![]() ![]() Sarcopenia is one of the musculoskeletal consequences of hypovitaminosis D. Geriatric giants, such as sarcopenia (progressive and generalized loss of skeletal muscle mass and strength) or cognitive decline, strongly influence elderly patients. This is a typical example of the situation where a lack of “hard evidence” is not synonymous with the possible lack of adverse effects. The phenomenon of drugs and vitamin D interactions is observed first and foremost in patients with comorbidity. The known factors affecting vitamin D metabolism interfere with cytochrome CYP3A4 activity. Therefore, all factors interfering with individual metabolic stages may affect 25-hydroxyvitamin D plasma concentration. Vitamin D status in geriatric population is an effect of joint interaction of all vitamin D metabolic pathways, aging processes and multimorbidity. In this group, low vitamin D plasma concentration is related to osteoporosis, osteomalacia, sarcopenia and myalgia. If she has a balanced diet, she may only need an additional 500 mg of calcium.Vitamin D deficiency is common in elderly people, especially in patients with comorbidity and polypharmcy. If she does not eat dairy, she may need a supplement. If a woman with these characteristics is meeting her RDA through food, it is best that she not add a calcium supplement. However, postmenopausal women at increased risk for fractures or osteoporosis need more calcium and vitamin D. There is evidence of risks (stroke and heart attack) of taking too much calcium through supplements. Men or women at risk for fracture or osteoporosisġ,200 mg calcium (diet + supplements) and 20–40 mcg (1,000 – 2,000 IUs) of vitamin D There is not enough scientific evidence to define the risks and benefits of taking calcium and vitamin D supplements in men. If a premenopausal woman does not eat any dairy foods, she likely needs to take a calcium supplement - 500 mg is probably enough to get her into a reasonable range. If a premenopausal woman meets her RDA through food, she should not take a calcium supplement. There is not enough scientific evidence to define the risks and benefits of taking calcium and vitamin D supplements in premenopausal women. The risks of taking calcium and vitamin D supplements are not known in this group, however, during the bone building years, girls need extra calcium and might benefit from vitamin D supplements as well. ![]()
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