
    San Bruno, CA
    Posts
    271
    I was considering posting a thread on vitamin D a couple of days ago.. Beat me to it.

    The other component of vit D, which I did not realize until just recently, is that vit D plays an important role in muscle function as well. In fact, endorcrinologists call vit D "the other steroid". There is a vit D receptor on the muscle cell and on the nucleus of the muscle. It plays a very important role in calcium transport and cell metabolism.

    The general incidence of vit D deficiency or 'insufficieny' (indicating low levels of D) is surprisingly common. And it's more common in female teens than male teens. It's correct that the higher latitudes have lower values, which also correlates with AIS incidence.

    There are several correlations with Vit D and scoliosis. There are far too many people with low levels for it to be directly causative though. However, it's certainly not helping to stabilize the curve either. I'm interested in learning more about the muscle component of it and if there are any naturally occurring vit D receptor defects in any population (other than knockout mice). You take some osteopenic bone and some mildly dysfunctional muscles..... Hmmm

  12. #12
    Join Date
    May 2009
    Posts
    3,729
    ahhh well..too bad it isnt REALLY "the other steroid"...cause' then i could get vitamin D injections instead of steroid injections at the pain management doctor's office!

    jess

  13. #13
    Join Date
    Apr 2009
    Posts
    1,244
    Quote Originally Posted by skevimc View Post
    There are several correlations with Vit D and scoliosis. There are far too many people with low levels for it to be directly causative though. However, it's certainly not helping to stabilize the curve either. I'm interested in learning more about the muscle component of it and if there are any naturally occurring vit D receptor defects in any population (other than knockout mice). You take some osteopenic bone and some mildly dysfunctional muscles..... Hmmm
    Aren't the B's and folic acid important to absorption of D? I can't remember. Agree that these things are not causative but that deficiencies certainly can't help.

    Another component that affects muscle is emotion. While this is said to be well known - I hardly every hear anyone talk about it. Emotions also play a key role in hormonal changes - and possibly the body's ability to absorb nutrients.

    I'll step aside now and allow my comments to be hammered ;-)
    Last edited by mamamax; 02-08-2010 at 01:07 PM.

  14. #14
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,317
    Quote Originally Posted by mamamax View Post
    I'll step aside now and allow my comments to be hammered ;-)
    That was pretty good!

    Life is complex.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  15. #15
    Join Date
    Jan 2010
    Location
    San Bruno, CA
    Posts
    271
    Quote Originally Posted by mamamax View Post
    Aren't the B's and folic acid important to absorption of D? I can't remember. Agree that these things are not causative but that deficiencies certainly can't help.

    Another component that affects muscle is emotion. While this is said to be well known - I hardly every hear anyone talk about it. Emotions also play a key role in hormonal changes - and possibly the body's ability to absorb nutrients.

    I'll step aside now and allow my comments to be hammered ;-)
    No hammering from me.

    I'm sure other vitamins, e.g. B vitamins, are necessary or important to proper absorption. But the things I've been reading on vit D deal specifically with strength and D levels and vit D receptors. For example giving D to different populations and measuring strength and lean mass. The results are pretty surprising although it's still very new information. Also there are some slight changes in the genetic receptor profile that are linked to decreased strength and muscle mass.

    Emotions.... Indeed. When I'm at a conference going to different seminars, the rooms talking about surgery and drugs are always packed to the gills. I mosey over to the QOL and exercise seminars and you can generally sit anywhere you want. Medicine and bio-research so frequently over look that exercise is itself a very powerful drug. And actually to be fair, the general public forgets this as well.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •