Vitamin D supplement won’t reduce fractures in healthy older people, study finds

Take 2000 IU (international units) daily of calcium-free supplemental vitamin D3 during over five years did not reduce fractures of the hip, wrist or pelvis compared to taking a daily placebo, the study found published Wednesday in the New England Journal of Medicine.

A placebo is a fake pill given to patients to believe they are getting the real treatment.

“This is the largest and longest randomized controlled trial of vitamin D supplementation in the United States – 25,871 men and women were recruited from all 50 states, 20% of whom Black participants,” said study author Dr. Meryl LeBoff, chief of the calcium and bone section in the division of endocrinology, diabetes, and hypertension at Brigham and Women’s Hospital in Boston.

“Overall, the results of this large clinical trial do not support the use of vitamin D supplements to reduce fractures in generally healthy American men and women,” said LeBoff, also a professor of medicine at Harvard Medical School.

“The validity of the study is excellent. It is consistent with previous data showing that a population not selected for vitamin D deficiency does not benefit from vitamin D supplementation,” said Dr Anne Rentoumis Cappola, Professor of Medicine in the Division of Endocrinology, Diabetes. , and Metabolism at the University of Pennsylvania Perelman School of Medicine in Philadelphia.

“Data from randomized clinical trials is the highest level of data and these have repeatedly failed to show any benefit of a vitamin when given to an unselected study population,” Cappola said. , who did not participate in the study.

Does not apply to everyone

However, the study results would not apply to people with severe vitamin D deficiency, LeBoff said. Nor does it apply to anyone with low bone mass, which is below optimal bone mineral density, or osteoporosis, a bone-thinning disease that makes bones so fragile that a fall or even slight stress can cause a fracture.

“This is a major public health problem in the United States. One in two women age 50 and older will develop an osteoporosis-related fracture in their remaining life,” LeBoff said. “It’s really important that patients with osteoporosis be evaluated for the many underlying factors that contribute to osteoporosis to see if there are reversible causes.”

The study findings also don’t apply to seniors in nursing homes, LeBoff said, due to the unique factors that apply to their living environment.

“They may not going outside to expose their skin to sunlight, which is a major source of vitamin D activation,” she said. “They may not have good nutrition, they may have other medical conditions or gastrointestinal issues, so they should talk to their doctor about their patient care.”

Need for vitamin D

The body needs vitamin D. The main role of the vitamin is to help the body absorb calcium from the intestines. In fact, the body cannot absorb calcium without the presence of vitamin D. The vitamin also plays a role in immune health, brain cell activity, and muscle function.

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In the United States, 15 micrograms, or 600 international units (IU) of vitamin D per day, is recommended for adults up to age 70. years, according to National Institutes of Health.
For adults over 70, the dose increases to 20 micrograms or 800 IU each day. The American Academy of Pediatrics recently doubled the recommended amount for infants, children and adolescents at 10 micrograms or 400 IU per day.

Unlike water-soluble vitamins, which the body can easily eliminate, vitamin D and its cousins ​​A, E and K accumulate in the liver and fat cells of the body until they are needed. Consumption well above the recommended daily dose can reach toxic levels.

A study 2017 found that 3% of Americans took more than the tolerable upper limit of 4,000 IU per day for adults, putting themselves at risk of overdose. About 18% were taking more than 1,000 IU per day.
Just after the first of the year, a Briton began to suffer from nausea, abdominal pain, diarrhea and repeated vomiting, as well as leg cramps and ringing in the ears after a month of taking the vitamin heavily D three times a year. daytime. Her vitamin D levels remained high for months, her doctor said..

If vitamin D supplements are being considered, daily levels of vitamin D from food should be factored into the decision, experts warn. In addition to fortified foods, eggs, cheese, shiitake mushrooms, salmon, swordfish, tuna, rainbow trout and beef liver contain vitamin D, as does coconut oil. Cod liver.

Anyone concerned about their vitamin D levels should have it evaluated by a doctor, experts say.

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