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Calcium and/or Vitamin D Supplementation for the Prevention of Fragility Fractures: Who Needs It?
Vitamin D and calcium have different biological functions, so the need for supplementation, and its safety and efficacy, need to be evaluated for each separately. Vitamin D deficiency is usually the result of low sunlight exposure (e.g., in frail older people, those who are veiled, those with dark-s...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231370/ https://www.ncbi.nlm.nih.gov/pubmed/32272593 http://dx.doi.org/10.3390/nu12041011 |
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author | Reid, Ian R Bolland, Mark J |
author_facet | Reid, Ian R Bolland, Mark J |
author_sort | Reid, Ian R |
collection | PubMed |
description | Vitamin D and calcium have different biological functions, so the need for supplementation, and its safety and efficacy, need to be evaluated for each separately. Vitamin D deficiency is usually the result of low sunlight exposure (e.g., in frail older people, those who are veiled, those with dark-skin living at higher latitudes) and is reversible with calciferol 400–800 IU/day. Calcium supplements produce a 1% increase in bone density in the first year of use, without further increases subsequently. Vitamin D supplements do not improve bone density in clinical trials except in analyses of subgroups with baseline levels of 25-hydroxyvitamin D <30 nmol/L. Supplementation with calcium, vitamin D, or their combination does not prevent fractures in community-dwelling adults, but a large study in vitamin D-deficient nursing home residents did demonstrate fracture prevention. When treating osteoporosis, co-administration of calcium with anti-resorptive drugs has not been shown to impact on treatment efficacy. Correction of severe vitamin D deficiency (<25 nmol/L) is necessary before use of potent anti-resorptive drugs to avoid hypocalcemia. Calcium supplements cause gastrointestinal side effects, particularly constipation, and increase the risk of kidney stones and, probably, heart attacks by about 20%. Low-dose vitamin D is safe, but doses >4000 IU/day have been associated with more falls and fractures. Current evidence does not support use of either calcium or vitamin D supplements in healthy community-dwelling adults. |
format | Online Article Text |
id | pubmed-7231370 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-72313702020-05-22 Calcium and/or Vitamin D Supplementation for the Prevention of Fragility Fractures: Who Needs It? Reid, Ian R Bolland, Mark J Nutrients Review Vitamin D and calcium have different biological functions, so the need for supplementation, and its safety and efficacy, need to be evaluated for each separately. Vitamin D deficiency is usually the result of low sunlight exposure (e.g., in frail older people, those who are veiled, those with dark-skin living at higher latitudes) and is reversible with calciferol 400–800 IU/day. Calcium supplements produce a 1% increase in bone density in the first year of use, without further increases subsequently. Vitamin D supplements do not improve bone density in clinical trials except in analyses of subgroups with baseline levels of 25-hydroxyvitamin D <30 nmol/L. Supplementation with calcium, vitamin D, or their combination does not prevent fractures in community-dwelling adults, but a large study in vitamin D-deficient nursing home residents did demonstrate fracture prevention. When treating osteoporosis, co-administration of calcium with anti-resorptive drugs has not been shown to impact on treatment efficacy. Correction of severe vitamin D deficiency (<25 nmol/L) is necessary before use of potent anti-resorptive drugs to avoid hypocalcemia. Calcium supplements cause gastrointestinal side effects, particularly constipation, and increase the risk of kidney stones and, probably, heart attacks by about 20%. Low-dose vitamin D is safe, but doses >4000 IU/day have been associated with more falls and fractures. Current evidence does not support use of either calcium or vitamin D supplements in healthy community-dwelling adults. MDPI 2020-04-07 /pmc/articles/PMC7231370/ /pubmed/32272593 http://dx.doi.org/10.3390/nu12041011 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Reid, Ian R Bolland, Mark J Calcium and/or Vitamin D Supplementation for the Prevention of Fragility Fractures: Who Needs It? |
title | Calcium and/or Vitamin D Supplementation for the Prevention of Fragility Fractures: Who Needs It? |
title_full | Calcium and/or Vitamin D Supplementation for the Prevention of Fragility Fractures: Who Needs It? |
title_fullStr | Calcium and/or Vitamin D Supplementation for the Prevention of Fragility Fractures: Who Needs It? |
title_full_unstemmed | Calcium and/or Vitamin D Supplementation for the Prevention of Fragility Fractures: Who Needs It? |
title_short | Calcium and/or Vitamin D Supplementation for the Prevention of Fragility Fractures: Who Needs It? |
title_sort | calcium and/or vitamin d supplementation for the prevention of fragility fractures: who needs it? |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231370/ https://www.ncbi.nlm.nih.gov/pubmed/32272593 http://dx.doi.org/10.3390/nu12041011 |
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