pile of pills

For decades physicians have been advising their older female patients to take extra calcium and vitamin D for bone strength. It seemed logical. Both calcium and vitamin D play a role in building bone. In theory, supplements should have helped. But was there any evidence to support these recommendations? A new study in JAMA (Dec. 26, 2017) challenges conventional wisdom. That’s because the investigators looked for data to support the standard wisdom. What they found has shocked health professionals and tens of millions of women.

Confusion About Calcium and Vitamin D for Bone Strength:

Brenda asks a good question:

“I had a hysterectomy at age 40. I was not allowed to take estrogen replacement therapy and now at 63 I have osteoporosis. I started taking calcium and Vitamin D3.  My local newspaper this morning has an article that says calcium with D3 does not help! Is this true?”

Even women who have not had a hysterectomy are wondering the same thing. The headlines are confusing. Here are just a few of this week’s health headlines:

“Vitamin D, Calcium Supplements May Not Lower Bone Fracture Risk”  NBC News

“Should You Really Be Taking Calcium and Vitamin D Supplements?”  CBS News

“Study Reveals Your Vitamin Supplements Doing No Good to Bones” Business Recorder

“Experts Rebuke Report Casting Doubt on Link Between Vitamin D, Calcium and Bone Health” Statesville Record & Landmark

What the Data Show:

The new study published in JAMA was a meta-analysis of 33 randomized controlled trials (RCTs) involving 51,145 subjects. The authors searched for RCTs in which individuals received calcium, vitamin D or both calcium and vitamin D supplements compared to placebo or no treatment. The outcomes they were evaluating were 1) hip fractures or 2) spinal fractures, non-spinal fractures and total fractures.

Results:

In two words, there was no difference between individuals who took calcium and/or vitamin D vs. placebo and the incidence of fractures. In their own words the researchers wrote:

“There was no significant association of calcium or vitamin D with risk of hip fracture compared with placebo or no treatment. There was no significant association of combined calcium and vitamin D with hip fracture compared with placebo or no treatment. No significant associations were found between calcium, vitamin D, or combined calcium and vitamin D supplements and the incidence of non vertebral, vertebral, or total fractures.”

Discussion:

“Results of this meta-analysis showed that calcium, calcium plus vitamin D, and vitamin D supplementation alone were not significantly associated with a lower incidence of hip, nonvertebral, vertebral, or total fractures in community-dwelling older adults.”

Conclusions:

“These findings do not support the routine use of these supplements in community-dwelling older people.”

In our words: taking calcium and vitamin D for bone strength was a bust because it did not prevent fractures. That is, after all, the point of taking supplements to prevent or treat osteoporosis.

Resistance: Calcium and Vitamin D for Bone Strength

If you go back up to the headline links you will see an article from the Statesville Record & Landmark titled “Experts rebuke report casting doubt on link between vitamin D, calcium and bone health”

In this report, a Creighton University scientist, Dr. Robert Recker, was quoted as saying:

“The paper in JAMA is ‘complete bull … if you excuse my expression. That’s going to cause a lot of harm.'”

Dr. Becker leads the Creighton Osteoporosis Research Center. He correctly points out that vitamin D is essential for the absorption of calcium and plays an integral role in bone formation. That said, the meta-analysis reviewed the available data on the key clinical outcomes people care about: broken bones. The results were not pretty.

We Told You So:

It is unbecoming of The People’s Pharmacy to challenge conventional wisdom. Nevertheless, if the data are not solid, it is our responsibility to point that out. Health professionals like to embrace the idea of “evidence-based medicine.” When the evidence does not pan out, however, many tend to shoot the messenger.

This is not the first time we have pointed out that there is a problem with the calcium theory of osteoporosis. We have taken a substantial amount of flak for doing so. Here is an article from about two years ago:

What Is the Story on Calcium Supplements?

If you review this article you will see two key sections:

Theory Falls Short:

Downsides of Calcium Supplements:

An even more in-depth analysis from Oct. 1, 2015 was titled:

Calcium Supplements Do NOT Prevent Broken Bones

And if you go back to 2010, we wrote about:

Calcium Supplements & Heart Attacks?

What Should You Do About Calcium and Vitamin D for bone Strength?

We are great believers in vitamin D, but we cannot promise that by itself this nutrient will prevent bone fractures. You can learn much more about vitamin D at this link:

Vitamin D Deficiency

Is It Possible to Build Bone Strength?:

To discover other ways to build strong bones, you may want to listen to a FREE one-hour interview we conducted a few years back with Walter Willett, MD, DrPH, Chairman of the Department of Nutrition and Frederick John Stare Professor of Epidemiology and Nutrition at Harvard University’s School of Public Health. In addition to Dr. Willett, we interviewed Michael Castleman, a medical journalist and author of Building Bone Vitality: A Revolutionary Diet Plan to Prevent Bone Loss and Reverse Osteoporosis.

