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Maintaining Healthy Bones

Comment on the Vitamin D and Calcium controversy:
On February 16, 2006, the New England Journal of Medicine published new findings from the Women’s Health Initiative (WHI) Study on the use of calcium and Vitamin D for hip fracture reduction (Jackson, R et al. NEJM354, 7: 684-96, 2006). The national press interpreted the information in this study to mean that calcium and Vitamin D supplementation do not cut fracture rates. However, a careful review of the study suggests that the press got it wrong and that calcium and Vitamin D are useful in preventing fractures.

In the WHI study, 36,282 postmenopausal women were given either a daily supplement of calcium (1,000 mgs) and Vitamin D (400 units) or a placebo (sugar pills). After seven years of observation there was no reported significant reduction in hip fractures in the group as a whole. This observation is what led to the misleading press reports.

However, when the group was analyzed more carefully, women over 60 years of age (those most likely to experience a hip fracture) were 21% less likely to have a hip fracture. When the researchers looked at the group who actually adhered to the recommended regimen of calcium and Vitamin D they found a 29% decrease in hip fractures.

Adequacy of calcium intake is important in the prevention of a variety of age related degenerative diseases. A combination of diet and supplementation is the best way of insuring adequacy of calcium intake.

Adequacy of Vitamin D intake is important in preventing a variety of health problems (including osteoporosis, chronic bone pain, cancer and diabetes).  Dosing should be based on serum Vitamin D3 levels and may vary from as low as 400 units per day to as high as 5,000 units per day. My current recommendation for a base dose of Vitamin D is 1000-2000 units per day. This can be obtained by taking Multi t/d (Pure Encapsulations) and Vitamin D 1,000 units (Pure Encapsulations).

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