Calcium for Bone Mineral Density
Calcium is a necessary substrate, but trials show BMD benefits concentrated in low-intake and institutionalized populations. Excess supplemental calcium has been linked to cardiovascular risk signals — meet needs from food first.
Overview
See calcium-rich foods for how much calcium common foods supply and who still needs a supplement.
How It Works
Dosing & Protocol
Typical dose
- Recommended dose
- Food first; supplement only the dietary gap, max 500 mg elemental per dose with meals.
- Expected timeframe
- 12+ months.
Protocol
- form
- Citrate with acid suppression or low stomach acid; carbonate with food otherwise
- step 1
- Estimate dietary calcium before supplementing - food first is the guiding principle here, because the cardiovascular and kidney stone signals attach to supplements rather than diet
- step 2
- Supplement only the shortfall to 1000-1200 mg/day total
- timing
- With meals; separate by 2 hours from iron, zinc, levothyroxine and tetracycline or quinolone antibiotics
- alongside
- Resistance and impact exercise change bone density more than supplementation does
- measurement
- DEXA at baseline and 2 years
- dose ceiling
- Maximum 500 mg elemental calcium per dose, with meals
- essential partner
- Correct vitamin D first - it governs how much calcium you absorb
Evidence
Effects of calcium supplementation on clinical fracture and bone structure: results of a 5-year, double-blind, placebo-controlled trial in elderly women
Prince RL, Devine A, Dhaliwal SS +1 more
calcium supplementation did not significantly reduce fracture risk
Vitamin K1 supplementation retards bone loss in postmenopausal women between 50 and 60 years of age
Braam LA, Knapen MH, Geusens P +4 more
calcium, magnesium, zinc, and vitamin D (MD group)
Effects of alendronate and alfacalcidol on bone in patients with myasthenia gravis initiating glucocorticoids treatment
Lv L, et al
However, treatment with alfacalcidol alone failed to prevent bone loss in patients with MG receiving glucocorticoid therapy.
Calcium plus vitamin D supplementation and the risk of fractures
Jackson RD, LaCroix AZ, Gass M +4 more
did not significantly reduce hip fracture, and increased the risk of kidney stones
Two-year randomized controlled trial of vitamin K1 (phylloquinone) and vitamin D3 plus calcium on the bone health of older women
Bolton-Smith C, McMurdo ME, Paterson CR +4 more
10 microg (400 IU) vitamin D(3) plus 1000 mg calcium/day
Vitamin D3 and calcium to prevent hip fractures in elderly women
Chapuy MC, Arlot ME, Duboeuf F +4 more
the number of hip fractures was 43 percent lower (P = 0.043)
Dietary boron: progress in establishing essential roles in human physiology
Hunt, C.D.
This review of human and animal data found boron influences calcium, magnesium and vitamin D metabolism and steroid hormone levels, with depletion-repletion studies suggesting boron may reduce urinary calcium loss, but no clinical trials demonstrating reduced fracture risk or improved bone mineral density in humans.
Bones of contention: bone mineral density recovery in celiac disease - a systematic review
Grace-Farfaglia P
Calcium repletion supports bone density recovery alongside a strict gluten-free diet.
Calcium intake and bone mineral density: systematic review and meta-analysis
Tai V, Leung W, Grey A +2 more
Increasing calcium intake from diet or supplements produced small one-off increases in bone mineral density of about 1-2% that did not accumulate over time.
Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals
Strause L, Saltman P, Smith KT
Calcium plus trace minerals including manganese reduced spinal bone loss more than calcium alone over two years.
Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis
Tang BM, Eslick GD, Nowson C +2 more
treatment was associated with a 12% risk reduction in fractures of all types
Choline-stabilized orthosilicic acid supplementation as an adjunct to calcium/vitamin D3 stimulates markers of bone formation in osteopenic females: a randomized, placebo-controlled trial
Spector TD, Calomme MR, Anderson SH
Bone formation marker PINP rose significantly in the 6 and 12 mg silicon arms; femoral and lumbar BMD changes did not reach significance.
Safety
Caveats
Do not exceed ~1,200 mg/day total without need. Kidney stone risk in susceptible individuals; separate from iron and thyroid medication.
Less likely to help if
Medical Disclaimer
The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.
Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.