You may have seen — and been confused — by recent articles about the use of vitamin D and calcium from the U.S. Preventive Services Task Force.
I’m concerned that the news stories aren’t telling the whole story in their reports about the recommendations of the Task Force against daily vitamin D supplementation for the prevention of fractures in postmenopausal women. The Task Force says there’s not enough evidence to assess the benefits or harms of supplementing with more than 400 IU of vitamin D and 1,000 mg of calcium. You may remember a similar report about vitamin D and calcium last year from the U.S. Institute of Medicine, and that was confusing too!
Here’s what both the government and media aren’t telling you:
- These government agencies have been looking at a series of older studies that used very low level vitamin D supplementation, just 200 to 400 IU. These low levels of vitamin D aren’t effective and do little good just as the new government reports suggest — that’s no surprise. However, many new scientific articles on vitamin D clearly show dramatic fracture reduction when higher levels of vitamin D are used and as therapeutic blood levels of vitamin D are achieved.
- The Task Force also strongly links these supplements with the risk of kidney stones. But noted vitamin D authority, Dr. Robert Heaney of Creighton University, makes it clear that “kidney stones are NOT caused by vitamin D.”
- In the recent vitamin D recommendations, the operative word is LOW DOSE. There’s a distinct blood level of vitamin D necessary to enhance calcium absorption, reduce parathyroid hormone levels, and thus provide for the reduction of fractures. If this blood level is not achieved, you will not see fracture-reduction benefits.
I have written extensively about this vitamin D blood level threshold, including a medical journal article in 2008 documenting the vast fracture reduction potential of vitamin D, when used in adequate doses.
In fact, fellow researchers and I suggest that therapeutic levels of vitamin D may well reduce all osteoporotic fractures by a full 50%. I have also noted that vitamin D clinical trial studies should not be considered valid unless researchers document that the amount of vitamin D used is enough to reach the critical blood level of at least 32ng/ml which is required for optimal calcium absorption and thus for fracture reduction.
I agree that low-dose vitamin D should not be recommended for fracture reduction because it is ineffective — it’s simply not enough vitamin D. However, we find ample documentation that reaching a therapeutic blood level of vitamin D (minimum of 32ng/ml) dramatically reduces fracture. That’s why you need to find out your vitamin D blood level and then supplement if necessary. Learn more with my blog and videos about vitamin D.
As for the calcium, I don’t have any issue with the recommendation of 1,200 mg total from diet and supplementation. As I have been saying for years, calcium by itself neither prevents bone loss nor needless osteoporotic fractures. We need a consistent, balanced supply of at least 20 key nutrients, which come from diet and sunshine, and supplements as needed.
Do not let scary, misleading headlines frighten you. Remember, you need to inform and empower yourself for Better Bones and a Better Body.