Don't count on heavy calcium supplements or bone broth to make bones heal faster after a fracture

Cost

Free, and you save the money and effort spent on calcium tablets, vitamin D and simmering broth every day. All you have to do is supplement when a test finds you short, and not take extra when you are not.

What you get

First, vitamin D. A 2023 systematic review included 14 studies and 2734 fracture patients. The authors concluded that vitamin D alone has very little effect on bone healing, whether the bone has united, and function after recovery. The few studies that saw a benefit were generally of low quality. The authors state that counting only randomized trials, none saw any benefit from supplementing. One of them enrolled 100 patients with long bone fractures who had low vitamin D. Half took 100,000 IU in one dose within two weeks of injury, and half took a placebo (fake pill). In each group 2 people had the bone fail to unite, 4% combined. Another enrolled 102 patients aged 18 to 50 with thigh or shin fractures, in four groups taking different doses or a placebo. At 3 months and 12 months, no difference was seen in healing scores. Another enrolled 32 postmenopausal women with wrist fractures. Compared with those who took none, the high-dose group, equivalent to 1800 IU a day, actually had lower compressive stiffness of the bone. Next, calcium. A 2014 systematic review said there are very few clinical studies on how insufficient vitamin D or vitamin D supplements affect fracture healing, and the conclusion is unclear. The two studies it found gave calcium and vitamin D together and saw more bone density or callus (newly formed bone) at the fracture site, but did not look at how fast it healed. Finally, bone broth. A measurement in Kaohsiung, Taiwan, took three kinds of bone broth noodle dishes bought from vendors, with a serving of broth at 450 to 550 grams. The calcium in each serving of broth averaged 14 to 39 milligrams, or 1.4% to 3.9% of the 1000 milligrams recommended per day. The authors concluded that the calcium in one serving of broth is less than 5% of the daily recommendation. China's recommendation is 800 milligrams a day for ages 18 to 49 and 1000 milligrams for 50 and over, with an upper limit of 2000 milligrams a day. That standard states that taking too much calcium over the long term raises the risk of kidney stones. A U.S. trial enrolled 36282 postmenopausal women who took 1000 milligrams of calcium plus 400 IU of vitamin D every day and were followed for an average of 7 years. Their kidney stone risk was about 17% higher (HR 1.17, 95% CI 1.02–1.34, the plausible range). Hip fracture was about 12% lower, but not significant (HR 0.88, 0.72–1.08). It looks like a good deal because of the intuition that “bones are made of calcium, so the more calcium, the faster they grow”

Notes

Dispute: there are two small leads. A Danish trial enrolled 30 older women with fractures of the upper arm near the shoulder, who had osteoporosis or low bone mass. Those who took 800 IU of vitamin D plus 1 gram of calcium a day had higher bone density at the fracture site at week 6 (0.623 versus 0.570 g/cm²). But it measured only bone density, did not look at whether the bone healed well, and had too few people. In the 102-person trial, when looked at in subgroups after the fact, people on high-dose vitamin D had slightly better function scores, and the authors said another trial is needed to confirm. People who are deficient in vitamin D to begin with are a different case. In one Dutch follow-up record, among people who were still deficient after supplementing, 9.7% had slowed healing. Among people who were not deficient to begin with it was 0.3%, and among those who got their levels up it was 1.7%. This is only a follow-up record and cannot prove cause. If a test finds you short, supplement as your doctor says until normal. People already diagnosed with osteoporosis, or who break a bone from a light fall, need anti-osteoporosis drugs; see §1.40 (anti-osteoporosis drugs), which calcium tablets cannot replace. Long-term supplementing in people who are not short of vitamin D has no benefit; see §6.3 (vitamin D supplements). What is being ruled out is “extra heavy supplementing,” not eating less calcium; keep getting enough calcium in your three meals, see §6.21 (cutting out calcium to prevent kidney stones). For what to do right after a fall when you suspect a fracture, see §13.41 (suspected fracture). The benefit is rated medium, calculated on a year's money spent on calcium tablets and vitamin D. The beneficiary is you.

Evidence grade

B : Supported by research but without a precise number, or based on small or single studies.

Sources

1. Gatt T, Grech A, Arshad H (2023). The Effect of Vitamin D Supplementation for Bone Healing in Fracture Patients: A Systematic Review. Advances in Orthopedics, 2023, 6236045. https://doi.org/10.1155/2023/6236045
2. Haines N, Kempton LB, Seymour RB, et al. (2017). The effect of a single early high-dose vitamin D supplement on fracture union in patients with hypovitaminosis D: a prospective randomised trial. Bone & Joint Journal, 99-B(11), 1520-1525. https://doi.org/10.1302/0301-620X.99B11.BJJ-2017-0271.R1
3. Slobogean GP, Bzovsky S, O'Hara NN, et al. (2023). Effect of Vitamin D3 Supplementation on Acute Fracture Healing: A Phase II Screening Randomized Double-Blind Controlled Trial. JBMR Plus, 7, e10705. https://doi.org/10.1002/jbm4.10705
4. Heyer FL, de Jong JJ, Willems PC, et al. (2021). The Effect of Bolus Vitamin D3 Supplementation on Distal Radius Fracture Healing: A Randomized Controlled Trial Using HR-pQCT. Journal of Bone and Mineral Research, 36, 1492-1501. https://doi.org/10.1002/jbmr.4311
5. Gorter EA, Hamdy NA, Appelman-Dijkstra NM, Schipper IB (2014). The role of vitamin D in human fracture healing: a systematic review of the literature. Bone, 64, 288-297. https://doi.org/10.1016/j.bone.2014.04.026
6. Hsu DJ, Lee CW, Tsai WC, Chien YC (2017). Essential and toxic metals in animal bone broths. Food & Nutrition Research, 61, 1347478（表 2、表 3）. https://doi.org/10.1080/16546628.2017.1347478
7. 国家卫生和计划生育委员会 (2018). WS/T 578.2—2018 中国居民膳食营养素参考摄入量 第 2 部分：常量元素（表 1；定义 3.7）. https://www.nhc.gov.cn/wjw/yingyang/201805/f2c614be95fe41dba8123c23a6e6fb55/files/1739783539207_73894.pdf
8. Jackson RD, LaCroix AZ, Gass M, et al. (2006). Calcium plus vitamin D supplementation and the risk of fractures. New England Journal of Medicine, 354(7), 669-683. https://doi.org/10.1056/NEJMoa055218
9. Doetsch AM, Faber J, Lynnerup N, et al. (2004). The effect of calcium and vitamin D3 supplementation on the healing of the proximal humerus fracture: a randomized placebo-controlled study. Calcified Tissue International, 75, 183-188. https://doi.org/10.1007/s00223-004-0167-0（备注里那项）
10. Gorter EA, Krijnen P, Schipper IB (2017). Vitamin D status and adult fracture healing. Journal of Clinical Orthopaedics and Trauma, 8(1), 34-37. https://doi.org/10.1016/j.jcot.2016.09.003（备注里那项）

Translated from the Chinese original. Original book, section 6, tip 30. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer