Vitamin D seems to play a key role in many systems in the body... Vitamin D can reduce fractures in elderly....
Without sufficient vitamin D, bones can become thin, brittle, or misshapen. Deficiency can arise from inadequate intake coupled with inadequate sunlight exposure; disorders that limit its absorption; conditions that impair conversion of vitamin D into active metabolites, such as liver or kidney disorders; or, rarely, by a number of hereditary disorders. Vitamin D deficiency results in impaired bone mineralization and leads to bone softening diseases, rickets in children and osteomalacia in adults, and possibly contributes to osteoporosis.
Vitamin D plays a number of other roles in human health including inhibition of calcitonin release from the thyroid gland. Calcitonin acts directly on osteoclasts, resulting in inhibition of bone resorption and cartilage degradation. Vitamin D can also inhibit parathyroid hormone secretion from the parathyroid gland, modulate neuromuscular and immune function and reduce inflammation.[
“Vitamin D seems to play a key role in many systems in the body, not just bones, but diseases like diabetes and certain cancers,” he said. “A serious shortage of vitamin D leads to a condition called osteomalacia, where your bone fails to mineralise.”
Vitamin D deficiency, he added, was linked to poor bone density and osteoporosis, and could occur in younger patients. Dr Gallacher said that among the hip fracture patients aged between 50 and 70 referred to him, most tended already to have very low bone density.
As people get older, their bodies become less adept at converting vitamin D from sunshine through their skin. To add to the problem, the diet in Scotland is traditionally low in vitamin D.
Dr Gallacher said: “In the United States, milk which is fortified with vitamin D can be purchased alongside ordinary milk and I think there’s an argument that it would be quite useful to do the same here. It makes logical sense to give people the choice.”
He welcomed the Scottish government’s recent move to raise awareness among pregnant women and young mothers about the importance of vitamin D.
Scotland now leads the world in following up cases of broken bones to trace their underlying cause and try to prevent further breaks. A fracture liaison service was pioneered in Glasgow in 1999. Now accessible to three quarters of the population of Scotland, the service means that anyone over 50 who suffers a fracture is automatically referred to have their bone density measured and, if low, their vitamin D level taken.
Those who have poor density, and are at risk of osteoporosis and further fractures, are treated with calcium and vitamin D supplements and other anti-osteoporosis therapies.
“We would like to have Scotland as the first country in the world with a comprehensive fracture liaison service,” said Dr Gallacher. “We’re 75 per cent of the way there and just need the financial investment to complete the loop. It would make Scotland a beacon for the rest of the world.”