Vitamin C for Osteopenia or Osteoporosis Fractures?
/I love it when I get questions from all of you. This helps me keep this blog relevant.
This week, I was asked about the value of taking high doses of Vitamin C after a fracture (for instance, after a broken wrist).
Is it helpful? Is it necessary?
First, you should know if you are actually at risk for Vitamin C insufficiency.
According to Crook et al. (2021), about 41% of the U.S. population has Vitamin C insufficiency. In their analysis, they found that the groups with the highest risk of insufficiency were males, adults aged 20–59, Black and Mexican Americans, smokers, individuals with increased BMI, middle and high poverty levels, and those with food insecurity. Women over 60 were actually the least likely to have insufficiency.
But what if you have osteoporosis or osteopenia? Should this diagnosis change your Vitamin C intake?
Brzezińska et al. asked this very question in 2020. Their paper was titled "Role of Vitamin C in Osteoporosis Development and Treatment-A Literature Review". The scientists reviewed 66 studies published between 2000-2020. They concluded that a balanced, well-rounded diet was the most appropriate way to achieve bone health, while the role of high-dose supplements was not established. Future studies may help us understand supplements better.
The balanced, well-rounded diet was further confirmed by a study by Zeng and colleagues (2020) in their paper titled "Can Dietary Intake of Vitamin C-Oriented Foods Reduce the Risk of Osteoporosis, Fracture, and BMD Loss? This group dug into the connection between vitamin C-rich foods and bone health by looking at 13 studies. They concluded that people who regularly consumed vitamin C-oriented foods had a reduced risk of osteoporosis and fractures.
Important Note - these studies suggest that dietary intake is the best solution, not supplements.
How Can You Boost Your Vitamin C Intake?
Here are some easy tips to make sure you're getting your daily dose of this bone-loving vitamin:
Fruit: Start your day with a delicious fruit that includes vitamin C- like oranges, kiwis, cantaloupe, or strawberries.
Veggie Power: Make veggies like broccoli, Brussels sprouts, red or green peppers, and kale a regular part of your meals.
A Little Sunshine ☀️ on Your Plate: Think of vitamin C as a little sunshine on your plate. It not only helps your bones but also boosts your overall well-being. Plus, it's an easy and tasty addition to your meals. The more color on your plate, the better - eat the rainbow.
What if you have a fracture? Should you increase your Vitamin C to assist with healing?
Yes, if your PCP recommends it. According to a 2022 Systematic Review by Barrios-Garay, "vitamin C seems to accelerate bone regeneration without adverse events". They do not have specific recommendations on the dose. This is something you should discuss with your PCP if/when you fracture.
Go out and enjoy those vitamin C-rich foods and let the goodness soak into your bones. I think organic, locally-grown fruits and vegetables are your best bet. Cancel the supplements and spend your money on the best quality food you can afford.
If you have any specific questions or topics you'd like me to cover in future blog posts, please feel free to reach out.
Andrea Trombley PT, DPT
References
Barrios-Garay K, Toledano-Serrabona J, Gay-Escoda C, Sánchez-Garcés MÁ. Clinical effect of vitamin C supplementation on bone healing: A systematic review. Med Oral Patol Oral Cir Bucal. 2022 May 1;27(3):e205-e215. doi: 10.4317/medoral.24944. PMID: 35368012; PMCID: PMC9054165.
Brzezińska, O., Łukasik, Z., Makowska, J., & Walczak, K. (2020). Role of Vitamin C in Osteoporosis Development and Treatment-A Literature Review. Nutrients, 12(8), 2394. https://doi.org/10.3390/nu12082394
Crook, J., Horgas, A., Yoon, S. J., Grundmann, O., & Johnson-Mallard, V. (2021). Insufficient Vitamin C Levels among Adults in the United States: Results from the NHANES Surveys, 2003-2006. Nutrients, 13(11), 3910. https://doi.org/10.3390/nu13113910
Zeng LF, Luo MH, Liang GH, Yang WY, Xiao X, Wei X, Yu J, Guo D, Chen HY, Pan JK, Huang HT, Liu Q, Guan ZT, Han YH, Zhao D, Zhao JL, Hou SR, Wu M, Lin JT, Li JH, Liang WX, Ou AH, Wang Q, Li ZP, Liu J. Can Dietary Intake of Vitamin C-Oriented Foods Reduce the Risk of Osteoporosis, Fracture, and BMD Loss? Systematic Review With Meta-Analyses of Recent Studies. Front Endocrinol (Lausanne). 2020 Feb 3;10:844. doi: 10.3389/fendo.2019.00844. PMID: 32117042; PMCID: PMC7008177.