Nutrients Are Needed to Heal Wounds and Injuries

Abby asked for suggestions to accelerate healing of her injuries. What should be done when a wound won’t heal?

More often than not, I think, slow healing wounds reflect nutritional deficiencies. Tissue regeneration is a nutrient-intensive process, and a lack of nutrients can radically slow it down.

Osteoporosis Epidemic Indicates a Widespread Deficiency of Bone Nutrients

Tissues are not static:  they are constantly broken down and regenerated. So just maintaining tissues requires a steady supply of nutrients.

Bone is particularly in need of certain nutrients: vitamins C, D, and K2; magnesium; and others. Unfortunately, the nutrients needed by bone are precisely the ones in which Americans are most deficient.

I believe that deficiencies in these nutrients are the main cause of the osteoporosis epidemic. Take vitamin K2. Most Americans are deficient in vitamin K2, which is needed for bone calcification. Non-vertebral fractures are five-fold more common in people with vitamin K2 deficiency. [1] The rise in fracture rate in women after menopause may be due to the fact that estrogen improves vitamin K2 status. [2]

Vitamin D is another nutrient critical for bone health. Bone mineral density peaks in the range 32 to 45 ng/ml. [3]

Vitamin C is a third nutrient necessary for bone health. Vitamin C is needed for collagen to form a meshwork that can then be mineralized by calcium, magnesium and other minerals. In the absence of vitamin C, bone is malformed.

Interestingly, cow’s milk has only one-fifth the vitamin C of human breast milk, and vitamin C is destroyed during pasteurization, so formula-fed babies before the days of vitamin C supplementation were prone to scurvy. Some believe that vitamin C and vitamin D deficiencies, not malicious parents, are responsible for “Shaken Baby Syndrome.” [4,5]

Vitamin Levels Determine the Success of Orthopedic Surgery

Today I read a press release about a study that found that 40% of all patients arriving for orthopedic surgery, and 52% of those coming in for trauma service, were deficient in vitamin D. Deficiency was defined as 25(OH)D levels below 20 ng/ml.

(We recommend keeping 25(OH)D between 35 and 50 ng/ml.)

What happened?  Those who had surgery with vitamin D deficiency failed to heal properly, while those who were vitamin D sufficient generally did well. Concluded the doctors:

“In the perfect world, test levels, fix and then operate,” said Joseph Lane, M.D., professor of Orthopedic Surgery and chief of the Metabolic Bone Disease Service at HSS, who led the study. “If you put people on 2,000-4,000 [milligrams] of vitamin D based on what their deficient value was, you can usually get them corrected in four to six weeks, which is when you are really going to need the vitamin D. If you are really aggressive right before surgery, you can correct deficient levels quickly, but you have to correct it, measure it, and then act on it.”

According to Dr. Lane, bone remodeling or bone tissue formation, a part of the healing process, occurs about two to four weeks after surgery. This is the critical stage when your body needs vitamin D….

“With arthroplasty, there is a certain number of patients that when you put in the prothesis, it breaks the bone adjacent to the protheses, which can really debilitate patients.” This could be prevented or minimized by rectifying vitamin D levels. Dr. Lane also explained that they now perform procedures where they grow a bone into a prosthesis without using cement. “In those people, it would be an advantage to have adequate vitamin D, because it matures the bone as it grows in, it is really healing into the prosthesis,” he said.

“The take home message is that low vitamin D has an implication in terms of muscle and fracture healing, it occurs in about 50 percent of people coming in for orthopedic surgery, and it is eminently correctable,” Dr. Lane said. “We recommend that people undergoing a procedure that involves the bone or the muscle should correct their vitamin D if they want to have an earlier faster, better, result. What we are saying is ‘wake up guys, smell the coffee; half of your patients have a problem, measure it, and if they are low, then fix it.'” [6]

Conclusion

If you have any sort of injury, make sure you are well nourished.

If an injury refuses to heal, consider it a red flag:  you are probably missing one or more crucial micronutrients. Take steps to identify the deficiencies and remedy them as quickly as possible.

References

[1] Cockayne S et al. Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. Arch Intern Med. 2006 Jun 26;166(12):1256-61. http://pmid.us/16801507

[2] Shea MK et al. Genetic and non-genetic correlates of vitamins K and D. Eur J Clin Nutr. 2009 Apr;63(4):458-64. http://pmid.us/18030310.

[3] Bischoff-Ferrari HA et al. Positive association between 25-hydroxy vitamin D levels and bone mineral density: a population-based study of younger and older adults. Am J Med. 2004 May 1;116(9):634-9. http://pmid.us/15093761.

[4] http://legaljustice4john.com/scurvySigns.htm.

[5] http://www.vitamindcouncil.org/newsletter/vitamin-d-deficiency-rickets-another-shattered-family.shtml.

[6] Hospital for Special Surgery (2010, October 7). Vitamin D deficiency rampant in patients undergoing orthopedic surgery, damaging patient recovery. ScienceDaily. October 7, 2010, http://www.sciencedaily.com/releases/2010/10/101006141556.htm.  Journal citation: L. Bogunovic, A. D. Kim, B. S. Beamer, J. Nguyen, J. M. Lane. Hypovitaminosis D in Patients Scheduled to Undergo Orthopaedic Surgery: A Single-Center Analysis. The Journal of Bone and Joint Surgery, 2010; 92 (13): 2300 DOI: 10.2106/JBJS.I.01231.

