Task force: Evidence for Vitamin D, calcium supplements lacking
The task force found evidence that Vitamin D and calcium supplements increase the risk of developing kidney stones.
February 26th, 2013
10:49 AM ET

Task force: Evidence for Vitamin D, calcium supplements lacking

You’ve seen it added to cereal boxes, gallons of milk and bottles of orange juice. Experts tout its benefits – from strong bones to a strong immune system – and warn of the dangers of Vitamin D deficiency.

The public relations push is working; between 2002 and 2011, sales of vitamin D supplements increased from $42 million to $605 million, according to the Nutrition Business Journal.

New recommendations from the U.S. Preventative Services Task Force could bump those sales even higher, or - if critics are right - confuse consumers as they head down the pharmacy aisle.

After completing a review of existing research, the USPSTF, an independent panel of doctors and experts in prevention and evidence-based medicine, is advising against taking moderate amounts of Vitamin D and calcium supplements because there is not enough evidence to prove the supplements reduce the risk of bone fractures.

More specifically, the USPSTF is recommending against supplements of Vitamin D in daily doses of less than 400 IU (international units), and calcium in daily doses of less than 1,000 milligrams for post-menopausal women.

Doctors currently recommend these supplements for women to prevent fractures; approximately 56% of women aged 60 years and older take supplemental vitamin D, and 60% take a supplement containing calcium, according to the USPSTF report. The report was published in this week’s edition of the Annals of Internal Medicine journal.

The task force found evidence that Vitamin D and calcium supplements increase the risk of developing kidney stones in this population, and insufficient evidence to show that the supplements reduce the risk of fractures.

Basically it boils down to this: “Don't take modest doses, they don't do any good,” says Dr. Virginia Moyer, chair of the USPSTF.

More research is needed, Moyer says, to determine whether higher doses of Vitamin D or calcium would prevent fractures in older men or women. She says the task force will be looking in the future at whether doctors should be screening for Vitamin D deficiencies.

The USPSTF’s recommendations don’t apply to those who are prone to falling, according to the report, or those who have a history of fractures, a documented Vitamin D deficiency or a diagnosis of osteoporosis.

Vitamin D is not actually a vitamin, according to nutrition experts Marion Nestle and Malden C. Nesheim; it’s a hormone produced by the body in reaction to sunlight.

“Like other hormones, vitamin D has multiple roles in the body, not all of them well-understood,” the experts wrote in an editorial about the USPSTF recommendations. As such, Vitamin D supplements must be considered a form of hormone replacement therapy, they wrote, and be subjected to similar probes about efficacy, dose and side effects.

As we’ve seen with recommendations from this group in the past (think prostate or cervical cancer screenings), there are those that disagree with the task force’s conclusion.

“These recommendations fail to recognize the well-established role of calcium and vitamin D in maintaining bone health,” the Council for Responsible Nutrition said in a statement. “If these recommendations are taken to heart, or misconstrued as general recommendations against calcium and vitamin D, consumers could be compromising their bone health and missing out on important other benefits from these nutrients.

“The bottom line: calcium and vitamin D are vital to staying healthy.”

The Centers for Disease Control and Prevention says African-Americans have the highest rates of Vitamin D deficiency - along with the highest bone density and fewest fractures. Approximately 12% of Mexican-Americans are deficient, while only 3% of non-Hispanic whites are at risk.

The Institute of Medicine recommends adults get at least 800 to 1000 mg of calcium daily, depending on their age, and at least 400 IU of Vitamin D. Adults can safely absorb up to 2,500 mg of calcium and 4,000 IU of Vitamin D.

Calcium is most commonly found in dairy products like milk, cheese and yogurt, but it’s also available in green leafy vegetables like spinach and kale. Vitamin D is crucial for helping your body absorb calcium, which is why the nutrients are often talked about together. Vitamin D can be found in fatty fish or fortified foods like cereal and orange juice. It’s also found in sun rays, where it’s absorbed through the skin.

soundoff (51 Responses)
  1. Count Iblis

    One can also ask why after many decades of research we can do no better than this? To me the lack of progress suggests that we need a different approach. If we had stopped eating vegetables a few centuries ago and resorted to using vitamin C pills to prevent rickets, could we have proven that you actually need higher dosages of vitamin C and that other compounds are also necessary? No, because you can only clearly demostrate that you need about 10 mg vitamin C per day to prevent rickets, there are no such clear cut results for the relation between vitamin C intake and other diseases.

