Fractures and vitamin D

This is a bit off topic, but it's such an interesting observation that I'd like to pass it on.

Over the past several years, there have been inevitable bone fractures: People slip on ice, for instance, and fracture a wrist or elbow. Or miss a step and fracture a foot, fall off a ladder and fracture a leg.

People will come to my office and tell me that their orthopedist commented that they healed faster than usual, often faster than anyone else they've seen before. My son was told this after he shattered his hand getting slammed against the boards in hockey; his orthopedist took the screws and cast off much sooner than usual since he judged that healing had occured early. (My son was taking 8000 units vitamin D in gelcap form; I also had him take 20,000 units for several days early after his injury to be absolutely sure he had sufficient levels.)

My suspicion is that people taking vitamin D sufficient to enjoy desirable blood levels (I aim for a 25-hydroxy vitamin D level of 60-70 ng/ml) heal fractures much faster, abbreviating healing time (crudely estimated) by at least 30%.

For any interested orthopedist, it would be an easy clinical study: Enroll people with traumatic fractures, randomize to vitamin D at, say, 10,000 units per day vs. placebo, watch who heals faster gauged by, for instance, x-ray. My prediction: Vitamin D will win hands down with faster healing and perhaps more assured fusion of the fracture site.

Comments (25) -

  • River Rat

    4/26/2010 11:18:16 PM |

    Just anecdotal, but I had an experience that confirms your theory.  In the middle of a 21-day trip down the Colorado through Grand Canyon, I fell and fractured my arm.  I decided just to splint it up and continue the trip, since the pain wasn't too bad.

    By the time I got to a clinic in Flagstaff, 10 days later, the doctor said everything had healed so well I didn't even need a cast.  

    Needless to say, there is lots of free Vitamin D in the Grand Canyon in summer!  We were in the sun all day long.  Maybe it made the difference.

  • ithink

    4/27/2010 12:18:12 AM |

    probably also has to do with the fact people are calcium deficient without vitamin d.

  • DrStrange

    4/27/2010 12:51:24 AM |

    Isn't there evidence that the blood level vs benefit curve reverse itself ("U" shape) above around 60 ng/ml?  Maybe just under or at that safer???

  • mongander

    4/27/2010 2:02:11 AM |

    Last fall I was happy with my blood level of vit D, 79 ng/ml, so I reduced my daily dose from 10,000 iu to 5,000 iu.   I just got my spring test result and my level dropped 23 points to 56 ng/ml.  I'm gonna go back to 10,000 iu, except maybe during the summer when I get a lot of sun.

  • TedHutchinson

    4/27/2010 12:23:13 PM |

    How to Optimize Vitamin D Supplementation to Prevent Cancer, Based on Cellular Adaptation and Hydroxylase Enzymology" You can read Reinhold Vieth's justification for keeping 25(OH)D both high and STABLE here.
    In order to regulate any system there has to be a means of both increasing and decreasing responses.
    Where the upregulation and down regulation is performed by different substances both of which are derived from Vitamin D, it follows these have to be kept tightly controlled and always in balance.
    Sudden rise in 25(OH)D causes a period of imbalance between those forces, during which too much immunosuppression may occur.
    The further north people live the more extreme differences between Summer/winter status. It isn't surprising those flying to the tropics for short midwinter sun breaks end up catching something from recycled germs during the flight home.
    Making sure your Vitamin D needs are met daily throughout the year evens out the percentage change in levels as naturally more vitamin D3 is made in low 25(OH)D skin than when 25(OH)D is high.

    Correcting vitamin D deficiency BEFORE a winter sun break results in a lower increase in 25(OH)D.
    Less change in status = shorter period of imbalance.

    I don't have to remind readers here Ergocalciferol speeds up the catabolism of vitamin D Cholecalciferol has a longer half life. Using Vitamin D2 therefore promotes greater/faster swings in status and should be avoided.

    Using Vitamin D3 supplements daily at amounts no greater than UVB exposed skin would naturally produce, most nearly replicates the changes in status human DNA would have evolved with.

    Apologies to Dr Vieth for assuming the copy of the paper linked to above was non-copyright and putting it online.  I think it's important the public have access to the full text rather than just my garbled version of this important paper.

  • Ned Kock

    4/27/2010 1:17:02 PM |

    Thanks Dr. Davis for the post sharing you personal experiences.


    The relationship seems to follow a U-curve pattern, with very high levels being associated with hypervitaminosis D problems.

    The levels mentioned by Dr. Davis seem well below the ones that can lead to toxicity. For example, a farmer in Puerto Rico had a level of 225 nmol/L (90 ng/mL), and had no signs of toxicity:

    From the post above, toxic doses seem to start around 50,000 IU per day. That's way more than the 10,000 IU or so that we get from sun exposure.

    My only point of disagreement with Dr. Davis is about our ability to produce vitamin D from sunlight after age 40. There is research (post above too) showing that the elderly can produce as much as 80 percent vitamin D from sunlight as do 20 or 30 year olds.

  • homertobias

    4/27/2010 3:21:19 PM |

    Hi Dr.Davis.
    I just wanted you to know that THIS PRACTIONER is running her own open label trial on 5-10 people with lp(a).  I will let you know the outcome.
    I just read your trial on 45 CAC high scorers that you published in Am J of Theraputics last year.  I hear that the registration process to publish is a horrific process. I am glad you persisted,  I really wanted your raw data but...

  • Tom

    4/27/2010 6:58:50 PM |

    I hope I'm not diverting from the topic here....I'm confused about the Vit D-Calcium interaction.

    I believe I understand correctly that high Vit D levels allow the body to more effectively process calcium.

    I don't understand how calcium requirements change with increased Vit D levels.  I have a blood level of 72 (D3) and 3 (D2).  But I haven't paid attention to my calcium intake.

