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Rheumatology

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Jackson RD et al. - Although estrogen, with or without progestin, significantly decreases fracture risk at all skeletal sites—almost irrespective of underlying risk for osteoporosis—its risks outweigh its benefits, negating its general use for fracture reduction. For calcium-replete women, calcium plus vitamin D supplementation has a non-significant effect, hence the case for universal supplementation loses merit. But, that argument gains credibility for women over age 60—as a 21% reduction in hip fractures attests—showing that calcium plus vitamin D has a positive effect on bone health in older postmenopausal women.

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