I’ve been blogging for years now about cavities without anyone bringing bone disease to my attention. Bone disease is a major epidemic in the United States, although a silent one. Bone disease causes little pain when at rest, so it is common to compensate by just doing less. Doing less is a normal part of the aging process, so many people have reached the conclusion that losing bone density is just a natural part of aging.

Maybe it is, and maybe it isn’t. I won’t believe that loss of bone density is a natural part of aging until I see alot more data. In the meantime, I’m going to take sensible actions to prevent loss of bone density.

There is overwhelming evidence that vitamins prevent cavities. Not surprisingly, it is the vitamins that prevent pandemic deficiency diseases that are most closely linked to the prevention of cavities. These are vitamins A, B3 (niacin), C, and D. Vitamin B1 (thiamine) is the only other deficiency disease responsible for a pandemic deficiency disease and I recommend taking it just for this reason. Vitamin B1 (thiamine) is special because it requires special proteins to be distributed throughout the body. I recommend taking a special form of thiamine – TTFD – that does not require these proteins and therefore can overcome any defects in the thiamine protein distribution system that may occur due to disease, injury, or genetic predisposition.

Although not technically bones, the teeth are closely related to bones. X-rays detect cavities in teeth by identify areas of lower than normal density in a tooth. X-rays are used in the same way to identify areas of lower than normal density in bones. When the bones of the skeletan are found to have slightly below normal density, the condition is called osteopenia. When density is way below normal, the condition is called osteoporosis.

Vitamin D is central to the health of both teeth and bones. I’ve reviewed the overwhelming evidence that vitamin D can prevent cavities. There is also overwhelming evidence that vitamin D prevents rickets – a disease that also causes lower than normal bone density. Unlike osteopenia and osteroporosis, Rickets has an obvious cause (severe vitamin D deficiency) and responds rapidly to the addition of vitamin D to the diet and/or regular exposure to sunlight. Unfortunately, there is no consensus as to the cause of osteopenia and osteroporosis and the disease definitely does not respond rapidly to vitamin D supplements. That said, it is well recognized that vitamin D lowers the risk and/or slows the rate of progression of osteropenia and calcium supplements with vitamin D are the most common treatment.

So – there’s no question that calcium supplements with 600 to 800 IU of vitamin D will not stop this epidemic. That’s not what I recommend.

Calcium plus vitamin D supplements typically contain only 200-800 IU of vitamin D. I believe the reason is side effects. A strong daily dose of noontime sunshine safely provides somewhere between 10,000 and 40,000 IU. Although almost unknown, it is an indisputable fact that daily doses of vitamin D above 5000 IU commonly cause debilitating side effects that are unknown from even extreme daily sun exposure. Vitamin D pills can be highly toxic. Vitamin D produced in the skin by sun exposure is never toxic. I’m sorry that no other documents on vitamin D think that this fact is worth your attention. I believe that this fact means that many people need to get vitamin D from the sun to be optimally healthy.

Bone density decline associated with aging is going to be a complex process. I don’t believe that getting out in the sun will turn out to be a miracle cure, although I’m sure it will help. Of course it will help – that’s why so many people take calcium with vitamin D – because it helps. My hope is to find a treatment with more dramatic effects. That’s where the other vitamins become important. Vitamins A, B3 (niacin), and C have well known roles in bone health. There’s less work on thiamin (vitamin B1), but it’s worth taking as a precaution.

Here’s a good place to start:

1) Lie flat in the sun in a bathing suit near noontime on most sunny days. Try to avoid substantial darkening of the skin. Use sunblock on your face and never burn yourself.

2) Take 2000 mg/day of vitamin C. This is the level recognized by the Food and Nutrition Board to cause no adverse effects for 95% of the population and only very mild adverse effects for the rest. It is as close to a risk-free dose as is possible. Keep in mind, eating anything every day carries risks. A small fraction of the population is intolerant of daily doses of all but the most benign food items.

3) Take 10,000 IU of vitamin A once per week. I repeat. One 10,000 IU dose of vitamin A every week, not every day. Vitamin A is frequently toxic. It’s OK to take more, and it’s necessary to be getting more from your diet (the RDA is 5000 IU). Just be really really careful. I’m not going to recommend higher doses of vitamin A supplements until I understand it better. I also recommend eating foods rich in vitamin A (e.g. eggs).

4) Take a 250 mg time-release niacin tablet once per week. I again repeat. One 250 mg time-release niacin tablet once per week. If the single dose is bothersome, break it in half and take the half tablets once every four days or so. There’s really no need for a digital routine. It’s fine to take the niacin and vitamin A tablets on some of the days when you’re worried about your health and to not take any when you’re feeling fine. Regularly drink 2 cups of dark roast coffee to enrich your dietary intake of niacin.

5) Take 50 mg tablet of enteric coated TTFD (a thiamine precursor) once per day. There are no known side effects. You’ll never know you are taking this supplement. Taking it won’t make you obviously better. Stopping taking it won’t make you obviously worse. If someone slips you a pill you won’t ever know. Only a scientist can appreciate this pill and it’s hard to appreciate even for a scientist. Just take it because there’s a chance that it will provide you with amazing benefits over the long haul and there’s almost zero risk.

Everywhere I look I see friends and family members curtailing activities. Athletic activities are the first to go. Then things like cooking, gardening, and working around the house. I hear all the time friends saying they “cured” aches and pains by avoiding some kind of ordinary physical activity that they did for years without thinking. I just don’t believe that ordinary activities cause this kind of pain. I believe poor nutrition is much more likely to be the cause.

If you’re getting older and experiencing more aches and pains from ordinary activities, there’s much to gain and nothing to lose by following my simple advice.