Vitamin D Supplements Just Expensive Urine?

Another popular belief is dashed. A study in Switzerland—published online in JAMA Internal Medicine—has found that higher doses of vitamin D were no more effective than lower doses in improving lower leg functioning. They were even associated with a higher risk of falls. What’s an elderly person to do?

Researchers divided 200 participants, ages 70 and older into three treatment groups. One group received 24, 000 IU of vitamin D3 monthly. Another group received 60, 000 IU and the third group received 24, 000 IU plus calcifediol.

After one year, groups two and three were more likely than the first group to reach a serum vitamin D level of at least 30 ng/mL (P=0.001), reported Heike Bischoff-Ferrari, M.D., Ph.D., of the University Hospital Zurich in Switzerland, and colleagues. They found that supplements were not more effective in improving lower extremity function, which was the same among all the groups.

All of the participants in the study had had a low-trauma fall in the previous 12 months and lived at home. To be included, participants had to be able to walk, use public transportation to attend clinical visits, and be willing to discontinue other calcium and vitamin D supplementation. They also had to score at least a 27 on the Mini-Mental State Examination to show that they understood the procedures and give their consent. The average age of the participants was 78 and 67% were female.

The number of falls varied significantly among treatment groups, with the highest incidence in the 60, 000 IU group and in the 24, 000 IU plus calcifediol group. “High monthly doses of vitamin D or a combination with calcifediol may not be warranted in seniors with a prior fall because of a potentially deleterious effect on falls, ” the authors stated.

There is little evidence that supplementation to achieve 30 ng/mL works, so “it is prudent to get recommended intakes of vitamin D and other vitamins from a balanced diet with foods that naturally contain what is manufactured into supplements, ” wrote Steven Cummings, M.D., of the California Pacific Medical Center Research Institute in San Francisco, and colleagues in an accompanying editorial.

Cummings added, “Clinicians should not recommend vitamin D supplements for other putative health benefits. There is no evidence from meta-analyses of randomized clinical trials that vitamin D supplementation reduces the risk of cardiovascular disease or cancer.”

The editorialists stated that until supplementation “is supported by randomized trials with updated meta-analyses, it would be prudent to follow recommendations from the Institute of Medicine that people 70 years or older have a total daily intake of 800 IU of vitamin D without routine measurement of serum 25D levels.”