Vitamin D and calcium supplements- new study results

OY. I've been taking Caltrate twice a day since beginning Aromasin, but it hasn't done anything for my bone density. Before Aromasin, I was borderline osteopenic. Now, after almost three years, I have full-blown osteoporosis. Maybe, I should discontinue the Calatrate? I feel like I take enough meds.....

These results are from a meta analysis of studies of "community dwelling adults." Is this a practice changing study? If so, what types of people does it apply to? Without access to the full-length paper, it is hard to assess the relevance (if any) of these results for women who have been diagnosed with breast cancer, let alone those who may be on an Aromatase Inhibitor, and/or who have been diagnosed with a vitamin D deficiency and/or osteopenia or osteoporosis, some of whom may be on bone support drugs.

The feature refers to patients from the Women's Health Initiative (presumably the "WHI" study) who received both calcium and Vitamin D. Some publications from the WHI study suggest that WHI was a study in healthy women (with no breast cancer diagnosis at enrollment).

In addition to possible limitations due the nature of the study group, what type(s) of Vitamin D (D2 or D3) and dose were used? What dose of calcium? What was their dietary calcium intake?

In case these findings are not applicable in the individual case, members here should not discontinue recommended vitamin D and/or calcium without first consulting with their physician and/or Medical Oncologist (if they are on an AI).

BarredOwl

This is a poor and flawed statistical study of community dwelling people looking if reported calcium and D intake prevented development of OP, NOT a study of people with known osteoporosis, much less osteoporosis with known decline in bone density from osteopenia to osteoporosis and on AI, and absolutely does not recommend docs move to stopping calcium or D in people with OP.

The Endocrine Society still recommends full-blown osteoporosis be treated not just to target a 25-hydroxy vitamin D over 30 ( even better is 40-60) but in addition to adequate calcium from diet or supplements at 1.2-1.5 gm elemental/day in divided doses, (citrate rather than carbonate if on acid blockers) which alone is rarely adequate, also recommends use of other additional rx, such as bisphosphonate antiresorptives ( alendronate or zometa or similar) or denosumab ( trade name prolia), if no known contraindications. Prolia has additional anti-BC action in bone as a double benefit but insurance does not always cover.

Ruling out other contributing causes of seconday OP is also important (hyperparathyroidism, hyperthyrodisim, etc.), and there are other options too.

Ask your primary care for referral to a board-certified endocrinologist, they are generally the best trained for OP management, not internists, not rheumatologists, not orthopedists, and sadly also not most oncologists.

Weight-bearing exercise, no smoking, and limited alcohol, plus aggressive fall prevention, are also important lifestyle issues.

This is one of the last paragraphs of the article ;

The researchers noted that thousands of people in this final group were participants in the Women's Health Initiative, a long-term study sponsored by the National Heart, Lung and Blood Institute in the U.S. Earlier reports based on data gathered by the Women's Health Initiative found that calcium and vitamin D supplements were associated with a lower risk of fractures, but only for women who took hormone therapy after menopause. To get a clearer picture of the direct link (if any) between supplements and fracture risk, Zhao and his colleagues opted not to include data from women on hormone therapy.

Besa, here is another study saying Vitamin D might help metastacis -

https://www.cancer.gov/news-events/cancer-currents...

All I know is I had a lot of bone and muscle pain when my Vitamin D was way too low. And will continue taking 5000 IU per day per doctors’ orders

This is interesting, Zometa and Reclast have the same zoledroni acid but different purposes.

What is Zometa?

Zometa (zoledronic acid) (sometimes called zoledronate) is a bisphosphonate medicinethat alters bone formation and breakdown in the body. This can slow bone loss and may help prevent bone fractures.

Zometa is used to treat high blood levels of calcium caused by cancer (also called hypercalcemia of malignancy). Zometa also treats multiple myeloma (a type of bone marrow cancer) or bone cancer that has spread from elsewhere in the body.

The Reclast brand of zoledronic acid is used in men and women to treat or prevent osteoporosis caused by menopause or by taking steroids. Reclast is also used to increase bone mass in men who have osteoporosis, and to treat Paget's disease of bone in men and women.

You should not use Reclast and Zometa at the same time.

Marijen, zometa and reclast are just trade names for the same generic agent, zoledronic acid, which is why if taking one you should not take the other as you would be duplicating the same drug.

The 5mg yearly dose is used frequently for osteoporosis in people who cannot tolerate or absorb oral bisphosphonates such as the now very cheap alendronate (fosamax), and they call it reclast. The 4mg dose is called zometa and used at varying frequencies (often monthly or every three months)for cancer mets and a few other less common conditions.

Chronic pain, I figured that out but my point is Zometa claims to be for one set of issues and Reclast for another. Just an observation

Chronicpain, I will have to look back for that study, and will post it when found.

Your point about the utilization of calcium is a good one. I was told specifically by my MD to use calcium citrate but I suspect that's frequently the case. Those who are taking PPIs OTC may not receive any advice on the topic at all. What that means for those studies of course is that the effectiveness of the calcium consumed is a great, big unknown and I don't believe I've ever seen that addressed. Good catch!