Sunday, February 08, 2015

Dem Bones Dem Bones


Here to the land of winter rain and clouds, high latitude, and summer fog, I brought my old bones. I did think about it before we moved here seven months ago, but we tipped the scale on the side of water in a drought-stricken state and headed where the possibilities were greatest. I figured I could get the Vitamin D3 I needed for my bones by catching whatever rays of sunshine offered themselves and through good supplements.

So, I went to the osteoporosis clinic last week and had a bone density test and got the results on Friday. Let's just say the news was not good, not good at all. Dem bones, dem old bones ain't what they used to be. The diagnosis was osteoporosis in the lumber spine, left hip and femur. Bummer.
A photo from the internet showing healthy vs osteoporotic bone

I did a little online sleuthing to see if I really could get enough sunshine to produce Vitamin D3 at 41 degrees northern latitude in the winter. The answer was a loud and shattering NO. The study most often cited was one done in 1988 by Webb, Kline, and Holick, "Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin." The abstract reads:
Sunlight has long been recognized as a major provider of vitamin D for humans; radiation in the UVB (290-315 nm) portion of the solar spectrum photolyzes 7-dehydrocholesterol in the skin to previtamin D3, which, in turn, is converted by a thermal process to vitamin D3. Latitude and season affect both the quantity and quality of solar radiation reaching the earth's surface, especially in the UVB region of the spectrum, but little is known about how these influence the ability of sunlight to synthesize vitamin D3 in skin. A model has been developed to evaluate the effect of seasonal and latitudinal changes on the potential of sunlight to initiate cutaneous production of vitamin D3. Human skin or [3 alpha-3H]7-dehydrocholesterol exposed to sunlight on cloudless days in Boston (42.2 degrees N) from November through February produced no previtamin D3. In Edmonton (52 degrees N) this ineffective winter period extended from October through March. Further south (34 degrees N and 18 degrees N), sunlight effectively photoconverted 7-dehydrocholesterol to previtamin D3 in the middle of winter. These results quantify the dramatic influence of changes in solar UVB radiation on cutaneous vitamin D3 synthesis and indicate the latitudinal increase in the length of the "vitamin D winter" during which dietary supplementation of the vitamin may be advisable.
I was surprised and dismayed to learn that I could not produce any Vitamin D3 no matter how much time I spent in the winter sunlight. And my meager attempts with supplements did not help my bones at all. All of the literature says that weight-bearing exercise, Vitamin D3 and Calcium are the best for maintaining good healthy bones. I really thought I had been doing all the right stuff. 

The bone density results have made us rethink our plans about where to live. We're starting to consider moving further south for the sun. It's a good thing that all (and I do mean ALL) the houses that have come on the market here have been so outrageously and laughably bad. They're as bad as my old bones.

21 comments:

  1. It's hard to balance what we need as we get older. I take 2000 units of D3 a day and a calcium even though my bone density has been fine. I also have one of those lights that is supposed to be good for moods but not sure what it does for bones. I think the coast is expensive anywhere you go. Is it possible for you to live in the family home in Santa Cruz? I know you really like that area.

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  2. Osteoporosis is scary. In 2006 a bone density scan show that I had an extreme case of it. The doctor put me on 3000 IU per day of vitamin D3, 4500 mg of calcium (taken as Tums) and Actonel. I was also to do weight bearing exercise. I started walking 2-4 miles a day at least 6 days a week. Two years later I had another scan that showed some improvement, but I was still classified with osteo. Two years later another scan showed me improved to the range of osteopenia, still worrisome, but a definite improvement. But...the next year my doctor pulled me off of Actonel after a study revealed that women who had been on Actonel for five years or more with developing stress fractures. He said to keep up with the vitamin D3, calcium and exercise, but I was paranoid, afraid that without the medicine I'd lose what bone mass I'd been able to build up. I shouldn't have worried. My last bone density scan, last year, showed absolutely no sign of bone loss. So it is possible to rebuild bone mass. Just don't be afraid of Actonel or whatever medicine a doctor might suggest. Used short term they work miracles. I do so hope that you're able to turn it around, too.

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  3. Such a big problem for a lot of us women. You're getting good news (above) though about being able to rebuild bone. My grandmother had high cholesterol and she was the trimmest, best health food eater of all time. Nothing to be done but to take meds. Docs literally could not find anything about her diet or lifestyle that could acct for her high values. Just genes. Damned genes.

