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No definitive peer-reviewed study has yet proven causation, though patient reports and preliminary analyses deserve attention

2000 Sep-Dec;22(5-6):384-92

The median total dose (including all administrations from pre-surgical PK and loading doses to post-hospital follow up) was 629 IU/kg (range: 464 1,457 IU/kg) for major orthopedic surgeries, 489 IU/kg (range: 296 738 IU/kg) for major non-orthopedic surgeries

When they are damagedwhether by high blood sugar (diabetes), physical trauma, autoimmune attacks, or compressionthey don't just "snap back" like a rubber band