Here is a link to the radio show. If you look below Dr. Willett’s bio, there is a link to Download the mp3. When you do that you will see Show 752: Bone Vitality. Above the orange box that says ADD TO CART, is an option to Choose CD or MP3 version. If you click on the down arrow you can toggle the MP3 option which is FREE! We think you will find this interview quite fascinating and way ahead of its time.

After listening to Dr. Walter Willett and Michael Castleman, please share your thoughts in the comment section below.

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  1. Anne
    Bakersfield, Ca.
    Reply

    I am 73 and I don’t take any pills for anything! I have always believed that once you start taking pills you always seen to add more pills thinking they will make you healthier. My doctor is surprised at how healthy I am, but she is from India and has the same belief as I do that your body can heal itself if you leave it alone, most of the time, at least.

  2. Nancy A B
    FL
    Reply

    Hi.
    I had a hysterectomy in 1987 age 31. I had a bone test in 2014, and I have Osteoporosis. My doctor put me on Alendromate 70 mg once a week. I walk 3 times a week, 2.50 miles, and am starting weigh training. I’m on Calcium, vitamin D-3, and magnesium. Should I stay on them or go off them. I’m 71. I try to eat real food with vitamins in it. I also drink no cow’s milk, only almond milk. Should I go off the calcium?

    • Terry Graedon
      Reply

      The almond milk probably does not supply as much calcium as cow’s milk would. Consequently, you might want to continue with your current regimen.

  3. Sara
    Seattle
    Reply

    Two things. One, it sure would be a nice thing if we could “like” a comment others have made. Some way to show that we have the same thoughts.

    And request 2, is there any way the “shows” can be somehow summarized in text? I just cannot spend an hour listening. I don’t retain things well from spoken words, and it would take me far, far less time to read a summary or even a transcription. I’d love to know that the calcium show had to say.

    Thanks for my favorite health site.

  4. Sandy
    Washington State
    Reply

    My husband, who majored in chemistry at the University of Kansas, told me similar information about calcium in 1980.

  5. John
    Silver Creek, NY
    Reply

    Vitamin D prevents falls in elderly. Do you why yet or how this works?

  6. ebm
    florida
    Reply

    Dr. Diamond, Reno, Nevada has emphasized for ca 20+ years to take Calcium ONLY with at least half the amount of Magnesium, 500 mg calcium to 250mg magnesium with Boron and K2.

    This is the only way to absorb it. In Dr. Diamond’s words: calcium
    strengthens bones and magn. knows where to put it! Most docs do not study this and recommend the hard as a rock calcium with D 400mg. Nurses used to call them bed pan bullets, which they found intact/undissolved. I only take vit/mins in capsule form to make sure they get broken down.

    So, it’s not necessarily the calcium, it is the uninformed advice
    docs give out for lack of knowledge and lack of interest to study
    nutrition.

  7. B. Jean
    San Antonio
    Reply

    I am interested in knowing what form of calcium was used. Also if participants did weight bearing exercises faithfully. Also, how much Vit. D was taken with the calcium. Also , how much MK-7 was taken with this regimen. In 2010 I was diagnosed with breast cancer, and took an aromatase inhibitor, which gets rid of all your estrogen, which naturally causes osteoporosis. My doc told me calcium will not go into your bones without estrogen. Wanted me to take a bisphosphenate(Fosimax) or others. I could not and would not take it because of my severe TMJ. I successfully raised my bone density into the normal range using a product called Bone Up, 6000 units Vit. D3, extra boron, strontium citrate, silicon drops. A very important nutrient called MK-7 is super important for getting calcium into your bones and not into your blood to damage your heart. And super important, I did much exercise on the treadmill with a high incline. My doc was impressed. My HDL is in the high 70’s and my triglycerides are about 40. My health is good. I am 74. B. Jean

  8. Mary Ellen
    Garner NC
    Reply

    I stopped taking Calcium when I read that it did nothing to prevent Ostro. That was slightly over a year ago. I was due for a bone scan right after I stopped the supplements. My Dr. agreed to postpone the test for a year to see if there was any bone loss. I had the scan about a month ago and there was absolutely no change in my scan from the year before. I still have Osteopenia but it is no worse than when I was taking horse pills of Calcium!

