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Calcium, Vitamin D For Osteoporosis: Are Recommendations Skewed By Conflicts Of Interest?

A photo illustration shows over-the-counter calcium supplements. (Bebeto Matthews/AP)

A photo illustration shows over-the-counter calcium supplements. (Bebeto Matthews/AP)

By Marina Renton
CommonHealth Intern

Might commercial influences be driving the widespread recommendation of calcium and vitamin D supplementation for the prevention and treatment of osteoporosis?

That’s the conclusion of an analysis published in the journal BMJ, written by Andrew Grey and Mark Bolland, endocrinologists and associate professors at the University of Auckland.

The analysis — strongly refuted by organizations that advocate for osteoporosis research — further complicates the already contentious issue of whether it’s a good idea to take the supplements and if so, at what dosage.

The Supplement Conundrum

Women over 50 are most likely to develop osteoporosis, a bone disease affecting millions of Americans that results in bone weakness and increased risk of fracture. Calcium and vitamin D supplements are widely recommended to prevent and treat the condition.

“But as we point out, the considerable body of randomized trial evidence doesn’t support that practice,” Grey, the study’s co-author, wrote in an email.  “We wondered why practice hasn’t changed to reflect the evidence.”

To promote bone health, over half of older Americans take calcium and vitamin D supplements, which can be prescribed by a doctor or purchased over the counter, the authors write.

The Institute of Medicine (IOM) recommends adults take in 1,000 mg of calcium per day (1,200 for adults 70+ and women 51-70) and 600 IU (international units) of vitamin D — 800 IU for the 70+ set.

As of 2013, the U.S. Preventive Services Task Force does not recommend daily calcium and vitamin D supplementation for non-institutionalized postmenopausal women to prevent fractures. This, they note, is not necessarily inconsistent with the IOM’s recommendations, which do not specifically discuss fracture prevention.

The supplements have been standard clinical practice in preventing or treating osteoporosis in older adults since the early 2000s. Since then, however, studies have emerged to contest their effectiveness, according to the paper. Continue reading