Vitamin D, Bone Health, and Ideas for Supplementation

The role of Vitamin D supplementation in osteoporotic and osteopenic patients has been well known for quite some time.  In fact, Vitamin D supplementation along calcium supplementation and weight bearing exercises are regarded as first line treatment in osteopenia and mild cases of osteoporosis.  In recent years, studies have shown the benefit of Vitamin D supplementation in other bone diseases (particularly when a deficiency is present) including healing of stress fractures and spinal fusions.

So how do we get Vitamin D?

One option is through diet.  Oftentimes milk is fortified with Vitamin D, which is convenient given thefact that Vitamin D helps our bodies absorb calcium.  Many types of fish, including salmon and swordfish, also provide Vitamin D.  One of the highest dietary sources of vitamin D is cod liver oil.  However, if you are like me, that does sound very appetizing.

We can also obtain Vitamin D through dietary supplements that are available at local pharmacies and health food stores.  Recommendations for dosing depend on nutritional status and comorbid medical conditions (i.e. underlying endocrine abnormalities).

My personal favorite way is to obtain Vitamin D via sun exposure (of course keeping in mind the importance of also protecting skin from sun damage).  While options to enjoy the great outdoors are more limited in Middle Tennessee in the colder months of the year, there are still plentiful options in town and within short driving distances.   Fall in particular can be a great time to enjoy the beautiful colors and it seems like this year has been particularly spectacular. 

1. Local hikes – Percy Warner Park and Radnor Lake both offer great trails for hiking.   Both have trails of varying distances and difficulties.  Percy Warner allows running and dogs on all trails.  Radnor only allows dogs and running on Otter Creek Road.
2. Waterfalls – There are MANY waterfalls within just a few hours drive of Nashville.  As a girl who grew up in Kansas, I did not have many opportunities to see these wonders of nature growing up, so I’m always thrilled for the chance to discover a new one.  Cummins Falls and Burgess Falls are located a short distance from Cookeville and can easily be seen in one outing.  Fall Creek Falls, which is a little further away, also offers great options for camping and hiking.
3. Mammouth Cave – While the touring the cave itself obviously does not offer any source of Vitamin D, there are hiking trails around the entrance of the cave that are worth hiking and biking.  And for the record, the caves are worth touring too.
4. Biking – Nashville has done a great job of providing greenways as an option for shared use off street trails.  The Natchez Trace is another great option for those looking for a scene paved/road option.   The recent installation of Nashville B-cycles is a fun way to get around town for those without a bike or looking for a less strenuous option

The above are just a few of the MANY ways to enjoy being outside.  I have found the smartphone app NashVitality to offer some great ideas as well.  Cumberland Transit, a local outdoor adventure store, often has events to promote various outdoors activities as well.

Sunyecz, John C, (Aug 2008). The use of calcium and vitamin D in the management of osteoporosis. Ther Clin Risk Manag. 4(4).

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2621390/

McCabe, MP, Smyth, MP, & Richardson, DR, (Jun 2012). Current concept review: vitamin D and stress fractures. Foot and Ankle Int. 33(6). http://www.ncbi.nlm.nih.gov/pubmed/22735329

Stocker, G, Buckoski, J, Bridwell, K, Lenke, L, Riew, K.D, & Zebala, L, Preoperative Vitamin D Status of Adults Undergoing Spinal Fusion. Presentation notes available online at: http://www.abstractsonline.com/Plan/ViewAbstract.aspx?sKey=b9eb264c-a11b-4673-8233-5d6de5b4d4ef&cKey=100f99b4-71c1-4e72-b0de-22891e972bd7&mKey=%7bBA8AA154-A9B9-41F9-91A7-F4A4CB050945%7d

(Jun 2011). Vitamin D Fact Sheet for Health Professionals. http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#h3