Quote:
Originally Posted by Harrison
Tim, I know you know since we talked about in email (check out the study I sent you), but some people do worse with supplemental D. Some suppose that the body cannot metabolize supplemental D in excess, especially if there exists an endocrine disorder of some kind. Perhaps with sunlight, this is not an issue.
You're right, though, D is a hormone and a secosteroid. Maybe because of these reasons, it can help some, but not all people with spine problems. I am just glad to see that some spine docs are screening patients for parathyroid and D metabolites as part of the screening process. Better to find any bone growth issues BEFORE surgery, eh?!
OK, sorry for the hijacking.
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Jack, also sorry to hijack. Feel free to move this post to wherever is appropriate.
Harrison, I did look into the dysregulation stuff. It appears that these cases are a minority of vitamin D problems, but I cannot find statistics. I'm a numbers guy, so this is frustrating. I did find out that people with vitamin D deficiency have low serum D2, D3, and total D levels while in dysregulation there may be high levels of D2 and total but low D3 (which is the active form) according to one article. However, I found contradictory info in another article. So it would appear that serum testing should be performed prior to beginning any high-dose replacement.
There is also the matter of possible infectious causes due to binding of the vitamin D receptor (VDR) by biofilm or other substances produced by phagocytic bacteria. In that case, I would presume that serum levels could be normal or elevated, but the patient would still have symptoms. Thanks for tuning me into this stuff. I was a skeptic last year when we 1st discussed this, but now I'm predicting this topic will head in the same direction as ulcer disease and h. pylori and cervical cancer and viruses.
BTW, were you aware that the VDR has been identified in 30 different organs and tissues in the human body? The actions/mechanisms/importance of that info has yet to be worked out. As you've said to me, pretty exciting stuff. We agree on pre-op bone density testing for all, and now I think at-risk patients (age>50, overweight, renal disease, location north of around Georgia, the list is long) should have vitamin D panels with serum calcium and maybe parathyroid and thyroid studies.
Jack, if you want to pay extra $$ for radiology services, I'll PM you with my address
. Glad to hear you're doing well in the other thread.
-tc-