    What perhaps can work is to do a RCT with young healthy people, let them undergo a workout program for a few years and try to see if the placebo group's fitness is significantly worse. There e.g. are some suggestions in the literature that taking 5000 IU/day of vitamin D helps people to recuperate from exercise. Then if 5000 IU/day is the natural dose and it's main role at these higher dosages is for the body to remain in shape, then that will indirectly also contribute to a better health.

    February 26, 2013 at 11:21 | Report abuse | Reply
    • Sue

      Calcium in the form of dairy and fortified with vitamin D is DANGEROUS to the body!!! This causes calcifications which are the base to many diseases and tumor growth. Calcium from vegetables (ex. Broccoli, Spinach) have a magnesium balance which helps the body to absorb the calcium properly!! We are NOT baby calves and should not consume dairy which has 2 extra hormones to promote a calf to grow into a cow. research it yourself. ...Calcium with a magnesium balance!

      February 26, 2013 at 21:18 | Report abuse |
    • BillRubin

      After reading the comments here and also the Task Force's publication, I think its important to point out that the absence of evidence is not evidence of absence.

      February 27, 2013 at 09:30 | Report abuse |
    • Count Iblis

      Correction: When I wrote "rickets" in my posting above, I obviously meant "scurvy" which is caused by severe vitamin C deficiency.

      March 2, 2013 at 18:45 | Report abuse |
    • Rosie Miranda

      First and foremost, absorption. If we don't absorb what we take, it does end up on our tissues and bones. If your not sure about that just test it out for yourselves. If you put natural vitamin E on one hand and synthetic vitamin E on the other hand you will observe that the natural vitamin E gets absorbed, while the synthetic vitamin E does not. It sits on the hand like a pile of grease. However the subject is Calcium and vitamin D. but the principle is the same. It would take me ten years to tell you the absorption story of calcium. If you know what your doing and you know your body well enough, calcium can be very beneficial. If you don't know what your doing and you really don't know your body that well, best to go to someone that has more than 3 credit hours in diet and nutrition.

      December 17, 2013 at 09:17 | Report abuse |
  2. Anony.

    "Vitamin D... also found in sun rays, where it’s absorbed through the skin."

    Lol, discredits the entire article

    February 26, 2013 at 11:38 | Report abuse | Reply
    • MC

      Rofl, I was thinking the exact same thing. The editor that let this get to a published state should be fired.

      I wonder if Dr. Gupta is aware he is associated with a new line of radical thinking. Vitamin D – its in the sunshine.

      February 26, 2013 at 11:57 | Report abuse |
    • delores57106

      It is NOT found in sun rays...sun rays synthesize it from cholesterol. However, with everyone taking cholesterol lowing drugs these days.......... see where I am headed?


      February 26, 2013 at 12:07 | Report abuse |
    • Andrew

      hmmm, this article :N Engl J Med 2012; 367:40-49July 5, 2012DOI: 10.1056/NEJMoa1109617 shows 30% reduction in hip fractures at what they characterize as 'high' >800 iu.

      February 26, 2013 at 12:40 | Report abuse |
    • Wes Bucey

      LOL, indeed. You mean I can't believe everything I read on the internet? The question at hand is why does CNN let anyone but an educated writer with a sound foundation in the topic get to write an article which is just a mishmash of the original article? I guess CNN has so little respect for its readers and viewers they feel we need science articles dumbed down. Well this was certainly dumb – was it CNN's intent?

      I can hardly wait for CNN to report on Chicken Little's scientific analysis of the meteor that boomed over the city of Chelyabinsk on Feb 15.

      February 26, 2013 at 15:23 | Report abuse |
    • Elly

      "It’s also found in sun rays, where it’s absorbed through the skin." – I was laughing so hard...
      I guess they didn't think anybody would read the article to the end... At least they could hide it somewhere in the middle, so it's harder to spot... LOL
      So you can finish reading and realize you wasted you time.

      February 26, 2013 at 17:18 | Report abuse |
  3. dan

    If I don't take vitamin D in the winter, my elbows will crack open and bleed. Dont know about bones but without it, my skin suffers.

