Taking Vitamin D Probably Won’t Prevent Falls or Fractures—Here’s What Will

Taking vitamin D, with or without calcium, does not lower the risk of older adults falling or having fractures, according to a new draft recommendation issued last week by the U.S. Preventive Services Task Force.

More than one in four older adults falls in the U.S. each year, which can lead to broken bones and other injuries. Vitamin D and calcium are sometimes taken together because the body needs vitamin D to absorb calcium, which is essential for bone health.

“Often patients have read or heard from someone that they should be taking them for a variety of reasons, and so they do,” Barbara Bawer, MD, a family medicine physician at The Ohio State University Wexner Medical Center, told Health.

The recommendation by the nationwide panel of experts doesn’t apply to people with osteoporosis, vitamin D deficiency, or those taking vitamin D for other medical reasons. 

While the report concluded that vitamin D doesn’t lower the risk of fractures or falls in older adults, it doesn’t say that people should forgo vitamin D or calcium or that they have no benefits.

Here’s what the panel found—plus what doctors who treat aging patients actually suggest for preventing falls and fractures.

The USPSTF’s panel conducted a systematic review of research on the role of calcium, vitamin D, and falls in older adults. The panel concluded with “moderate certainty” that supplementing with vitamin D showed no benefit for preventing falls and fractures in older adults.

Panelists also found that supplementing with vitamin D, with or without calcium, can increase the risk of kidney stones. As a result, the panel doesn’t recommend that men and women aged 60 and up supplement with vitamin D, with or without calcium, to prevent fractures and falls.

The panel’s findings build on a 2018 recommendation against postmenopausal women taking 400 units or less of vitamin D and 1,000 milligrams or less of calcium to prevent fractures. (At the time, the panel said there wasn’t enough evidence to make recommendations for men.)

There are a few reasons why the risk of falls and fractures increases as you age. “Your bone stock really peaks in your 20s and 30s,” Alex Jahangir, MD, vice chair and a professor in the Department of Orthopaedic Surgery at Vanderbilt Health, told Health. “Your bone quality is also lower as you get older. As a result, if you fall, you’re more inclined to get a fracture.”

Mobility can also be more difficult as you get older due to conditions like osteoarthritis or other forms of arthritis, Bawer said. “This alters the way we walk, including shuffling of the feet, leaning in various ways to help offset pain,” she said.

Neurological conditions like neuropathy, which can change the sensation in the toes or feet, can also impact balance and mobility, raising the risk of falls, Clifford Segil, DO, a neurologist who treats older adults at Providence Saint John’s Health Center in Santa Monica, CA, told Health.

“Eyesight is usually worse as well as we age, and so we can misstep or not see something in our way which can lead to falls,” Bawer said.

Some medications can also lead to dizziness and loss of balance, and older adults tend to be on more medications to manage health conditions than younger adults, John Fudyma, MD, interim chief of geriatrics and palliative care in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, told Health.

Per Fudyma, a vitamin D deficiency can also make you more prone to falls.

Doctors stress that the findings don’t suggest that there’s no value to taking vitamin D and calcium—only that the combination is unlikely to prevent older adults from having fractures and falls.

“Vitamin D and calcium are important for other functions in the body,” Fudyma said. “But in the general, average population who is 60 and above, it’s not recommended to supplement with them to prevent fractures and falls.”

In addition to strengthening bones, vitamin D and calcium are necessary for muscle and brain function. Doctors generally recommend that people obtain them through food rather than supplements, but supplements may be an option for people who don’t get enough of the nutrients from food. Per Bawer, these groups include:

• People with osteoporosis, a disease that develops when bone mineral density and mass decreases
• Those who have issues absorbing some nutrients
• People whose diets are low in calcium
• People who don’t spend any time outdoors or limited time outside
• People with hyperparathyroidism, inflammatory bowel diseases, or celiac disease

“Early studies in patients who had vitamin D deficiency and low intakes of calcium show a beneficial effect of supplementation,” Sue Shapses, PhD, RD, a vitamin D researcher and professor of nutritional sciences at the Rutgers University School of Environmental and Biological Sciences, told Health.

Doctors said there are a few ways to lower the risk of fractures and falls with age.

• Take routine walks. “I tell people to walk more,” Segil said. Not only does this help build up muscle and bone strength, but it can also help with balance.
• Do strength training. Weight-bearing exercises can help build up bone strength, Segil said. “I would advise people to do weight-bearing exercises over taking a vitamin any day of the week,” he added.
• Try balance exercises. “Doing balance exercises like tai-chi, Pilates, and yoga can help as well,” Bawer said.
• Look at your medications. People with osteoporosis can take medications like bisphosphonates to lower the risk of fractures, Shapses said.
• Ramp up protein intake. On the dietary front, having plenty of protein may also help lower the risk of fractures and falls, Shapses said.
• Stay on top of your eye health. Bawer suggests getting annual eye exams and wearing necessary visual tools like glasses and contacts.
• Get plenty of sleep. “Get enough sleep because as people are more tired, their risk of falls increases and therefore fractures,” Bawer said.
• Tidy up your home. Decluttering your environment to reduce trip hazards is crucial, too, Fudyma said.

Unfortunately, lowering the risk of fractures and falls in older adults isn’t as simple as taking a supplement. “For most people with adequate vitamin D and calcium levels, supplements don’t help prevent falls or fractures,” Shapses said. “Supplements are only helpful if you are deficient.”