No matter which osteoporosis drug your doctor chooses for you, it's helpful to know as much as possible about how the disease has affected you. One way to tell is to ask about your "markers."
When you're being treated for osteoporosis, your doctor orders a blood or urine test. This reveals several markers -- levels of different enzymes, proteins, and other substances circulating in the body -- that provide clues about your disease and the progress of your treatment.
How much vitamin D do I need?
In November 2010, the Institute of Medicine's expert committee set a new "dietary reference intake" for vitamin D.
Assuming that a person gets virtually no vitamin D from sunshine -- and that this person gets adequate amounts of calcium -- the IOM committee recommends getting the following amounts of vitamin D from diet or supplements (Note that the IOM's upper limit is not a recommended intake, but what the IOM considers the highest safe level):
Bone-specific alkaline phosphatase (Bone ALP or BALP). This is an estimate of the rate of bone formation over your entire skeleton. Bone formation may sound like a good thing, but depending on the circumstances, too much can be bad. People with osteoporosis generally have BALP levels that are up to three times normal.
Osteocalcin. This is another marker of bone formation.
Urinary N-telopeptide of type I collagen, or uNTX. This is a marker of bone resorption, or loss of bone.
Vitamin D levels. This measure assesses whether you have a deficiency of vitamin D, which is essential for your body's absorption of calcium. You can be taking plenty of calcium, but if you don't have enough vitamin D, it won't be efficiently absorbed by your body.
SOURCES: Michael Holick, MD, PhD, professor of medicine,
physiology and biophysics, Boston University Medical Center. Robert Recker, MD,
MACP, professor of medicine and director, Osteoporosis Research Center,
Creighton University School of Medicine, Omaha, Neb. National Osteoporosis