Vitamin D for Improved Bone Health and Prevention of Stress Fractures: A Review of the Literature

Lawley, Richard; Syrop, Isaac P.; Fredericson, Michael

doi:10.1249/jsr.0000000000000718

Cited by 16 publications

(15 citation statements)

References 48 publications

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“…(28) It has been theorized that osteocyte apoptosis, bone marrow edema, localized contractile muscle pressure, and vitamin D (25(OH)D) deficiency may have a role in above-mentioned pathogenetic processes. (29)(30)(31)(32)(33) Of note, the process of bone remodeling in response to increased mechanical loading is of double effect. Namely, it may aid to repair microcracks while also temporarily decreasing bone elastic modulus.…”

Section: Introductionmentioning

confidence: 99%

Generalized Uncoupled Bone Remodeling Associated With Delayed Healing of Fatigue Fractures

et al. 2022

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Fatigue fractures in bones are common injuries with load-bearing activities, during which the remodeling aimed at removing microdamage has been suggested to play a role in increasing related fracture risk. Much attention has been given to the uncoupling between osteoclastic bone resorption and osteoblastic osteogenesis in fatigue fracture cases; however, the underlying pathophysiologic mechanisms of impaired fracture healing are yet unknown. Here we report multiple fatigue fractures in a physically active woman receiving contraceptive pills for years. Her fracture healing was remarkably slow, although she has been otherwise healthy. The patient underwent bone biopsy of the iliac crest that showed remarkable peritrabecular fibrosis with increased osteoclastic bone resorption combined with relatively low bone formation. Analysis of bone biochemical composition revealed a more complex picture: First, notable declines in bone mineral content-based parameters indicating abnormal mineralization were evident in both cancellous and cortical bone. Second, there was elevation in mineral crystal size, perfection, and collagen maturity in her bone tissues from different anatomical sites. To our knowledge, this is the first report showing generalized uncoupling in bone remodeling, increased peritrabecular fibrosis, and bone compositional changes associated with delayed healing of fatigue fractures. These results may explain delayed healing of fatigue and stress fractures.

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Section: Introductionmentioning

confidence: 99%

Generalized Uncoupled Bone Remodeling Associated With Delayed Healing of Fatigue Fractures

et al. 2022

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“…It has been theorized that vitamin D (25(OH)D) has a central role in the development of stress fractures. The term 25(OH)D will now be used throughout the manuscript for Vitamin D. Recently, there has been an increased investigation into the relationship of 25(OH)D and stress fractures [6,7]. 25(OH)D deficiency has been shown to be associated with an increased incidence of bone fatigue and stress fractures [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…We have a considerable knowledge about the epidemiology of bone overuse injuries and stress fractures in athletes [13,14], bone health of athletes [15][16][17][18], skeletal muscle function in athletes [19] and the influence of 25(OH)D supplementation on bone mass [16], muscle strength [16] and performance in athletes [17,[19][20][21]. However, little is known regarding the relationship between stress fractures in athletes and the importance of 25(OH)D [6]. Limited experience suggests that calcium and 25(OH)D supplementation might be helpful [11].…”

Section: Introductionmentioning

confidence: 99%

“…Several reviews already reported the importance of 25(OH)D in athletes regarding different aspects such as the influence on performance [20,21], bone health [6], bone health and athletic performance [17], muscle function and performance [19], and the intake of calcium and 25(OH)D in the prevention of stress fractures [15]. Accordingly, a narrative review was conducted according to the definition outlined by Grant and Booth [22].…”

