Diabetes and Osteoperosis

Diabetes and Osteoporosis: Is Vitamin D the Missing Link?

Written by Kathy Lynch, PharmD – Women’s International Pharmacy


Studies suggest that osteoporosis and bone fractures are a significant and under-reported complication of Diabetes Mellitus (DM). An increase in osteopenia and bone fracture risk, coupled with a decrease in bone mineral density (BMD), is well documented in diabetics with little or no insulin production (Type I).

This same risk in diabetics with insulin resistance (Type II) is more uncertain. Even though Type II diabetics have a higher BMD than the non-diabetic population, both Type II and Type I diabetics have an increased risk of experiencing an osteoporosis-related fracture.

There may be more than just low BMD involved. Cytokines are substances made in immune system cells that have negative effects in both diabetes and osteoporosis. Vitamin D is known to be beneficial to the immune system as well as helpful in maintaining bone health.

Scientists have recently theorized that vitamin D may be beneficial in preventing Type I and Type II diabetes. Epidemiological studies have demonstrated that high doses of vitamin D are associated with a decreased risk of Type I diabetes when cod liver oil is given to babies or mothers in their third trimester.

Multiple studies suggest that vitamin D has a positive effect on pancreatic cells as well as on insulin production, secretion, and sensitivity. Higher blood levels of vitamin D3 are associated with a lower risk of metabolic syndrome in Type II diabetics. Poor blood sugar control has been observed during the winter months when vitamin D from the sun is less available.

Wouldn’t it be wonderful if vitamin D could help build strong bones while combating diabetes at the same time? Further research is warranted.

  • Leidig-Bruckner G, et al. Prevalence and Determinants of Osteoporosis in Patients with Type I and Type 2 Diabetes Mellitus. BMC Endocr Disord 2014;14(33):1-13.
  • Chau DL, Edelman SV. Osteoporosis and Diabetes. Clinical Diabetes. 2002;20(3):153-157.
  •  Brown SA, Sharpless JL. Osteoporosis: An Under-appreciated Complication of Diabetes. Clinical Diabetes. 2004;22(1):10-20.
  • Harinarayan CV. Vitamin D and Diabetes Mellitus. Hormones. 2014;13(2):163-181.
  • National Institutes of Health. What People with Diabetes Need to Know About Osteoporosis. https://www.niams.nih.gov.
Diabetes and Osteoperosis 2017-12-13T12:42:53+00:00

Book Review: Heart Attacks, Heart Failure and Diabetes by Mark Starr, MD

Book Review – Heart Attacks, Heart Failure and Diabetes: Prevention and Treatment by Mark Starr, MD(H)

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy


Dr. Mark Starr, the author of a classic book titled Hypothyroidism Type 2: The Epidemic, recently published a book called Heart Attacks, Heart Failure, and Diabetes: Prevention and Treatment.

You may ask, “Why is this relevant to thyroid disease?” The reason is that Dr. Starr relies heavily on the research of Dr. Broda Barnes, a pioneer in the treatment of thyroid disease, for this new book. Dr. Barnes detailed much of his research in Hypothyroidism, the Unsuspected Illness, a book published in 1976 that continues to be a mind opener for anyone interested in thyroid issues. Dr. Barnes also published a lesser known book that same year called Solved: the Riddle of Heart Attacks. (For more information on Dr. Barnes’ life work, visit http://www.brodabarnes.org/.)

One would think that the field of medicine would have evolved significantly since 1976, providing us with more insight and better treatments. Sadly, this is not the case, and we find ourselves revisiting history for enlightenment.

Dr. Starr’s new book is a touchstone back to the very careful research provided by some of the giants in medical observations and research. He goes back as far as 1918 to Dr. Hermann Zondek’s profound work, which demonstrated that the enlarged heart in congestive heart failure can and does shrink back down to normal size when the underlying hypothyroidism is treated.

Dr. Starr notes that hypothyroidism and diabetes also go hand in hand. In fact, he contends that appropriate thyroid treatment can prevent the development of many of the secondary problems of diabetes, such as blindness, atherosclerosis and neuropathies.

One of the highlights of Dr. Starr’s new book is a thorough discussion of the limitations of using TSH (thyroid stimulating hormone) as an indicator of hypothyroidism. The thyroid gland produces 4 thyroid hormones: T1, T2, T3, and T4. The majority of the hormone produced is T4, which has very weak activity. The primary action from thyroid hormones comes from T3. In order to increase the availability of T3, enzymes in the body work to remove an iodine molecule from T4 to create T3.