    Can anyone clarify the relationship between Vid D and calcium please?

    Thank you in advance.

  • DrStrange

    4/27/2010 7:00:05 PM |

    "The relationship seems to follow a U-curve pattern, with very high levels being associated with hypervitaminosis D problems."

    Not hypervitaminosis D but rather reversal of D's benefits.  I had read that above 60 ng/ml the risk of prostate cancer increased again.  Just now searching for the study found on D council site, a recent article showing the likelihood that this outcome was because the research subjects had all gotten their higher D levels from Cod liver oil and the vitiman A in that is what reversed the benefits of D, not the high levels of D!  So seems I could well have been misinformed about that.

  • sonny

    4/27/2010 11:32:00 PM |

    Just threw out all multivitamins in the house after hearing about vitamin A interfering with vitamin D absorption.

  • TedHutchinson

    4/28/2010 8:27:12 AM |

    @ Dr Strange
    Tuohimaa's team claiming they have found a U shaped curve for Vitamin D is based in Tampere, Finland latitude 61N
    People at that latitude with high 25(OH)D levels have experienced a greater change in level from summer to winter or if they choose to take a winter sun break will experience further re-balancing of the immune system. Vieth argues it is the length and number of periods of imbalance that drive the effects Tuohimaa reports.

    Now we have greater availability of effective strength D3 it will be easier for people at that latitude to attain and maintain the levels that enabled the Inuit to survive long winters with over 6000iu daily vitamin D3 provided from traditional diet.

    @ Tom
    Video of Heaney explaining the calcium/vitamin D story

    The Vitamin D requirement in health and disease Heaney similar information in PDF form but in greater detail.
    Bear in mind when considering Vitamin D and Calcium absorption that other co-factors work in synergy with Vitamin D.
    Magnesium is required to power the  production of the active hormone Calcitriol that lowers PTH and magnesium also counterbalances the role of calcium as magnesium is a natural calcium channel blocker.
    Each Vitamin D Receptor requires zinc.
    Also Vitamin K2 mk4 is critical for healthy bone density transporting calcium from bloodstream to bone.

  • Kent

    4/28/2010 8:13:45 PM |

    There has been at least one study done. Here's one with guinea pigs.

    This is another area where common sence and experience shouldn't really require a study to initiate this course of action. Example; I saw the other day there was a "study" done on children that proved that what they saw on TV affected their actions. I'm sure many parents are glad that study "finally" came through!

  • Jason

    4/28/2010 9:40:56 PM |

    New study on grains:

    "Published research shows eating two to four serves of wholegrain foods a day can reduce the risk of heart disease by as much as 40 percent - equal to the effect of cholesterol lowering drugs,"

  • Tom

    4/29/2010 1:03:42 PM |

    To TED,

    Thank you Ted for the information.  The Heaney video was very interesting and worthwhile.  It's interesting that he says optimal D3 for calcium absorbtion is between 80 and 120 nmol.  I'm at 70 nmol and thought I was fine!
    The video is well worth watching.

    nevertheless, I'm still trying to understand how much calcium I should be taking, assuming I get my D3 to 80 or so.

    Your remarks about Magnesium, etc. are helpful.  Thank you.  But again, I struggle with how much?  


  • Daniel

    4/30/2010 4:23:49 PM |

    Another explanation, this one from Cannell, for the U curve found in Scandinavia is cod liver oil.  

    People with the highest vit D levels may be consuming enormous amounts of cod liver oil and, thus, vitamin A.

    Excess retinol may thwart the action of vit D by competing for certain nuclear receptors.

  • P90X Results

    5/3/2010 9:57:44 AM |

    This is very useful information of Obesity. You can find more information about how to prevent heart diseases. I am very excited about your post, it's really amazing.

  • Tom

    5/3/2010 10:45:10 PM |

    To Ted,

    Thank you once more for this information.

    I just read that calcium has been implicated in Prostrate cancer.  have you heard anything about this?

  • Anonymous

    7/28/2010 5:01:59 PM |

    Do you know if anything helps for soft tissue injuries? I am still not fully recovered from a foot injury 5 months after the acute phase. The orthopedist expected it to take 4 weeks to heal and I'm a little concerned about how long it will take.

  • Troy @ shipping quote

    12/31/2010 5:44:10 AM |

    The above blog post is quite informative. Having good information related to bones and its requirements. I was not knowing that Vit D is so important for our bones. But good to know about that. Want to ask what are the natural resources of Vit D in our daily diet?


    1/1/2011 12:48:29 PM |

    Quite an informative blog post. I know that inadequate amount of vitamin D in diet can lead to osteoporosis, which is a brittle bone disease. But are there any side effects of excessive intake of vitamin D.

  • Nevil - same day courier

    3/22/2011 12:13:49 PM |

    Great post William, my friend is really having some bone problem, so this information will be quite useful for him. Looking forward for more post on the same topic.

  • Hal

    5/7/2011 4:11:01 PM |

    I know someone who was in a car accident that resulted in very serious fractures of one arm and wrist.  He is in his late 60's and his injuries were not healing.  

    I came to know this person about 6 months after the accident.   He was taking about 2 grams of  calcium per day thinking that this would help his bones, perhaps because the doctor told him to talk more calcium, but no supplemental  Vitamin D.   I told him that the should be taking at least 5000UI D3  per day pointing out that Walmart has 5000UI gel caps for cheap ($5 per 100 at that time) and that he was likely taking too much calcium.  He started taking more D3 although I am not sure how much since I didn't want to be pushy.  

    It has been about 9 months now since he started taking more D3 and his injuries have healed and he has had surgery to remove most of the plates and screws that had been put in place.    Was D3 the reason for this?    I don't know but I am sure that it didn't hurt either.