Share on PinterestScientists are investigating the link between vitamin D supplements and bone fractures in older adults. Leire Cavia/Stocksy
- Vitamin D supplements, with or without calcium, are important for overall health.
- However, vitamin D supplements have no effect on preventing falls or fractures in older adults, according to the U.S. Preventative Services Task Force.
- Vitamin D supplementation for postmenopausal women and older men — given that those populations had normal vitamin D levels, no previous fractures, and no issues with bone density — was found to be unnecessary and had no bearing on the severity of injuries from falls.
- Experts say that recommendations for vitamin D in older adults have changed over time with the publication of new studies.
Vitamin D supplements with or without calcium, while necessary for overall health, have no effect on preventing falls or fractures in older adults, according to a new draft recommendation from the U.S. Preventative Services Task Force.
By analyzing 20 unique randomized, controlled studies in 54 different publications, reviewers determined that additional vitamin D supplementation for postmenopausal women and older men — given that those populations had normal vitamin D levels, no previous fractures, and no issues with bone density — was unnecessary and had no bearing on the severity of injuries from falls.
The finding was an update from a 2018 recommendation that postmenopausal women should not supplement with 400 units or less of vitamin D and 1,000 milligrams or less of calcium for the primary prevention of fracture; men were not included in that recommendation.
What is vitamin D good for?
Vitamin D is essential for the bones and teeth, the immune system, brain health, and for regulating inflammation. The body produces vitamin D as a response to sun exposure.
Certain foods and supplements can also boost vitamin D intake. Despite its name, vitamin D is not a vitamin but a hormone or prohormone.
An adequate intake of vitamin D may support good immune function and reduce the risk of autoimmune diseases. Researchers believe there may be a link between long-term vitamin D deficiency and the development of autoimmune conditions, such as type 1 diabetes and rheumatoid arthritis, but more research is necessary to confirm the link.
A lack of exposure to sunlight, the natural process of aging, and high levels of body fat can all contribute to vitamin D deficiency, which can lead to osteoporosis, bone and joint pain, and muscle weakness. These are all factors associated with falls and fractures in older adults.
What are physicians’ recommendations for vitamin D intake?
Mary Tinetti, MD, a Yale Medicine geriatrician and Gladys Phillips Crofoot Professor of Medicine at Yale School of Medicine, who is an expert in fall prevention, told Medical News Today that the recommendations for vitamin D supplementation have shifted numerous times.
“Falls and vitamin D is an ever-changing topic, with guidelines about testing and supplementing changing, and different groups are making different recommendations depending on current data and what data are considered,” Tinetti said.
David Cutler, MD, board certified family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, told MNT that belief in the benefits of vitamin D has changed over time as more research has been published.
“Vitamin D was once considered a panacea for a variety of ailments but now is considered by some to be unimportant. Many recent, large, well-conducted studies have shown no benefits in reducing fracture risk, cardiovascular disease, cancer prevention, or death from vitamin D supplementation,” Cutler said.
“Some experts suggested that vitamin D could be obtained safely from sun exposure, a recommendation that was considered controversial because of a potentially increased risk of skin cancer. Other experts suggested that perhaps being outdoors with sun exposure caused improved health outcomes independent of increased vitamin D. Needless to say, this nuanced balancing of benefits and risks is difficult for experts, let alone the average person, to reconcile,” Cutler explained.
Do I need to take vitamin D supplements?
Cutler added that many people do not need extra vitamin D supplements in general, but he supported the new findings that it doesn’t eliminate the danger to older adults from falls. He emphasized that the context of someone’s overall health should be taken into account when considering the need for vitamin D supplements.
“The appropriate conclusion is not that patients do not need any vitamin D but more correctly that patients with adequate amounts of vitamin D will not reduce their fracture risk by additional supplementation.”
— David Cutler, MD
“Addressing the issue of vitamin D supplementation with your physician requires looking at all the potential benefits and risks in the context of your personal health situation. This includes addressing diet for adequate calcium intake, exercise for fall prevention, and genetic factors that may affect the risk of kidney stones. So, it is only by comprehensively evaluating your entire health status that an appropriate recommendation for vitamin D supplementation can be made,” Cutler said.
