At the Center for Better Bones, we are constantly thinking about fracture reduction and looking for data to help us compare the fracture-reduction potential of bone drugs and natural therapies. Recently, two very interesting “meta-analysis” reviews came across my desk. One review assessed the fracture-reduction potential of bisphosphonate drugs, and the other did the same for vitamin D. At the end of the day, vitamin D was shown to reduce more fractures than the popular bisphosphonate drugs.
Let’s look at the details.
The bisphosphonate drug studies. The bone drug overview analysis pooled data from 31 bisphosphonate drug studies, involving a total of 376,134 postmenopausal women. Twenty of these studies were the gold-standard placebo-controlled, randomized research trials, and the other eleven studies used fracture data from large clinical databases.
The object of this meta-analysis was to see if the bisphosphonate fracture-reduction rate reported from the randomized, highly controlled research trials was achievable among real world patients in the doctor’s office. The answer was yes. The authors of this article, published in Osteoporosis International, were delighted to find the bone medications yielded “real world” fracture reduction, just as they did in the highly controlled research trials. Overall, the total fracture reduction potential of this leading class of osteoporosis drugs was 22%.
The vitamin D studies. How powerful is vitamin D as a fracture-reduction agent? To answer this question, researchers conducted a similar meta-analysis of clinical trials investigating vitamin D and fracture. They summarized the findings of 12 state-of-the-art randomized control trials, involving 19,114 individuals 60 years of age and older.
This analysis found that, “A vitamin D dose of 700–800 IU a day reduced the relative risk of hip fracture by 26% and any non-vertebral fracture by 23%.” Lower dose vitamin D was not effective at reducing fractures, and no clinical trials had looked at the fracture-reduction power of higher dose vitamin D.
In other studies where participants supplement to achieve a therapeutic blood level of vitamin D, which is 32 ng/mL, fracture reduction has been seen to exceed 50%.
Supplementing with vitamin D is a safe, natural, inexpensive, way to reduce needless osteoporotic fractures and support your overall health. And, according to these two scientific meta-analyses, in adequate doses vitamin D may well be more effective than today’s most popular osteoporosis drugs. Remember, you can always make vitamin D in your body by exposing your skin to the sun as well. Here are our Better Bones guidelines for sunlight exposure:
• Short periods, 15-20 minutes daily, of near full-body exposure (without sunscreen) are best for light-skinned people.
• Use sunscreen after this initial period if necessary to avoid a sunburn.
• The useful ultraviolet rays are strongest between 10 am and 2 pm.
• Very dark-skinned people require 4-6 times more sunlight exposure than light-skinned people.
• In northern or southern latitudes distant from the Equator, longer exposure is needed, especially during the spring and fall.
• In climates of the northern or southern latitudes distant from the Equator, very little or no vitamin D is produced in the skin during the winter months.
If you’d like to assess your fracture risk, see our fracture risk and bone health profile.
References:
Bischoff-Ferrari, HA et al. 2005. Fracture prevention with vitamin D supplementation: A meta-analysis of randomized controlled trials. JAMA, 293(18): 2257-2264.
Brown, SE. 2008. Vitamin D and fracture reduction: An evaluation of the existing research. Alternative Medicine Review, 13(1):21-33.
Wilkes, MM et al. 2010. Bisphosphonates and osteoporotic fractures: A cross-design synthesis of results among compliant/persistent postmenopausal women in clinical practice versus randomized controlled trials. Osteoporosis International, 21(4):679-688.