Skip to main content

Effect of vitamin D supplementation on muscle strength: a systematic review and meta-analysis



This systematic review demonstrates that vitamin D supplementation does not have a significant effect on muscle strength in vitamin D replete adults. However, a limited number of studies demonstrate an increase in proximal muscle strength in adults with vitamin D deficiency.


The purpose of this study is to systematically review the evidence on the effect of vitamin D supplementation on muscle strength in adults.


A comprehensive systematic database search was performed. Inclusion criteria included randomised controlled trials (RCTs) involving adult human participants. All forms and doses of vitamin D supplementation with or without calcium supplementation were included compared with placebo or standard care. Outcome measures included evaluation of strength. Outcomes were compared by calculating standardised mean difference (SMD) and 95% confidence intervals.


Of 52 identified studies, 17 RCTs involving 5,072 participants met the inclusion criteria. Meta-analysis showed no significant effect of vitamin D supplementation on grip strength (SMD −0.02, 95%CI −0.15,0.11) or proximal lower limb strength (SMD 0.1, 95%CI −0.01,0.22) in adults with 25(OH)D levels >25 nmol/L. Pooled data from two studies in vitamin D deficient participants (25(OH)D <25 nmol/L) demonstrated a large effect of vitamin D supplementation on hip muscle strength (SMD 3.52, 95%CI 2.18, 4.85).


Based on studies included in this systematic review, vitamin D supplementation does not have a significant effect on muscle strength in adults with baseline 25(OH)D >25 nmol/L. However, a limited number of studies demonstrate an increase in proximal muscle strength in adults with vitamin D deficiency.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3


  1. 1.

    Holick MF (2007) Vitamin D deficiency. N Engl J Med 357:266–281

    CAS  Article  PubMed  Google Scholar 

  2. 2.

    Allain TJ, Dhesi J (2003) Hypovitaminosis D in older adults. Gerontology 49:273–278

    CAS  Article  PubMed  Google Scholar 

  3. 3.

    Nesby-O'Dell S, Scanlon KS, Cogswell ME, Gillespie C, Hollis BW, Looker AC, Allen C, Doughertly C, Gunter EW, Bowman BA (2002) Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: third National Health and Nutrition Examination Survey, 1988–1994. Am J Clin Nutr 76:187–192

    PubMed  Google Scholar 

  4. 4.

    Pappa HM, Grand RJ, Gordon CM (2006) Report on the vitamin D status of adult and pediatric patients with inflammatory bowel disease and its significance for bone health and disease. Inflamm Bowel Dis 12:1162–1174

    Article  PubMed  Google Scholar 

  5. 5.

    Bischoff HA, Borchers M, Gudat F, Duermueller U, Theiler R, Stahelin HB, Dick W (2001) In situ detection of 1, 25-dihydroxyvitamin D3 receptor in human skeletal muscle tissue. Histochem J 33:19–24

    CAS  Article  PubMed  Google Scholar 

  6. 6.

    Simpson RU, Thomas GA, Arnold AJ (1985) Identification of 1, 25-dihydroxyvitamin D3 receptors and activities in muscle. J Biol Chem 260:8882–8891

    CAS  PubMed  Google Scholar 

  7. 7.

    Russell JA (1994) Osteomalacic myopathy. Muscle Nerve 17:578–580

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Ziambaras K, Dagogo-Jack S (1997) Reversible muscle weakness in patients with vitamin D deficiency. West J Med 167:435–439

    CAS  PubMed  Google Scholar 

  9. 9.

    Houston DK, Cesari M, Ferrucci L, Cherubini A, Maggio D, Bartali B, Johnson MA, Schwartz GG, Kritchevsky SB (2007) Association between vitamin D status and physical performance: the InCHIANTI study. J Gerontol A Biol Sci Med Sci 62:440–446

    PubMed  Google Scholar 

  10. 10.

    Bischoff-Ferrari HA, Dietrich T, Orav EJ, Hu FB, Zhang Y, Karlson EW, Dawson-Hughes B (2004) Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged > or =60 y. Am J Clin Nutr 80:752–758

    CAS  PubMed  Google Scholar 

  11. 11.

    Mowe M, Haug E, Bohmer T (1999) Low serum calcidiol concentration in older adults with reduced muscular function. J Am Geriatr Soc 47:220–226

    CAS  PubMed  Google Scholar 

  12. 12.

    Wicherts IS, van Schoor NM, Boeke AJ, Visser M, Deeg DJ, Smit J, Knol DL, Lips P (2007) Vitamin D status predicts physical performance and its decline in older persons. J Clin Endocrinol Metab 92:2058–2065

    CAS  Article  PubMed  Google Scholar 

  13. 13.

