Remember baby aspirin for everyone? Then not? Vit D and calcium supplements now also questioned

If I had a dime for every time something was recommended "for everyone"...

I’ve been in healthcare long enough for a mild eye roll when a medication emerges as a wonder drug and questions start popping up about whether everyone should be on it. My latest skepticism targets include Metformin and our promising, but very early-times, obesity drugs. Both definitely have clear indications and promise, but it takes years of research to study enough people to know the full story in smaller populations, a necessary but frustrating process. Between 2013 and 2016, early studies resulted in recommendations for daily baby aspirin every day in older adults to prevent heart disease. That quietly went away in 2022, in case you didn’t notice.

Now Vit D and calcium supplements—long accepted as a weapons to prevent osteoporosis in older adults—are the latest to be found to be of questionable value and potentially a risk for many. I know…heresy for older adults, but here we are. The U.S. Preventive Services Task Force (USPSTF) now gives these routine supplementation a grade of D, noting there is little evidence to suggest routine use will help older adults avoid broken bones, including rightfully-dreaded hip fractures. The Task Force’s grade recognized moderate/high certainty that supplementation provides no net benefit, and/or that harms potentially outweigh benefits.

The Task Force now recommends against these supplements for people who are not taking them for “other medical reasons.” The new recommendations (no supplementation outside food) apply to people living at home—not higher risk nursing home residents—and post-menopausal women and men 60+.

Do remember there can be very good reasons for supplementation in specific populations. High mortality rates after falls resulting in hip fractures are well known—so don’t be your own doctor on this if you might be in a risk category. But if you’re not, the new research says Vit D and calcium won’t help lower risk and could actually increase risk for issues like kidney stones. Of course, if you’ve been in a healthcare for a while as either a customer or provider, you also know it’s hard to get a provider to tell you to stop taking something, so discontinuing Vit D and/or calcium supplementation in the absence of a specific indication may likely be up to you.

I don’t mean to sound cynical about medical research; I depend on it daily, and our US research in particular has saved the lives of hundreds of millions worldwide. It’s the “everyone should take it” and “wonder-drug” phases where I have some experience-rooted cynicism. As we consider what non-natural sources we’re putting into our bodies, what’s really important is to do more than look at headlines. Read the research, like the links above. Make sure it makes sense to you, and talk to your provider about potential risk factors that put you in a different category.