Are You Getting Enough Calcium and Vitamin D?

If you have osteoporosis, you may need to know how to choose the right forms of calcium and vitamin D supplements.

By Dennis Thompson, Jr.

Medically reviewed by Lindsey Marcellin, MD, MPH

Calcium and vitamin D are both vital nutrients that help maintain good bone health, and they've each been touted as natural treatments for osteoporosis. The two work in tandem: A diet low in calcium is a primary risk factor for osteoporosis, and the body cannot process calcium without the aid of vitamin D.

Vitamin D is made by the human body in response to sun exposure. Unfortunately, many people don’t get the calcium or vitamin D they need from the foods they eat or the time they spend outdoors. Supplements may be in order to get the full benefit of these natural treatments for osteoporosis. Fortunately, calcium and vitamin D supplements are widely available, but the key lies in how you choose and use them.

Calcium as a Natural Treatment for Osteoporosis

Our bones and teeth contain 99 percent of the calcium in our bodies. Calcium works as a natural treatment for osteoporosis by helping to build and maintain healthy bones, but it also serves a number of other purposes. Calcium aids in the process of normal blood clotting, nerve transmission, and muscle contractions, among other uses. If your calcium intake isn't sufficient, your body will begin to draw calcium from your bones to support these other body functions.

The human body doesn’t produce calcium itself. To make matters worse, our bodies lose calcium daily through sweat, urine, and feces, and in the process of creating skin, nail, and hair cells. That's why you need to replenish the calcium in your body every day.

The best way to get calcium is through your diet. Foods like milk and cheese, spinach, tofu, and fortified breakfast cereals contain not only high levels of calcium, but also other nutrients necessary for good health, including vitamin D.

The daily amount of calcium recommended by the National Osteoporosis Foundation as part of an overall osteoporosis prevention plan is:

• 1,000 milligrams of calcium for adults under 50
• 1,200 milligrams for adults age 50 and over

Since bone growth in childhood is a leading factor in determining a person's chances of getting osteoporosis, children and teenagers between ages 9 and 18 should be taking in 1,300 milligrams of calcium per day.

Vitamin D as a Natural Treatment for Osteoporosis

Vitamin D is essential to calcium absorption in the gut, and if you aren't getting enough vitamin D, much of the calcium in your diet could go unprocessed and be lost. Vitamin D also plays a role in bone growth, and without it bones can become brittle and thin.

Your skin produces vitamin D through exposure to the ultraviolet rays contained in sunlight, and your body is able to store that vitamin D for later use. Sunlight is the best source of vitamin D, though wearing sunscreen will prevent your body from producing and storing it.

However, as people get older their skin becomes less able to create vitamin D through exposure to sunlight. Dairy products, like low-fat or fat-free milk with added vitamin D, are great sources of both the vitamin and calcium, but there are few foods that naturally contain high levels of vitamin D. For this reason, many people will need to take vitamin D supplements to make sure they're getting enough. People who live in places like the Pacific Northwest, where the sun can be obscured for weeks or months by rain clouds, also should consider taking vitamin D supplements.

The National Osteoporosis Foundation recommends that:

• Adults under age 50 get 400 IU to 800 IU of vitamin D daily.
• Adults age 50 and older get 800 IU to 1,000 IU of vitamin D daily.

Some medical scientists believe there is evidence that even higher levels of vitamin D would be helpful, but more evidence is needed to confirm this.

Calcium and Vitamin D Supplement Tips

Calcium and vitamin D supplements are available from a wide variety of stores, including supermarkets, drug stores, department stores, and natural food stores. But picking the right supplement — and then using it wisely — can be a tricky proposition. Here are tips to help you make the right decisions:

• Read labels. Supplements are not as tightly regulated as drugs. To make sure you're getting good quality supplements, look for a "USP verified" label on the packaging. That stands for US Pharmacopeia, a non-profit organization that tests supplements for purity and potency, and also reviews participating companies' manufacturing processes.
• Shop smart for calcium. Avoid non-USP verified calcium supplements made from oyster shells, bone meal, or dolomite, and those simply labeled as coming from "natural sources." These can contain lead or aluminum from the shellfish used to manufacture the supplement.
• Get the right amount. Calcium supplements sometimes come combined with other substances, and in such cases, will be labeled as calcium citrate, calcium carbonate, or calcium phosphate. A 300-milligram tablet does not mean there are 300 mg of the actual element of calcium. The amount ofelemental calcium is much less, and should be listed on the label.
• Spread it out. Don't take your daily calcium tablets all at once. Your body can only absorb about 500 milligrams of calcium at a time. Taking more than that at one sitting is wasteful.
• Not too much! People who take too much vitamin D can become sick from it. Symptoms can include nausea, vomiting, poor appetite, weakness, weight loss, and constipation. If too much calcium is released into the bloodstream as a result of a vitamin D overload, you might experience heart rhythm abnormalities or confusion and difficulty thinking.

For the best approach to preventing osteoporosis, “bone up” on these two essential nutrients and develop your own plan that puts diet first, then uses supplements when needed to reach your daily intake goals.