A new review of medical research shows that vitamin D plays a bigger role in bone health than we thought. Scientists found that most people who break bones or have orthopedic surgery don’t have enough vitamin D in their bodies. Low vitamin D levels are linked to more infections after surgery, slower bone healing, and bones that don’t heal properly. The good news? Getting enough vitamin D through supplements is cheap, safe, and easy. Doctors are now recommending that hospitals check vitamin D levels in orthopedic patients and make sure they get enough of this important nutrient, especially before and after bone surgery or fracture treatment.

The Quick Take

  • What they studied: Whether vitamin D levels affect how well bones heal after injury or surgery, and whether low vitamin D increases the risk of infection and healing problems
  • Who participated: This was a review of many different studies involving adults who had bone fractures or orthopedic surgery. The studies looked at thousands of patients across different hospitals and research centers
  • Key finding: Between 43-90% of orthopedic patients had low vitamin D levels (below 30 ng/mL). Patients with low vitamin D had more infections after surgery and slower bone healing. Vitamin D levels dropped even more after surgery, making the problem worse during the critical healing period
  • What it means for you: If you’re having bone surgery or dealing with a fracture, getting enough vitamin D may help you heal faster and reduce your infection risk. Talk to your doctor about checking your vitamin D levels before surgery. Taking a daily vitamin D supplement (at least 800 IU) is a simple, safe, and inexpensive step that could improve your recovery

The Research Details

This is a narrative review, which means researchers looked at many different studies about vitamin D and bone health to summarize what we know. They focused on studies involving adults who had orthopedic problems like fractures or bone surgery. The researchers examined how vitamin D levels related to infection rates, how well bones healed, and whether bones failed to heal properly (called nonunion). They looked at different types of studies, including observational studies (where researchers just watched what happened) and prospective studies (where researchers followed patients over time to see what happened next).

The review pulled together evidence from multiple hospitals and research centers to find patterns. By combining information from many studies, the researchers could see whether vitamin D deficiency was truly connected to worse outcomes, or if it was just a coincidence. This approach helps doctors understand the bigger picture of how vitamin D affects bone healing.

Understanding how vitamin D affects bone healing is important because vitamin D deficiency is extremely common and easy to fix. Unlike some health problems that require expensive treatments, vitamin D supplementation is cheap and safe. If vitamin D really does help bones heal and prevent infections, then hospitals could improve patient outcomes by simply checking vitamin D levels and giving supplements. This is especially important because infections after bone surgery can be serious and costly. By identifying a modifiable factor like vitamin D, doctors have a simple tool to help patients recover better

This is a narrative review, which means it summarizes existing research rather than conducting a new experiment. Narrative reviews are helpful for understanding what we know overall, but they depend on the quality of the studies being reviewed. The strength of this review comes from the fact that multiple different types of studies (observational, prospective, and registry studies) all pointed to the same conclusion about vitamin D and bone healing. When different research approaches agree, it makes the finding more trustworthy. However, because this is a review of other studies rather than a new study itself, the findings are only as strong as the original research it’s based on

What the Results Show

The review found that vitamin D deficiency is extremely common in orthopedic patients, with 43-90% of patients having levels below 30 ng/mL (the threshold for deficiency). This is a huge range, but even the lower number means nearly half of all bone surgery patients don’t have enough vitamin D.

Patients with low vitamin D had significantly higher rates of infections after surgery. When researchers compared patients who got infections to those who didn’t, the infected patients consistently had lower vitamin D levels at the time of surgery. This suggests that vitamin D status before surgery may influence infection risk.

Another important finding was that vitamin D levels drop even more after surgery—by up to 40%. This is concerning because the early weeks after surgery are when infection risk is highest and when bones are starting to heal. Having even lower vitamin D during this critical time could make problems worse.

For bone healing specifically, the evidence showed that patients with ongoing vitamin D deficiency experienced delayed healing or complete failure to heal. Some bones didn’t heal at all (nonunion), and this problem was more common in patients with low vitamin D levels.