  9. redonna3843@gmail.com
    California
    Reply

    I am a 74 year old female. About 20 years ago, after complaining of pain in both my left knee as well as my thoracic spine, and then proceeding with MRIs and X=Rays, I was diagnosed with an increase in calcium deposits in both of these areas. I proceeded with some physical therapy for my back problem. In process, my therapist asked if I was taking calcium supplements and I responded that I was. This was our further conversation:
    Therapist: Why?
    My answer: Because everyone says we need more calcium.
    Therapist: Do you have a family history of osteoporosis?
    Me: No
    Therapist: Then stop taking calcium. It may be contributing to your build-up of more bone that is now causing you pain.
    (As an aside, the therapist made a comment about the Dairy Council lobby and its influence on a national increase in unnecessary supplementary calcium intake, which I found very interesting but I must admit I did no follow-up research on this information).
    So, I did stop taking calcium supplements.
    Then very recently, I had a bone density test, my first since 10 years ago. The result was that I have the same numbers from 10 years ago, showing on the low scale for osteopenia. Then in the report I was advised to “continue” to take the calcium I had been taking all along for the last ten years. (I had taken no calcium supplements in the past 15 years.) So calcium did nothing to either increase or decrease my bone density. Whatever I’m doing to keep these low numbers, it’s not taking calcium supplements.

  10. Fred O
    Madison, WI
    Reply

    A number of years ago, you pooh-poohed me when I called in and said that vitamin K would turn out to be as important as vitamin D.

    I told you so.

    • Js
      WI
      Reply

      I recently had a bone density test, am 701/2. It was suggested I take Boniva at 65, didn’t, at time seemed to be life sentence.
      A month ago I did a search of related clinical trial, thought I might find drug combos now. Instead found trials with bluberries, plums, and stomping! It seems that maybe research is focusing on real food and life style now. What do you think of tentative conclusion I have reached?
      I am waiting for appt with Osteoporosis expert. Have been drinking blueberry kefer with healthy additives. Thoughts? Mayo Clinic who I also research seemed to indicate it is not fosamax, but more lifestyle based, of what I preferred to think.

      Interested in more info on BoneUp, also!

  11. Phyllis HAKE
    WA
    Reply

    Where does vitamin k2 come in here?

    • Barbara
      NY
      Reply

      Vitamin K keeps calcium where it belongs – in your bones instead of circulating in your blood and depositing in your heart and/or arteries.

  12. Patty
    Portland, Oregon
    Reply

    I took calcium until I read your article some years back that it didn’t help prevent broken bones. I haven’t had a calcium pill since. Since I live where there is no sun to be seen day after day this time of year, I conscientiously take my 1000 units of vitamin D daily and get real sunshine in suitable doses when it is available.

    Thank you for all the helpful information over the years.

  13. Sally
    North Carolina
    Reply

    I personally don’t think doctor’s know a damn thing about nutrition (or exercise). I’ve had some doctors tell me to take all kinds of supplements and others say “just eat a mix of healthy foods”. The supplement industry is a multi-million/billion dollar industry with no FDA overseeing (and they allow drugs on the market that prove dangerous, if not deadly). Then the drugs that cost millions to get on the market are recalled. It’s more than a “rip-off”. It’s “live free and die”.

  14. Mary Jane
    NYC
    Reply

    At one point, I was taking Strontium regularly (on the advice of a doctor), to build bones. After a while, I developed a bony lump on the top of a shoulder joint. I stopped taking the Strontium, and it went away.

  15. Paula
    Florida and Maine
    Reply

    I am surprised that the medical establishment keeps missing out on the key to so much of this: MAGNESIUM. People are deficient due to the depletion of the soil and it is critical to depositing Calcium in the bones and out of soft tissue. Read Dr. Carolyn Dean’s The Magnesium Miracle or The Calcium Lie by Dr. Robert Thompson. Vitamin D can only be metabolized when there is enough Magnesium to do so.

  16. Lyndon
    Chapel Hill, NC
    Reply

    I think that if you want to have strong bones you have to put a burden on them so they will stay strong. Or, begin putting a burden on them so they will get stronger.Our bodies purge themselves of what they don’t need. If you don’t need strength your muscle mass atrophies… but doesn’t abandon ship.
    Bones, however, do “abandon ship.” They deteriorate and we piss away calcium getting thinner, weaker and brittle over time. Our bodies conserve energy by putting aside what they don’t need or use. It really doesn’;t matter how much calcium we take in if our bodies determine we don’t need strong bones because we never put any stress on them.
    Then… they break.

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