Dear Dr. Roach: Im 70, Caucasian and slim. I was diagnosed with osteoporosis five years ago. Before that, I took Fosamax for five years. The only things I take are 1,000 mg calcium citrate, 3 mg boron and a multivitamin containing 2,000 IU vitamin D. An X-ray showed three compression fractured vertebra. I read that taking more than 1,000 IU of vitamin D can cause bone mass loss! I started crying thinking that I caused the fractures from taking too much vitamin D. Ive stopped the multivitamin and just take 500 IU of the vitamin D. Im outside an hour a day. Do you know of bone mass loss from too much? V.W.
Answer: Low levels of vitamin D are a common and treatable cause of bone loss, which can ultimately lead to fractures. Its a good idea to check the vitamin D level in people with known osteoporosis. There remains some controversy about the optimum level of vitamin D, but a level between 30 and 50 ng/mL is generally considered safe.
Very high levels of vitamin D can cause calcium to come out of bones, and can cause risk of kidney stones as well as symptoms. However, this is almost unheard of in a dose less than 4,000 units daily. I think it is very unlikely that you were taking too much vitamin D, so theres no need to blame yourself.
Although people with boron deficiency are at higher risk of bone loss, using boron as part of osteoporosis treatment has never been shown to reduce fracture rates. I dont recommend boron supplementation. Leafy green vegetables like spinach and kale are good sources in the diet.
Dear Dr. Roach: In a six-month period last year, I was anesthetized six times for various procedures and surgeries. I have had some memory problems, shaky handwriting and spelling problems. Was this too much? Did my symptoms come from the anesthesia? Is this common, and is it permanent? D.H.
Answer: People sometimes can have a period of time after a surgical procedure where they are not quite themselves, mentally. This is more common in people who already have some kind of impairment, such as mild dementia, that may not have been noted before. It can take months to recover, and multiple procedures would be likely to prolong the time until full recovery. Being in the ICU is also a major risk for developing confusion afterward.
Some procedures are clearly necessary and may improve overall function. However, it is always wise to consider whether surgery is necessary, especially in people at higher risk. That includes older people.
