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Expert panel says vitamin D, calcium supplements may not help against fractures

Vitamin D and calcium supplements have been touted to help make bones stronger. But after reviewing the evidence, the U.S. Preventative Services Task Force (USPSTF) is saying that adding them to daily diets does not give added protection against fractures.

The USPSTF, an independent panel of physicians that advise the government on treatment guidelines, recommended against daily supplements of vitamin D greater than 400 IU and calcium greater than 1,000 mg doses for postmenopausal women to prevent bone breaks. The task force also said there was insufficient evidence that higher doses or that taking pills for premenopausal women or men in general gave any additional help. However, they still recommend that community-dwelling adults ages 65 or older and other high-risk groups to take vitamin D to prevent falls.

Their recommendation appeared in the Annals of Internal Medicine on Feb. 26.

"It's important to keep in mind that the presumption is that the people we are talking about here do not have known bone disease, they don't have osteoporosis and they are not vitamin D deficient," task force chair Dr. Virginia Moyer, a pediatrics professor at Baylor College of Medicine, told TIME. "This is supplemental, so this is above and beyond getting what the expert consensus is for what you should be getting everyday."

Vitamin D is a hormone that works to help blood keep normal levels of calcium and phosphorus, and is known to help the body absorb calcium (which makes up strong bones), according to the Mayo Clinic. Some previous research has suggested that vitamin D can increase bone mineral density, decrease fractures, provide added protection against hypertension, cancer, different autoimmune diseases and osteoporosis.

About 56 and 60 percent of women 60 and older take vitamin D and calcium supplements respectively, the authors wrote.

To come up with their conclusion, the USPSTF asked for two systematic evidence reviews and a meta-analysis on vitamin D supplementation with or without calcium on community-dwelling adults. They discovered that it did not prevent fractures, and in fact, increased the chances supplement-takers got kidney stones. One in 273 women taking the pills developed kidney stones.

This doesn't mean people should avoid vitamin D.

"We are not saying, 'Don't get your daily requirement.' We are just looking at whether there is any benefit to adding a bunch of stuff on top of your daily requirement," Moyer said.

The researchers added that they need more evidence and research to see if higher doses help or doctors need to screen for Vitamin D deficiencies.

"Physicians and patients need to make decisions based on the best available evidence they can find. Keep in mind that vitamin D and calcium are over-the-counter medications, and quite frequently physicians don't even know their patients are taking these things," Moyer said. "It's good for your physician to actually know what you are taking because there is always a possibility that it could interact with something else your taking. Even if what you're taking to you seems like nothing more than a nutritional supplement."

Clifford Rosen, a senior scientist at Maine Medical Center Research Institute and former president of the American Society for Bone and Mineral Research, said to USA Today the recommendation against supplements had been a growing trend for doctors today because of potential risks. For example high doses of calcium and heart attacks have been linked in some studies.

"Most people are doing very well in the United States in terms of their vitamin and mineral intake and they don't need supplements," he stated.

However, others fear that the recommendations might make some women who are not getting their daily nutritional requirements skip their supplements.

"I have a 91-year-old grandmother who takes calcium supplements," Taylor Wallace, senior director of science and regulatory affairs for the Council for Responsible Nutrition, told USA Today. "It really scares me that she would see something that says 'stop taking your calcium, stop taking your vitamin D,' when she doesn't go outside and she doesn't eat a lot of dairy."

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