Half of all postmenopausal women will have an osteoporosis-related fracture in their lifetime. Hip fractures are common in older people and have serious consequences. More than 300,000 people are hospitalized each year in the United States for hip fractures. In the absence of treatment, one-year mortality is 70%; with surgery, one-year mortality is 21%. Patients may never regain their pre-fracture activity level and may not even regain the ability to walk. The US Preventive Services Task Force (USPSTF) recommends screening women ages 50-64 and younger women at high risk, but their strategy has been tested and proven little better than chance.
Vitamin D supplements are among the most popular supplements on the market.
A typical pro-vitamin D website, LifeExtension.com, tells us:
Most people can benefit from taking vitamin D. Since you are unlikely to get enough vitamin D from sunlight and food, vitamin D supplements will be a good idea for many people… About 42 % of Americans are vitamin D deficient.
They acknowledge that experts disagree on what constitutes a normal vitamin D level. Commonly accepted categories are:
- Deficiency: < 20 ng/mL
- Deficiency: 20-30 ng/mL
- Sufficiency: >30 ng/mL
- But they warn that “normal” may not be optimal. Some authorities define optimal levels as 40-60 ng/mL. They go one step further and recommend aiming for 50-80 ng/mL. They suggest having your vitamin D levels tested several times along with your routine blood tests for total blood count and lipid profile.
The USPSTF used to recommend vitamin D and calcium supplements to prevent falls in community-dwelling adults age 65 or older who are at increased risk for falls.
After reading information like this, I was worried because I rarely go out in the sun and I don’t drink milk. For many years I took a calcium and vitamin D pill prescribed by my doctor. At one point I asked my doctor if I could stop taking it and she told me it was probably best to keep going.
I thought it protected me from hip fractures, but recent research says otherwise. Much research suggests associations between low vitamin D levels and mortality, ADHD, depression, cognitive impairment, schizophrenia, diabetes, and certain infectious diseases; But the evidence is mixed, often flawed and of low quality. Increasing low vitamin D levels with supplements may not be effective in reversing these conditions. The proof is summarized in Wikipedia article on vitamin D.
The VITAL trial This was a large, placebo-controlled study designed to assess the cardiovascular and carcinogenic benefits of omega-3 fatty acids and vitamin D for healthy adults. It has been found that vitamin D supplements do not protect against the development of cancer or cardiovascular disease, falls, cognitive decline, migraines, strokes, macular degeneration or joint pain, and do not reduce neither is body weight or BMI. In an additional study published in the New England Journal of Medicine The authors found no difference in the incidence of fractures between those taking vitamin D and those who did. An accompanying editorial By two doctors, Steven Cummings and Clifford Rosen, it was titled “A Decisive Verdict on Vitamin D Supplementation”.
They found
no significant differences between groups in the incidence of fractures in participants at high risk of fracture (i.e. those taking osteoporosis medications [1240 participants] or with a history of fragility fractures [2578 participants].
And when vitamin D blood levels were stratified, even those with levels below 20 ng/mL did not benefit from supplements. There was also no benefit for levels below 12 ng/mL, but the numbers in this group were small, so doubt remains.
Complications: There were no significant differences in the incidence of hypercalcaemia and kidney stones between the vitamin D and placebo groups.
Based on the VITAL study and other recent research, the editorialists have concluded that
Providers should stop screening for 25-hydroxyvitamin D levels or recommend vitamin D supplements, and people should stop taking vitamin D supplements to prevent major illnesses or prolong life.
They said the terms “deficiency” and “insufficiency” should be reconsidered. And of course, the “sufficient” level of vitamin D remains to be determined.
They pointed out that some uncertainties remained. Blood tests may be helpful for some patients who may have a severe deficiency, such as people living in residential settings without sun exposure, patients with malabsorption, or those receiving osteoporosis treatments that can cause hypocalcemia and may benefit vitamin D.
I have decided to stop taking the calcium/vitamin D pills, and this new information confirms that it was a good decision.
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