![]() ![]() The USPSTF assessed the magnitude of this harm as small. The USPSTF found adequate evidence that supplementation with vitamin D and calcium increases the incidence of kidney stones. The USPSTF found inadequate evidence regarding the effects of higher doses of vitamin D and calcium supplementation, alone or combined, on the incidence of fractures in community-dwelling, postmenopausal women. ![]() The USPSTF found adequate evidence that daily supplementation with 400 IU or less of vitamin D combined with 1000 mg or less of calcium has no effect on the incidence of fractures in community-dwelling, postmenopausal women. The USPSTF found inadequate evidence to determine the effects of vitamin D and calcium supplementation, alone or combined, on the incidence of fractures in men and premenopausal women. 1, 2 Within 1 year of experiencing a hip fracture, many patients are unable to walk independently, more than half require assistance with activities of daily living, 3, 4 and 20% to 30% of patients will die. 3.Approximately 2 million osteoporotic fractures occurred in the United States in 2005. Calcium supplements do not replace other osteoporosis treatments such as hormone replacement, bisphosphonates (e.g., Risedronate and alendronate ) and raloxifene (brand: Evista).Doses of calcium above 500 mg are not absorbed as well as smaller doses, so large doses of the supplement should be taken in divided doses (eg morning and evening).Calcium citrate is well absorbed in the fasted state as well as during meals.Many natural calcium carbonate preparations such as oyster shells or bone meal contain some lead.Calcium carbonate is not absorbed well when combined with medicines specifically for GERD (called proton pump inhibitors or H2 blockers), which block stomach acid. Oral tablets are best absorbed with a low-iron meal (such as breakfast). Calcium carbonate is the least expensive and highly effective form of calcium.Calcium supplements: If you cannot get enough calcium from dietary sources, consult your doctor to determine the best type, dose, and timing of calcium supplements. Some cereals, soy products, and fruit juices are fortified with calcium. Major dietary sources of calcium include milk and other dairy products (hard cheese, cottage cheese or yogurt) as well as green vegetables (kale and broccoli). ![]()
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