Exclusions included: diseases affecting bone metabolism, cognitive impairment, drugs affecting bone metabolism (bisphosphonates, selective estrogen receptor modulators, and corticosteroids), renal failure, hypercalcemia, nephrolithiasis, and decreased mobility (recent stroke recovery and Parkinson’s disease).įormulations of vitamin D included cholecalciferol (D 3) 400 to 2000 IU/d for 4 months to 5 years or 100,000 to 500,000 IU every 3 to 12 months for 1 to 5 years calcifediol (25(OH)D 3) 600 IU/d for 4 years and ergocalciferol (D 2) 400 IU/d for 2 years or 3000 to 300,000 IU every 3 to 12 months for 10 months to 3 years. Also, laboratory studies show that vitamin D can reduce cancer cell growth, help control infections and reduce inflammation. It is a fat-soluble vitamin that has long been known to help the body absorb and retain calcium and phosphorus both are critical for building bone. Only 3 trials required patients to have had a previous fracture. Vitamin D is both a nutrient we eat and a hormone our bodies make. 1 Patients lived in community and nursing home settings and ranged in age from 50 to 85 years 24% to 100% were female. 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).Ī 2014 meta-analysis of 15 trials (quasi-random and RCT) with a total of 28,271 patients that compared the effect of vitamin D on fracture risk with placebo or no treatment, found no benefit for vitamin D supplementation ( TABLE). Vitamin D supplementation, with or without calcium, doesn’t affect mortality. The vitamin D analogs alfacalcidol and calcitriol also don’t reduce hip or nonvertebral fractures (SOR: A, multiple randomized, controlled trials ), although alfacalcidol (but not calcitriol) does reduce vertebral fractures by 43% (SOR: B, one RCT and one quasi-randomized trial with potential for bias) 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 : A, large, high-quality meta-analysis of randomized or quasi-randomized placebo-controlled trials).
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