    Annweiler C, Schott-Petelaz AM, Berrut G, Kressig RW, Bridenbaugh S, Herrmann FR, Beauchet O (2009) Vitamin D deficiency-related quadriceps weakness: results of the Epidemiologie De l'Osteoporose cohort. J Am Geriatr Soc 57:368–369

    Article  PubMed  Google Scholar 

  14. 14.

    Verreault R, Semba RD, Volpato S, Ferrucci L, Fried LP, Guralnik JM (2002) Low serum vitamin d does not predict new disability or loss of muscle strength in older women. J Am Geriatr Soc 50:912–917

    Article  PubMed  Google Scholar 

  15. 15.

    Boonen S, Lysens R, Verbeke G, Joosten E, Dejaeger E, Pelemans W, Flamaing J, Bouillon R (1998) Relationship between age-associated endocrine deficiencies and muscle function in elderly women: a cross-sectional study. Age Ageing 27:449–454

    CAS  Article  PubMed  Google Scholar 

  16. 16.

    Annweiler C, Beauchet O, Berrut G, Fantino B, Bonnefoy M, Herrmann FR, Schott AM (2009) Is there an association between serum 25-hydroxyvitamin D concentration and muscle strength among older women? Results from baseline assessment of the EPIDOS study. J Nutr Health Aging 13:90–95

    CAS  Article  PubMed  Google Scholar 

  17. 17.

    Latham NK, Anderson CS, Reid IR (2003) Effects of vitamin D supplementation on strength, physical performance, and falls in older persons: a systematic review. J Am Geriatr Soc 51:1219–1226

    Article  PubMed  Google Scholar 

  18. 18.

    Holick MF (2009) Vitamin D: the other steroid hormone for muscle function and strength. Menopause 16(6):1077–1078

    Article  PubMed  Google Scholar 

  19. 19.

    Maher CG, Sherrington C, Herbert RD, Moseley AM, Elkins M (2003) Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther 83:713–721

    PubMed  Google Scholar 

  20. 20.

    Tooth L, Bennett S, McCluskey A, Hoffmann T, McKenna K, Lovarini M (2005) Appraising the quality of randomized controlled trials: inter-rater reliability for the OTseeker evidence database. J Eval Clin Pract 11:547–555

    Article  PubMed  Google Scholar 

  21. 21.

    Cohen J (1992) A power primer. Psychol Bull 112:155–159

    CAS  Article  PubMed  Google Scholar 

  22. 22.

    Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560

    Article  PubMed  Google Scholar 

  23. 23.

    Bischoff HA, Stahelin HB, Dick W, Akos R, Knecht M, Salis C, Nebiker M, Theiler R, Pfeifer M, Begerow B, Lew RA, Conzelmann M (2003) Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res 18:343–351

    CAS  Article  PubMed  Google Scholar 

  24. 24.

    Brunner RL, Cochrane B, Jackson RD, Larson J, Lewis C, Limacher M, Rosal M, Shumaker S, Wallace R (2008) Calcium, vitamin D supplementation, and physical function in the Women's Health Initiative. J Am Diet Assoc 108:1472–1479

    Article  PubMed  Google Scholar 

  25. 25.

    Bunout D, Barrera G, Leiva L, Gattas V, de la Maza MP, Avendano M, Hirsch S (2006) Effects of vitamin D supplementation and exercise training on physical performance in Chilean vitamin D deficient elderly subjects. Exp Gerontol 41:746–752

    CAS  Article  PubMed  Google Scholar 

  26. 26.

    Corless D, Dawson E, Fraser F, Ellis M, Evans SJ, Perry JD, Reisner C, Silver CP, Beer M, Boucher BJ et al (1985) Do vitamin D supplements improve the physical capabilities of elderly hospital patients? Age Ageing 14:76–84

    CAS  Article  PubMed  Google Scholar 

  27. 27.

    Dhesi JK, Jackson SH, Bearne LM, Moniz C, Hurley MV, Swift CG, Allain TJ (2004) Vitamin D supplementation improves neuromuscular function in older people who fall. Age Ageing 33:589–595

    Article  PubMed  Google Scholar 

  28. 28.

    Grady D, Halloran B, Cummings S, Leveille S, Wells L, Black D, Byl N (1991) 1, 25-Dihydroxyvitamin D3 and muscle strength in the elderly: a randomized controlled trial. J Clin Endocrinol Metab 73:1111–1117

    CAS  Article  PubMed  Google Scholar 

  29. 29.

