Taking vitamin D supplements has been universally recommended to boost bone health and prevent bone fractures – especially in older adults – but a new study showed they may not be doing much after all.
The study published in the New England Journal of Medicine found daily doses of vitamin D supplements did not seem to make any difference in protecting against bone fractures in healthy people who were not severely deficient in vitamin D. The researchers also found there were no differences in the effects of vitamin D on fractures based on race, ethnic group, body mass index or age.
“In a generally healthy population, vitamin D supplementation did not reduce the risk of total fractures, osteoporotic fractures or hip fractures,” said Dr. JoAnn Manson, MD, DrPH, leader of the VITAL trial study and chief of preventive medicine at Brigham and Women’s Hospital, told Seasons.
The researchers included more than 25,000 adults in the trial (with an average age of 67), who were randomly assigned to take 2,000 international units (IU) of vitamin D or a placebo, then followed for five years.
During the study period, nearly 2,000 bone fractures occurred among 1,500 participants; however, taking vitamin D had no significance on who suffered a fracture and who didn’t.
During the study period, nearly 2,000 bone fractures occurred among 1,500 participants; however, taking vitamin D had no significance on who suffered a fracture and who didn’t.
What these results mean for seniors and caregivers
Despite the findings, Manson said it does not mean people should stop taking vitamin D supplements or that vitamin D has no health benefits—because it certainly does.
“This does not mean that vitamin D isn’t optimal for bone health because, without doubt, vitamin D and calcium are essential for bone health,” she said.
However, she emphasized that based on the findings, only small to moderate amounts of vitamin D are necessary for bone health, and higher amounts do not mean greater benefits.
Based on the findings, only small to moderate amounts of vitamin D are necessary for bone health, and higher amounts do not mean greater benefits.
“Most people, especially healthy adults, get the amount of vitamin D necessary from sun exposure, time outdoors, or even from foods and general dietary intake,” she added.
Scott Braunstein, MD, medical director at Sollis Health, said that because the study was not focused on the population at greatest risk for fractures – particularly seniors with low sunlight exposure or low dietary intake of vitamin D – the results should be interpreted with caution, and that people shouldn’t stop taking any supplements without speaking with their doctor first.
“High-risk seniors, particularly those with known osteoporosis, should not conclude (based on the recent study) that taking vitamin D plus calcium supplements will not help reduce their chances of suffering a fractured bone,” Braunstein explained. “Instead, each person should discuss their individual risk profile with their doctor.”
High-risk seniors should not conclude that taking vitamin D plus calcium supplements will not help reduce their chances of suffering a fractured bone… Each person should discuss their individual risk profile with their doctor.
Manson said the main message from this study isn’t to encourage people to toss out their vitamin D supplements; rather, it’s meant to inform generally healthy, younger and midlife adults that “there should be less attention to screening for vitamin D blood levels.”
According to the researchers, nearly 20% of adults in the U.S. currently take vitamin D supplements often based on blood tests or screenings that find they have deficient levels of vitamin D. Manson said the study should encourage doctors and patients to question the value of routine vitamin D testing or screening.
“The screening for vitamin D blood levels should be targeted to those who have osteoporosis, bone health problems, restricted diets, people who spend limited time outdoors or individuals who live in a nursing home,” she explained. “Vitamin D screening and testing for vitamin D blood levels should be done much less frequently since it’s generally not helpful to healthy patients. It’s a major cost to the health care system.”
She added screening needs to be targeted at the people who are most likely to benefit from screening. Also, supplements should be targeted to people who have risk factors or an increased risk of either vitamin D deficiency or bone health problems where they may have higher needs for vitamin D.
How do I know if I’m vitamin D deficient?
According to Braunstein, most people do not know if they are vitamin D deficient; however, anyone diagnosed with osteoporosis or has an osteoporotic fracture should have their vitamin D levels checked.
The most common causes of deficiency include inadequate sunlight exposure, problems with dietary absorption, or certain genetic deficiencies. Braunstein said certain medications, such as phenytoin (Dilantin, Phenytek), can accelerate the metabolism of vitamin D. Elderly who are hospitalized or institutionalized are more susceptible to being deficient as well.
Symptoms of vitamin D deficiency include:
- Fatigue
- Bone pain
- Muscle weakness
- Aches or cramps
- Mood changes (including depression)
Other ways to boost vitamin D levels
Beyond taking vitamin D supplements to boost levels, experts say people should consume foods that naturally contain vitamin D:
- Dairy products (cheese and yogurt)
- Salmon
- Tuna
- Egg yolk
- Beef liver
- Fortified cereals
People can also spend time outdoors or sit by a window to get vitamin D naturally. Braunstein said if you’re taking vitamin D supplements, you should generally be consuming at least 1,000 to 1,200 mg of calcium as well to enhance its benefits.
…if you’re taking vitamin D supplements, you should generally be consuming at least 1,000 to 1,200 mg of calcium as well to enhance its benefits.
“It is always best to discuss your questions with your primary doctor, who knows you best, as each person has individual factors that need to be considered,” he said.