The review identified that vitamin D does more than just help with calcium and bone strength. It also helps the immune system fight infections by promoting the production of antimicrobial peptides (natural infection-fighting substances) and by supporting immune cells called macrophages. Additionally, vitamin D supports osteoblasts, which are the cells responsible for building new bone tissue. These multiple roles explain why vitamin D deficiency could affect both infection risk and bone healing at the same time

This review builds on growing recognition in the medical community that vitamin D is important for orthopedic outcomes. Previous research had focused mainly on vitamin D’s role in calcium absorption and bone strength. This review adds to that understanding by showing that vitamin D also plays important roles in immune function and infection prevention. The consistent findings across multiple studies suggest that earlier observations about vitamin D and bone health are being confirmed by newer research

As a narrative review, this study summarizes other people’s research rather than conducting new experiments. The quality depends on the studies being reviewed. The review notes that vitamin D deficiency was found in 43-90% of patients—a very wide range—which suggests that different studies measured vitamin D differently or studied different patient populations. The review doesn’t specify exactly how many total patients were included across all the studies reviewed. Additionally, while the review shows that low vitamin D is associated with worse outcomes, it doesn’t prove that vitamin D deficiency causes these problems; it’s possible that other factors related to overall health could explain both low vitamin D and poor healing

The Bottom Line

Based on this evidence, doctors should: (1) Check vitamin D levels in all orthopedic patients before surgery or fracture treatment (moderate confidence—supported by consistent findings across multiple studies); (2) Recommend daily vitamin D supplementation of at least 800 IU to maintain levels above 30 ng/mL (moderate confidence—this is a safe, inexpensive intervention); (3) Continue vitamin D supplementation after surgery during the critical healing period (moderate confidence—since levels drop after surgery and this is when infection risk is highest). These recommendations are considered safe because vitamin D supplementation at these levels has no known serious side effects

These findings are most relevant to: people having orthopedic surgery, people with bone fractures, people recovering from bone injuries, and their doctors. If you fall into any of these categories, ask your doctor to check your vitamin D level. People with chronic bone problems, older adults, people with limited sun exposure, or those with certain digestive conditions that affect nutrient absorption should be especially interested. However, these findings are specifically about orthopedic patients, so people without bone-related issues should follow general vitamin D guidelines from their doctors

Vitamin D supplementation is not a quick fix. Bone healing typically takes weeks to months depending on the severity of the fracture or surgery. You should expect to take vitamin D supplements consistently during this entire period. Some benefits (like improved immune function) may start within days to weeks, but the main benefit—better bone healing—takes the full healing timeline. Don’t expect dramatic changes immediately; think of vitamin D as supporting your body’s natural healing process

Want to Apply This Research?

  • Track daily vitamin D supplementation intake (dose and time taken) and note any post-surgery milestones like infection signs, pain levels, and mobility improvements. Users can log their vitamin D supplement dose each day and mark whether they experienced any signs of infection (fever, increased redness, drainage) or healing progress (reduced pain, increased range of motion)
  • Set a daily reminder to take your vitamin D supplement at the same time each day (such as with breakfast). If you’re having orthopedic surgery, ask your doctor to check your vitamin D level before the procedure and discuss supplementation. After surgery, continue taking your vitamin D supplement as directed and report any signs of infection to your doctor immediately
  • For long-term tracking, users should log their vitamin D supplement adherence weekly and note any changes in healing progress or infection signs. If possible, recheck vitamin D levels 4-6 weeks after surgery to ensure levels are adequate. Track overall recovery milestones like return to normal activities, pain reduction, and any complications

This review summarizes research on vitamin D and orthopedic outcomes but does not constitute medical advice. Vitamin D supplementation recommendations should be personalized based on your individual health status, current vitamin D levels, medications, and medical conditions. Before starting any new supplement, especially if you have kidney disease, heart disease, or take certain medications, consult with your healthcare provider. If you are having orthopedic surgery or dealing with a bone fracture, work with your orthopedic surgeon and primary care doctor to determine appropriate vitamin D screening and supplementation for your specific situation. This information is intended to help you have informed conversations with your healthcare team, not to replace professional medical advice