HFHT's Practising Wisely Newsletter
For the whole healthcare team.
Issue 50: Vitamin D and Calcium - A Not So Dynamic Duo?
February 20, 2018
While portrayed in the past as: “Vitamin D and calcium: A dynamic duo in the maintenance of strong bone”, it is becoming more evident that this combination does little to prevent fractures in older adults.

Richard Lehman is a retired British GP who reviews the latest research in the top medical journals, often with a humorous spin. His latest issue includes a recent review in JAMA. Allow us to quote Dr. Lehman:

“Deprescribing can be difficult, but here is an easy first step which you can take with the next old lady who comes through your door: In this meta-analysis of randomized clinical trials [see our Quick Links section for the data] , the use of supplements that included calcium, vitamin D, or both compared with placebo or no treatment was not associated with a lower risk of fractures among community-dwelling older adults. These findings do not support the routine use of these supplements in community-dwelling older people. Just a matter of swallowing hard and admitting you were wrong to prescribe them in the first place.”

Another trusted source NNT (again, available in our Quick Links section) in their review confirm the inefficacy of vitamin d/calcium in preventing fractures in people living in the community, giving this treatment a “caution” score, indicating harms may outweigh benefits.

Among frail, elderly individuals in institutional settings , there was a small reduction in hip fractures, with supplements, so the news is not all bad for makers of vitamins.
Quick Links:
Choosing Wisely Committee:
Follow the HFHT on Social Media: