Our Thoughts: U.S. Preventive Services Task Force Rules on Calcium and Vitamin D

The U.S. Preventive Services Task Force published a draft recommendation statement today regarding the efficacy of calcium and vitamin D for the prevention of cancer and bone fractures. To nobody's surprise, they did not recommend them for any combination of cancer prevention and bone fractures. After reading the statement, it is hard to argue with them. Here's why:

If the task force was to recommend them, then insurance would have to cover calcium and vitamin D supplements for cancer prevention and bone fracture prevention. Big Pharma would never let this happen.

Here are our comments on their five positions:

"The U.S. Preventive Services Task Force (USPSTF) concludes that the current evidence is insufficient to assess the balance of the benefits and harms of vitamin D supplementation, with or without calcium, for the primary prevention of cancer in adults."

AGREE to DISAGREE. At the doses they looked at, 400IU or less, there would very little impact on cancer prevention. The studies they looked at were also not structured properly and the adequate length of time to see true results could not be taken seriously. We would venture to say that with more research in the pipeline at higher doses, this recommendation will change in the future.

"The USPSTF concludes that the current evidence is insufficient to assess the balance of the benefits and harms of combined vitamin D and calcium supplementation for the primary prevention of fractures in premenopausal women or in men."

AGREE. We have never, and will never, recommend calcium and vitamin D, especially in the doses that most physicians prescribe, for prevention of fractures in premenopausal women or men WITHOUT MAGNESIUM. Even if vitamin D enhances the absorption of calcium, it cannot to make up for the imbalance that taking calcium without magnesium creates.

"The USPSTF concludes that the current evidence is insufficient to assess the balance of the benefits and harms of daily supplementation with more than 400 IU of vitamin D3 and 1,000 mg of calcium for the primary prevention of fractures in noninstitutionalized postmenopausal women."

AGREE. For the same reason as the aforementioned, there is little benefit if not accompanied by magnesium. Our clients have heard this message over and over again for over two decades.

"The USPSTF recommends against daily supplementation with less than 400 IU of vitamin D3 and 1,000 mg of calcium carbonate for the primary prevention of fractures in noninstitutionalized postmenopausal women."

HIGHLY AGREE. We are so happy that they specifically targeted calcium carbonate. We have always recommended against calcium carbonate (rock calcium source such as TUMS) for several reasons: it is very poorly absorbed; it blocks absorption of other minerals; it neutralizes stomach acid. We applaud them for this ruling.

"The USPSTF has previously concluded in a separate recommendation that vitamin D supplementation is effective in preventing falls in community-dwelling adults aged 65 years or older who are at increased risk for falls (B recommendation)."

AGREE. There is a lot of evidence to back up this recommendation.

Final thought: We are huge proponents of individualized doses of high quality calcium sources, vitamin D3, WITH magnesium for the prevention of fractures. The trio would not be our first recommendation for the prevention of cancer. However, they could not harm and certainly may assist.