    Johnson KR, Jobber J, Stonawski BJ (1980) Prophylactic vitamin D in the elderly. Age Ageing 9:121–127

    CAS  Article  PubMed  Google Scholar 

  30. 30.

    Kenny AM, Biskup B, Robbins B, Marcella G, Burleson JA (2003) Effects of vitamin D supplementation on strength, physical function, and health perception in older, community-dwelling men. J Am Geriatr Soc 51:1762–1767

    Article  PubMed  Google Scholar 

  31. 31.

    Kukuljan S, Nowson CA, Bass SL, Sanders K, Nicholson GC, Seibel MJ, Salmon J, Daly RM (2009) Effects of a multi-component exercise program and calcium-vitamin-D-3-fortified milk on bone mineral density in older men: a randomised controlled trial. Osteoporos Int 20:1241–1251

    CAS  Article  PubMed  Google Scholar 

  32. 32.

    Latham NK, Anderson CS, Lee A, Bennett DA, Moseley A, Cameron ID (2003) A randomized, controlled trial of quadriceps resistance exercise and vitamin D in frail older people: the Frailty Interventions Trial in Elderly Subjects (FITNESS). J Am Geriatr Soc 51:291–299

    Article  PubMed  Google Scholar 

  33. 33.

    Moreira-Pfrimer LD, Pedrosa MA, Teixeira L, Lazaretti-Castro M (2009) Treatment of vitamin D deficiency increases lower limb muscle strength in institutionalized older people independently of regular physical activity: a randomized double-blind controlled trial. Ann Nutr Metab 54:291–300

    CAS  Article  PubMed  Google Scholar 

  34. 34.

    Pfeifer M, Begerow B, Minne HW, Suppan K, Fahrleitner-Pammer A, Dobnig H (2009) Effects of a long-term vitamin D and calcium supplementation on falls and parameters of muscle function in community-dwelling older individuals. Osteoporos Int 20:315–322

    CAS  Article  PubMed  Google Scholar 

  35. 35.

    Sato Y, Iwamoto J, Kanoko T, Satoh K (2005) Low-dose vitamin D prevents muscular atrophy and reduces falls and hip fractures in women after stroke: a randomized controlled trial. Cerebrovasc Dis 20:187–192

    CAS  Article  PubMed  Google Scholar 

  36. 36.

    Sato Y, Iwamoto J, Kanoko T, Satoh K (2005) Amelioration of osteoporosis and hypovitaminosis D by sunlight exposure in hospitalized, elderly women with Alzheimer's disease: a randomized controlled trial. J Bone Miner Res 20:1327–1333

    CAS  Article  PubMed  Google Scholar 

  37. 37.

    Smedshaug GB, Pedersen JI, Meyer HE (2007) Can vitamin D supplementation improve grip strength in elderly nursing home residents? A double-blinded controlled trial. Scand J Food Nutr 51:74–78

    Article  Google Scholar 

  38. 38.

    Gupta R, Sharma U, Gupta N, Kalaivani M, Singh U, Guleria R, Jagannathan NR, Goswami R (2010) Effect of cholecalciferol and calcium supplementation on muscle strength and energy metabolism in vitamin D deficient Asian Indians: a randomized controlled trial. Clin Endocrinol (Oxf). doi:10.1111/j.1365-2265.2010.03816.x

    Google Scholar 

  39. 39.

    Janssen HC, Samson MM, Verhaar HJ (2010) Muscle strength and mobility in vitamin D-insufficient female geriatric patients: a randomized controlled trial on vitamin D and calcium supplementation. Aging Clin Exp Res 22:78–84

    CAS  PubMed  Google Scholar 

  40. 40.

    Armas LA, Hollis BW, Heaney RP (2004) Vitamin D2 is much less effective than vitamin D3 in humans. J Clin Endocrinol Metab 89:5387–5391

    CAS  Article  PubMed  Google Scholar 

  41. 41.

    Houghton LA, Vieth R (2006) The case against ergocalciferol (vitamin D2) as a vitamin supplement. Am J Clin Nutr 84:694–697

    CAS  PubMed  Google Scholar 

  42. 42.

    Boonen S, Lips P, Bouillon R, Bischoff-Ferrari HA, Vanderschueren D, Haentjens P (2007) Need for additional calcium to reduce the risk of hip fracture with vitamin d supplementation: evidence from a comparative metaanalysis of randomized controlled trials. J Clin Endocrinol Metab 92:1415–1423

    CAS  Article  PubMed  Google Scholar 

  43. 43.

