Want Dr. Calendine’s articles to stand out in your Google and AI search results? Add him as a preferred source (one tap).
Do Calcium and Vitamin D Supplements for Fractures Actually Work?
For most healthy older adults, calcium and vitamin D supplements for fractures do very little. A large 2026 review pooled 69 randomized trials and more than 153,000 people, and the result was clear: these supplements did not meaningfully lower the risk of breaking a bone or falling.
Here is what I tell my patients in clinic. If you are taking these pills hoping they will keep your bones from breaking, the evidence no longer supports that for the average person. That does not mean every patient should stop; it means the picture is more specific than “take calcium and you will be protected.”
After more than twenty years caring for hip and knee patients as a board-certified orthopaedic surgeon, I have seen how much hope people place in supplements. My job is to be honest about what the science shows, and to point you toward the things that actually move the needle.
What Did the New Research Find?
The review, published in The BMJ in May 2026, is one of the largest of its kind. Researchers combined 69 randomized controlled trials, the gold standard for testing whether a treatment works, covering 153,902 adults.
They looked at three approaches: calcium alone, vitamin D alone, and the two combined. Across the board, the benefit for preventing fractures and falls was small enough that it would not change most patients’ lives.
Calcium and Vitamin D Supplements for Fractures: The Numbers
Vitamin D taken by itself showed no effect on fracture risk, and the certainty behind that finding was high. Calcium alone showed little to no effect. Combined calcium and vitamin D did reach statistical significance, but the real-world benefit was tiny: about 1 percent fewer fractures, which means roughly 100 people would need to take the supplements to prevent a single break.
Most of that small combined benefit traced back to one older trial in very frail nursing-home residents. Strip that study out, and the benefit mostly disappears.
What About Falls?
Vitamin D was also studied specifically for preventing falls, and the result was the same: little to no effect, with high certainty. This surprised many clinicians, because for years vitamin D was promoted as a way to steady older adults on their feet.
This Builds on a Government Recommendation
These findings line up with guidance from the U.S. Preventive Services Task Force, an independent panel of national experts. In a draft recommendation, the Task Force advised against taking vitamin D, with or without calcium, to prevent fractures in postmenopausal women and in men age 60 and older.
The Task Force gave this a “D” grade. In plain terms, that means they recommend against using these supplements for this specific purpose. They also pointed to a real downside: supplements can carry harms, including a higher risk of kidney stones.
Does This Mean Vitamin D Is Useless?
No. Vitamin D and calcium are still essential nutrients for bone and muscle. The review did not say these nutrients do not matter; it said that taking extra as a supplement does not prevent fractures in people who already have enough.
If your blood level is low, correcting a true deficiency is worthwhile, and your doctor can guide that. The trials that found no benefit mostly enrolled people who started with normal or near-normal levels, which is exactly why piling on more did not help.
Why Falls and Fractures Matter as You Age
Falls are the leading cause of injury in older adults, and the stakes are high. According to the Centers for Disease Control and Prevention, nearly 39,000 adults age 65 and older died from a fall in 2021, which is about 100 fall-related deaths every day.
Almost a third of people 65 and older fall each year. A broken hip or wrist can take away independence in a way that is hard to get back. So the question of how to prevent these injuries is not academic; it is one of the most important things I discuss with older patients, and it shapes how I prepare people for joint surgery.
Who Should Keep Taking Their Supplements?
This is the part I want you to read twice. The new evidence applies to generally healthy older adults taking supplements as insurance against a future fracture. It does not apply to everyone.
You should not stop your calcium or vitamin D without talking to your doctor if any of these describe you:
- You have been diagnosed with osteoporosis (thinning, weakened bone).
- You have a confirmed vitamin D deficiency on a blood test.
- You have a medical condition that affects how your body absorbs vitamin D.
- Your physician prescribed these supplements for a specific reason.
There is an important reason for that last point. Almost every medication we use to treat osteoporosis was studied with calcium and vitamin D given alongside it. If you take an osteoporosis drug, these supplements are often part of how it is meant to work.
What Actually Prevents Falls and Fractures?
The encouraging news is that the most effective tools are within your reach, and most cost nothing. The same review and the Task Force both point to a short list of things that genuinely help.
Move Your Body, On Purpose
Structured exercise is the single best-supported way to prevent falls. That means balance work and resistance (strength) training, not just walking. National guidelines suggest about 150 minutes a week of a mix that includes weight-bearing activity, strength training, and balance practice such as tai chi.
In my practice, patients who build leg and core strength before and after total knee replacement or total hip replacement recover faster and fall less. Strong muscles protect bones, and they protect new joints too.
Get Screened and Make Your Home Safer
Women 65 and older should be screened for osteoporosis, and some women sooner depending on risk. A bone density test tells us whether your bones actually need targeted treatment, which is far more useful than guessing.
Simple home changes lower fall risk too: better lighting, removing loose rugs, grab bars in the bathroom, and a review of any medications that affect balance.
Feed Your Bones Through Food First
Most doctors, myself included, prefer you get calcium and vitamin D from food rather than pills when possible. Dairy, leafy greens such as kale and broccoli, sardines, canned salmon, and fortified foods like cereal and orange juice all supply these nutrients in a form your body handles well.
Food also avoids the side effects that supplements sometimes bring. Calcium pills can be hard on the stomach, causing constipation, bloating, or cramping in some older adults. None of these harms are reason to panic, but they are worth weighing against a benefit that, for most people, is very small.
What I Tell My Patients
If you are healthy and taking calcium and vitamin D only to avoid a future fracture, bring it up at your next visit. There may be a better use of your effort and money.
If you have osteoporosis, a deficiency, or a prescription, keep doing what your doctor advised and ask before changing anything. And whatever your situation, put your energy into strength, balance, and a safer home. Those are the choices that protect the patients I see every week.
If you have questions about bone health, an arthritic hip or knee, or recovery after joint replacement, our team at the Bone and Joint Institute of Tennessee is here to help.
Ready to talk through your bone and joint health? Schedule a consultation with Dr. Cory Calendine, or call us at (615) 791-2630. We are located at 3000 Edward Curd Lane, Franklin, TN 37067.
This article is for educational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any supplement or treatment. Individual results vary based on your health history. Dr. Calendine maintains a disclosed paid consulting relationship with Stryker.
References
- Massé O, Mercurio CM, Dupuis S, et al. Calcium, vitamin D, or combined supplementation to prevent fractures and falls: systematic review and meta-analysis. BMJ. 2026;393:e088050. doi:10.1136/bmj-2025-088050
- Vitamin D, calcium, or combined supplementation to prevent fractures and falls (linked editorial). BMJ. 2026. doi:10.1136/bmj.s913
- U.S. Preventive Services Task Force. Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures and Falls in Community-Dwelling Adults: Draft Recommendation Statement. December 2024. uspreventiveservicestaskforce.org
- Bergen G, Stevens MR, Burns ER. Falls and fall injuries among adults aged 65 years and older, United States. MMWR Morb Mortal Wkly Rep. 2016;65(37):993-998. doi:10.15585/mmwr.mm6537a2
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. Exercise for Your Bone Health. National Institutes of Health. niams.nih.gov
