Vitamins Are Worthless:
For decades, many doctors have told their patients not to bother with vitamin and mineral supplements. The argument is that such pills are a waste of money.
Calcium is Wonderful:
The one exception is calcium. Women have been urged to swallow calcium supplements to keep their bones strong. Ads on television and in magazines make it seem as if a calcium supplement is essential for a healthy skeleton. The gist of the ads is that taking calcium pills along with vitamin D can prevent osteoporosis.
The Disappointing Truth About Calcium Supplements:
If only that were true! Unfortunately, studies over the years have not demonstrated that people taking calcium supplements have substantially better bone mineral density. Nor are they less likely to break a bone. Recent reviews of medical research demonstrate that such expectations are unrealistic.
One study was a meta-analysis of 59 randomized controlled trials, the best sort of research for determining efficacy of a medication or supplement (The BMJ, Sept. 29, 2015). The scientists found that the meager improvement in bone mineral density noted in people randomly assigned to get additional calcium through pills or food did not last beyond the first year or two. Adding vitamin D to the supplement (to increase calcium absorption) made no difference. The researchers concluded:
“for most individuals concerned about their bone density, increasing calcium intake is unlikely to be beneficial.”
Calcium and Bones:
But what about fractures? That is what people actually care about, after all. The implied promise has been that calcium supplementation will build strong bones that don’t break. Women who worry that they may end up hunched over like their grandmothers are willing to swallow a couple of pills every day to avoid that.
Another study in The BMJ (Sept. 29, 2015) reveals that:
“Dietary calcium intake is not associated with risk of fracture, and there is no clinical trial evidence that increasing calcium intake from dietary sources prevents fractures. Evidence that calcium supplements prevent fractures is weak and inconsistent.”
The researchers go on to state quite clearly that:
“Collectively, these results suggest that clinicians, advocacy organisations, and health policymakers should not recommend increasing calcium intake for fracture prevention, either with calcium supplements or through dietary sources.”
The Downside of Calcium Supplements:
If calcium supplements were totally benign, it wouldn’t matter if people swallowed a couple of unnecessary pills each day. But there is growing evidence that there are downsides to extra calcium. One potential problem is an increased risk of kidney stones (New England Journal of Medicine, Feb. 16, 2006).
In addition to this extremely painful complication, calcium supplements have been linked to hospitalizations for abdominal distress with constipation, bloating or cramping (Journal of Bone Mineral Research, March, 2012).
The side effect that concerns us the most, however, is that the chance of a heart attack is increased by 20 to 40 percent among people taking calcium pills (Journal of Internal Medicine, Oct., 2015).
With the weight of the evidence now against calcium supplementation for preventing osteoporosis, physicians may want to re-evaluate their approach. Patients taking calcium should discuss this question with their health care providers rather than assume a recommendation made years ago is still valid.
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