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Vitamin D for Bone Mineral Density? Little Evidence of Benefit — Physician’s First Watch

Medical News |
October 11, 2013

Vitamin D for Bone Mineral Density? Little Evidence of Benefit

By Amy Orciari Herman

Vitamin D supplementation does not appear to improve bone mineral density (BMD) in generally healthy adults, according to a Lancet meta-analysis.

Researchers examined 23 randomized trials of vitamin D supplementation that included over 4000 adults (average age, 59; 92% women). Most of the studies were placebo-controlled; in over half, the daily dose was 800 IU or more. BMD was measured at the lumbar spine, femoral neck, total hip, trochanter, total body, or forearm.

Participants' average 25-hydroxyvitamin D level increased from 53 nmol/L at baseline to 92 nmol/L at follow-up. However, the effects on BMD were minimal: a small increase was seen at the femoral neck, with no effect elsewhere. The researchers say, "such a localized effect could be artifactual, or could be a chance finding."

They conclude, "Continuing widespread use of vitamin D for osteoporosis prevention in community-dwelling adults without specific risk factors for vitamin D deficiency seems to be inappropriate."

Reader Comments (10)

Herman Medow Ph.D. Other Healthcare Professional, Psychology Consultants, inc.

I am more than skeptical, and wonder why anybody funded
this study, given the epidemiological studies showing
widespread Vitamin D deficiencies in the population- there are most certainly people supplementing whose D levels are well
above 20 and would not benefit from supplementation to
improve bone density- baffling why no measures of
"before" and "after" BMDs- results would be interesting
comparing people with low D levels to those supplementing-=
I am also puzzled by the term "hi-risk" for low D, since you
can easily measure levels- given the clear test available -
you can easily confirm starting D levels and relate to BMD-
As a Psychologist who consults to patrents in nursing homes,
I am grateful that I can request Physicians to order D levels
for any patient who presents with depression-Vitamin D is,
of course not a treatment for depression, however symptoms of depression are frequently symptoms of low
D levels,even lower than 10- Evidence for the role of this
vitamin keeps mounting in so many studies, for so many
health issues , I would be neglectful, if I did not make use
of medical professionals and simply went about with
my psychotherapy interventions andf maybe concluded
that I was working with a treatment-resistant patient.

Morris Orocofsky Physician, Internal Medicine, Interfaith Community Clinic

Why would you expect any other conclusion in patients with normal vit D levels and normal BMD? D supplementation outside of your great StLNate with universal health ,may be a great idea in the massive uninsured.

Morris Orocofsky Physician, Internal Medicine, Interfaith Community Clinic

Why would you expect any other conclusion in patients with normal vit D levels and normal BMD? D supplementation outside of your great StLNate with universal health ,may be a great idea in the massive uninsured.

myrna cox retired

I have been taking vit D for years and I still have back pain etc.

Vince Miraglia

It is not surprising that doses of less than 800IU a day should show little effect. Most experts in vitamin d feel 2000Iu a day would be a more appropriate dose .More for those who are obese K2 also plays an important role in bone metabolism. Really the only thing that matters from the patients prospective is what effect this has on bone fractures. This study choose not to look in detail at that endpoint.

Jean smith Other, Other

I take 3,000 IU of Vitamin D a day, so I hope it does some good.

Pat Brennan

Did they take D or D3?

Amy Herman, Editor Physician's First Watch

They took D2 or D3

SUSAN WOMELDORF,MD Physician, Family Medicine/General Practice, urgent care

did anyone look at number of fractures as this seems like a much more clnicaly relevant endpoint

Victor Elinoff MD Physician, Family Medicine/General Practice

I don't understand the conclusion. If the baseline Vit D Is 54 which is not deficient then increasing or supplementing would Not work. Suppose the baseline was below 20 ?

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