Leave a comment ?

68 Comments.

  1. Hi, Paul

    FYI: both of me & my husband also have grow taller (0.5″) in the last 2 years,

    (ps. i have given away your book to a friend. i probably need to get few more copies, just in case.)

    regards,

  2. Hi Paul,

    As always your blog is great.

    1. When you talk about carbs by weight for calories, do you mean COOKED or RAW/ EG rice. The same goes for meats.

    2. Can you direct me to detailed information regarding Ketogenic diet information as I am a 65 year old type 2 diabetic of at least 20 years standing and to date I have not submitted to any medication besides some supplements and diet.

    Since starting on Coconut oil I feel that my insulin resistance is way down – cutting out all grains (except for white rice and an occasional meal of buckwheat – for a treat) my 30 years plus of high blood pressure virtually disappeared in under one week.

    Many thanks for sharing your knowledge, and your training in the scientic approach to interpreting information.

  3. Hi Josh,

    I mean cooked. For rice it matters, since rice absorbs a lot of water in cooking, but for most others it doesn’t matter much.

    Unfortunately it’s not really possible to make detailed prescriptions for diabetics. The reason is that every diabetic is a little different. There are different levels of residual beta cell function; and different pathologies elsewhere in the body to go along with it. Plus, our experience with diabetes is small. So you have to experiment.

    I believe two things:

    – Diabetics should generally eat more protein and less carbs than non-diabetics. Our normal ketogenic diet recommendation is 200 calories carbs, 400 calories protein per day. For a diabetic trying to be ketogenic you might try 100 carb calories and 500 protein calories for a start, then experiment.

    – For neurological issues you generally want a moderate ketosis and 4-6 tbsp coconut oil per day produces that. Diabetics should be less ketotic than that. So only a little coconut oil may be needed.

    However, it’s not proven that a ketogenic diet is best. Eating more carbs and fewer fats may improve insulin sensitivity and help the pancreatic beta cells recover. Anything up to 20% of calories from carbs might be a good strategy.

    It’s really up to you to experiment and find what works for you.

    Please do let me know how things go with you!

    Best, Paul

  4. Hi Paul,

    Thank you for the clear, concise and practically immediate reply.

    Will have a blood test next week and fill you in on the insulin resistance, and the overall improvements in the condition attained over the last 3 months. Diet does seem to be the key, and coconut oil has been very beneficial. I generally lower my carb intake by making the fried rice on your site from a half a small cup of basmai rice and dilute it with a half kilo each of mixed vegetables and baby green peas. To this I add two tablespoons of butter and 4 tablespoons of Coconut oil. It is filling, nutritious, and has taken away the CHEMICAL hunger I used to experiance all the time for years, probably a reduction in leptin levels.

    Do you know of any scientific proof that Gymnema Silvestra supplements can regenerate Beta Cells? or is this another myth created by te Supplemenst industry as part of their marketing.

    Will get back to you next week.

    Regards

    Josh

  5. Hi Paul,

    In your book you recommend taking vitamin K2 as a mix of the two forms MK-4 and MK-7, but even among the supplements you recommend, I seem unable to find one that contains both. Do you have any more up-to-date information on this issue?

    Thanks!

    Jo

  6. thanks! will add it to my vitamin D3 supplementation!

    Jo

  7. My skin has been slow to heal for many years (I’m a 50 years old). Can’t seem to figure out what nutrients might be missing. Slight burns that should disappear in a week or two, leave scars that take about 2 years to fade.

    When I transitioned to a PHD, many things improved, but this did not. Thoughts?

  8. Hi, do you have any suggestions for a 80-years old lady with osteoporosis and arthritis who is probably in need of a surgery for a broken hip? There was no trauma it just broke and she only noticed the pain. I told them to get D3 and K2 but any other ideas would be welcome to help her recovery. She doesn’t eat processed foods but bread is a staple in her diet. She eats mostly vegetables and some fruits, a little meat and doesn’t like fish. I don’t expect her to run around since she’s been in serious pain for decades but I hope she can recover from this. How much D3 and K2 should she take, and how much else?
    Thank you very much for your advices.

  9. Josh Poznanski

    Hi Paul 🙂

    Re Jo’s inquiry regarding Vitamin K -I purchase one which is a softget with all 3 k’s as below

    Vitamin K Activity from: 2400 mcg 3,000%
    Vitamin K2 (as menaquinone-7) 100 mcg
    Vitamin K2 (as menaquinone-4) 1300 mcg
    Vitamin K1 (phytonadione) 1000 mcg

    Don’t want to put my foot in it by naming supplier as you get a commission from the ones you recommend, but let me know if I can mention it for all the readers.

    Regards, and thanks for the OUTSTANDING blog.

    Josh (Australia)

  10. While I realize your quoted passage above appears the same way in the original, I wanted to point out that the amount of Vitamin D they are naming – “2,000 to 4,000 [milligrams]” – HAS to be incorrect. The median lethal dose of Vitamin D is 21mg/kg (according to this source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191699/ ), which works out to about 1400mg for a 160 pound person.

    I’m pretty sure the unit in brackets should have been IU. Just wanted to point that out to anyone who might be viewing this article with an eye to repleting a Vitamin D deficiency.

  11. the link at the top of this page does not work suggestions to accelerate healing of her injuries.
    http://perfecthealthdiet.com/?p=692&cpage=1#comment-2784

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