Don’t count on loading calcium or drinking bone broth after a fracture to make bone heal faster

Trials of vitamin D after fracture show no case where bone healed better. Studies of calcium plus vitamin D together are few; whether they help is unclear. Calcium in a large bowl of bone broth is only a few tenths of a percent of the daily need. People already vitamin D deficient or with osteoporosis are a separate case.

Cost

No money, and you also save the cost and effort of calcium tablets, vitamin D, and simmering broth every day. All you need is to test for deficiency and supplement only if deficient; if not deficient, do not add extra.

Benefit

First vitamin D. A 2023 systematic review included 14 studies and 2734 fracture patients. The authors conclude that vitamin D alone has little effect on bone healing, union, or function after recovery. Studies that seemed to show benefit were generally lower quality. They state that counting only randomized trials, none showed a benefit from supplementing. One enrolled 100 long-bone fracture patients with low vitamin D: half took 100000 IU once within two weeks of injury; half took placebo. Two in each arm failed to unite — 4% together. Another enrolled 102 people aged 18 to 50 with thigh or lower-leg fractures in four dose or placebo groups. At 3 and 12 months, healing scores showed no difference. Another enrolled 32 postmenopausal women with wrist fractures. Versus no supplement, a high-dose group equivalent to about 1800 IU a day had lower compressive stiffness of bone. Next calcium. A 2014 systematic review says clinical studies of how vitamin D insufficiency or supplementing affects fracture healing are few and conclusions unclear. The two studies it found used calcium plus vitamin D together. They saw higher bone density or callus (new bone) at the fracture site; they did not look at healing speed. Finally bone broth. A Kaohsiung, Taiwan assay bought three bone-broth noodle soups, 450 to 550 g of broth per serving. Mean calcium per serving was 14 to 39 mg — 1.4% to 3.9% of a 1000 mg daily recommendation. The authors conclude one serving supplies under 5% of the daily recommendation. China’s recommendation is 800 mg a day at ages 18 to 49 and 1000 mg from 50 up; daily upper limit 2000 mg. The health industry standard that sets these figures also states that long-term excess calcium raises kidney-stone risk. A U.S. trial of 36282 postmenopausal women taking 1000 mg calcium plus 400 IU vitamin D daily, followed a mean 7 years: kidney-stone risk about 17% higher (HR 1.17, 95% CI 1.02–1.34, credible range). Hip fracture about 12% lower, not significant (HR 0.88, 0.72–1.08). It looks worthwhile because of the intuition “bone is made of calcium, so more calcium grows faster.”

Notes

Controversy: two small leads. A Danish trial enrolled 30 older women with proximal upper-arm fractures who had osteoporosis or low bone mass. Those taking 800 IU vitamin D plus 1 g calcium daily had higher bone density at the fracture at week 6 (0.623 versus 0.570 g/cm²). But it only measured density, not whether bone healed well, and the sample was tiny. A post-hoc look at the 102-person trial found slightly better function scores on high-dose vitamin D; the authors say more trials are needed to confirm. People already vitamin D deficient are a separate case. In a Dutch follow-up record, delayed healing was 9.7% among those still deficient after supplementing, 0.3% among those not deficient, and 1.7% among those whose levels rose. That is only follow-up recording; it does not prove cause. If deficiency is found, supplement to normal as the doctor says. People already diagnosed with osteoporosis, or who fracture from a light fall, need anti-osteoporosis drugs — Section 1, Item 40 (anti-osteoporosis drugs); calcium tablets do not replace them. Long-term supplementing when not vitamin D deficient has no benefit — Item 3 in this section (vitamin D supplements). What to reject is “extra heavy loading,” not eating less calcium; keep meal calcium adequate — Item 21 in this section (don’t give up calcium to prevent kidney stones). Just fell and suspect a fracture: Section 13, Item 41 (suspected fracture). Benefit set to medium by a year’s cost of calcium and vitamin D. The beneficiary is you.

Sources · 9

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. 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. 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. 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. 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. 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）. 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）. nhc.gov.cn/wjw/yingyang/201805/f2c614be95fe41…
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. 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. doi.org/10.1007/s00223-004-0167-0（备注里那项）；Gorter EA, Krijnen P, Schipper IB (2017). Vitamin D status and adult fracture healing. Journal of Clinical Orthopaedics and Trauma, 8(1), 34-37. doi.org/10.1016/j.jcot.2016.09.003（备注里那项）