Calcium Plus Vitamin D Supplementation and Joint Symptoms in Postmenopausal Women in the Women's Health Initiative Randomized Trial

Abstract

Background Low vitamin D intake and levels have been associated with increased joint symptoms in some observational studies but the findings are mixed and evidence from randomized trials sparse. Objective To evaluate the influence of supplemental calcium and vitamin D on joint symptoms in the Women's Health Initiative randomized, placebo-controlled, clinical trial. Design In post hoc analyses, the results of the WHI randomized clinical trial in which 36,282 postmenopausal women were randomized to calcium carbonate (1000 mg as elemental calcium) with vitamin D3 (400 IU) daily or placebo were examined in the 6% subgroup of 1911 participants, over-sampled for minorities, who had serial joint symptom assessment. Qualitative information on joint pain and joint swelling was collected by questionnaire before entry and 2 years after randomization. Logistic regression models were used to compare the occurrence and severity of joint symptoms across randomization groups. Results At baseline, total calcium and vitamin D intakes from diet and supplements were similar in the two randomization groups. In addition, both joint pain (reported by 73%) and joint swelling (reported by 34%) were commonly reported and comparable in the supplement and placebo groups. Two years after randomization, no statistically significant differences between supplement and placebo groups were seen for joint pain frequency (74.6% compared to 75.1%, [P=0.79] for supplement and placebo groups, respectively) or joint swelling frequency (34.6% compared to 32.4%, [P=0.29], respectively) or in severity scores for either outcome. Subgroup analyses suggested study participants also using non-protocol calcium supplements at study entry may have less joint pain with supplement group randomization (interaction P-value=0.02).. Conclusions Joint symptoms are relatively common in postmenopausal women. However, daily supplementation with 1000 mg of calcium carbonate and 400 IU of vitamin D3 in a randomized, placebo-controlled clinical trial setting did not reduce the self-reported frequency or severity of joint symptoms.

Dietary and Supplemental Vitamin C and D on Symptom Severity and Physical Function in Knee Osteoarthritis

“…As opposed to some studies (8, 11, 12), we found a correlation suggesting that higher intake of dietary vitamin D is associated with higher levels of pain. Because of the cross-sectional nature of the data, we cannot determine causality or directionality in the association.…”

“…However, studies examining vitamin D intake and osteoarthritis pain reveal conflicting results, with some studies demonstrating minor to no benefit for pain outcomes (5, 8, 11). For example, a study examining 36,282 participants from the Women’s Health Initiative randomized trial found vitamin D did not have an association with the frequency or severity of joint symptoms (12). One randomized controlled pilot study consisting of 107 patients, who were given vitamin D or a placebo over a 12 month period, found little to no effect of Vitamin D on pain and functional disability (11).…”

Role of Jumpstart Nutrition®, a Dietary Supplement, to Ameliorate Calcium-to-Phosphorus Ratio and Parathyroid Hormone of Patients with Osteoarthritis

“…The present results suggest that there is a close relationship of the risk factors between the bone related biomarkers (CPR, PTH and vitamin D) ( Figures 2-7 and Tables 2 and 3) and pain with disability-related outcome measures (KOOS and KPS) (Figures 8-10) in OA. The results elucidated the treatment of OA with a bone supplement especially composed of calcium, phosphorus, vitamin-K 2 , coenzyme-Q 10 , folic acid, vitamin C, boswellic acids, and curcumin, which is more efficacious in comparison with the commonly composed available supplements with vitamin D [49] or with calcium and vitamin [50] or with calcium and hydrolyzed amino acid [51] or glucosamine sulphate [52] or a combination of glucosamine sulphate and chondroitin sulphate [53] or other such combinations without vitamin-K 2 or coenzyme-Q 10 .…”

The role of antioxidant vitamins in gynecologic malignancies

“…Dane są zatem kontrowersyjne. Sprzeczne wyniki zostały przedstawione także w dwóch innych badaniach (12,13) . Lappe i wsp.…”

“…Chlebowski i wsp. (13) , którzy badali kobiety po menopauzie z Women's Health Initiative (>36 000 uczestniczek) przyjmujące witaminę D z wapniem, nie wykazali jednak redukcji ryzyka rozwoju raka piersi. Niemniej inne prace dowodzą, że witamina D jest związana z obniżeniem ryzyka rozwoju raka piersi, znajduje zastosowanie w zwiększaniu radioczułości leczonego raka piersi, a nawet bywa lokalnie podawana w terapii przerzutów skórnych raka piersi (14,15) .…”