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How Much Vitamin D Do We Need for Skeletal Health?

  • Symposium: Bone Repair and Regeneration
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Vitamin D is critical for musculoskeletal health and has been implicated in the risk of extraskeletal diseases, including cancer, cardiovascular diseases, and autoimmune diseases, as well as overall mortality. Although numerous studies deal and have dealt with vitamin D deficiency and its consequences, experts cannot agree on the right 25-hydroxyvitamin D levels. This survey aims to shed light on the ongoing vitamin D controversy from different angles.

Questions/purposes

We discuss the minimum threshold for the 25-hydroxyvitamin D level to guarantee optimal health, why vitamin is D critical to musculoskeletal and extraskeletal functions, and new evidence for the success of prevention measures such as food fortification.

Methods

We searched PubMed, Google Scholar, and reference lists of articles using several keywords. The most recent search was in February 2011.

Results

While the use of parathyroid hormone as a surrogate measure did not lead to a consensus concerning the required 25-hydroxyvitamin D serum level, the combined analysis of bone mineralization and vitamin D status has established minimum levels of more than 75 nmol/L (30 ng/mL) to guarantee at least skeletal health. An effective measure to approach this status is food fortification, which has been demonstrated by countries such as Canada, the United States, and Finland.

Conclusions

Given the health economic implications of failure to maintain a balanced vitamin D status, action is recommended to integrate current scientific knowledge on vitamin D into physicians’ treatment of patients and governmental policies on food fortification.

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Acknowledgments

The authors thank Dr. Thorsten Schinke for critical reading of the manuscript and helpful comments. The authors also thank Drs. Orla Klatte, Steffen Kessler, Felix Netter, Nils Proksch, Simon Meier, Frederic Pastor, and Till Köhne, who substantially contributed to the HBBD trial, as well as The Voxel-Man Group of the University Medical Center Hamburg-Eppendorf. Christoph von Domarus and Jonathan Brown contributed equally to this study.

Author information

Authors and Affiliations

  1. Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

    Christoph von Domarus MD, Jonathan Brown Dipl-Ing, Florian Barvencik MD & Michael Amling MD

  2. Department of Trauma, Hand, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Pia Pogoda MD

Authors
  1. Christoph von Domarus MD
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  2. Jonathan Brown Dipl-Ing
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  3. Florian Barvencik MD
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  4. Michael Amling MD
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  5. Pia Pogoda MD
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Corresponding author

Correspondence to Michael Amling MD.

Additional information

This study was supported within the framework of the Transregional Research Group 793: Osteoporotic Fracture Healing of the German Research Community (DFG Forschergruppe 793) (MA) and DFG Am 103/13-2 (PP).

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von Domarus, C., Brown, J., Barvencik, F. et al. How Much Vitamin D Do We Need for Skeletal Health?. Clin Orthop Relat Res 469, 3127–3133 (2011). https://doi.org/10.1007/s11999-011-1880-4

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  • DOI: https://doi.org/10.1007/s11999-011-1880-4

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