Osteoporosis - treatment - Vitamin D

Vitamin D:
As age increases there will be decrease in the ability of the skin and kidney to synthesize active form of vit D, and intestinal absorption.
Circulating levels of 1,25- dihydroxyvitamin D is regulated by calcium, phosphate and parathyroid hormone.
Treatment with calcitriol reduced 3 fold dec in vertebral fractures, 43% red in hip fractures.
Around 800 units of vit D supplementation recommended in over age 70.
And around 400 units daily to younger post menopausal women. Higher doses can cause hypercalciuria with a risk of stone formation.
Serum level below 15 ng/ml is abnormal.
Effective response to vit D requires adequate calcium intake.
Excessive intake of retinol reported to be associated with an increase in hip fractures in women not on hormone therapy.
Changes of bone remodeling
Pathophysiology
Signs and symptoms
Risk factors and investigations
Investigations
Diagnostic tests and biochemical markers
Hormonal treatment
Estrogen modulators, calcium
Vitamin D
Bisphosphonates
Calcitonin, Fluoride, Tibolone
Prevention