BMJ  2005;331:108-109 (9 July), doi:10.1136/bmj.331.7508.108-b

Letter

Calcium and vitamin D in preventing fractures

Data are not sufficient to show inefficacy

The first 150 words of the full text of this article appear below.

EDITOR—The study by Porthouse et al had two major design flaws.¹ Firstly, the dose of vitamin D (800 IU per day) is subphysiological and therefore subtherapeutic. Secondly, their use of "self report" as a measure of compliance is unreliable.

The dose of vitamin D at 800 IU daily was not determined scientifically but determined arbitrarily before sufficient scientific methodology was available.^2-4 Heaney et al determined the physiological requirement of vitamin D by showing that healthy men use 4000 IU cholecalciferol daily,² an amount that is safely attainable with supplementation³ and often exceeded with exposure of the total body to equatorial sun.⁴

We provided six guidelines for interventional studies with vitamin D.⁵ Dosages of vitamin D must reflect physiological requirements and natural endogenous production and should therefore be in the range of 3000-10 000 IU daily. Vitamin D supplementation must be continued for at least five to nine months. . . . [Full text of this article]

Biotics Research Corporation, 6801 Biotics Research Drive, Rosenberg, TX 77471, USA avasquez@bioticsresearch.com

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Relevant Article

Randomised controlled trial of calcium and supplementation with cholecalciferol (vitamin D₃) for prevention of fractures in primary care

Jill Porthouse, Sarah Cockayne, Christine King, Lucy Saxon, Elizabeth Steele, Terry Aspray, Mike Baverstock, Yvonne Birks, Jo Dumville, Roger Francis, Cynthia Iglesias, Suezann Puffer, Anne Sutcliffe, Ian Watt, and David J Torgerson
BMJ 2005 330: 1003. [Abstract] [Full Text] [PDF]