The People's Perspective on Medicine

Should You Take Vitamin D Supplements for Stronger Bones?

A meta-analysis of randomized controlled trials concluded that vitamin D supplements don't lead to stronger bones. This confirms earlier recommendations.

Vitamin D is essential for strong bones. When young children don’t get enough vitamin D, they can develop a bone deformity called rickets. This nutrient acts as a hormone in the body. It is vital for hundreds of activities, including calcium regulation. But do vitamin D supplements make for stronger bones?

Studies Don’t Support Stronger Bones from Vitamin D Supplements:

Millions of people take both vitamin D and calcium supplements in an effort to maintain strong bones as they age. But a new meta-analysis of 81 randomized controlled trials involving over 50,000 participants concludes “that vitamin D supplementation does not prevent fractures or falls, or have clinically meaningful effects on bone mineral density” (The Lancet Diabetes & Endocrinology, online Oct. 4, 2018). This was true even in studies that used doses of 800 IU vitamin D daily.

Can supplements adequately replace the vitamin D that human skin makes when it is exposed to sunshine? We don’t have the studies to answer that question.

Task Force Didn’t Recommend Vitamin D for Stronger Bones:

More than six years ago, the US Preventive Services Task Force issued confusing guidelines on the topic of vitamin D supplements for stronger bones. For years, women have been told to take high doses of calcium along with some vitamin D to strengthen bones. But in 2012, the USPSTF advised postmenopausal women that taking calcium and vitamin D won’t prevent broken bones after all.

Studies showed that 400 IU of vitamin D and 1000 mg of calcium daily do not prevent osteoporotic fractures. Such supplements might increase the risk of kidney stones, however. Some research suggests that 400 IU of vitamin D as a daily supplement is not enough to achieve optimal blood levels of circulating 25-hydroxyvitamin D (Nutrients, Dec. 2015). Individuals vary greatly in their response to vitamin D supplements. Consequently, the dose should be personalized to achieve 25-hydroxyvitamin D levels over 30 ng/ml.

Karen commented:

“400 IU of D3, while it may be the RDA, won’t move the needle. The relevant measure that needs to be reported in this study is, what was the blood level of D3 of the participants who suffered broken bones? My doctor believes it takes +-1000 IU of D3 to move blood level by 10 ng, more if you’re fat.”

Preventing Bone Loss:

What can you do to keep your bones strong? If you get calcium from your diet and vitamin D from moderate sun exposure, you should have the nutritional foundation for bone health. Bones also respond to regular exercise such as running, walking, dancing or playing tennis.

You can learn more about preventing bone loss in our Guide to Osteoporosis, while our Guide to Vitamin D Deficiency tells more about sources and doses of this very important vitamin.

The USPSTF did not compare supplements and osteoporosis drugs. When possible, preventing bone loss with weight-bearing exercise, a diet rich in calcium from a variety of sources including green leafy vegetables (which also supply vitamin K, magnesium and other nutrients vital for stronger bones) and vitamin D from the sun or from fatty fish may be the best approach. Our interview (Show 752) with Michael Castleman, co-author of Building Bone Vitality: A Revolutionary Diet Plan to Prevent Bone Loss and Reverse Osteoporosis, and Walter Willett, MD, DrPH, Chairman of Nutrition at Harvard School of Public Health, may also be of interest.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
Vitamin D Deficiency

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I hear so much conflicting information.

This is about leg cramps! I’ve used soap under my sheets for years. But two weeks ago, I started getting massive cramps at night, as soon as I’m horizontal. I immediately upped the bananas and put heat on my legs with a heating pad. I also started taking 2 TB of cider vinegar with water before bed. They’re still a problem. It occurred to me that switching to water aerobics from yoga about three weeks ago may be a problem as maybe I’m on my toes in the water. I have no idea. I didn’t change my diet, so I’m really puzzled.

One half teaspoon of mustard will stop cramps within a minute.

Stay Off Your Toes

Maybe magnesium would help the leg cramps?

When testing first became popular I was found to be @ 20. I took 5000 units 2 X a day for some time . When I tested in the 90’s my doctor suggested I back off. I have been taking 5000 units once a day for a couple of years. My most recent test was @ 83. However, I have lost 3 inches in height from my tallest, and my shelves are much to high! I am 85,
can’t win.

But it might help with one’s immune system. Fewer colds/sickness in itself can prevent falls.

I was under the impression that vitamin K2 was an essential precursor to supplementing with vitamin D. I’m surprised that this element didn’t appear to be considered.

For years I have been taking 4000 IU of D3 nearly daily to maintain an optimum level of 25-hydroxyvitamin D (it hovers around 45-50). I had been diagnosed with osteopenia, the precursor to osteoporosis. My last DEXA scan indicated I no longer had osteopenia and that my bones had strengthened. I am post-menopausal and over 60. I will continue with the regimen!

I have been seeing a doctor specializing in kidney issues. He did a thorough blood test and found that I only had about 1/3 the D3 circulating in my blood that is considered desirable. That is in spite of the fact that I have a gardening business and am in the sun many hours a week with no sunscreen. He said that as we age – I am 70 – we may not convert a number of elements into the desired form the human body needs. He put me on 2,000 units a day. I am trying a type where you put a drop on your tongue and a squirt under the tongue. I look forward to my next blood test to see if this works. He told me I would feel stronger as my D3 blood level increases. I do feel better and can work a longer day. We’ll see what the test reveals.

Magnesium is important. Diabetes, thiazide diuretics, and caffeinated beverages increase urinary excretion of magnesium. Reverse osmosis water is less expensive than bottled water, but has no magnesium.

Whenever I see a retraction or re-thought health recommendation (i.e.: eat margarine, not butter), I am impressed by how little we know about the human body. Should any of us even bother with so called recommendations, only to find out years or decades later our money was wasted or worse, our health damaged?

Bonnie … I see that you asked a question about “health recommendations” to this site — and I often wonder “where do they respond to you/us???” Have a good day!

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