Introduction and Methodology of the Analysis
A recent systematic review led by a Montreal-based researcher indicates that the majority of older adults taking calcium or vitamin D supplements to reduce their risk of fractures likely derive no benefit from them. The study’s findings suggest that the preventive use of these products should be the subject of a systematic discussion with a healthcare professional.
No Significant Benefits for the General Population
Analysis of absolute risk reductions and thresholds considered clinically significant led the scientists to a clear conclusion. The study authors write that “this study found little or no beneficial effects associated with taking calcium, vitamin D, or a combination of both supplements for the prevention of fractures and falls.” In light of these observations, the researchers go on to state that these results “do not justify the routine use of calcium, vitamin D, or a combination of both to prevent fractures or falls.”
Pharmacist Olivier Massé, who works in the geriatric short-stay unit at Sacré-Cœur Hospital, confirms this trend observed in clinical settings. “There are plenty of valid reasons to take (these supplements), but there are also plenty of patients who take them for no good reason,” said Mr. Massé. He notes that for a significant portion of the patient population, “aside from having been told once that they absolutely had to take vitamin D and calcium, they don’t have very clear medical indications.”
Clinical Exceptions and Specific Contraindications
However, the conclusions of this systematic review have specific limitations regarding the profiles of the patients involved. The researchers caution that “these results may not be generalizable to people with specific bone disorders, nor to those undergoing drug treatment for osteoporosis or taking long-term corticosteroids.” These exceptions also include people receiving supplementation due to specific endocrine disorders or following bariatric surgery.
Olivier Massé emphasizes the importance of continuing prescriptions when the medical condition requires it. “In fact,” said Mr. Massé, “the key message is not that everyone currently taking calcium or vitamin D should necessarily stop.” He emphasizes the importance of targeted treatments: “So, there are still plenty of good reasons to take calcium and vitamin D,” he stated, before summarizing the study’s findings: “What we’ve just demonstrated is that, for the average person, prescribing supplementation for the general adult population may not be all that useful.”
Side Effects and a Call to Reevaluate Recommendations
Beyond the questioned preventive efficacy, the research team emphasizes that taking these supplements leads to significant side effects. The study’s authors note “that calcium-based dietary supplements are often difficult to swallow and poorly tolerated by older adults, frequently causing gastrointestinal side effects such as constipation, bloating, abdominal pain, or cramps.”
Based on all of this evidence, the scientists formally urge clinicians, expert groups responsible for developing guidelines, and regulatory agencies to “reassess their general recommendations regarding calcium and vitamin D supplementation in light of current data.” This effort aims to update standards of medical practice in line with the latest knowledge.
Implications for Prescribing and Proven Alternatives
The financial and administrative burden associated with these prescriptions remains significant within the healthcare system. Vitamin D is, in fact, among the top ten products generating the most annual claims with the RAMQ. “We are always in favor of shared decision-making,” said Mr. Massé. He recommends that patients initiate a dialogue: “So, especially if patients have been prescribed calcium and vitamin D, it would be a very good idea to ask their healthcare professionals whether it is still appropriate to continue or not.” He concluded that for low-risk patients with no specific medical indication, “calcium and vitamin D supplementation does not appear to reduce fractures and falls.”
With a view to proposing effective preventive solutions, the study’s authors direct practitioners and patients toward clinically validated alternatives. They note that only specific drug treatments and physical activity have been shown to be effective in reducing the risk of fractures. Regarding physical exercise, they specify that activities focused on balance or strength training, in particular, yield tangible results.
Source: lenouvelliste.ca
Calcium and Vitamin D Supplements: A Systematic Review Questions Their Effectiveness in Preventing Fractures
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