Endocrine Abstracts

In 100 consecutive osteoporotic women referred to our clinic we assessed 25OHD3 and PTH levels. Patients suffered from postmenopausal osteoporosis and intolerance of oral bisphosphonates, were treated at least for 6 months with calcium and vitamin D. The reasons of intolerance of oral medication were gastritis (53), esophagitis (18) or peptic ulcer (29 cases). Patients were therefore chronically treated with proton pump inhibitors (PPI). They were referred to our Clinic in order to take intravenous ibandronate and were all assessed by referring physician as ‘ready to medication’ with it. We found, however, that only in eight of them the levels of 25OH D3 were proper (i.e. >30 ng/ml). Generally 25OH D3 levels were very low – on average 17.91 ng/ml (±4.04), and in 69 patients were lower than 20 ng/ml. Ten patients had 25OHD concentrations even lower than 10 ng/ml with evident symptoms of muscle weakness. In all of them the levels of PTH were elevated (78.05 pg/ml ±4.31), however in all group we haven’t found an evident correlation between PTH and 25OH D3 (r=−0.48; P=0.11).

The reason of these low vitamin D levels was using too low doses during supplementation. All, except 10 women were treated only with 400 – 800 j D3 daily. According to the data presented above, these doses are evidently too low to achieve recommended concentrations (i.e. >30 ng/ml), especially in subjects with gastritis or peptic ulcer and prolonged therapy with PPI.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.