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  4. I am sorry to say that I don't think it is going to matter where you live in terms of your bone health. I hate to sound so negative, but I believe that. those who suffer from osteoporosis are going to suffer from osteoporosis, in my opinion. Some people in southern climates never budge in terms of exercise, never go outside for 6 months a year into the bright sunshine because the summer heat is so unbearable. Yet they have strong bones into very old age regardless of this lifestyle. I hope a more southern climate will provide more bone density if you choose to relocate; at least it may be more pleasant. I am so ready for the sunshine here - all this rain is making my whole body hurt!

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  5. agree, but sun too...
    Where are you headed?

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  6. Oh dear I am sorry to hear that. No use moveing over here, we have less that you do. I hope you fins a way to get more D3

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  7. Very sorry about that. But you are doing all the right stuff and with more of that you can be fine.

    The problem with the sunlight exposure is to not use any skin cream at all (which is a bummer because well, skin cancer?) but even then the effect can be minor.

    Still, I have seen young women with severe osteo from the Middle East where the sun shines all day but women are covered head to toe in their black hijabs.

    The thing is to find the right supplement and to check whether you are actually absorbing it. Many over the counter supplements can pass through your digestive system without much of an impact. This can be assessed through lab tests.

    I have to watch for osteo due to the meds I need to take (side effect of cortisone etc.) and it took me a while, three attempts in fact, to find a supplement that does the job. And cycling is the perfect exercise. But I always say that.

    Take care and keep on moving.

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  8. That has to be scary but I know you will do what you must to "fix" it. Sometimes it is just in your genes. I have a friend who does everything right---exercise. healthy eating, plus plenty of sun and supplements in winter, but still has osteoporosis. We do the best we can with what we have been given.

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  9. Sorry about your bad news. Most of my life has been one continuous weight-bearing exercise, so I may be good in the bones area.

    Wishing you the best.

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  10. One other thought I had regarding the calcium. Do you also take magnesium with it? It helps the calcium be more effective.

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  11. Rain-- I was taking 400 units of D a day with 600 mg of calcium and 200 of magnesium in a delicious liquid supplement. I have added another 500 units of D and plan to have my D levels tested ASAP. Can't move into the family beach house. It's become the whole family's vacation getaway, and that's as it should be.

    Gin-- Thank you for commenting and sharing your very uplifting story. I have been walking 2 miles a day, when the weather permits. I now plan to add a mile or two more to that total. Not sure I would do any pharmaceuticals, but will try everything else.

    Tara-- I'm going to do everything I can to reverse this. I plan to build bones, STRONG bones. The stories I've read have been very inspirational.

    Sky-- I think the thing that makes a more southern latitude really important for me is my very brown skin. It takes much longer to derive the benefits of vitamin d from sunlight with my skin tone. Ever since I was a little kid people have asked me if I was from India. I'm very brown with brown eyes. Northern latitudes laugh at me and my earnest attempts at getting vitamin d.

    steve-- Not sure where we're going to go. Would love to go back to Santa Cruz, but OMG, the housing prices there are absurd. We both love the coast, and that's got to be in the equation. We'll keep you posted.

    Bill-- Thank you for your kind words. I think about my blogging friends in very northern latitudes and wonder how they do it.

    sabine-- I never use sunscreen. I probably should, but I think my skin color protects me a bit. I have just been reading about the osteoporosis situation for women in the middle east. Such an outrage, I am blown away by it. Good advice about checking my body's absorption of the supplements I have been using. And definitely more walking and biking in our future!

    Arkansas Patti-- I'm going to do everything I can to build more bone. I'm so small, it's really going to be a challenge. But I like a good challenge! Hah!

    Pablo-- I plan to start wearing weights when I walk. I can't believe my lumbar spine is so bad. It seriously scares me. I wish I could run, but even when I was young, I would get a pain in my side after a short distance. I'm a good steady-paced walker, and hopefully I can rebuild what's been lost.

    Rain-- Yes my supplement has calcium, magnesium, and vitamin d. Of course last week's take down of supplements at some big box stores (not where I shop ever!) made me wonder about the efficacy of what I'm using.

