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Panel says vitamin D, calcium won’t prevent fractures: Did we hear that correctly?

Posted on: June 13, 2012   by  Brant Cebulla


By now, I’m sure you’ve all seen headlines on the head scratching report by the US Preventive Services Task Force that has proclaimed that postmenopausal women do not need to supplement with vitamin D and calcium. USA Today was one of many outlets to cover the report in their story, “Panel to postmenopausal women: Don’t take Vitamin D, calcium.”

The Task Force has stated that there is insufficient evidence that vitamin D and calcium reduce risk of fractures and cancer, and therefore, postmenopausal women do not need to take these supplements. In fact, one of the researchers on the panel, Dr. Kirsten Bibbins-Domingo, has publicly gone on record to say, “Vitamin D remains an essential part of a healthy diet.”

Yikes! Yet another expert that thinks vitamin D comes from diet. We’ll try not to let this statement blemish the merits of the rest of the report.

Without getting into an exhaustive debate at where the research stands to date, I think the panel is missing the most important question at hand: mortality. Regardless of whether research has consistently shown that vitamin D and calcium reduce risk of fractures and cancer, how does it fare with broad-spectrum mortality?

Recently, a team of researchers from all over the world led by Professor Lars Rejnmark performed a meta-analysis on over 70,000 participants that partook in vitamin D and calcium randomized controlled trials. They wanted to know this exact question: what is vitamin D and calcium supplementation’s effect on mortality?

Rejnmark L et al. Vitamin D with Calcium Reduces Mortality: Patient Level Pooled Analysis of 70,528 Patients from Eight Major Vitamin D Trials. J Clin Endocrinol Metab. 2012 May 17.

They yielded data from 70,528 participants from 24 randomized controlled trials who were taking vitamin D and calcium, vitamin D alone, or placebo. Most of the studies were originally drawn up to assess effects on frailty and bone health in community-dwelling elderly.

In the vitamin D and calcium groups, many of the groups took between 400-800 IU of vitamin D and around 1000-1200 mg of calcium. In all the trials that they analyzed, they followed the participants for 36 months.

What did they find? That calcium and vitamin D supplementation reduced mortality by 7% in the three year period compared to those that took placebo! The authors concluded,

“Calcium with vitamin D supplementation to elderly participants is overall not harmful to survival, and may have beneficial effects on general health.”

Needless to say, we feel once again a large governmental health agency got it wrong. While the US Preventive Services Task Force wants to push that postmenopausal women shouldn’t take calcium and vitamin D simply because we need more research, a meta-analysis of randomized controlled trials (the best standard in research) has found that it reduces mortality. Is that not sufficient evidence that vitamin D and calcium supplementation may be a good idea? At this point in vitamin D research, it seems many expert panels are more interested in boasting their scientific prowess than offering sound public advice.

Let the record state that with research to date, calcium and vitamin D supplementation reduces mortality in postmenopausal women and if care is taken in supplementing, it is likely a good idea.

Note: the Vitamin D Council does not have a calcium supplementation recommendation. Vitamin D intake at our recommendation (5,000 IU/day except when sunbathing) may reduce calcium requirements.

4 Responses to Panel says vitamin D, calcium won’t prevent fractures: Did we hear that correctly?

  1. [email protected]

    Three times, since I moved to Arizona in 1980, doctors have told me I was “critically low” on Vitamin D. Twice they gave me prescriptions for it and declared me “cured” after 30 days. I also had to have a hysterectomy for prolapsed uterus in 1990. At that time my doctor told me to start taking 1200 mg of calcium for the rest of my life. He said other doctors may tell me I don’t need it but take it anyway. When I went to get calcium I found some with a small amount of vitamin D added to it and remembered the two times I was put on it. I figured it wouldn’t hurt and it might help so that is the one I bought.
    In 1994 I suffered a subarachnoid hemorrhage (aneurism). As you probably know, 94% of the people that have them die before they can get to a hospital. They expected me to die that night and I often wondered what kept me alive and helped me to overcome it. I live independently and drive myself wherever I go. I’m left side deficit but believe if I’d been taking the proper amount of vitamin D in 1994 I would not have had the aneurism and the vitamin D is more than likely the reason I survived. That’s the only difference I could find between me and the thousands that die from aneurisms every year.
    In 2003 my doctor again diagnosed me with very low levels and told me to buy a bottle and start taking it. I went home that time and researched it on the internet and found your site and have been reading your newsletters ever since. Thank you for all the work you do teaching us the importance of vitamin D. I will take it the rest of my life.

  2. [email protected]

    Yes, need more than 400 IU of vitamin D to strengthen bones
    The task force tentative results were widely miss-reported on the internet in June 2012.
    VitaminDWiki knows of only a single study which found that bones would be stronger with 400 IU of vitamin D, and that study of twins used 800 mg of Calcium AND 400 mg of Magnesium

    It ”might’ be possible to have strong bones with 400 IU of vitamin D with ALL of the bone cofactors (Calcium, Magnesium, Vitamin K2, Boron, Silicon, and Strontium)
    Many studies have shown that at least 800, and probably 1000 IU of vitamin D is needed.
    The cofactors are strongly recommended – to both build the bones and keep the Calcium from depositing in the arteries, kidney stones, etc.
    The web page which includes the hyperlinks is:

  3. Ron Carmichael

    Generally, it is possible to get by with an oral dose of 400iu, I would submit, only IF the subject is also getting good raw sunlight exposure. I cannot see how, based on what I have learned over years of study, including here and sites like vitamindwiki, one can achieve a blood level of 50 ng/ml by taking only 400iu alone. Empiric results of oral supplementation would have me tend towards 5,000 per 100 pounds, in order to get “close” to 50 ng/ml.

  4. Jim Larsen

    “The USPSTF recommends against daily supplementation with ≤400 IU of vitamin D3 and 1,000 mg of calcium carbonate for the primary prevention of fractures in noninstitutionalized postmenopausal women.
    This is a grade D recommendation.
    The USPSTF has previously concluded in a separate recommendation that vitamin D supplementation is effective in preventing falls in community-dwelling adults aged 65 years or older who are at increased risk for falls (B recommendation). The full recommendation statement is available at http://www.uspreventiveservicestaskforce.org

    This is a highly limited and concrete statement. Try reversing it. <400 iu D is good at reversing fractures?




    Most importantly, if the outcome is optimal bone health, then D and calcium (whether calcium carbonate or more bioavailable forms) are only 2 variables. This "blind dosing" model is fundamentally the wrong paradigm.

    1. "Blind dosing" gives folks x amount of nutrients whether they need it or not. Supplemental calcium will only help calcium deficient folks. The better model is "test then treat."

    2. Bones needs at least 20 nutrients to be healthy and strong. The DRI only cover a few of the thousands of nutrients we've identified. Look at green tea or plums re bones, for example. Remember, bones make RBCs.

    3. Bones are living tissue that (just like muscles) adapt and grow based on exercise, in this case, impact exercise. http://well.blogs.nytimes.com/2009/11/11/phys-ed-the-best-exercises-for-healthy-bones/

    I'd rather the USPSTF focused on saying here's what healthy bones need to be optimally strong rather than arguing over ineffective doses.

    In fact, I'd say VDC ought to consider the same approach.

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