Visit the Microscopic Colitis Foundation Website
http://www.healthcanal.com/substance-ab ... Study.html
People taking oral steroids are twice as likely as the general population to have severe vitamin D deficiency, according to a study of more than 31,000 children and adults by scientists at Albert Einstein College of Medicine of Yeshiva University.
Their findings, in the September 28 online edition of The Journal of Clinical Endocrinology and Metabolism, suggest that physicians should more diligently monitor vitamin D levels in patients being treated with oral steroids.
Amy Skversky, M.D., M.S."When doctors write that prescription for steroids and they're sending the patients for lab tests, they should also get the vitamin D level measured," said study lead author Amy Skversky, M.D., M.S., assistant professor of pediatrics at Einstein and Montefiore Medical Center, the University Hospital for Einstein.
The severe vitamin D deficiency assessed in this study (defined as levels below 10 nanograms per milliliter of blood) is known to be associated with osteomalacia (softening of the bones), rickets (softening of bones in children) and clinical myopathy (muscle weakness). While there is much debate on the issue, vitamin D levels between 20 and 50 ng/ml are generally considered adequate for bone and overall health in healthy individuals. Steroids have been shown to cause vitamin D deficiency, possibly by increasing levels of an enzyme that inactivates the vitamin.
Smaller studies involving people often prescribed steroids (i.e., children with asthma and patients with Crohn's disease and lupus) have found significantly reduced vitamin D levels in these patients. To further assess this association between steroid use and vitamin D levels, the Einstein researchers carried out the first-ever study of a large, nationally representative sample of people.
The researchers examined data collected from participants who had participated in the National Health and Nutrition Examination Survey 2001-2006. About one percent of the participants answered "yes" when asked if they had used oral steroids during the previous 30 days.
Eleven percent of the self-reported steroid users had severely low vitamin D levels compared with a severe vitamin D deficiency of 5 percent for people not taking steroids — a two-fold increased risk for severe vitamin D deficiency. The risk was particularly pronounced for steroid users under 18, who were 14 times more likely to have a severe vitamin D deficiency compared with young non-steroid users. (Participants who reported using inhaled steroids were not included in the steroid-user group.)
The paper is titled "Association of Glucocorticoid Use and Low 25-Hydroxyvitamin D Levels: Results from the National Health and Nutrition Examination Survey (NHANES): 2001–2006." Co-authors include senior author Michal Melamed, M.D., M.H.S., Matthew Abramowitz, M.D., M.S., and Frederick Kaskel, M.D., Ph.D., all at Einstein; and Juhi Kumar, M.D., M.P.H. at Weill Cornell Medical Center. This research was funded by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institutes of Health and National Center for Research Resources, both part of the National Institutes of Health.
Vit D article
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
-
Gabes-Apg
- Emperor Penguin
- Posts: 8367
- Joined: Mon Dec 21, 2009 3:12 pm
- Location: Hunter Valley NSW Australia
Vit D article
Gabes Ryan
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
Hi Gabes,
That report, (while technically accurate), gives the impression that steroids cause a depletion of vitamin D. While that might possibly be true, I'm guessing that it's not, and here's why:
Who are the biggest users of steroids? People with asthma, and people with certain autoimmune issues, especially IBDs. Right? The researchers ignored, (exempted from the steroid group), the corticosteroid users who had asthma, so that leaves the steroid group composed primarily of people with certain autoimmune issues and IBDs, with IBDs dominating the group, of course. Since it's well known that IBDs deplete vitamin D levels, that's almost certainly the reason why the steroid group was more likely to be vitamin D deficient. It's not the steroid usage, it's the reason why they were using steroids in the first place, that determines the association with vitamin D deficiency.
Here's the point that proves that my theory is correct: Why did they ignore the asthmatics who used inhaled corticosteroids? Presumably, because there was nothing remarkable about the vitamin D profile of those users - they showed the same vitamin D profile as the general population, (because asthma does not cause a depletion of vitamin D), therefore, there was no reason to leave them in the steroid group. In fact, if they had left them in that group, that would have diluted their results, and it would have made the association between vitamin D and glucocorticoids appear less remarkable, so they arbitrarily chose to move their data from the steroid group to the control group, in order to make their results more impressive. IMO, that's pretty solid evidence that corticosteroid usage has nothing to do with vitamin D levels. Only the reason why the medications are used, matters, since that determines the vitamin D connection.
If Albert Einstein had been doing that study, I'll bet he would have noticed that connection.
At least, that's the way I see it.
Thanks for the link.
Tex
That report, (while technically accurate), gives the impression that steroids cause a depletion of vitamin D. While that might possibly be true, I'm guessing that it's not, and here's why:
Who are the biggest users of steroids? People with asthma, and people with certain autoimmune issues, especially IBDs. Right? The researchers ignored, (exempted from the steroid group), the corticosteroid users who had asthma, so that leaves the steroid group composed primarily of people with certain autoimmune issues and IBDs, with IBDs dominating the group, of course. Since it's well known that IBDs deplete vitamin D levels, that's almost certainly the reason why the steroid group was more likely to be vitamin D deficient. It's not the steroid usage, it's the reason why they were using steroids in the first place, that determines the association with vitamin D deficiency.
Here's the point that proves that my theory is correct: Why did they ignore the asthmatics who used inhaled corticosteroids? Presumably, because there was nothing remarkable about the vitamin D profile of those users - they showed the same vitamin D profile as the general population, (because asthma does not cause a depletion of vitamin D), therefore, there was no reason to leave them in the steroid group. In fact, if they had left them in that group, that would have diluted their results, and it would have made the association between vitamin D and glucocorticoids appear less remarkable, so they arbitrarily chose to move their data from the steroid group to the control group, in order to make their results more impressive. IMO, that's pretty solid evidence that corticosteroid usage has nothing to do with vitamin D levels. Only the reason why the medications are used, matters, since that determines the vitamin D connection.
If Albert Einstein had been doing that study, I'll bet he would have noticed that connection.
At least, that's the way I see it.
Thanks for the link.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.