🩺 As an NSP (Nutrition Support Pharmacist), many ask if they should take MORE Vitamin D and LESS Calcium. Here’s the latest...
- Vitamin D recommendations..
- Experts suggest 1000 IU/day instead of 400 IU/day. More critical than calcium for 💪 bone health and has other benefits.
- Many get insufficient vitamin D due to reduced ☀️ sun exposure.
- Milk only has 100 IU per cup! 🥛. Recommend 400-800 IU/day, especially for those in higher latitudes or limited sun.
- Use D3 (cholecalciferol) 💊 instead of D2 (ergocalciferol); D3 is more active and helps prevent fractures.
- Advise that up to 2000 IU/day of D3 is safe.
- Calcium recommendations..
- Women: 🚫 Limit calcium supplements to 700 mg/day. Men: Do not take calcium supplements.
- Most get 600 mg/day from diet, so women can still reach 1200 mg with food + supplements ⟶ For men, 600 mg from food is sufficient with adequate vitamin D.
- Note: ❓ Concerns about high calcium and prostate cancer risk, but evidence is inconclusive.
- Follow Canadian osteoporosis recommendations:
- 1000 mg/day for men up to age 50 and premenopausal women.
- 📅 1500 mg/day for men over 50 and postmenopausal women.
- A cup 🥛 of yogurt, milk, or fortified juice provides about 300 mg of calcium.
- If dietary intake is low, suggest supplements to make up the difference.
References
- Hathcock JN, Shao A, Vieth R, Heaney R. Risk assessment for vitamin D. Am J Clin Nutr. 2007;85(1):6-18.
- Shea B, Wells G, Cranney A, et al. Calcium supplementation on bone loss in postmenopausal women. Cochrane Database Syst Rev. 2003;(4):CD004526.
- Boonen S, Lips P, Bet al. 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. 2007;92(4):1415-1423.
