Medically Reviewed by Jennifer Robinson, MD on October 25, 2020 Planning to eat right for healthier bones? Calcium is probably the
nutrient you think of first. But vitamin D is just as important for keeping bones strong and preventing the bone disease osteoporosis. Vitamin D helps your intestines absorb calcium from the food you eat. Getting enough of both nutrients is an important part of making sure your bones are dense and strong. Unlike calcium, which you only get through food, your body makes vitamin D when sunlight hits your skin. Active people who live in sunny regions can get at least
some of what they need from spending time outdoors every day. But in less temperate areas such as Minnesota, Michigan, and New York, the skin makes less vitamin D in the winter months, especially for older adults. The amount your skin makes depends on where you live, how light or dark your skin is, and the time of day you’re outside. It could be about 15 minutes for a very fair-skinned person and an hour or two for someone with darker skin. But you have to be careful -- too much time in
the sun raises your chance of having skin cancer. Even though sunlight is a key part of your body’s vitamin D production, it’s best to protect your skin with clothing and sunscreen if you’ll be outside for more than a few minutes. How
else can you get vitamin D? A few foods have it, such as: But it’s hard to get the amount you need from food alone. Experts recommend 600 international units (IU) of vitamin D per day for adults up to age 70, and 800 IU for people 71 and older. If you’re not getting enough from sunlight and food, you may need to
take a supplement. You can get vitamin D in multivitamins and also in combination with a calcium supplement, as well as on its own. Keep in mind, though, that many diet supplements have vitamin D, so before you take another one, check the labels and
let your doctor know what you’re taking. Getting too much vitamin D, especially above 4,000 IU per day, can be dangerous. If you already have osteoporosis, keep in mind that vitamin D and calcium alone are not enough to treat the disease. You’ll need to take them along with other
medications your doctor prescribes.
 The US Preventive Services Task Force (USPSTF) has recently published recommendations on vitamin D and calcium supplements for preventing bone fractures in adults. The Role of Vitamin D and Calcium in Bone Health Calcium is an essential mineral for many body functions, including building and maintaining healthy bones. Human bodies do not make calcium; they get it from food or supplements. Because bones are constantly being broken down and rebuilt, calcium is needed throughout life. Vitamin D also is essential for bone health, mostly because it helps ingested calcium be absorbed from the intestine. Most vitamin D in the body is made by the skin in response to sunlight, but it can also be absorbed from food and supplements. Bone Density and Fracture Risk As people age, the rate of bone breakdown starts to overtake the rate of bone building. In women, a major reason is a decrease in estrogen levels during menopause. Over time, this can lead to low bone density (weak bones). Eventually, it can cause osteoporosis (porous bones). People with osteoporosis are more likely to have bone fractures, especially after trauma such as a fall. Getting enough vitamin D and calcium through food earlier in life can decrease the risk of developing osteoporosis later in life. However, the role of taking vitamin D and calcium supplements is less clear. What Is the Population Under Consideration for Taking Vitamin D and Calcium Supplements to Prevent Fractures? This recommendation applies to adults with no known osteoporosis or vitamin D deficiency, no history of osteoporotic bone fractures, and no increased risk of falls and who live in the community (not in a nursing home or other institutional care setting). What Are the Potential Benefits and Harms of Taking Vitamin D and Calcium Supplements to Prevent Fractures? The possible benefit of taking vitamin D and calcium supplements is that it helps prevent osteoporosis, thereby decreasing bone fractures. However, there is currently not enough evidence to say that this is the case for most older adults. Evidence does show that taking lower doses of vitamin D and calcium (≤400 IU of vitamin D and ≤1000 mg of calcium daily) does not prevent fractures in postmenopausal women. Potential harms of taking combined vitamin D and calcium supplements include a small increased risk of kidney stones. The possible link between vitamin D and calcium supplementation and cardiovascular disease outcomes is controversial, but no studies have shown a direct link between them. How Strong Is the Recommendation to Take Vitamin D and Calcium Supplements to Prevent Fractures? For men and women who have not gone through menopause, there is not enough evidence to weigh the benefits and harms of taking vitamin D and calcium supplements for preventing fractures. For postmenopausal women, there is not enough evidence to weigh the benefits and harms of taking >400 IU of vitamin D and >1000 mg of calcium daily, but there is some evidence that taking ≤400 IU of vitamin D and ≤1000 mg of calcium daily has no net benefit for preventing fractures. Bottom Line: Current Recommendation for Taking Vitamin D and Calcium Supplements to Prevent Fractures The USPSTF concludes that for community-dwelling men and premenopausal women, there is insufficient evidence to assess the balance of benefits and harms of vitamin D and calcium supplementation, alone or combined, for the prevention of fractures (“I” statement). For postmenopausal women, the USPSTF recommends against taking ≤400 IU of vitamin D and ≤1000 mg of calcium daily for preventing fractures (“D” statement). For postmenopausal women, there is insufficient evidence for taking >400 IU of vitamin D and >1000 mg of calcium daily for preventing fractures (“I” statement). Source: US Preventive Services Task Force. Vitamin D, calcium, or combined supplementation for the primary prevention of fractures in community-dwelling adults [published online April 17, 2018]. JAMA. doi:10.1001/jama.2018.3185 Topic: Preventive Medicine How much vitamin D should I take daily for osteoporosis?The dose of vitamin D in the management of osteoporosis should be no less than 700-800 IU per day. An optimal dose of vitamin D should raise serum concentrations of 25(OH)D to the desirable range of at least 75 nmol/l. Higher intermittent oral doses of vitamin D may overcome low adherence.
What are the current nutritional recommendations about calcium and vitamin D for seniors with osteoporosis?Adults at risk of or diagnosed with osteoporosis should include food sources of calcium and if needed, take a supplement to reach these intakes: o 19 to 50 years: 1000 mg per day from food and supplements combined. o Over 50 years: 1200 mg per day from food and supplements combined.
How much vitamin D and calcium should I take daily?How much calcium and vitamin D do you need? NOF recommends that women age 50 and younger get 1,000 mg of calcium from all sources daily and that women age 51 and older get 1,200 mg. For men, NOF recommends 1,000 mg of calcium daily for those age 70 and younger and 1,200 mg for men age 71 and older.
Does taking calcium and vitamin D help osteoporosis?Calcium is probably the nutrient you think of first. But vitamin D is just as important for keeping bones strong and preventing the bone disease osteoporosis. Vitamin D helps your intestines absorb calcium from the food you eat.
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Calcium and vitamin d recommendations for osteoporosis
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