News July 2003 Issue

In the News: 07/03

Vitamin D—In Big Doses—Foils Fractures
Taking megadoses of vitamin D just three times a year lowers the risk of bone fractures in older people, suggests a recent study in the British Medical Journal. The study followed 2,686 men and women between the ages of 65 and 85. Participants were given one capsule containing 100,000 IU of vitamin D or a placebo capsule every four months for five years. Compared with those on placebos, people who took vitamin D had a 22 percent lower rate of first fractures at any site and a 33 percent lower rate for fractures of the hip, spine, wrist, or forearm—sites often damaged by bone-thinning osteoporosis. Earlier research had showed that taking vitamin D and calcium supplements daily lowered fracture rates, but studies of vitamin D alone have been inconclusive, with one previous study finding no fracture-prevention benefit from a 400 IU daily dosage. The large doses used in the new study averaged 800 IU per day—a daily intake experts consider safe for vitamin D. Although the study indicates that this strategy appears to be safe and effective, you should not take higher-than-recommended amounts of vitamins without a doctor's supervision.


Another NSAID Risk?
If you didn’t have enough to worry about over the potential side effects of NSAID use (gastrointestinal bleeding, ulcers), a French study has determined that nonsteroidal anti-inflammatory drugs may also bring about acute diarrhea. After comparing 285 patients who suffered from diarrhea, it was found that exposure to NSAIDs one to six days before the onset of symptoms nearly tripled the risk of severe diarrhea. What was not determined was whether patients had taken NSAIDs to treat stomach flu (which would have brought on illness-related diarrhea) or whether they had taken antibiotics, which also increase the risk of diarrhea. Stephen J. Bickson, M.D., a gastroenterologist at the University of Virginia Health Center, observed in HealthNews, “While patients should be aware that NSAID use may be associated with diarrhea, these results should not deter people from taking appropriate medication for pain and inflammation.”


Make A Friend With Your Pharmacist
You can reduce your risk of suffering serious drug complications if you talk to your pharmacist about your prescriptions, according to a study in a recent issue of the American Journal of Managed Care. The study found that consultations with pharmacists about “high risk” medications —those with strict dosage ranges or significant adverse effects—reduced medication-related deaths by 8 percent in patients enrolled in a managed care plan in Southern California. Rates of hospitalization also dropped. The study suggests that people on risky medications should always talk to their doctor or pharmacist about possible side effects and how to avoid them.


Glucosamine/Chondroitin As Rub-In?
Like most supplements, glucosamine and chondroitin sulfate, marketed as pain-relievers for osteoarthritis—though formal studies have yet to actually prove their benefit—have always been available in pill form. Now a study in the Journal of Rheumatology suggests that a cream that includes these compounds offers a similar benefit. The study followed 59 people with knee osteoarthritis who used either JointFlex, a nonprescription cream that contains glucosamine and chondroitin sulfate, or a placebo cream. After four and eight weeks, those using JointFlex had lower pain scores than those on the placebo, but placebo takers also reported less pain. Only a small percentage of glucosamine and chondroitin taken in pill form actually reaches cartilage tissue in the joint. But no one knows whether these compounds can reach joint cartilage through the skin, a prospect many orthopaedic experts consider unlikely. The active ingredient in JointFlex is camphor, a compound known for its antirheu-matic properties. The placebo cream contained no camphor but did contain peppermint oil—another ingredient with short-term pain-killing properties. Bottom line: More research is needed to determine which componenets can be absorbed through the skin to produce a beneficial effect.

Yet another benefit of taking NSAIDs to ease arthritis pain is the protective effect that such drugs may offer in fighting Alzheimer’s disease. Dr. Bas in’t Veld of the Erasmus Medical Center in Rotterdam, Holland, has discovered in a study of nearly 7,000 people age 55 and older that those who had used NSAIDs for two years or more had 80 percent less risk of developing Alzheimer’s disease. Another report, from scientists at the University of California (San Diego), suggests that the benefits of NSAIDs may not be due to their anti-inflammatory properties. Rather, they may result from the fact that these drugs lower levels of a peptide which forms the plaques in the brain that are characteristic of Alzheimer’s disease.