Calcium and Vitamin D Supplements

Osteoporosis Canada recommends that adequate calcium and vitamin D be taken on a daily basis, and has published the following recommendations:

Daily Calcium Intake

Calcium requirements are 1000 mg elemental calcium daily for women under 50yrs of age and 1200 mg elemental calcium daily for women > 50 years 

It is preferred that calcium be taken from dietary sources instead of supplements – if this is not possible due to lactose intolerance or other factors then calcium supplements either calcium carbonate or calcium citrate 500 mg daily is advised. Calcium levels in the blood and urine can be measured and the dose of the supplement can be modified based on these results 

  1. Pre-pubertal children (ages 4-8 years): 800 mg/day
  2. Adolescents (ages 9-18 years): 1300 mg/day
  3. Women aged 19-50 years: 1000 mg/day
  4. Women over 50 years of age: 1200 mg/day
  5. Pregnant or lactating women (18 years and under): 1000 mg/day
  6. Men aged 19-50 years: 1000 mg/day
  7. Men over 50 years of age: 1500 mg/day

Daily Vitamin D Intake

Vitamin D is present in a few food groups, including fatty fish, eggs and D fortified milk and cereal, it is difficult to meet daily requirements with diet alone. Vitamin D in doses of 800-1000 iu daily will prevent vitamin D deficiency in most people. Osteoporosis Canada advises Canadians to discuss their vitamin D requirements with their physician states Dr Khan Chair of Rapid Response Committee of the Osteoporosis Canada Scientific Advisory Board. 

Suggested vitamin D dose for Canadians is 800u daily to 2000 iu daily 

Your Doctor can measure the vitamin D level and modify the dose of your supplements. It is advisable to aim for a vitamin D level of 75-125nmol/l 

  1. Women aged 19-50 years: 400 IU (10ug)/day
  2. Women over 50 years of age: 800 IU (20 ug)/daily
  3. Pregnant or lactating women (18 years and over): 400 IU (10 ug)/day
  4. Men aged 19-50 years: 400 IU (10 ug)/day
  5. Men over 50 years of age: 800 IU (20 ug)/day

Vitamin D3 is specified, as it shows greater potency than Vitamin D2; therefore more of the latter may be required to meet these recommendations.

Other Dietary Factors

  • Maintaining adequate protein intake.
  • Excess caffeine (more than 4 cups of coffee per day) should be avoided.
  • Excess dietary sodium (more than 2100 mg/day or 90 mmol/day) should be avoided, as it reduces bone mass density in adult men and women.
  • No evidence exists to recommend additional intake of the following nutrients for the prevention or treatment of osteoporosis: magnesium, copper, zinc, phosphorous, manganese, iron, essential fatty acids.

Lifestyle Changes

Smoking and alcohol consumption have a detrimental effect on bone health. It is highly recommended that individuals avoid smoking and limit or avoid alcohol consumption. Dietary and lifestyle counselling is also available through Oakville Trafalgar Memorial Hospital.

Tips on Managing Your Osteoporosis 

  1. Osteoporosis is a preventable and treatable disease.
  2. Always try to maintain a positive attitude.
  3. Your only physical limitations are to avoid bending and heavy lifting.
  4. Try to obtain your calcium requirements from foods rich in calcium i.e. diary products, salmon, figs, almonds, broccoli and tofu.
  5. If you are not able to obtain your calcium needs from diet alone, then calcium supplements are recommended. Calcium carbonate or calcium citrate are the recommended calcium supplements.
  6. Limit alcohol, soft drink and coffee intake.
  7. Stop smoking.
  8. Walking is the best weight-bearing exercise.
  9. A daily walking program of 30-40 minutes will improve your bone density and reduce your risk of fracture.