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  12. I take my calcium and magnesium separately. Actually I like something called Natural Calm for the magnesium. It is a powder that is added to hot water for a drink. My doctor wanted me taking 2000 units of Vit. D as although I was high on bone strength, I was low on D. We'll see what comes up when I go in for a physical in May whether it's worked to increase it to get my own levels high enough.

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  13. You've got the right attitude and the right information. I'm sure you will help dem bones.

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  14. Should never have left that "rain shadow" in PT. ;-)

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  15. Rain-- I'm going to rethink my supplement intake and figure out what I need and how to get the best of it. I think the low Vitamin D, in your case, may just be the northern latitude and lack of sunlight.

    NCmountainwoman-- I'm hoping to really work this out, save and strengthen my bones, and not risk a fracture in my future.

    Phil-- Hah! When we were in Port Townsend, my Vitamin D level was 13. That's so below normal, it was scary! I raised it to normal levels within a year with sunlight in California. I wish the pacific northwest had more sunlight. We would have never left.

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  16. it was low when I was not very faithful with supplements. I've never taken a multiple vitamin; so I take the things I think my diet won't give me. I was in Arizona for two months at the end of '14; so that should have given me plenty of sun. The problem with it being sun is skin cancer because you can't use anything to block the sun or you don't get the Vit. D benefit but if you don't protect your skin, at a certain age, cancers happen. It's kind of a Catch-22

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  17. Well, that's a bummer. I think both environment/intake and genetics have something to do with things like osteoporosis, as well as things like bad cholesterol, so it may be that some medication will be needed. Whatever it takes I hope it gets better. I know what something like this, that hits out of the blue, can do to you psychologically.

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  18. Sorry to hear about the bone density test as well as the limited housing market in and around Arcata.

    I'm not a doctor, but my intuition is that your bones are better than the doctors would have you think. You are doing all the right things. When we get older, our bones get older. The bone density tests show that. I'm not convinced that prescription medicine is the answer or that we are falling apart to the degree they would have us believe.

    Have you considered looking at houses in Gualala?

    http://www.zillow.com/homes/for_sale/Gualala-CA/pmf,pf_pt/49278_rid/days_sort/38.961811,-123.291664,38.661118,-123.737984_rect/10_zm/2_p/

    My parents lived there from 1974 until 1994. This is the realty company that sold their house:

    http://www.kennedyrealestate.com/areainfo.html

    Gualala has a climate somewhat like the San Juan Islands. It's warmer and drier than the surrounding area, especially if one lives a little bit inland. When it is foggy along the ocean, there is often sun a few minutes inland.

    Sending love and encouragement!

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  19. Rain-- I don't take multiples either. It'll be interesting to see your D numbers in May. I'm hoping for a great number!

    Mark-- I have an appointment with the doc next week and will have my Vitamin D levels checked before then. I have good cholesterol numbers. The reality is I never achieved maximum bone density as a teenager or young adult. I am very small (5'2" 101 lbs). My bones didn't have much to begin with, and age takes its toll. I am not surprised, but I was seriously disheartened by the news.

    am-- Thank you for your kind words, love, and encouragement. I tend to lean in the direction that you do, that my bones are probably better than they think. I won't do pharmaceutical medications, but I will do everything else. Gualala sounds interesting. I don't know where we'll go next. My heart belongs to Santa Cruz, but the median home price there is $600,000. That's completely crazy, but the "bay area" is wildly expensive. We'll come up with a plan and post all about it here!

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  20. Is there something wrong with the prescription drugs for osteoporosis? I know that breaking bones isn't all it can do. My aunt, who died of other causes many years ago, had the dowager's hump which some get. She walked and exercised but back then there were no other options. My bone density is stronger than average but if it was not, I'd not be reluctant to take a prescription med if the other answers weren't fixing it. It could be that your bone density is natural for you and it takes figuring out what is going on with each issue. But if there are side effects to the med for it, I'd be interested in learning more. My daughter could end up with it as an issue someday; so research is beneficial.

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  21. Rain-- There has been some bizarre side-effects from the bisphosphonates (Fosamax, Boniva, etc) associated with femur fractures and necrosis of the jaw. The bummer about pharmaceuticals is that the user always has to weigh the benefits against the risks. I tend to be one of those people who get the worst side effects, so I shy away from most meds.

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