Osteoarthritis and Vitamin D Deficiency

Hello, @ssbionicknee. I'm fascinated by your nickname and think of it as one of your tricks to keep your head and mind up and looking forward in the midst of some significant physical problems. My personal experience is not a reflection of yours, but I have had some chance to deal with osteoporosis that befell my wife. Her treatment over two years improved her bone strength and functions, and her condition is now referred to as osteopenia.

During her recovery period, we settled on three main principles: First, Vitamin D3 softgels of 25mcg (1000 International Units) once each day; her medical team warned against any more than 2000 IUs per day; larger doses are promoted by some supplement-selling stores. Second, she takes one Calcium tablet per day (600mg Calcium with Vitamin D3 of 400 IUs added). Third (often overlooked), your parathyroid function; this gland manages calcium levels in crucial cells and tissues.

You may wish to speak with your doctors about these practices to see whether they would help improve your situation. I hope you'll favor these smaller doses of Vitamin D3 if you start them immediately and before you can talk about them with your doctor, then ask whether a parathyroid test would be appropriate in response to the finding of severe Vitamin D deficiency. Good luck with your continued treatment and recovery. Martin

@predictable, thank you! You gave me a lot of good info. I didn't think to consider that the thyroid could be the cause of the Vitamin D deficiency. I was considering them to be separate issues. Holding off on the vitamin D is probably a good idea until I see the doctor. I joined after my TKR. I was joking with friends that I was going to be like the bionic woman when it was over. Hence the name bionic knee. At that point I did not know I would be having surgery on my shoulder and other knee. I now tell people that I am being refurbished. 🙂

You're welcome @ssbionicknee. The hormone gland managing calcium is the PARATHYROID, not the thyroid. Just to be clear. I bought a laptop a while ago. It was refurbished. Best I ever had! Martin

Hello @ssbionicknee,

I am glad that you posted about this and also that Martin, @predictable, responded to your post. Martin has very good insights and he has offered you some good suggestions. I also have a very low Vit D level (17) and I can't seem to bring it up. Having your parathyroid level checked (blood test) is a good idea. As Martin said the parathyroid is different than the thyroid. These two glands are located near each other but perform different tasks in the body.

Here is a Mayo video about the parathyroid, just click on the link,
https://www.mayoclinic.org/diseases-conditions/hyperparathyroidism/multimedia/patient-experience-parathyroid-video/vid-20143231
Here is some written information about hyperparathyroidism,
https://www.mayoclinic.org/diseases-conditions/hyperparathyroidism/symptoms-causes/syc-203561
And here is a discussion group on Connect about others who are dealing with elevated parathyroid levels, https://connect.mayoclinic.org/discussion/elevated-parathyroid-hormone-pth/?orderby=DESC#chv4-comment-stream-header.

Have you had any problems with kidney stones, bone density problems or any other elevated calcium levels, @ssbionicknee ?

@hopeful33250 Thank you for the links. I watched the video, but the written information says it is no longer available. I'm going to try and look it up. I have had 2 kidney stones. The first one at 19 and the second several years later. I don't believe I have ever had a bone density test. I was diagnosed with OA in my right knee in 2009, when I was 42. I did some physical therapy and the knee held up until 2018. I also have low potassium and take a prescription potassium supplement. I am a bit confused as to where to start. I am trying to see my primary care for the low vitamin D. I also have an appointment to see a bone and spine doctor for lumbar stenosis to see what is causing the cold sensation in my thigh and I need my left knee replaced. From the information about parathyroid levels, it is beginning to sound like they are all related somehow. Right now I tire very easily. I tend to wake up a lot during the night, which may be pain related. I need to take a nap most days. I get winded if I am walking around too much and when I go up and down the stairs, In fact, the reason I had blood drawn was because my doctor noticed how winded I was when I walked into her office.

Hello @ssbionicknee

I am glad you posted again. If you would be interested in a suggestion, I would recommend that you schedule an appointment with an endocrinologist. This kind of specialist would be best able to diagnose a parathyroid problem and provide some good feedback.

Please keep in touch. I'm looking forward to hearing how you are doing.

Hello @hopeful33250 I wanted to follow up. I was trying to find a new PC because mine is not listening to me. I had no option but to follow up with my regular PC. He informed me that everyone had low Vitamin D and that it had been a waste of time to test it. Although, I felt a little better after I began taking Vitamin D. Because of the lab results, he had to follow up with some more blood work. I felt like he thought I was wasting his time. As a result of the new blood work I have learned that I am anemic and my B12 was very low. I have to have a B12 shot once a week for 4 weeks and then once a month for 5 months. He also told me to take 325mg of iron per day. I had my first shot of B12 and am going to begin the iron tonight. I am a bit concerned about the side effects of taking such a high dose of iron. I asked about the thyroid test and he did not order it. After I asked,he asked the lab to test the TSH??? I am waiting to hear about that. My liver was fine. I can now see why I was so exhausted all the time. Hopefully, I will begin to have more energy as I build up my low levels.

Hi @ssbionicknee. I am so sorry you are suffering from so many painful issues. I think your thought to find a different (or additional) doctor is a good one. I know that finding a new doctor is very stressful, but a new perspective could be extremely beneficial. I agree with Theresa's suggestion to see an endocrinologist. Thyroid, parathyroid, vitamin deficiencies, and many other issues are their areas of expertise. I consider the two endocrinologists I have seen to be magicians. I know that often a busy PC does not have the time, or training to sort out problems such as yours. Perhaps your doctor could refer you to an appropriate specialist. In reading your notes, I have wondered if you live in an area where there are very few doctors. I wish you well. For today, I wish you hope and some freedom from pain. For the future, I wish you knowledge and health. PS: I love your sense of humor.

Hi @medshy! I have to keep a sense of humor. It really does help me to see that I am a lot better off than some people. I feel blessed. I am going to need to look for an endocrinologist. I do live in a small town and to get a good doctor, I need to drive about an hour away. My orthopedic doctors are about an hour away. I have recently tried to switch my PC, but am finding that many are not taking new patients and if they are, I was going to have to wait 4 months to get an appointment. I wish the Mayo clinic were closer, because I am sure I could find a good doctor there. Now that we all seem to agree I need an endocrinologist, I need to start looking. Wish me luck!! 😀

Interesting research article shared by @steeldove on Vitamin D deficiency.

Screening for Vitamin D Deficiency in Adults - US Preventive Services Task Force Recommendation Statement
-- https://jamanetwork.com/journals/jama/fullarticle/2778487