    DIPART (The vitamin D Individual Patient Analysis of Randomized Trials) Group (2010) Patient level pooled analysis of 68, 500 patients from seven major vitamin D fracture trials in US and Europe. BMJ 340:b5463

    Article  Google Scholar 

  44. 44.

    Ceglia L (2008) Vitamin D and skeletal muscle tissue and function. Mol Aspects Med 29:407–414

    CAS  Article  PubMed  Google Scholar 

  45. 45.

    Sorensen O, Lund B, Saltin B, Lund B, Andersen H, Hjorth L, Melsen F, Mosekilde L (1979) Myopathy in bone loss of ageing:improvement by treatment with 1 alpha-hydroxycholecalciferol and calcium. Clin Sci (London) 56:157–161

    CAS  Google Scholar 

  46. 46.

    Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, Staehelin HB, Bazemore MG, Zee RY, Wong JB (2004) Effect of vitamin D on falls: a meta-analysis. JAMA 291:1999–2006

    CAS  Article  PubMed  Google Scholar 

  47. 47.

    Snijder MB, van Schoor NM, Pluijm SM, van Dam RM, Visser M, Lips P (2006) Vitamin D status in relation to one-year risk of recurrent falling in older men and women. J Clin Endocrinol Metab 91:2980–2985

    CAS  Article  PubMed  Google Scholar 

  48. 48.

    Gilsanz V, Kremer A, Mo AO, Wren TA, Kremer R (2010) Vitamin D status and its relation to muscle mass and muscle fat in young women. J Clin Endocrinol Metab 95:1595–1601

    CAS  Article  PubMed  Google Scholar 

  49. 49.

    Kolber MJ, Beekhuizen K, Cheng MS, Fiebert IM (2007) The reliability of hand-held dynamometry in measuring isometric strength of the shoulder internal and external rotator musculature using a stabilization device. Physiother Theory Pract 23:119–124

    Article  PubMed  Google Scholar 

  50. 50.

    Wikholm JB, Bohannon RW (1991) Hand-held dynamometer measurements: tester strength makes a difference. J Orthop Sports Phys Ther 13:191–198

    CAS  PubMed  Google Scholar 

  51. 51.

    Hopkins WG (2000) Measures of reliability in sports medicine and science. Sports Med 30:1–15

    CAS  Article  PubMed  Google Scholar 

  52. 52.

    Dawson-Hughes B, Mithal A, Bonjour JP, Boonen S, Burckhardt P, Fuleihan GE, Josse RG, Lips P, Morales-Torres J, Yoshimura N (2010) IOF position statement: vitamin D recommendations for older adults. Osteoporos Int. doi:10.1007/s00198-010-1285-3

    Google Scholar 

  53. 53.

    Verhage AP et al (1998) The Delphi list: a criteria list for quality assessment of randomised clinical trials for conducting systematic reviews developed by Delphi consesus. J Clin Epidemiol 51(12):1235–41

    Article  Google Scholar 

Download references

Conflicts of interest


Author information



Corresponding author

Correspondence to K. A. Stockton.

Appendix 1—search strategy

Appendix 1—search strategy

The databases, searched with language restrictions (English only) included: MEDLINE, CINAHL, EMBASE, Pubmed, Cochrane Controlled Trials Register, Sportdiscus, Scopus and Full text clinicians’ health journals @ Ovid from the earliest time to May 2010.


1. Muscle 725,556
2. Vitamin D 46,203
3. Vitamin D2 3,330
4. Vitamin D3 21,590
5. 1-alpha hydroxyvitamin D3 924
6. 1-alpha hydroxycalciferol 6
7. 1,25 dihydroxyvitamin D3 15,436
8. 1,25 dihydroxycholecalciferol 14,828
9. 25 hydroxycholecalciferol 2,901
10. 25 hydroxyvitamin D 3,660
11. Calcitriol 14,347
12. Ergocalciferol 2,791
13. Cholecalciferol 19,270
14. Calcifediol 2,319
15. Alfacalcidiol 871
16. Calcidiol 2,438
17. Calciferol 2,931
18. 2 to 17 “OR” 48,722
19. 1. “AND” 18 1,611
20. 19 limits RCT, clinical trial, meta-analysis, review 315
21. eliminate review 53
22. 21 “AND” English 51


Search format repeated for Cinahl, Sportdiscus, Cochrane library, Pubmed and Embase.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Stockton, K.A., Mengersen, K., Paratz, J.D. et al. Effect of vitamin D supplementation on muscle strength: a systematic review and meta-analysis. Osteoporos Int 22, 859–871 (2011).

Download citation


  • Muscle
  • Muscle fibre
  • Strength
  • Vitamin D