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Meta Analysis Concludes Vitamin D Supplements Help Prevent Fractures

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March 27, 2009

Meta-analysis concludes vitamin D supplements help prevent fractures

Meta-analysis concludes vitamin D supplements help prevent fractures

The March 23, 2009 issue of the American Medical Association journal Archives of Internal Medicine reported the results of a meta-analysis conducted at the University of Zurich in Switzerland which concluded that supplementing with vitamin D was effective for preventing fractures in older men and women, as long as higher dose supplements were used.

Heike A. Bischoff-Ferrari, DrPH, University Hospital, Zurich, and associates selected twelve clinical trials which investigated the effect of oral vitamin D supplements on non-spinal fractures that included a total of 42,279 participants aged 65 or older. Eight of the trials examined the supplements' effect on hip fractures.

The pooled analysis found a 14 percent decrease in nonvertebral fracture risk and a 9 percent decrease in hip fracture for subjects who received vitamin D supplements. When data from the nine trials which tested a dose of vitamin D greater than 400 international units per day were combined in a separate analysis, a 20 percent reduction in nonvertebral fractures and an 18 percent decrease in hip fracture risk were revealed. For the three high quality trials in which the dose of vitamin D was 380 international units or less, no effect on fracture risk was noted. In a comparison of the benefits of higher dose vitamin D2 and D3, vitamin D3 (cholecalciferol) emerged as protective against nonvertebral fracture, while the effect of vitamin D2 (ergocalciferol) was not considered significant. Greater increases in serum 25-hydroxyvitamin D also predicted a larger reduction in non-spinal fracture risk, while increased calcium did not appear to offer further protection. "Physiologically, the calcium-sparing effect of vitamin D may explain why we did not see an additional benefit of calcium supplementation at a higher dose of vitamin D," the authors noted.

In their introduction to the article, the Dr Bischoff-Ferrari and colleagues remark that "The anti-fracture benefits of vitamin D have been questioned by several recent trials, leading to uncertainty among patients and physicians regarding recommendations for vitamin D supplementation. Factors that may obscure a benefit of vitamin D are low adherence to treatment, low dose of vitamin D or the use of less potent ergocalciferol (vitamin D2)."

"The greater fracture reduction with a higher received dose or higher achieved 25-hydroxyvitamin D levels for both any non-vertebral fractures and hip fractures suggests that higher doses of vitamin D should be explored in future research to optimize anti-fracture efficacy," the authors write in their conclusion. "Also, it is possible that greater benefits may be achieved with earlier initiation of vitamin D supplementation and longer duration of use. Our results do not support use of low-dose vitamin D with or without calcium in the prevention of fractures among older individuals."

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Health Concern Life Extension Highlight

Osteoporosis

The benefits of a healthy diet and exercise for people with osteoporosis are widely accepted. However, most conventional medical sources touch upon only calcium and vitamin D when it comes to nutrients that help reduce the risk of osteoporosis. In reality, researchers are discovering that bone health and remodeling are complex processes that are influenced by many hormones and nutrients.

The following supplements and nutrients have been shown to reduce the risk of fractures:

  • DHEA—suggested starting dose of 15 to 75 milligrams (mg) daily, followed by blood testing in three to six weeks to make sure that optimal levels of this hormone are maintained
  • Calcium—1200 mg (dicalcium malate and calcium bisglycinate) daily
  • Vitamin D3—800 international units (IU) daily
  • Magnesium—340 mg daily
  • Zinc—2 mg daily
  • Manganese—1 mg daily
  • Silicon—5 mg daily
  • Boron—3 mg daily
  • Melatonin—1 to 3 mg daily at bedtime
  • Vitamin C—1 to 3 grams (g) daily
  • Vitamin E—400 IU daily (with 200 mg gamma tocopherol)
  • Vitamin B12 with folic acid—300 to 1200 micrograms (mcg) B12 and 800 to 3200 mcg folic acid daily
  • Vitamin K—up to 10 mg daily
  • Whey protein—up to 50 g daily (contains the essential amino acids L-arginine and L-lysine)
  • Soy isoflavones (genistein, daidzein, glycitein)—55 to 120 mg daily

Life Extension Magazine March 2009
Why Life Extension's Pharmacy is Unique

As the newly appointed Director of Pharmacy Operations, Frank La Corte, RPh, PD, is upgrading the Life Extension Pharmacy to provide unique and valuable services for its clients. Using over 20 years of experience in the pharmaceutical and compounding sectors, Pharmacist La Corte has set several targets for himself and the Life Extension Pharmacy.

Combining 28 years of nutraceutical research and formulation with an in-depth knowledge of pharmaceuticals, Frank La Corte’s first goal is to develop a personalized relationship with customers for their ongoing health care needs, something that is sadly too often lacking in major chain store operations today. Secondly, he seeks to offer pharmacy customers direct access to qualified pharmacists for advice about prescriptions and how these medications can work synergistically with nutrient and hormone supplements in keeping you healthy. For example, taking prescription “statins” to lower your cholesterol/triglycerides can deplete your body’s supply of coenzyme Q10, while taking bisphosphonate drugs to protect against bone fractures (like Actonel® or Fosamax®) can be useless without adequate calcium and vitamin D.

The Life Extension Pharmacy also looks forward to providing you with pertinent pharmaceutical information on a quarterly basis via the Life Extension magazine. Next quarter, look out for an informative article on postmenopausal osteoporosis prevention and treatment.

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Dayna Dye
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