Section: Introductionmentioning

confidence: 99%

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Vitamin D and Stress Fractures in Sport: Preventive and Therapeutic Measures—A Narrative Review

et al. 2021

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There are numerous risk factors for stress fractures that have been identified in literature. Among different risk factors, a prolonged lack of vitamin D (25(OH)D) can lead to stress fractures in athletes since 25(OH)D insufficiency is associated with an increased incidence of a fracture. A 25(OH)D value of <75.8 nmol/L is a risk factor for a stress fracture. 25(OH)D deficiency is, however, only one of several potential risk factors. Well-documented risk factors for a stress fracture include female sex, white ethnicity, older age, taller stature, lower aerobic fitness, prior physical inactivity, greater amounts of current physical training, thinner bones, 25(OH)D deficiency, iron deficiency, menstrual disturbances, and inadequate intake of 25(OH)D and/or calcium. Stress fractures are not uncommon in athletes and affect around 20% of all competitors. Most athletes with a stress fracture are under 25 years of age. Stress fractures can affect every sporty person, from weekend athletes to top athletes. Stress fractures are common in certain sports disciplines such as basketball, baseball, athletics, rowing, soccer, aerobics, and classical ballet. The lower extremity is increasingly affected for stress fractures with the locations of the tibia, metatarsalia and pelvis. Regarding prevention and therapy, 25(OH)D seems to play an important role. Athletes should have an evaluation of 25(OH)D -dependent calcium homeostasis based on laboratory tests of 25-OH-D3, calcium, creatinine, and parathyroid hormone. In case of a deficiency of 25(OH)D, normal blood levels of ≥30 ng/mL may be restored by optimizing the athlete’s lifestyle and, if appropriate, an oral substitution of 25(OH)D. Very recent studies suggested that the prevalence of stress fractures decreased when athletes are supplemented daily with 800 IU 25(OH)D and 2000 mg calcium. Recommendations of daily 25(OH)D intake may go up to 2000 IU of 25(OH)D per day.

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“…VitD plays a vital role in an athlete’s health, training, and performance (2). The vital role includes athletic bone health, besides immune health (3).…”

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confidence: 99%

COVID-19 and Vitamin D Supplementation

Trojian¹

2022

Curr Sports Med Rep

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Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) disease (COVID-19) has affected many people. Vaccination and masks have significantly reduced the morbidity and mortality of the disease. Vitamin D (VitD) and its effects on infections from viruses have been of interest. Many athletes have low serum levels of VitD (1). VitD plays a vital role in an athlete's health, training, and performance (2). The vital role includes athletic bone health, besides immune health (3).The antimicrobial protein, cathelicidin LL-37, is increased with correction of low VitD over 6 to 8 wk. Cathelicidin exerts antiviral activity against respiratory viruses, disrupting the viral envelope (4). VitD has received notoriety as potentially protective against the COVID-19 infection since it may be associated with immunocompetence, inflammation, aging, and other diseases connected to the outcomes of COVID-19. In the Nurses' Health Study II, performed from May 2020 to 2021, they shoulder evidence that higher predicted circulating VitD, in the form of VitD 25 hydroxy concentration, had a lower risk of . In a review of COVID-19 and VitD, the author showed that people with low VitD levels have more severe COVID-19 symptoms than those with serum levels over 50 ng•mL −1 of VitD (6). People with low VitD are not the healthiest patients, so they may get sicker with COVID-19.Researchers have pointed out that VitD does not work without binding to the VitD receptor (VDR) and VitD binding protein (DBP). The activated immune system cells express the intracellular VDR, which suggests a potential role for VitD as a localized endogenous modulator of immune function. In addition, VDR has genetic variations that may affect the responsiveness to VitD levels. DBP, a serum 458-amino acid protein, is the primary VitD carrier. It has considerable polymorphism with three common alleles (7). Researchers have noted that DBP-2 can have lower VitD, which may make certain patients more prone to a more severe course of . Another researcher noted a negative connection between another version of DBP, the DBP1 allele, and COVID-19 prevalence and mortality (9). More research on VDR and DBP is needed to determine their effects on COVID-19 and other health processes.

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Vitamin D for Improved Bone Health and Prevention of Stress Fractures: A Review of the Literature

Cited by 16 publications

References 48 publications

Generalized Uncoupled Bone Remodeling Associated With Delayed Healing of Fatigue Fractures

Generalized Uncoupled Bone Remodeling Associated With Delayed Healing of Fatigue Fractures

Vitamin D and Stress Fractures in Sport: Preventive and Therapeutic Measures—A Narrative Review

COVID-19 and Vitamin D Supplementation

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