New analysis questions benefits of calcium/vitamin d supplementation

One variable confounding all these studies is that osteopenia and osteoporosis have long been and are still being treated with drugs that reduce bone strength all the while increasing bone mineral density.
(Are fractures more common among those with osteopenia than those with osteoporosis because they are most commonly treated with bisphosphonates?)

Calcium is NOT a problem for us to focus on. Your doctor has to run the tests to be sure you don't have coronary artery disease and can even take a supplement with calcium. Good while you are a kid. No matter what I do, my blood calcium is ALWAYS the same and doesn't budge. Focus on a well-rounded diet.

I agree. It was very vague on the type of calcium being ingested, when it is taken, what foods it is taken with, what other supplements are being taken and what exercise is being done by the people in the study.

Calcium and vitamin D alone will not fix anything. You need a bunch of other nutrients, high levels of protein, other supplements and specific foods. AND exercise - especially weight bearing and heavy strength. For example calcium carbonate used in plant based milk is not absorbed as well even under good supporting conditions. It is rock calcium and not as easily bioavailable as calcium citrate or plant derived calcium. I could go on. The study was extremely vague as to the other studies it was using to reach its conclusions. Maybe AI could shed more light.

I’m sticking to my calcium supplements and other interventions. Was static from 2018 until last year when I had to drop my exercise routine for 9 months due to injury playing pickleball ( not a fracture). I had a slight drop at my last DEXA. I’m now recovered and I am working much harder to intervene. It could be that the exercise is the key to pushing that calcium into the bones. But bottom line bones need calcium and if you are not doing all the right things to help your body absorb it I doubt you will see a difference.

Drs are also very bad at not giving patients the full picture. Take calcium and vitamin d they say. No mention of when, what type or correct dosage (at least my primary care did back in 2018 when I had my first DEXA). Then offered me Fosamax. It’s just so easy to prescribe drugs!

I did the research and went the natural route for now. But, a lot of people are not in a position to do everything they possibly can to impact their bones without drugs. Cost (supplements are definitely not cheap) and mobility are two big factors, so drugs are sometimes the only option to consider.

@jmc50 first, it involves bigtime hydration….avoids sodium, potassium and phosphorus as much as possible…go low on sugar..it limits dairy and protein (though plant proteins are okay)… avoid alcohol and sodas ! ….highly processed foods must be very limited …careful with carbs..there are good lists online from reputable sources like Mayo Clinic, Cleveland Clinic…this is just a barebones outline…depending on the level of one’s kidney function, it can be more, or less strict. One can find plenty to eat, though, fresh fruits and veggies and a creative spirit in the kitchen makes a difference.

@sueinthelou so true…doctors are very bad at giving the full picture. All I got 2 years ago when diagnosed was to take prescription D and calcium, start fosamax, weight bearing exercise (without description or what is good and safe) see you in a year.

@gently You might be interested in an article I posted yesterday under this heading: "Study: 2/3rd of All Fractures Are Not Attributable to Osteoporosis"

Also, there are articles that discuss that bisphosphonates offer little benefit as far as fracture prevention. I can provide a link to a couple if you are interested.

daisy17, thanks. I appreciate all links.
This article gives me a variation of an old thought. Because we measure osteoporosis by areal bone mineral density, maybe all the osteoporotic patients on bisphosphonates are subsequently measuring as osteopenic, thereby increasing the number of osteopenic fractures. The article doesn't indicate whether the populations in this study were treatment naive.

@gently I am not understanding your question, specifically this statement: "patients on bisphosphonates are subsequently measuring as osteopenic, thereby increasing the number of osteopenic fractures". Can you clarify?

daisy17, I see how that sentence is completely unclear.
The premise evolves from the way bisphosphonates work. They don't add new bone. They preserve older fissured bone, increasing bmd by accumulation. The amount of mineral in a measured space doesn't reveal the structure of the minerals. The bones we save with bisphosphonates are just as porous ( while increasingly brittle and avascular). In the same technical sense that a crushed vertebra reads as highly mineralized, areal mineral density increases without improving porosity.
Before 2002 bisphosphonates were all we had to slow down bone processes. I think it is true that bisphosphonates have prevented some fractures. But maybe more fractures occur among women who are osteopenic than among those who are osteoporotic because the dexa-definition of osteoporosis is disguised by use of bisphosphonates.

@gently That is why I refused Fosamax when recommended by my doctor. (I can't take Forteo or Tymlos due to parathyroid issues.). These articles say bisphosphonates usually show increased BMD on your DEXA scan, but offer minimal protection against fractures. That might be because they operate by slowing bone loss, but they also slow bone growth. In my mind, you end up with old bone which may be more brittle and, as a result, not really strong against fractures.

The following article says "According to the review conducted by the ACP (American College of Physicians), the relative risk reduction of hip fractures with bisphosphonate treatment for at least 3 years is 36%; however, the absolute risk reduction is only 0.6%. Framed as number needed to treat, 167 patients need to be treated for 3 years to prevent one hip fracture. "
https://www.amjmed.com/article/S0002-9343(24)00101-3/fulltext
https://www.consumerreports.org/cro/2012/04/popular-osteoporosis-drugs-come-with-mounting-concerns/index.htm