Does vitamin D without calcium reduce fracture risk
Abstract
Q: Does vitamin D without calcium reduce fracture risk? Evidence-based answer: No. Supplemental vitamin D without calcium -- in doses averaging as much as 800 IU per day -- doesn't reduce the risk of hip, vertebral, or nonvertebral fractures in postmenopausal women and older men (strength of recommendation [SOR]: A, large, high-quality meta-analysis of randomized or quasirandomized placebo-controlled trials). The vitamin D analogs alfacalcidol and calcitriol also don't reduce hip or nonvertebral fractures (SOR: A, multiple randomized, controlled trials [RCTs]), although alfacalcidol (but not calcitriol) does reduce vertebral fractures by 43% (SOR: B, one RCT and one quasi-randomized trial with potential for bias) Vitamin D supplementation, with or without calcium, doesn't affect mortality. It does double the risk of mild hypercalcemia (about 2.7 mmol/L increase), raise the risk of renal calculi or mild renal insufficiency by 16%, and slightly increase (4%) gastrointestinal adverse effects (SOR: A, meta-analysis of RCTs or quasi-randomized trials).
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
Read the paper
Related studies
- Effectiveness of Bisphosphonates and Denosumab on Risk of Vertebral Fractures in Prostate Cancer Patients Under Androgen Deprivation Therapies: A Real-World Prospective Study
- Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil
- Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study
- Muscle strength and body composition are clinical indicators of osteoporosis
- Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.