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Can low vitamin D cause bone fractures?

Medically reviewed on August 1, 2022 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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We’re all looking for ways to stay healthy, and keeping up with daily vitamin requirements is an integral part of overall wellness. Vitamin D, in particular, is essential for several biological functions, including maintaining bone health. But do you know your vitamin D status?

If you’re asking, “Can low vitamin D cause bone fractures?” the answer is yes. In fact, vitamin D deficiency can lead to a whole host of health issues, including weakened bones, bone loss, bone disease like osteoporosis, and bone injuries beyond small bone fractures and fissures. To easily check your levels from the comfort of your home, consider using an at-home vitamin D deficiency testing kit. Follow along to discover the connection between vitamin D and bone health and learn the best way to support your skeleton for the long and short term.

The role of vitamin D in your health

Vitamins can affect multiple bodily systems, working synergistically with cells, proteins, and hormones to perform complex and crucial biological functions. As one of the 13 essential vitamins that make up a healthy diet, your body uses vitamin D in the following ways:

  • Immune response – Your body needs vitamin D to fight off various viruses and bacteria. As a pillar of immune system support, vitamin D can help ensure your body is prepared to protect you from illnesses.
  • Nerves and muscles – Your nerves are the messengers of your body. Vitamin D ensures your nervous system continues functioning properly and sends signals between your body and your brain. Additionally, vitamin D also helps maintain your muscles. If it weren’t for vitamin D, you might be unable to move.
  • Bone health – One of vitamin D’s primary functions is to help your body absorb calcium, a major building block for your bones—both for developing children and aging adults. Not only does it help strengthen and maintain your skeletal system, but it also provides the necessary nutrients to keep your bones strong and resilient.

Calcium is the mineral most associated with bone and tooth health. In fact, 99% of your body’s calcium is stored in your bones. [1] Calcium is sourced from the food in your diet, including green leafy vegetables, dairy products, and calcium-enriched foods. Without vitamin D supplementation, all that calcium supplementation would go to waste, as your body would be unable to synthesize it.

What are the different types of vitamin D?

Although it’s often referred to simply as vitamin D, there are actually two different forms of vitamin D: [2]

  • Vitamin D2 – Vitamin D2, also called ergocalciferol, typically comes from plant sources. Its main natural source is mushrooms. However, ergocalciferol is easier to produce in a lab. This makes it the most commonly found form of vitamin D in fortified foods and supplements.
  • Vitamin D3 – Vitamin D3 is also referred to as cholecalciferol. It’s typically found in animal products, such as liver, fish oils, fatty fish, and egg yolks. Your skin also produces cholecalciferol when it’s exposed to sunlight. To ensure adequate levels of vitamin D3, especially for those with limited sun exposure or dietary restrictions, vitamin D3 supplements are available.

Both types of vitamin D are metabolized as calcitriol. In your body, calcitriol facilitates calcium absorption.

How does vitamin D impact your bone health?

Vitamin D significantly impacts bone health by ensuring adequate calcium absorption from the diet, which is essential for maintaining bone density and strength. It also plays a crucial role in bone remodeling, a process where old bone tissue is replaced with new, maintaining bone integrity and reducing fracture risk.

So, is vitamin D good for bones? The answer is a resounding yes. The good news is that there isn’t evidence to support that one type of vitamin D is better than the other for bone health. [3] Both forms are crucial to your body’s ability to properly absorb and use calcium.

Can too much vitamin D weaken your bones or immune system?

Excessive vitamin D intake can lead to hypercalcemia, a condition characterized by elevated levels of calcium in the blood. This imbalance can cause calcium to deposit in soft tissues and organs, potentially leading to complications such as kidney stones or kidney damage. In the bones, an overload of vitamin D may stimulate bone resorption, where calcium is leached from the bones, paradoxically weakening them despite vitamin D's bone-strengthening role.

What causes vitamin D deficiency?

A vitamin D insufficiency simply refers to the condition of not having enough of this essential vitamin in your body. A deficiency doesn’t always start right away. In fact, as a fat-soluble vitamin, it could be days—or even weeks— before your body’s surplus of vitamin D is used up.

That said, once gone, the symptoms of vitamin D deficiency (including weakened bones and bone mineral density loss) may occur rather quickly. The length and severity of a vitamin D deficiency will depend on how long it’s left untreated. Conditions will likely worsen if your body doesn’t receive the vitamin D it needs.

