Vitamin D and Calcium Supplements: Yes or No?

PJ Hamel Health Guide
  • Last month, the U.S. Preventive Services Task Force (USPSTF) released a draft recommendation that may significantly impact the way you think about vitamins and supplements. The new USPSTF recommendation states that postmenopausal women NOT take vitamin D and extra calcium to reduce the risk of fractures. But wait; there’s more to this story…

    The USPSTF is at it again.

    The same advisory group that several years ago recommended women under age 50 stop having mammograms has now come up with another head-scratching advisory:
     
    Older women shouldn’t take vitamin D and calcium supplements to help prevent fractures.

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    Huh?

    Let’s backtrack. What IS this USPSTF, anyway?

    According to the U.S. Department of Health and Human Services (HHS), which funds its work, the USPSTF is “an independent group of national experts in prevention and evidence-based medicine that works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services…”

    In other words, this group of mainly practicing clinicians examines data on patient outcomes to determine the best, most effective ways to try to prevent a variety of diseases.

    In 2009, the group focused on breast cancer. And created a firestorm with a recommendation that women under age 50 NOT undergo regular screening mammograms.

    It seems the number of women saved by regular breast cancer screening is outweighed by the expense – both financial, and emotional – of screening tens of thousands of other women not affected by the disease.

    Yes, early detection saves lives… sometimes. But not often enough to be worth it, according to the USPSTF. (Within 24 hours, HHS had backed off support of the USPSTF report, noting that each woman should make her own decision about mammograms, in concert with her personal physician.)

    Now the group has taken up osteoporosis prevention. Or, at least the prevention of fractures in older women, which are often the result of bone loss – osteopenia or osteoporosis.

    Its draft recommendation, released June 12: postmenopausal women shouldn’t take a daily dose of less than 400IU or 1000mg of calcium to reduce the risk of bone fractures.

    The task force also noted, without making a recommendation, that higher levels of vitamin D and calcium don’t seem to offer bone protection to either pre- and postmenopausal women; nor reduce cancer risk. (Stein, 2012).

    Let’s look at this more closely, to really understand this new recommendation (which is expected to be finalized later this summer).

    The task force recommendation is for low levels of vitamin D and calcium supplementation, probably less than most of us are taking. And yes, they found that these low levels (less than 400IU of vitamin D, less than 1000mg of calcium) don’t reduce fracture risk.

    But how about higher levels of these supplements?

    Apparently, there’s insufficient evidence, one way or the other, to determine if levels greater than 400IU of vitamin D and 1000mg of calcium are beneficial. USPSTF member Kirsten Bibbins-Domingo noted that the task force “can’t rule out that higher doses may have some benefits.” (Stein, 2012)


  • “It may be that higher doses are beneficial,” she said. “But that would be an area that we would certainly want to see the studies to know the benefits are there and outweigh any potential risk of higher doses.” (Stein, 2012)

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    Potential risks would include, for instance, the link between high levels of vitamin D supplementation and kidney stones.

    Proponents of vitamin D are dismissing the report, specifically because of the low levels of supplementation examined.

    Dr. Bruce Hollis, a professor at the Medical University of South Carolina and a 35-year vitamin D researcher, has called the USPSTF draft recommendation “a sham,” noting that the levels examined would be appropriate only for an infant. (Stein, 2012)

    As with the USPSTF recommendations on breast cancer screening, it sounds like this new vitamin D and calcium advisory should be taken with a grain of salt. There’s not enough information, one way or another, to determine whether your daily 1000IU vitamin D and 1500mg calcium supplements are helping you.

    Until more data becomes available, it’s up to you to determine their potential risks and benefits.

    Sources

    Stein, R. (2012, June 12). Panel questions benefits of vitamin d supplements. Retrieved from http://www.northcountrypublicradio.org/news/npr/154840966/panel-questions-benefits-of-vitamin-d-supplements

    U.S. preventive services task force. (n.d.). Retrieved from http://www.ahrq.gov/clinic/uspstfix.htm

Published On: July 16, 2012