Calcium + Vitamin D: “Little To No Use” vs Fractures?

We’ve written before about supplementation of calcium and vitamin D, for example:

Vit D + Calcium: Too Much Of A Good Thing? ← this also talks about safe and effective doses, and what goes wrong if you take too much

And even if you get the dosage right, there are still more ways to mess it up! See: How Taking Vitamin D Supplements Can Sabotage Your Vitamin D Levels

Which latter is mostly because of people making mistakes in the category of: Vitamin D2 vs Vitamin D3: What You Would Benefit From Knowing

But we still should supplement to keep our bones healthy, right?

Per the title of this one (the main title, at the top, with the words “little to not use” in it), no, it’s probably not that helpful, really. To be clear, getting plenty of these things one way or another is important; diet is the best means of doing it (more on this later in the “learn more” section), and if anything, it’s possible those who supplement in order to “be on the safe side” and “cover all bases” may:

1. fall into the sabotage trap we talked about up top
2. fall into complacency by not including enough dietary sources “because the supplements will cover it”

Recently, researchers (Dr. Katherine Desforges et al.) did a very large (n=153,902 over the course of 69 randomized controlled trials) systematic review and meta-analysis and found that calcium supplements, vitamin D supplements, or the combination of both provided little to no clinically meaningful reduction in fractures for most adults studied, and even the absolute reduction in fracture risk was too small to be considered clinically meaningful.

That’s absolute risk reduction for fractures in general; calcium, vitamin D, and/or combined supplementation also showed little to no benefit for:

• Total number of falls
• Hip fractures
• Vertebral fractures
• Non-vertebral fractures
• Risk of falling*

*This may seem like an odd one to include, but it is relevant too, for example: The Common Meds That Make You More Likely To Die From A fall

You may be wondering how applicable these numbers are to you, and who the sample population was. Most participants were:

• Not considered at high risk for fractures or falls (73%)
• Living independently in the community (87%)

The findings therefore apply mainly to typical independently-living adults, especially older adults without severe osteoporosis or other major bone disorders. Evidence was more limited for:

• Individuals with specific metabolic bone diseases
• People at very high fracture risk
• Residents of nursing homes or long-term care facilities
• People already receiving osteoporosis medications

For the longest time, calcium and vitamin D supplementation has been routinely recommended for bone health. This review shakes that all up, and strongly suggests that for the average adult, these supplements are unlikely to meaningfully prevent fractures or falls.

You can read the paper itself, here: Calcium, vitamin D, or combined supplementation to prevent fractures and falls: systematic review and meta-analysis

As for what to do instead, you might consider checking out:

• The Bare-Bones Truth About Osteoporosis
• The HRT That Prevents Osteoporosis Without Side Effects
• A New, Very Accessible Weapon Against Osteoporosis & Osteopenia
• Osteoporosis & Exercises: Which To Do (And Which To Avoid)
• Which Osteoporosis Medication, If Any, Is Right For You?

Want to learn more?

There is also a common issue that a lot of people get enough calcium and vitamin D, but then a lot of that calcium doesn’t make it past the arteries.

Thus, the calcium paradox: we want to get (usually: more) calcium, but we want it building our bones, not lining our arteries. How, then, to resolve this problem, and simultaneously fight the dual threats of calcium deficiency (osteoporosis) and calcium excess (atherosclerosis)?

The answer lies in vitamin K2, which assists the calcium in getting to where you need it, rather than having it accumulating where you don’t.

Learn more: Vitamin K2 And The Calcium Paradox

And as for why you might want to favor getting it from food if you can, then while the title says “vitamins”, this book discusses an assortment of vitamins, minerals, and other nutrients; the “other nutrients” category including amino acids (branched chain and essential), prebiotics and probiotics, and triglycerides of various kinds:

Eat Your Vitamins – by Mascha Davis, RDN ← see our review, here

Take care!