Several factors could contribute to a vitamin D deficiency, including:

  • Absorption diseases – Often, deficiencies spring up when absorption is interrupted. Conditions like celiac disease and Crohn’s disease can directly interfere with the natural absorption that occurs during digestion. Even if you’re supplying your body with adequate vitamin D, a disconnect between consumption and absorption could result in a serious deficiency.
  • Lack of sun – In some cases, vitamin D deficiency is caused by a lack of sun. If you find yourself frequently indoors or living in a climate with little to no sunshine, it’s not at all uncommon to develop a vitamin D deficiency.
  • Insufficient diet – Not eating enough greens? Our diets are the primary source of most vitamins. While you can always rely on the sun for a dose of vitamin D, a varied and healthy diet can benefit your bones, body, and overall wellness.

What are the side effects of vitamin D deficiency?

A lack of vitamins and minerals is bad news for health and wellness in general. From strange bruising to bothersome rashes, the symptoms of a deficiency can sometimes be hard to pinpoint without the help of a medical professional. Vitamin D deficiency, in particular, can lead to fatigue, kidney problems, digestive issues, and several other health issues. Additionally, your largest concern is likely the dangerous, long-term bone damage you could sustain from a lack of vitamin D. Consider the following conditions associated with this deficiency.

Bone mineralization refers to the process of adding mineral density (calcium) within bone tissue. [4] When mineralization doesn’t occur correctly, it can result in health issues, including:

  • Rickets – A dangerous disease that often affects developing children, rickets is caused by a vitamin D, calcium, or phosphate deficiency. [5] Without adequate vitamins or minerals, bones can become soft and weak, causing them to form incorrectly.
  • Osteomalacia– Similar to rickets but found exclusively in adults, osteomalacia results in a breakdown of bone density. [7] Symptoms typically include pain in the legs and hips, frequent fractures, and mobility issues.

There are more than 200 hundred bones in the human body, and all of them need calcium to thrive. Without vitamin D, your body can’t absorb enough calcium to maintain bone density. This can lead to issues like: [7]

  • Fractures, breaks, and cracks – It’s no surprise that brittle bones are more prone to breakage. Typically, fractures occur when bones are put under extreme stress—such as a car accident or a fall—but a prolonged vitamin D deficiency could leave your bones so weakened that even a minor accident could lead to a painful break. You are at a high fracture risk if you have a low vitamin D level.
  • Slow fracture healing – Recovery times vary depending on the severity and location of a break. Still, a vitamin D deficiency could slow down the healing process or interfere with proper bone regrowth. This may lead to further complications, including reduced mobility and extended discomfort.
  • Muscle weakness – Vitamin D also contributes to muscle function, and deficiency can lead to weakened muscles and physical fatigue. This, in turn, could make you more susceptible to falls, increasing the likelihood of bone fractures.

Bone fractures and related physical trauma are extremely dangerous for older individuals. If you’re over 70, you know the risks of breaking bones. Seniors are often recommended higher doses of vitamin D, to reduce their fracture risk and related issues.

Osteoporosis

Osteoporosis is strongly correlated with vitamin D and calcium deficiencies, a disease that directly affects bone health and density. This condition leads to frequent breaks and fractures, often leading to mobility problems and long-term health crises. [8]

If you’re concerned about osteoporosis, consider the following:

  • Consider your risk factors – Your age, family history, and current medications are all potential risk factors for developing osteoporosis. Risk factors don’t mean you’re certain to develop osteoporosis—even those in high-risk groups can avoid this condition. If your healthcare provider has questions or concerns about your potential risk, be sure to supply accurate and thorough information.
  • Seek medical testing – Osteoporosis is considered a “silent disease.” While some risk factors are known, there are no telltale signs of the disease. That is, until you begin fracturing bones. Medical testing could provide an accurate image of your current bone density, providing insight into your likelihood of developing this disease.
  • Develop healthy habits – You can make positive lifestyle changes to help reduce your risk of osteoporosis. The best steps you can take include eliminating smoking, eating a balanced diet, and prioritizing your calcium and vitamin D intake every day.

How to source your vitamin D

You know the importance of vitamin D, but do you know where to look for it? You can get your vitamin D through any of the following sources:

  • Sunlight – Your skin can convert the sun’s rays into vitamin D. This natural process makes getting vitamin D fairly straightforward for anyone living in a sunny climate. It takes less than 30 minutes of sun to get all the vitamin D you need for the day.
  • Diet – Leafy green vegetables and dairy are two excellent sources of vitamin D. Additionally, you can look to vitamin-enriched bread, cereals, and grains to fill out your daily recommended amounts.
  • Supplements – Today, it’s easier to source high-quality vitamin supplements designed to supply you with the proper amount of vitamin D. Some supplements may even offer co-active ingredients that could afford additional health benefits.

