YouTube Transcript:
Do Calcium and Vitamin D REALLY reduce fracture risk in Osteoporosis??
Skip watching entire videos - get the full transcript, search for keywords, and copy with one click.
Share:
Video Transcript
calcium and vitamin D have been
recommended universally for osteoporosis
prevention and treatment by the World
Health Organization the bone health and
osteoporosis Foundation medical colleges
across the board the Women's Health
Initiative a study that came out in the
early 2000s and changed a lot of things
around the way we treat hormones and the
way we use vitamin D and calcium as well
it supported that recommendation and
what's awesome about this video and the
new data is that we now have 20year data
going back and looking at long-term
followup from this massive Tri that was
published at least some of the early
Publications in the early 2000s so when
we have long-term data on studies this
big this is really really important data
to go through now I'm going to tell you
exactly how we use calcium and vitamin D
in our program but before we do that I
want to go through this study and I want
to talk about sort of what it showed
originally and all of the data that we
have now on multiple follow-up studies
that were all put together in this one
study that I reviewed today now this new
study was just published on May 1st of
2020 4 there's a really important part
of this study that talks about hormones
and I'm going to do in a different video
but in this video I want to talk about
what really isn't probably not as
controversial but not nearly talked
about as much which is the calcium and
vitamin D trial so the initial goal of
the calcium and vitamin D intervention
of the Women's Health Initiative was to
look at the reduction of hip fractures
total fractures and possibly Adverse
Events which I know a lot of you are
interested in particularly in heart
attack cardiovascular disease
calcification of vessels particularly
the coronary arteries the arteries that
feed blood to your heart um kidney
stones and other stuff so there's a lot
of concern around calcium
supplementation and the Women's Health
Initiative used kind of what I would
consider Antiquated calcium
supplementation in calcium carbonate and
not a lot of vitamin D so 400 IU of
vitamin D and so the question is is man
do we see these risks that we're
concerned about with calcium
supplementation that people talk about
all the time with heart attacks and so
forth so this trial was big it had 36
6,282 women in it and they were randomly
assigned to either Placebo or
intervention and again they had a th000
milligrams of calcium carbonate and 400
IU of vitamin D3 or Placebo now here's
an issue when they designed the trial
they didn't want people to not want to
do the intervention and they also had a
hard time probably finding people that
weren't already on some kind of
supplementation even back then and so
they allowed personal supplementation of
calcium and vitamin D up to I think a
milligram of calcium and 600 IU of
vitamin D that I think was then later
increased to 1,000 IU of vitamin D so
that's one of the big criticisms of this
trial because you could imagine if you
had a placebo but someone was already on
something that's identical to the
placebo or even higher dose than what's
in the placebo that could really confuse
your results and and I think that really
did confuse the results as you'll see so
when the initial publication came out
this was a 7-year intervention and they
were looking again Placebo versus the
intervention of calcium and d and what
what they found is that the intervention
did not significantly affect hip
fracture rates meaning that vitamin D
and calcium did not reduce hip fractures
in this massive trial but remember that
people in the placebo group were also
probably taking calcium and vitamin D so
how could there be a difference right so
this is again one of the opportunities
you have here is to look at subgroups
and because they had this all very well
charted out hopefully you can actually
take a look at people who weren't taking
their own supplementation who were on
the placebo compared to those that were
on the intervention so not only is that
important but also potentially
differences in age groups are important
and so when you look in the data here
what you can see is that the data do
show that there was a reduction in
fracture in the over 60y old Group which
kind of makes sense because you don't
see that many fractures uh in the 50 to
59 year old group hopefully what's
interesting though is that in that
original study they did show that there
was an increase in fracture in the
younger group with calcium and vitamin D
now how could that possibly be well I
imagine that probably at that point in
time because not as many people were
taking vitamin D and calcium back then
so my guess is that those were
individuals that probably already had a
pre-existing diagnosis they probably
already have bone health issues and so
you were probably exposing them to a
little bit of bias and already having a
risk for fracture and there also weren't
that many fractures another issue we see
here around supplementation studies or
any intervention that involves a patient
actively taking a pill especially if
it's multiple pills is compliance now
they used self-reported compliance
obviously these people weren't locked in
a a ward for years and you know given
pills so they had to report whether or
not they took the uh supplementation and
so probably there's some bias there
people don't like to admit that they
don't take stuff but for the people that
admitted not taking at least 80% of
their pills there was also a difference
in the outcome so for people that were
compliant meaning that they took over
80% of what they were recommended to
take that they said they did have a
reduction in hip fracture across all age
groups compared to those that uh were on
Placebo so again it's really deceiving
when the study says there's no
difference but when you look at people
who actually took the supplement there
was a difference so confusing and this
is why reading headlines and reading
abstracts do not give you all the
information that you need to interpret
research and then the final thing that I
thought was really important is that
when you did finally remove those that
were taking their own home
supplementation did you see an
improvement in hip fracture and the
answer is yes although they looked at
this statistically a couple of different
ways and in one Avenue it did meet
significance in the other Avenue it
didn't so certainly there was a trend
and yes it was statistically significant
kind of so then what about bone material
density well bone materal density was a
little bit mixed there was an
improvement in total hip bone mineral
density and those that were taking the
calcium and vitamin D intervention
versus those on Placebo but this was not
true elsewhere in the spine so only in
the total hip did you see that
difference all right so I said this was
