Does Fragile Help with Bone Fracture Healing?
There is no evidence that the supplement "Fragile" (containing vitamin C, lysine, proline, and vitamin B6) improves bone fracture healing, and vitamin C supplementation specifically has been shown in high-quality randomized trials to provide no benefit for fracture outcomes.
Evidence on Individual Components
Vitamin C
- A large double-blind randomized controlled trial of 336 patients with distal radial fractures found that 500 mg daily vitamin C for 50 days produced no significant difference in functional outcomes (DASH scores), time to fracture healing, or complication rates at one year compared to placebo 1
- In the same trial, vitamin C actually showed worse outcomes in some subgroups: patients with nondisplaced fractures had greater wrist flexion deficits (p=0.008) and higher rates of complex regional pain syndrome at 6 weeks (p=0.022) 1
- A 2022 systematic review concluded that while animal studies suggest potential benefits, human studies have failed to demonstrate that vitamin C accelerates bone healing, and no specific dose or route of administration can be recommended 2
Vitamin B6
- Vitamin B6 has been studied primarily for fracture prevention (reducing future fracture risk), not for healing existing fractures 3
- In women aged 45-74 years, higher vitamin B6 intake (≥2.03 mg/day) was associated with 22% lower risk of hip fractures compared to low intake (≤1.30 mg/day), but this addresses prevention, not healing of acute fractures 3
- The mechanism appears related to collagen matrix maintenance in bone rather than acute fracture repair 3
Lysine and Proline
- No clinical evidence was identified examining lysine or proline supplementation for bone fracture healing in the provided literature
What Actually Works for Fracture Healing
Calcium and Vitamin D (The Evidence-Based Approach)
- For patients with documented vitamin D deficiency or osteoporosis, calcium (1000-1200 mg/day total from all sources) plus vitamin D (800 IU/day) is recommended 4, 5
- However, routine supplementation in community-dwelling adults without deficiency does not prevent fractures or improve healing 4, 6
- The benefit is limited to specific populations: nursing home residents with vitamin D deficiency, patients on chronic steroids, or those with documented osteoporosis 5, 6
Critical Implementation Points
- Check baseline 25-hydroxyvitamin D levels before supplementing; correction is only necessary if levels are <30 ng/mL (75 nmol/L) 4
- Calculate dietary calcium intake first; supplements should only bridge the gap to 1000-1200 mg total daily 4
- Calcium supplements increase kidney stone risk (1 additional stone per 273 women treated over 7 years) and possibly cardiovascular events by ~20% 4, 6
Common Pitfalls to Avoid
- Do not assume vitamin supplements accelerate fracture healing in well-nourished patients without documented deficiencies 1, 2
- Do not use vitamin C supplementation for fracture healing based on the negative RCT evidence 1
- Do not supplement calcium without checking dietary intake first, as excessive supplementation causes harm without benefit 4, 6
- Do not delay proven interventions (early mobilization, physical therapy, bisphosphonates for osteoporotic fractures) in favor of unproven nutritional supplements 5, 7
Bottom Line
The supplement "Fragile" has no evidence base for improving bone fracture healing. Focus instead on ensuring adequate (not excessive) calcium and vitamin D status in high-risk populations, early mobilization, appropriate pain control, and treatment of underlying osteoporosis with bisphosphonates when indicated 4, 5, 7.