As it turns out, there are separate enzymes at work in the pituitary gland, where TSH is produced, and the rest of the body. Because of these separate enzyme-producing systems, the amount of active T3 in the pituitary gland can be as much as 1000 times the amount of T3 available to the rest of the body. The production of TSH will stay low until the pituitary T3 is also exhausted. The result is that the body can be in a low thyroid state, with significant symptoms, for a long time before TSH levels are signaled to increase.

There is no better teacher than personal experience. Dr. Starr relates his own health struggle with untreated (at first!) hypothyroidism, and also shares some of his patients’ experiences.

This book serves as a reminder of the fundamental nature of thyroid function in diseases that are of epidemic proportions today. If you happen to start with this book, it will likely whet your appetite for even more of the type of information offered in his first book.

  • Starr M. Heart Attacks, Heart Failure, and Diabetes. Irvine, CA: New Voice Publications; 2014.
  • Starr M. Hypothyroidism Type 2: The Epidemic. Columbia, MO: Mark Starr Trust; 2005.
  • Broda BO. Hypothyroidism: The Unsuspected Illness. New York, NY: Harper; 1976.
  • Broda O. Barnes M.D., Research Foundation Inc. http://www.brodabarnes.org/.
Book Review: Heart Attacks, Heart Failure and Diabetes by Mark Starr, MD 2017-12-13T12:44:39+00:00

Blood Sugar and the Aging Brain

Blood Sugar and the Aging Brain

Written by Kathy Lynch, PharmD – Women’s International Pharmacy


Alzheimer’s Disease is sometimes called the “Disease of the Baby Boomers.” So it is not surprising that current brain research is focusing on this disorder.

A recent study on blood sugar levels and brain deterioration by Dr. Cherbuin and associates looked at 266 healthy, non-diabetic individuals, ages 60-64. The results indicated that high normal-fasting blood sugar levels were associated with brain wasting, particularly in areas relevant to aging. In another study, abnormally high blood sugar levels were associated with shrinkage of parts of the teenage brain as well.

Low testosterone, as well as high cortisol levels and estrogen/progesterone imbalances, can also lead to blood sugar/insulin disturbances.

Although more research needs to be done, controlling blood sugar levels through a healthy diet and exercise may prove to be beneficial in maintaining healthy brain function throughout life.

  • Cherbuin N, et al. Higher normal fasting plasma glucose is associated with hippocampal atrophy: The PATH Study. Neurology. 2012 Sep 4;79(10):1019-26. doi: 10.1212/WNL.0b013e31826846de.
  • Yau PL, et al. Obesity and Metabolic Syndrome and Functional and Structural Brain Impairments in Adolescence. Pediatrics. 2012 Oct; 130(4).
Blood Sugar and the Aging Brain 2017-12-13T12:41:16+00:00

Diabetes and Testosterone

Diabetes and Testosterone

Written by Kathy Lynch, PharmD – Women’s International Pharmacy


A testosterone deficiency has long been suspected in people with diabetes. A recent study concluded that males with sexual performance issues and/or abdominal obesity and metabolic diseases should be tested for low testosterone and treated accordingly.

A literature review examined the effects of testosterone therapy on patients with metabolic syndrome and found that they exhibited decreased fasting blood sugar, waist measurement, and triglyceride levels. In addition, insulin-dependent diabetic women with no menstrual cycle were found to have significantly lower levels of testosterone than cycling diabetic and non-diabetic women.

Diabetic men and women may want to have their testosterone level evaluated in light of the above findings.

  • “Testosterone Deficiency in Men: Systematic Review and Standard Operating Procedures for Diagnosis and Treatment” by Buvat J, Maggi M, Guay A, Torres LO; The Journal of Sex Medicine; 2012 Sept 12 (Epub ahead of print).
  • “Testosterone and metabolic syndrome: a meta-analysis study” by Corona G, Monami M, Rastrelli G, et al.; The Journal of Sex Medicine; 2011 Jan; 8 (1):272-83.
  • “Serum sex hormone concentrations in insulin dependent diabetic women with and without amenorrhoea” by Djursing H, Hagen C, Nyboe Andersen A, Svenstrup B, Bennett P, Molsted Pedersen L.; Clinical Endocrinology (Oxf); 1985 Aug:23 (2):147-54.
Diabetes and Testosterone 2017-12-13T12:49:01+00:00