Will Vitamin D Prevent Osteoporosis –Probably Not

A recent excerpt from the NY Times regarding a study published online in The Lancet.  nyti.ms/1gnT1vz 

In a large review of studies, researchers have found almost no evidence that taking vitamin D supplements has any effect in preventing osteoporosis in middle-aged adults.

The analysis…included 23 randomized trials that measured the effect of vitamin D on bone density at four sites — spine, neck, hip and forearm — and included more than 4,000 generally healthy participants whose average age was 59.

The studies used dosages that varied from 500 units a day to 800 or more, given on varying schedules. In some studies, the subjects were given calcium as well.

Neither the pooled data nor any single study showed a significant increase in bone density across all four sites….The authors write that the widely believed idea that vitamin D promotes bone mineralization is probably incorrect.

“We’re not talking about people who are really vitamin D deficient,” said the lead author, Dr. Ian R. Reid, a professor of medicine at the University of Auckland in New Zealand. “But for healthy people focused on osteoporosis prevention, vitamin D does not make a positive contribution.”

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7 thoughts on “Will Vitamin D Prevent Osteoporosis –Probably Not

      • There are flaws in your argument.

        1. Studies that find “vitamin” D ineffective typically administer doses in the 100s of IUs, 500 to 800 here. But you said 800 “or more” for some patients, and I am not clear what “or more” means. Suffice it to say that vitamin D researchers (the ones that have been specializing on D for years, if not decades) all agree that daily intake should be in the 1,000s. At least 2,000 IU and the recommendations go up from there. Getting UVB from the sun (at the right time of day, in the proper season, and at the right altitude) can get you 18,000 IUs only in 10 to 20 minutes if you have the top two types of fair skin. D intoxication becomes a serious concern after 150,000 ng/ml (25-hydroxyl-D). On the one hand, the body will shut down sun-produced 25-OH-D precursors when its needs are satisfied, which makes it intoxication impossible if the sun is the only source (D in food is negligible, except in some fish). On the other hand, D pills can lead to intoxication with high doses, although pills lead to 25-OH-D with half the HALF-LIFE of 25-oH-D produced by the sun.

        The point is that studies such as this one are risible (although 800 “or plus” remains a mystery to me). The administered doses seem only large relative to the US government’s recommended 400 IU. But the D experts have recommended doses above 2,000 units for at least a decade. They have recommended D-OH-25 to be above the 40-60 ng/ml range for D really to prevent diseases (assuming you are not nutritively deficient, the next point).

        2. Minerals are absorbed in bones when their cofactors are present. There happens to be a widespread deficiency of magnesium in the population. You are not going to absorb calcium properly at least without magnesium present. Just giving patients calcium pills is a mistake without attention to the availability of mineral cofactors. BTW, vitamin K, especially K2, plays a vital role in channeling Ca into bones and teeth, away from blood vessels, where excessive Ca — relative to deficient Mg — contributes to plaque. The Ca-Mg causes other horror stories, which suggest that MDs have prematurely sent many people to their graves for lack of a larger nutrition picture.

        Michael F. Holick’s (PhD, MD) research is one of many PUBMED starting points for what has been learned on D in the last 4 decades.

      • Steve,

        Thanks for your thoughtful comments. The title of the blog post is a little too dismissive of the role of Vitamin D. As you may know, Lancet articles are often provocative.

        Vitamin D clearly plays an important role in bone metabolism and it would be unwise to ignore deficiency. At the same time, simply giving a typical dose of Vitamin D is not going to stop most cases of osteoporosis.

        The situation is perhaps analogous to agents like Lipitor for elevated cholesterol. For quite a long time, researchers were not able to prove that Lipitor conferred a longevity benefit. This became only apparent with long-term use and of course many people taking Lipitor continue with cardiovascular events.

        For Vitamin D, it is likely that there will be improvements in many with appropriate dosing. Yet, as you know, peak bone deposition occurs at a much younger age than when most bone problems develop. As such, other strategies, besides Vitamin D supplementation, to mitigate osteoporosis are likely necessary. It is interesting that a study which analyzed 23 other studies could not find a positive benefit from Vitamin D supplementation.

        Regards,

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