Supplement Recommendations for Greater Tuberosity Fracture
For a greater tuberosity fracture of the humerus, you should take 1000-1200 mg of elemental calcium daily (divided into doses of 500-600 mg taken with meals) combined with 800 IU of vitamin D3 daily to support bone healing and prevent future fractures. 1
Calcium Supplementation Strategy
Dosing and Timing
- Divide your total daily calcium into 2-3 doses of no more than 500-600 mg each, as absorption efficiency decreases significantly with larger single doses 2, 1
- Take calcium supplements with meals to enhance absorption, particularly important for calcium carbonate formulations 2, 1
Choosing the Right Formulation
- Calcium carbonate (40% elemental calcium) is the most cost-effective first choice and should be your default option 2, 1
- Switch to calcium citrate (21% elemental calcium) if you experience constipation, bloating, or take proton pump inhibitors for acid reflux, as citrate can be absorbed without stomach acid 2, 1
- Calcium citrate may be taken with or without meals, providing more flexibility 2, 1
Vitamin D Co-Administration
Essential Combination Therapy
- Take 800 IU of vitamin D3 (cholecalciferol) daily alongside your calcium, as this combination has been shown to reduce fractures by 12% overall and by 29% in institutionalized elderly persons 2, 1
- The combination of calcium plus vitamin D is superior to calcium alone for fracture healing and prevention 2, 1
Target Levels
- Aim for serum 25(OH)D levels of ≥30 ng/mL for optimal bone health 1
- Your physician should check your vitamin D level if you have risk factors for deficiency (limited sun exposure, darker skin, obesity) 3
Duration and Monitoring
- Continue supplementation for a minimum of 5 years given your established fracture 1
- Request bone density testing (DXA scan) after 2 years of treatment to assess your response 1
Critical Safety Limits
- Do not exceed 2000-2500 mg of total daily calcium from all sources (diet plus supplements) to minimize kidney stone risk 2, 1
- Be aware that calcium supplements carry a 17% increased risk of kidney stones compared to placebo 2
- Count dietary calcium sources (dairy products, fortified foods) toward your total daily intake 2
Important Caveats
When Supplements May Not Be Sufficient
While the evidence shows calcium and vitamin D provide modest fracture reduction benefits, the benefit is primarily seen in institutionalized elderly persons rather than community-dwelling individuals 2. For a traumatic greater tuberosity fracture in a younger, active person, these supplements support healing but may not dramatically alter outcomes 4, 5.
Consider Additional Therapy
If you are over age 50 or have risk factors for osteoporosis (postmenopausal woman, chronic steroid use, previous fragility fracture), strongly consider bisphosphonate therapy in addition to calcium and vitamin D, as this combination reduces vertebral fractures and increases bone mineral density more effectively than supplements alone 1, 6, 7
Dietary Sources Preferred
Prioritize getting calcium from dietary sources when possible (dairy products, leafy greens, fortified foods), as dietary calcium carries lower risks of kidney stones and potential cardiovascular concerns compared to supplements 2, 1
Common Pitfalls to Avoid
- Do not take all your calcium at once - this reduces absorption and increases gastrointestinal side effects 2, 1
- Do not use calcium supplementation alone without vitamin D, as calcium alone has shown inconsistent and sometimes paradoxically negative effects on fracture risk 2, 6
- Do not assume supplements replace proper rehabilitation - early mobilization and a specific shoulder rehabilitation program starting within one week of injury are critical for functional recovery from greater tuberosity fractures 5, 8