Is vitamin D supplementation beneficial to those who have osteoporosis?

Osteoporosis is a classic deficiency syndrome in adults that is characterized by low

bone mass and structural deterioration of bone tissue, which leads to increased bone
fragility and susceptibility to fracture. Vitamin D, along with calcium, is a key component in
bone physiology, but the combination of the two and the relative effectiveness of each
mineral are unclear. Peak bone mass is obtained around age 30, and from there, the body
will start to lose more bone than it is being made through a process called resorption.
Overtime, bone becomes weak and fragile, so maintaining healthy and strong bones at a
young age is critical for preventing higher risk of fractures. Many risk factors contribute to
the development of osteoporosis including age, race, lifestyle choices, and medical
conditions and treatments. Moreover, women are at a higher risk for developing
osteoporosis than men.
3
Its been long believed that vitamin D and calcium can reduce the
risk of adverse events such as fractures and falls associated with osteoporosis, but whether
or not vitamin D alone is beneficial is still a controversial topic.
Vitamin D supplementation is a common treatment for people who have
osteoporosis. It is considered important to have sufficient amounts of vitamin D because it is
essential for increasing intestinal calcium absorption. When there is an insufficiency of
vitamin D, calcium concentration in serum decreases, which in turn increases secretion of
parathyroid hormone. Parathyroid hormone stimulates bone resorption, which breaks down
the bones. Vitamin D is important to supplement in those people who have a deficiency so
that the calcium levels in the blood do not significantly decrease, which would cause bone
resorption.
In a study done with elderly patients, vitamin D and calcium supplementation was
provided in a randomized study to see if the supplementation would decrease tooth loss
and bone loss in different areas of the body.
4
145 subjects in the study were placed in a
controlled study where 82 were given supplements and 63 were given a placebo. During the
trial, 27% of the placebo population lost one or more teeth, while only 13% of the
supplemented group lost one or more teeth. The results of the study show that it is
beneficial to consume the suggested amounts of vitamin D and calcium in order to increase
tooth retention rates, especially in older adults.
Although there has been a pre notion that vitamin D supplements are beneficial in
preventing osteoporosis, recent studies have shown that taking a vitamin D supplement for
this reason is ineffectual. A study conducted on adolescence in Lebanon measured the
effect of vitamin D supplements on bone mass in children who have not yet gone through
puberty
1
. The study revealed that there was no effect on bone mass in boys who were
taking an additional amount of vitamin D and only had an effect on the femoral neck in girls
1
.
Once a person has osteoporosis, vitamin D cannot increase the bone density, which does
not give hope for a person already diagnosed with osteoporosis. Another study that took
place in Norway showed just that. Women who had osteoporosis were given vitamin D
supplemental treatments with varying amounts
2
. The conclusion of the experiment stated
that the amount of the supplement taken did not affect the bone mass density
2
. It also
mentioned that the participants who had taken a greater dose was even less effective in
bone the reduction of turnover rates
2
. These two studies suggest that an increased amount
of vitamin D intake would have little to no effect on osteoporosis and therefore would not be
beneficial.
In conclusion, vitamin D supplementation is beneficial to help prevent bone loss,
especially with the elderly, but increased benefits are seen when vitamin D is supplemented
with calcium. Although the general consensus promotes the use of vitamin D for prevention
of osteoporosis, the issue lies with how much is needed for optimal effect. All in all, vitamin
D is beneficial and should be supplemented as a way to help maintain bone density, but
more research is needed in order to recommend an optimal dosage that would reduce risk
of osteoporosis and prevention of fractures and falls.



































References:

1. Al-Shaar L, Nabulsi M, Maalouf J, El-Rassi R, Vieth R, Beck TJ, El-Hajj Fuleihan G.
Effect of vitamin D replacement on hip structural geometry in adolescents: A randomized
controlled trial. Bone, 2013 Oct;56(2):296-303. doi: 10.1016/j.bone.2013.06.020.

2. Grimnes G, Joakimsen R, Figenschau Y, Torjesen PA, Alms B, Jorde R. The effect
of high-dose vitamin D on bone mineral density and bone turnover markers in
postmenopausal women with low bone mass a randomized controlled 1-year trial.
Osteoporos Int. 2012;23(1):201-11.

3. Korpelainen R, Korpelainen J, Heikkinen J, Vaananen K, Keinanen-Kiukaanniemi S.
Lifelong risk factors for osteoporosis and fractures in elderly women with low body mass
index--a population-based study. Bone. Aug 2006;39(2):385-391.

4. Krall EA, Wehler C, Garcia RI, Harris SS, Dawson-Hughes B. Calcium and vitamin D
supplements reduce tooth loss in the elderly. The American journal of medicine. Oct 15
2001;111(6):452-456.