Whether you’re spending time under the sun or opting for a supplement with your morning meal, getting your daily dose of vitamin D doesn’t have to be difficult. In fact, it’s one of the easiest ways to avoid preventable bone injuries and other related health issues.

How much vitamin D do you need for healthy bones?

How much vitamin D should I take? Your vitamin D needs will likely change throughout your lifetime. Vitamin D is typically measured in international units (IU). The general daily vitamin D recommendations are as follows: [12]

  • Infants should get at least 400 IU per day until they reach one year of age
  • Children and adults up to age 70 need at least 600 IU per day
  • Adults over the age of 70 need at least 800 IU per day

Remember that you don’t always absorb all of the vitamin D you consume. Medication, health conditions, and other factors can interfere with vitamin D usage in your body. You may need to take in more than the daily recommendation to ensure that you absorb the appropriate amount your body and bones need. If you're unsure about the optimal levels of vitamin D for your health, it's important to find out what is your vitamin D level supposed to be. Knowing your specific needs can help you adjust your intake accordingly and maintain bone health effectively.

Other ways to increase bone density

Increasing bone density is vital for preventing fractures and conditions like osteoporosis, especially as you age. Apart from ensuring adequate vitamin D levels, there are several other strategies to enhance bone strength:

  • Regular Exercise: Engage in weight-bearing and strength-training exercises to stimulate bone growth and increase density.
  • Limit Alcohol and Caffeine: Minimize consumption of alcohol and caffeine to improve calcium absorption and support bone health.
  • Quit Smoking: Smoking decreases bone density; quitting can significantly improve your bone health.
  • Magnesium and Vitamin K2 Intake: Include foods high in magnesium and vitamin K2, like nuts, seeds, fermented foods, and dairy, to aid in calcium absorption and bone formation.
  • Omega-3 Fatty Acids: Found in fish oil and flaxseed, omega-3 fatty acids can also support bone health.

Maintain your vitamin D levels with Everlywell

Vitamin D is a key component of skeletal health. With a little knowledge about how this essential vitamin functions, you’re more prepared to avoid painful fractures, bone loss, bone disease, and other bone issues. Another strategy is to keep tabs on your vitamin D levels with Everlywell. Curious about how to determine your vitamin D status?

Make health simpler, smarter, and more effective by exploring our lab-certified home health tests. From our Vitamin D Test to our Celiac Disease Screening Test, you can enjoy accurate, physician-reviewed data delivered safely and securely. Plus, we offer a range of nutritional supplements (including vitamin D supplements) to help ensure you feel your best.

Related content

Can low vitamin D affect your teeth?

Is vitamin D good for bones?

How much vitamin D should I take?

References

  1. Calcium. MedlinePlus. Medical Citation URL. Accessed August 1, 2022.
  2. Vitamin D Overview. PubMed. Medical Citation URL. Accessed August 1, 2022.
  3. Effect of High Dose Vitamin D2 vs D3 on Total and Free 25-Hydroxyvitamin D. PubMed. Medical Citation URL. Accessed August 1, 2022.
  4. What Is Bone Mineralization? The Journal of Clinical Endocrinology & Metabolism. Medical Citation URL. Accessed August 1, 2022.
  5. Rickets. MedlinePlus. Medical Citation URL. Accessed August 1, 2022.
  6. Osteomalacia. Cleveland Clinic. Medical Citation URL. Accessed August 1, 2022.
  7. The role of vitamin D for bone health and fracture prevention. NIH. Medical Citation URL. Accessed August 1, 2022.
  8. Osteoporosis. MedlinePlus. Accessed August 1, 2022.
  9. Prevalence of Vitamin D Deficiency and Associated Risk Factors in the US Population. NIH. Medical Citation URL. Accessed August 1, 2022.
  10. Vitamin D Deficiency. MedlinePlus. Medical Citation URL. Accessed August 1, 2022.
  11. The effect of vitamin D on bone and osteoporosis. NIH. Medical Citation URL. Accessed August 1, 2022.
  12. Vitamin D Fact Sheet. NIH. Medical Citation URL. Accessed August 1, 2022.
Jillian Foglesong Stabile, MD, FAAFP is a board-certified Family Physician. Since completing her residency training in 2010, she’s been practicing full-scope family medicine in a rural setting. Dr. Foglesong Stabile’s practice includes caring for patients of all ages for preventative care as well as chronic disease management. She also provides prenatal care and delivers babies. Dr. Foglesong Stabile completed a teaching fellowship in 2020 and teaches the family medicine clerkship for one of her local medical schools. Dr. Foglesong Stabile’s favorite thing about family medicine is the variety of patients she sees in her clinical practice.
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