Editor—Porthouse et al conducted a good randomised controlled trial of calcium and supplementation with cholecalciferol (vitamin D3) for prevention of fractures in primary care.1 However, vitamin D and calcium are not enough.
No mention was made of the extensive research from Japan and the Netherlands, which shows that vitamin K supplementation has a powerful effect in decreasing osteoporosis and osteoporosis related fractures. Combining vitamin K, vitamin D, and calcium seems ideal.
Researchers from Osaka Medical College showed that vitamin K and vitamin D together increased bone density much better than vitamin K alone.2
When comparing calcium and vitamin D alone with placebo, researchers at the University of Maastricht found little benefit on bone loss. But those randomised to take vitamin K in addition to calcium and vitamin D had significantly less femoral neck bone loss after three years.3
Figure 1.
Credit: STEVE HORRELL/SPL
The Yamaguchi osteoporosis prevention study showed that vitamin K alone reduced vertebral fractures by 56% compared to placebo, comparable to the benefit found from etidronate.4
Researchers at Hirosaki University in Japan showed that vitamin K lowered bone fractures in elderly female patients with Parkinson's by 90%.5 The same research team showed an 86% decrease in fractures in elderly patients with Alzheimer's treated with a combination of vitamin K, vitamin D, and calcium compared with placebo.w1
If the medical standard became to first use vitamins D and K with calcium before using bisphosphonates or selective oestrogen receptor modulators, the public would save billions of dollars a year.
Supplementary Material
Additional reference on bmj.com
Competing interests: None declared.
References
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