a follow-up study though right so up
till now I've only talked about the
original publication back in the early
2000s so the follow-up study actually
the first one came out 11.1 years after
the intervention and there was no
statistically significant effect of
calcium plus vitamin D on hip fractures
again this is the statement that they
make right but again if you look into
the data you have to see then that those
that were adherent to the uh medication
the supplementation the intervention did
see a reduction in hip fracture so how
misleading it's so frustrating uh that
the authors would choose to put the
other statement first where they could
just say if you take calcium and vitamin
D there's going to be a decrease in
fracture risk however if you aren't
compliant with your supplementation then
you're not going to see that Improvement
fracture risk so I I think that this
certainly could have been said better
and I think the headlines could have
read it better uh but ultimately this
11-year follow-up did show that there
was an improvement in hit fracture risk
with calcium and vitamin D alone now
this study also talked about the risks I
think this is really important because
this is long-term data on taking a
calcium supplementation at what I would
consider to be a pretty high dose and
they did a really good job of collecting
data on risks what kind of bad outcomes
occurred and so this is really important
but before we get there if you're having
a hard time putting together all of this
information and you're just confused
about what to do sign up for our free
master class we run this thing every you
think week or every other week uh we're
doing it as often as we can because
people have found it so helpful we've
had tens of thousands of people now go
through this master class and again it's
totally free and you can watch me put
together how we uh look at all the
different evidence the things that we
put into a program for our patients and
then answer questions for about 15
minutes so if you haven't done it and
you're struggling with bone health and
all the information that you're
receiving please sign up for the master
class it'll really help things to get
straightened out for you so then in this
long-term data what about the heart
attacks what about the heart disease
what about calcification so what's
really cool here is that they were able
to look at this track all these data and
show that there was no significant
effect on overall mortality meaning that
patients didn't die more often from
being in the uh intervention group
rather than the placebo group there was
actually a trend toward being protective
in total mortality but we can't say that
that's a real finding there was also no
significant effect on cardiovascular
events meaning heart attacks or on
calcification so looking at
calcification in the coronary arteries
there was no effect of having been on
the supplement versus not having been on
the supplement the only thing that did
stand out though is that there was a 17%
increase in kidney stones in the
intervention and that's actually not
surprising so then what's the takeaway
from these long-term complications well
I think that the kidney stone takeaway
is that when you use calcium carbonate
and calcium citrate there's evidence to
show that you get a spike in blood
calcium levels that's not true when you
use microcrystalline hydroxy appetite
complex products it's not true when you
use other Whole Food forms like algae
Cal products
another algae based calcium because
Whole Food forms your body knows more
what to do with and your body can better
process those things that calcium versus
if you get it in a calcium carbonate or
calcium citrate form so I'm not
surprised to see the increase in kidney
stones now I'm happy to see that there
was no increase in overall mortality
cardiovascular events all the things
associated with coronary artery
calcification but we do also have to
remember that those studies didn't
actually break down who was adherent who
wasn't who had their own supplementation
at home Etc so maybe take it with a
grain of salt because we need to really
dig into those data more and those
studies didn't do that okay so what's
the overall big picture here on calcium
and vitamin D what does this study
actually help us to do well for me it
helps to reinforce the fact that we need
probably calcium and vitamin D if we
want to optimize our bone health and I
get a little uh Kickback here from
people who say that they're getting it
all through diet and it is totally
possible to get it all through diet but
you have to remember that people that
have osteoporosis and osteopenia are
starting from a disadvantaged starting
point they have a pathologic condition
kind of just means that they need to be
super physiologic in their dosing either
coming through food or coming through
supplementation so this is why we do use
calcium and you can look at our best
calcium in 2024 uh conversation because
we have kind of shifted how we use
calcium in our practice but we
definitely do use it in conjunction with
supporting getting the right amount of
calcium through diet now vitamin D is
also interesting so vitamin D we're
using less of now and I have a whole
video on this as well and you can watch
that video to understand where we have
made a change from being pretty
aggressive about using um uh vitamin D3
and and looking at 25 hydroxy D in blood
versus where we are now and remember too
though that the Improvement in calcium
and vitamin D for hip fracture is really
subtle and the Improvement in bone
mineral density is also really subtle
and that's why I would argue that this
is not the only tool that you should
consider there are so many different
things you can do that are more powerful
than calcium and vitamin D even from a
supplement perspective there are
supplements that will independently
improve bone mineral density more than
calcium and vitamin D I also think that
in general osteoporosis is not a Calcium
deficiency it might be a vitamin D
deficiency but usually there are other
things going on that you need to uncover
before calcium and vitamin D can really
be effective so remember that an
osteoporosis diagnosis isn't the the end
but deciding to reverse it is a
Click on any text or timestamp to jump to that moment in the video
Share:
Most transcripts ready in under 5 seconds
One-Click Copy125+ LanguagesSearch ContentJump to Timestamps
Paste YouTube URL
Enter any YouTube video link to get the full transcript
Transcript Extraction Form
Most transcripts ready in under 5 seconds
Get Our Chrome Extension
Get transcripts instantly without leaving YouTube. Install our Chrome extension for one-click access to any video's transcript directly on the watch page.
Works with YouTube, Coursera, Udemy and more educational platforms
Get Instant Transcripts: Just Edit the Domain in Your Address Bar!
YouTube
←
→
↻
https://www.youtube.com/watch?v=UF8uR6Z6KLc
YoutubeToText
←
→
↻
https://youtubetotext.net/watch?v=UF8uR6Z6KLc