    February 26, 2013 at 11:52 | Report abuse | Reply
  4. delores57106

    It is NOT found in sun rays...sun rays synthesize it from cholesterol. However, with everyone taking cholesterol lowing drugs these days.......... see where I am headed?


    February 26, 2013 at 12:06 | Report abuse | Reply
    • TheDude82

      Thank you, the wording in that part of the article bothered me as well. It implies that somehow the suns rays magically carry vitamin D through the solar system, from deep within a suns core, where it falls to earth and is picked up and absorbed through the skin. Seems legit!

      February 26, 2013 at 12:16 | Report abuse |
    • Jacksonian4350

      Cholesterol lowering drugs, such as statins, simply reduce the amount of cholesterol produced by the liver down to normal levels. So they should have no effect on Vitamin D levels.

      February 26, 2013 at 12:32 | Report abuse |
  5. TheDude82

    This study seems to omit the influence that moderate doses of vitamin D play in alleviating depression and other issues related to the lack of sun exposure. A major reason many people take Vitamin D supplements in some parts of the world. It drives me crazy when studies like these are so narrow in scope, ignoring huge sections of the market that they are making recommendation to. If you are going to start making such wild statements, wouldn't be proper to take the time to do a complete study, rather than look at a single aspect of a products usage and then start making wild recommendations based on that? just asking.

    February 26, 2013 at 12:10 | Report abuse | Reply
    • foodandart

      I have found that just sitting in the sun for 15 minutes – wherever and whenever it's out – in winter – is great for lifting depression, and it gives a burst of vitamin D to your body.

      It also keeps the blue off, so you don't have that 'minty-green' winter complexion..

      February 26, 2013 at 13:52 | Report abuse |
  6. Snurfles

    So much misinformation. I watched a friend nearly die from a lack of calcium (she malabsorbs vitamins and minerals and had stopped taking supplements). Now that she is taking the correct amounts of Calcium and D, she is back to being a healthy, vibrant human being. This article is crap.

    February 26, 2013 at 12:32 | Report abuse | Reply
    • Tim

      I agree, this study is crap. Yet another nutcase study.

      February 26, 2013 at 13:39 | Report abuse |
    • foodandart

      Yeah, but snurfles, not everyone mal-absorbs nutrients.

      For the *majority* of women who are NOT dealing with such an issue, supplements give you nutrient-laden pee is all.

      February 26, 2013 at 13:46 | Report abuse |
  7. Moi

    Supplements are crap. I stopped all of them, including calcium, D, fish oil, all of them and I have never been healthier. I am post-menopausal and my bones and health have become better and better because of diet and exercise and outdoor activity. You absorb vitamins and minerals better the natural way, most supplements just go through your system.

    February 26, 2013 at 13:07 | Report abuse | Reply
  8. foodandart

    Weight training and exercise is the ticket for strong bones. and when I say 'weight' I mean WEIGHT.
    None of this sitting on a weight machine pushing a single 10-pound weight with your legs.. Opt for 150 pounds to start and go from there (I'm at 275 and counting) It'll firm those trouble areas of the thighs, help maintain bone density and keep your heart working.
    The notion that you can 'take a pill' and magically sort your health (or lack thereof) issues is laughable and finally the USPSTF is looking hard and fast at the *scientific* data and results.
    We need to move beyond the drug and supplement makers so-called 'science' which is based not so much on reality, but on generating sales, and into the scientific and results-oriented world of What Actually Works.
    It will take some time for the old advertising-based 'beliefs' to fade, but this is a step in the right direction.
    Get thee to the gym and lift weights ladies! Don't go light because you think you'll look like a man. You won't unless you take steroids, so no fear of pumping iron, okay?
    I do and feel GREAT and can take a tumble and crash (off my bike, I trail-ride a lot and do crazy things that kids usually try) and other than bruises and my pride, am fine with it – and YES, I'm post-menopausal.

    February 26, 2013 at 13:37 | Report abuse | Reply
  9. Tim

    Now all we will hear on the stupid news tonight is this ridiculous study. I've said it before, and will say it again, these groups are doing this to get themselves publicity. Say the most ridiculous opposite thing just so they can get attention.

    Diane Sawyer and her on air "doctor" will talk about what big news this is. They are all idiots.

