N Engl J Med. 2012 Jul 5;367(1):40-9.
Bischoff-Ferrari HA, Willett WC, Orav EJ, Lips P, Meunier PJ, Lyons RA, Flicker L, Wark J, Jackson RD, Cauley JA, Meyer HE, Pfeifer M, Sanders KM, Stähelin HB, Theiler R, Dawson-Hughes B.
Center on Aging and Mobility, University of Zurich and Waid City Hospital, Zurich, Switzerland.
BACKGROUND: The results of meta-analyses examining the relationship between vitamin D supplementation and fracture reduction have been inconsistent.
METHODS: We pooled participant-level data from 11 double-blind, randomized, controlled trials of oral vitamin D supplementation (daily, weekly, or every 4 months), with or without calcium, as compared with placebo or calcium alone in persons 65 years of age or older. Primary end points were the incidence of hip and any nonvertebral fractures according to Cox regression analyses, with adjustment for age group, sex, type of dwelling, and study. Our primary aim was to compare data from quartiles of actual intake of vitamin D (including each individual participant's adherence to the treatment and supplement use outside the study protocol) in the treatment groups of all trials with data from the control groups.
RESULTS: We included 31,022 persons (mean age, 76 years; 91% women) with 1111 incident hip fractures and 3770 nonvertebral fractures. Participants who were randomly assigned to receive vitamin D, as compared with those assigned to control groups, had a nonsignificant 10% reduction in the risk of hip fracture (hazard ratio, 0.90; 95% confidence interval [CI], 0.80 to 1.01) and a 7% reduction in the risk of nonvertebral fracture (hazard ratio, 0.93; 95% CI, 0.87 to 0.99). By quartiles of actual intake, reduction in the risk of fracture was shown only at the
highest intake level (median, 800 IU daily; range, 792 to 2000), with a 30% reduction in the risk of hip fracture (hazard ratio, 0.70; 95% CI, 0.58 to 0.86) and a 14% reduction in the risk of any nonvertebral fracture (hazard ratio, 0.86; 95% CI, 0.76 to 0.96). Benefits at the highest level of vitamin D intake were fairly consistent across subgroups defined by age group, type of dwelling, baseline 25-hydroxyvitamin D level, and additional calcium intake.
High-dose vitamin D supplementation (?800 IU daily) was somewhat favorable in the prevention of hip fracture and any nonvertebral fracture in persons 65 years of age or older. (Funded by the Swiss National Foundations and others.).
Comment in: Vitamin D- -baseline status and effective dose. [N Engl J Med. 2012]
PDF is attached at the bottom of this page
Cofactors of Calcium, Magnesium, and Vitamin K are also VERY IMPORTANT for strong bones
- Overview Fractures and vitamin D
- Kaiser working to decrease hip and other fractures – Nov 2011 does not mention vitamin D
- Women with hip fractures very low on vitamins D3 and K – Mar 2011
- 75 percent of hip fractures associated with vitamin D deficiency - Jan 2011
- 30 percent less chance of dying after hip fracture if take vitamin D and other drugs – 2011
- Hip fracture patients had only 16 ng of vitamin D – May 2011
- Hip fractures worse if very low on vitamin D – Mar 2011
- Calcium and vitamin D after hip fracture reduced death rate by 25% – Feb 2011
- Hip fractures in India - editorial with recommendation - Sept 2010
Perhaps start with 600,000 IU of vitamin D (D2? D3?)and continue with 60,00- IU monthly
- Vitamin D 2nd most recommended way to prevent next hip fracture – Nov 2010
LTC was first
- Hip surgery followed by 100,000 IU then 1,000 IU of vitamin D daily – June 2010
- Better total hip replacement if have high vitamin D – April 2010
- CLICK HERE to use Google Site search of VitaminDWiki for "hip fracture" 382 items June 2012
- 4,000 IU vitamin D helped after hip fracture file
- Is it ethical to not give vitamin D in osteoporosis trials– NEJM Sept 2010
- National Osteoporosis Foundation on Vitamin D - more than 30 ng - 2010 - vs the 20 ng of the Institute of Medicine
- Prefer more than 30 ng of Vitamin D and 700 mg Calcium for Osteoporosis – Mar 2011
- Overview Osteoporosis and vitamin D has the following summary as of July 2012
FACT: Bones need Calcium (this has been known for a very long time)
FACT: Vitamin D improves Calcium bioavailability (3X ?)
FACT: Should not take > 750 mg of Calcium if taking lots of vitamin D (Caclium becomes too bio-available)
FACT: Adding vitamin D via Sun, UV, or supplements increased vitamin D in the blood
FACT: Vitamin D supplements are very low cost
FACT: Many trials, studies. reviews, and meta-analysis have found that adding vitamin D reduces osteoporosis
FACT: Toxic level of vitamin D is about 4X higher than the amount needed to reduce osteoporosis
FACT: Cofactors help build bones.
It appears that to TREAT Osteoporosis:
- Calcium OR vitamin D is OK,
- Calcium + vitamin D is GOOD,
- Calcium + vitamin D + other cofactors is GREAT
CONCLUSION: To PREVENT many diseases, including Osteoporosis, as well as TREAT Osteoporosis
Take about 750 mg of Calcium and 2000+ IU of vitamin D and Co-factors daily