The Truth About B Vitamins And Fracture Risk

Last week two frantic patients notified me by email that they read in the Times Science Section on May 28, 2019 that large doses of B vitamins in older women are associated with higher risk of hip fractures. Both of these women suffered from osteoporosis and were terrified of getting a fracture from the B vitamins they were taking. The article states that 2.4 micrograms of B12 and 1.5 mg of B6 the RDA for these 2 nutrients would be filled by eating a can of tuna.

First of all, this was an observational study. That means that you look over the records of the women and see what correlations you can draw. But this is not a way to prove causation. For that you need to do a placebo controlled prospective study. That means that you get 2 groups of women and give B vitamins to one group and no B vitamins to the other group and see which group develops more fractures. You also have to control for conditions such as osteoporosis, calcium and magnesium deficiency, and nutritional deficiency in general as vitamin C, D, and K deficiencies can be associated with osteoporosis, and thereby hip fractures.

Anyway, after researching this in the literature I found a large prospective randomized trial showing no effect of vitamin B12 and folate in high doses (B12 was 0 .4 mg, folate 0.8 mg and B6 40 mg.) They actually found that there was no association between B21, folate with hip fracture and the risk was slightly elevated in the extended time period with the B6. J Bone Miner Res. 2017 Oct;32(10):1981-1989. doi: 10.1002/jbmr.3189. Epub 2017 Jun 28.

Another study links bone fractures with high homocysteine, which incidentally is reduced by B12, folate, and B6 supplementation. The abstract states that, “This review will explore the emerging evidence of the supporting role of certain B Vitamins as modifiable factors associated with bone health.” They indicated that it would take more research to see if the B vitamins would decrease fracture risk. (Nutrients. 2015 Mar 30;7(4):2176-92. doi: 10.3390/nu7042176. B vitamins, homocysteine and bone health.)

Certainly nowhere in the research did I find any mention of increased fracture risk from B12 or folate and actually the opposite may be the case that B vitamins actually reduce risk of fracture by lowering homocysteine.

Why are we being told in such a frightening fashion that taking nutritional supplements could be bad for us? Why do you think!

References:
Health News. 2005 Jun;11(6):8. Vitamin therapy may reduce hip fracture risk. Folate, B12 appear to reduce homocysteine levels.
B Vitamins and Hip Fracture: Secondary Analyses and Extended Follow-Up of Two Large Randomized Controlled Trials. Garcia Lopez M et al. J Bone Miner Res. (2017)
J Bone Miner Res. 2017 Oct;32(10):1981-1989. doi: 10.1002/jbmr.3189. Epub 2017 Jun 28.
Micronutrients and the risk of hip fracture: Case-control study. Torbergsen AC et al. Clin Nutr. (2017) Clin Nutr. 2017 Apr;36(2):438-443. doi: 10.1016/j.clnu.2015.12.014. Epub 2015 Dec 23.
B vitamins, homocysteine and bone health. Fratoni V et al. Nutrients. (2015) Nutrients. 2015 Mar 30;7(4):2176-92. doi: 10.3390/nu7042176.

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