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Add calcium and vitamin D to HRT for healthier bones?

Women taking hormone replacement therapy (HRT) after the menopause are less likely to break their hip if they also take a supplement combining calcium and vitamin D, a large study shows.

BMJ Group News

What do we know already?

xray of shoulder

Your bones naturally become thinner as you get older, whether you’re a man or a woman. But at the time of the menopause some women start to lose bone a lot faster. This is because their bodies are making less of the hormone oestrogen.

To help replace this oestrogen, some women take hormone replacement therapy (HRT). This treatment isn’t right for everyone, as it can raise the risk of breast cancer, heart attacks, and other problems. However, studies show it can help prevent bone loss and reduce the risk of broken bones.

In the new study, researchers explored whether taking calcium and vitamin D might further reduce this risk when combined with HRT. Calcium and vitamin D are the most important nutrients for building strong bones. But it’s unclear whether taking calcium and vitamin D supplements after the menopause can improve a woman’s bone health, as studies have had conflicting results. Also, until now, little good-quality research has looked at whether these supplements might be of benefit to women taking HRT.

Researchers gathered data from a study of nearly 30,000 women who had been randomly selected to take either HRT or a dummy (placebo) treatment. More than 16,000 women from this study were also randomly assigned to take either a supplement combining calcium and vitamin D or a placebo. Over seven years, the researchers then looked at whether the women taking both HRT and the supplement were more or less likely to break their hip, compared with women taking only one or none of these treatments.

What does the new study say?

Women taking both HRT and calcium-vitamin D supplements were less likely to break their hip during the study. The researchers estimated that around 11 in every 10,000 women taking both treatments would break their hip over a year, compared with 18 in every 10,000 women taking HRT alone. Women taking only calcium-vitamin D supplements weren’t any less likely to break their hip than those taking none of the treatments.

How reliable is the research?

This was a large study and its findings should be fairly reliable. Studies like this, which randomly select people to have different treatments, are the most reliable type for finding out the effects of treatments and how they compare.

It’s worth noting that the study didn’t explore how adding a calcium-vitamin D supplement to HRT might affect the risk of breaking other bones besides the hips. Other studies will need to look at this.

What does this mean for me?

If you are past the menopause and take HRT, this study suggests that taking a calcium-vitamin D supplement may help to better protect your bones. You might discuss these findings with your GP, to see if this type of supplement might be right for you.

Published on June 27, 2013

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