American Association of Clinical Endocrinologists

AACE response to new proposed recommendations from USPSTF on calcium and vitamin D

The new US Preventive Services Task Force proposed recommendations on calcium and vitamin D have been in the news. The USPSTF concludes that the doses of calcium and vitamin D that they considered are not protective against fractures or cancers.

They studied a low dose of vitamin D (400 IU) that is known to be ineffective against fractures, so the outcome is not surprising.  Since many of the trials included people already getting plenty of calcium and vitamin D (where more would not be expected be have any benefit) or subjects at low risk for fractures or cancer (where benefits would be hard to demonstrate).

They previously concluded, in a separate recommendation, that vitamin D supplementation is effective in preventing falls, so, despite their language that "the USPSTF recommends against daily supplementation with ≤400 IU of vitamin D3 and 1,000 mg of calcium carbonate for the primary prevention of fractures in non-institutionalized postmenopausal women" they still recommend vitamin D for reducing the risk of falling.

AACE recommends that people with osteoporosis and those concerned about bone health consume 1000-1200 mg calcium daily, using supplements only if diet is insufficient and then only enough calcium supplement to reach the target intake of 1200 mg daily. For many patients with osteoporosis it may be appropriate to do a blood test of vitamin D and individualize the amount of vitamin D supplement. For most older patients, a vitamin D supplement of 2000 IU daily, which can be obtained without a prescription, should be both safe and beneficial.

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