    Next study out, vegetables will be bad for you, and Twinkies will be healthy.

    February 26, 2013 at 13:38 | Report abuse | Reply
  10. Mother Dog

    This reminds me of the HRT study which said that taking hormone replacement raises the odds for getting breast cancer in women. They didn't mention, at first anyway, that the study was conducted using only Premarin and Prempro, which are derived from horse urine....which means that some fifty thousand horses, in Canada, are kept pregnant....God knows what happens to the male colts. It's sick, but, anyway, the study ignored hormone replacement from soy or wild yams.
    Notice this study refers to "Vitamin D", not Vitamin D3 which is the one that we've been told over and over again we tend to be low on as we get older. I shall ignore this one, too, and wait for them to hopefully correct themselves someday.
    As for taking or not taking nutrients in pill form, if your diet is not filled with fresh vegetables, fruits, moderate amounts of lean meats, raw nuts and seeds, whole grains, etc., i.e. if you're eating in fast food restaurants and consuming a lot of processed foods, vitamin supplements, in my opinion, would be a very good idea for you!

    February 26, 2013 at 14:23 | Report abuse | Reply
  11. Jerry Snyder

    No, it isn't, either. Perhaps lacking for specific medical doctors recommending it to solve some specific symptom or other - but doctors are usually consulted only after the time symptoms appear. The evidence is strong that Vit D WITH Vit K affect many, many aspects of celluar function. Plus, "experience" is not always "anectodal", even tho medical TREATMENT for symptoms needs strong CLINICAL data. The body's natural state is NOT illness and sickness - and, there highly sensitivie regulatory "instrumentation" exists all over the body - genuine personal experience tells us a lot, even if not, necessarily, how doctors should treat pre-existing diseases ! For example : http://articles.mercola.com/sites/articles/archive/2011/03/26/the-delicate-dance-between-vitamins-d-and-k.aspx

    February 27, 2013 at 06:35 | Report abuse | Reply
  12. Jerry Snyder

    Sorry for the typos and errors in sense in my previous post - would you please delete that one and let this replace it ? Thank you. This is what I meant to post - there could be further editing, but this is generally what I would like to point out : No, evidience is NOT lacking, either. Perhaps specific medical doctors looking to solve some specific symptom need money-making chemical equations, but ther is plenty of evidence on the subject nonetheless. Then, too, doctors usually come into play only after disease symptoms acutally appear. The evidence is strong that Vit D WITH Vit K affect many, many aspects of celluar function - before any disease states develop ! Plus, "experience" is not always "anectodal", even tho medical TREATMENT for symptoms needs strong CLINICAL data. The body's natural state is NOT illness and sickness – and, there exists much highly sensitivie regulatory "instrumentation" all over the body. Genuine, cogent personal experience tells us a lot, even if not, necessarily, how doctors should treat pre-existing diseases ! For example : http://articles.mercola.com/sites/articles/archive/2011/03/26/the-delicate-dance-between-vitamins-d-and-k.aspx

    February 27, 2013 at 06:46 | Report abuse | Reply
  13. Mickey

    Personally, I have seen my husband take Vitamin C and it actually relieved his post-nasal drip so he's not coughing continuously during alergy season and progressing into severe bronchitis. Then, with regard to Vitamin D, it is a sure cure for depression during the winter months. Also, my daughter was actually hearing noises and it turned out to be a potassium difficiency – eat a banana each day and you'll keep the crazy voices away. It's said to say that we eat so many empty calories each day due to foods with poor nutritional value. The pharmaceuticals are loving this type of article. For what would normally cost $50 a pill from them (with fatal side effects) is costing us pennies for the vitamin supplements.

