For hip fracture , at a 15 % relative risk , the effect estimate lay between the futility boundary and the inferior boundary , meaning there is reliable evidence that vitamin D supplementation does not reduce hip fractures by this amount , but uncertainty remains as to whether it might increase hip fractures .
The effect estimate lay within the futility boundary at thresholds of 0·5 % for total hip , forearm , and total body bone mineral density , and 1·0 % for lumbar spine and femoral neck , providing reliable evidence that vitamin D does not alter these outcomes by these amounts .
INTERPRETATION Our findings suggest that vitamin D supplementation does not prevent fractures or falls , or have clinical ly meaningful effects on bone mineral density .
There were no differences between the effects of higher and lower doses of vitamin D. There is little justification to use vitamin D supplements to maintain or improve musculoskeletal health .
BACKGROUND The effects of vitamin D on fractures , falls , and bone mineral density are uncertain , particularly for high vitamin D doses .
We aim ed to determine the effect of vitamin D supplementation on fractures , falls , and bone density .
Vitamin D and aromatase inhibitor-induced musculoskeletal symptoms (AIMSS): a phase II, double-blind, placebo-controlled, randomized trial
A double-blind placebo-controlled r and omized phase II trial was performed to determine whether High Dose Vitamin D2 supplementation ( HDD ) in women receiving adjuvant anastrozole improves aromatase inhibitor-induced musculoskeletal symptoms ( AIMS S ) and bone loss .  Patients with early breast cancer and AIMS S were stratified according to their baseline 25-hydroxy vitamin D ( 25OHD ) level . Stratum A ( 20–29 ng/ml ) received either HDD 50,000 IU capsules weekly for 8 weeks then monthly for 4 months or placebo . Stratum B ( 10–19 ng/ml ) received either HDD for 16 weeks and then monthly for 2 months , or placebo . AIMS S was assessed by the Brief Pain Inventory-Short Form ( BPI-SF ) , the Fibromyalgia Impact Question naire ( FIQ ) , and the Health Assessment Question naire-Disability Index ( HAQ-DI ) at baseline , 2 , 4 , and 6 months . Bone Mineral Density ( BMD ) was measured at baseline and at 6 months . The primary endpoint of the study was the change-from-baseline musculoskeletal pain . The secondary endpoint was the percent change in BMD at 6 months . Sixty women were enrolled . Baseline characteristics were comparable between the groups . At 2 months , FIQ pain ( P = 0.0045 ) , BPI worst-pain ( P = 0.04 ) , BPI average-pain ( P = 0.0067 ) , BPI pain-severity ( P = 0.04 ) , and BPI interference ( P = 0.034 ) scores were better in the HDD than placebo group . The positive effect of HDD on AIMS S was stronger across all time points in Stratum B than Stratum A ( FIQ pain , P = 0.04 ; BPI average , P = 0.03 ; BPI severity , P = 0.03 ; BPI interference , P = 0.04 ) . BMD at the femoral neck decreased in the placebo and did not change in the HDD group ( P = 0.06 ) . Weekly HDD improves AIMS S and may have a positive effect on bone health . Vitamin D supplementation strategies for breast cancer patients on AI should be further investigated
For hip fracture , at a 15 % relative risk , the effect estimate lay between the futility boundary and the inferior boundary , meaning there is reliable evidence that vitamin D supplementation does not reduce hip fractures by this amount , but uncertainty remains as to whether it might increase hip fractures .
The effect estimate lay within the futility boundary at thresholds of 0·5 % for total hip , forearm , and total body bone mineral density , and 1·0 % for lumbar spine and femoral neck , providing reliable evidence that vitamin D does not alter these outcomes by these amounts .
INTERPRETATION Our findings suggest that vitamin D supplementation does not prevent fractures or falls , or have clinical ly meaningful effects on bone mineral density .
There were no differences between the effects of higher and lower doses of vitamin D. There is little justification to use vitamin D supplements to maintain or improve musculoskeletal health .
BACKGROUND The effects of vitamin D on fractures , falls , and bone mineral density are uncertain , particularly for high vitamin D doses .
We aim ed to determine the effect of vitamin D supplementation on fractures , falls , and bone density .