Vitamin D is associated with musculoskeletal health, and deficiency in this vitamin leads to increased risk of falls and osteoporotic fractures.
- Even in Australia vitamin D deficiency is common, but it is under-recognised.
- Evidence is accumulating that vitamin D supplementation reduces falls and fragility fractures, particularly in groups at risk of vitamin D deficiency. The number-needed-to-treat to prevent falls in the elderly is small (n=15).
- Assays for 25-hydroxyvitamin D often do not measure vitamin D2 (ergocalciferol) as well as vitamin D3 (cholecalciferol). This makes assessing treatment responses to vitamin D2 supplements difficult.
- Vitamin D deficiency should be corrected prior to treatment with intravenous bisphosphonates to avoid hypocalcaemia. Low vitamin D levels should also be corrected in patients on oral bisphosphonates.
- Calcium supplements will need to be given with vitamin D supplements if patients’ dietary calcium intakes are suboptimal.
- More studies regarding the role of vitamin D supplementation in the primary prevention of fragility fractures in the elderly are required.