    February 27, 2013 at 16:26 | Report abuse | Reply
  14. Libby

    I had low D and high calcium in my blood. I was in terrible shape for a long long time. Awful pain, gaining weight, etc. etc. After being told by a sleep doctor I needed a man in my bed and a shrink I was depressed, I had a bone density test and was asked if I had been in a car wreck, which I had not. I had a parathyroid tumor. The bone people did not diagnose me, they wanted me to take expensive shots. They did tell me about the parathyroid. So I looked it up on the internet, which of course doctors hate. I diagnosed myself and was correct. After going to Houston to see the specialist, it was confirmed and removed. Great doctors, minimally invasive procedure. I opened my eyes after the operation and that weird awful crazy electrical type pain was gone. It was like a miracle. I lost two inches in height and will never get it back, but I feel so much better. I still have pain from the compression fractures in my back and will have to figure out what to do about that, but the weight is coming off, over all the quality of my life is much much better. It has only been six months now and I do take a prescription vitamin D once a month as well as calcium supplements at night. They will retest blood and bone density when it has been a year. After reading this, I do not know what to do. I do know that had I taken the treatment for my bones as advised after the bone density test, it would have caused strokes or seizures. That doctor was literally drooling over my "good" insurance. They talked about that more than anything else. Thank god for M.D. Anderson. They are allowing my body time to correct itself before prescribing those shots and monthly pill things that are on the market now. M.D. Anderson said I probably had that tumor 8 to 10 years. My local doctors just kept telling me that I was getting old and fat. Argh! However, in their defense, the blood test that measures D has only recently been developed. The D, calcium and PHT (the real culprit) is what is at play here. I still don't understand it. I am a little bitter however. Years and years of being told I was depressed and fat. Be careful people. There is so much we do not understand.

    February 28, 2013 at 09:45 | Report abuse | Reply
  15. Andrea Duran

    My mother had severe osteoporosis and lost 4 1/2 inches of height in the last 15 years of her life. A fall in 1996 left her essentially bedridden until she died in 1998 at the age of 78, and I am absolutely determined to not suffer a similar fate. I had osteopenia in 2006 (DEXA scan). Right after that scan, I began taking bioidentical hormones (progesterone and testosterone) along with 10,000 IUs Vitamin D (my level is optimal at 70 ng/ml, just had my blood test last week), weight training exercise (I use light weights at home and weight machines at the gym). A repeat DEXA in 2009 showed not only do I no longer have osteopenia, my bones are comfortably in the normal range. I will NEVER take the bone density drugs, and my doctors fully support my choice. My primary care/hormone physician told me 9 years ago that calcium was not what builds bone strength, testosterone/Vitamin D (the RDA of 400 IUs daily is absurd) does. The hormone optimization has cured my hot flashes, restless leg syndrome, acid reflux and seasonal allergies, gotten me off seven medications, and besides helping to build bone, has also helped to build muscle tissue to stabilize my back (I have four disrupted discs from a long ago car accident). Testosterone also helps with cardiac health, as the heart is a muscle. I have more energy and focus than at any time in my adult life. I would far rather be (bioidentically) hormonally optimized than take a handful of toxic medications. I travel from NC to Southern CA to be a patient at Hormonal Health and Aging in Rancho Mirage and it's among the best decisions I have ever made. I know I am doing what is healthiest for me. Best wishes to all for hormonal health.

    February 28, 2013 at 14:24 | Report abuse | Reply
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  29. Dane Swanson

    Yes, I am aware D can be toxic in most cases. But the body can use D3 as it is the most absorbed. You don't get all your D from the sun. You need supplementation. Always see your doctor before taking any form of supplements.

    July 12, 2013 at 18:26 | Report abuse | Reply
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  31. J'S

    I don't know why they are doing research on this... It's already been proven that vitamin K2 is necessary to be coupled with calcium and vitamin D to take it to the right places in the body. All this added calcium without its K2 partner causes calcifications/calcium deposits all over the body leading to increased heart attack risks, joint problems, kidney stones, and the list goes on and on and on. If you're going to take calcium supplements you've GOT to take calcium CITRATE plus K2 along with it; K2 makes calcium go only where it belongs. And if you really want to make it work right, take your magnesium & D3 with calcium citrate and K2 all at the same time (with a good meal that has some fat in it). Otherwise you are wasting your time, money, and increasing health risks. Cheers!

    November 12, 2013 at 09:16 | Report abuse | Reply
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  33. Henol

    Vitamin D is fundamental for solid bones, since it enables the body to utilize calcium from the eating routine. Customarily, vitamin D lack has been related with rickets, an ailment in which the bone tissue doesn't appropriately mineralize, prompting delicate bones and skeletal distortions.

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  34. Henol

    Toxicity from vitamin D is mediated by altering calcium metabolism, which is potentially lethal. Vitamin D should be taken daily, with meals or a source of fat, like fish oil.

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