Calcium and Vitamin D

Why do I need calcium and vitamin D?

Calcium and vitamin D are needed for strong bones. Nerves, muscles, and blood vessels need calcium to work. Vitamin D helps the body absorb calcium. Vitamin D helps strengthen muscles and prevent falls in older people. Vitamin D might also help prevent cancer and heart disease.

What are sources of calcium and vitamin D?

Calcium is found in foods. Dairy products are good sources. Eight ounces of yogurt (228 gram) or milk (1 cup (236 mL)), or 1.5 oz. (43 gram) of cheese, can provide around 300 mg. Orange juice with added calcium has 300 mg per 8 oz. (236 mL) serving. Vitamin D is made by sun-exposed skin. It is also found in some foods. Salmon is one of the best sources. A 3 oz. (86 gram) serving of sockeye salmon has almost 800 IU. A 3 oz. serving of tuna canned in water has about 150 IU. Dairy products with added vitamin D are good sources. Examples are a cup of milk (115 to 124 IU) or 6 ozs.(171 grams) of yogurt (80 IU). A cup of orange juice with added vitamin D has 80 IU. Calcium and vitamin D supplements are also available.

Do I need a supplement? Are they safe?

Many people are low on vitamin D. It is hard to get enough vitamin D from food. And most people don't get much sun exposure. They use sunscreens, stay indoors, or live at a northern latitude. So most people need a vitamin D supplement. Ask if you should have your vitamin D level checked.

People get about 300 mg calcium from nondairy foods daily. If you eat two servings of high-calcium foods (e.g., dairy), you can get around 900 mg per day total. Adding a 300 mg calcium supplement daily, or a third high-calcium serving, will provide a total of 1200 mg daily. You may have heard calcium supplements are not safe. There has been bad press about heart attacks and prostate cancer. Calcium supplements have not been proven unsafe. But don't go overboard with calcium supplements. Get your calcium from diet when possible. Avoid calcium supplements from coral or dolomite, a kind of limestone. They can contain heavy metals like lead.

How do I choose a calcium or vitamin D supplement?

Most calcium products are calcium carbonate (e.g., Tums, Caltrate) or calcium citrate (e.g., Citracal). Both work. Calcium carbonate doesn't cost much and provides the most calcium per dose. Read the label to check the calcium amount "per serving." This can vary based on the type of calcium you select. Calcium citrate may be better for patients who don't absorb calcium as well. Examples are older people or those on certain heartburn medications. Calcium is best absorbed if not more than 500 mg is taken at a time. Some supplements contain other ingredients (e.g., magnesium, vitamin K). These don't work any better than those with just calcium. Vitamin D is available over-the-counter in some calcium products or by itself. There are also high-dose vitamin D products that are prescribed if you have low vitamin D levels. It is okay to take a multivitamin or eat vitamin Dcontaining foods while taking prescription-strength vitamin D. Vitamin D comes as vitamin D2 or vitamin D3. Either can be used. In the U.S., look for a vitamin D supplement that is USP Verified. In Canada, look for a product with a Natural Product Number (NPN). These products have been tested for good quality.

How much calcium and vitamin D do I need?

Women up to 50 years old and men up to age 70 should aim for 1000 mg of calcium daily total (from food and supplements). Women over 50 years old and men over 70 should aim for 1200 mg of calcium daily total (from food and supplements). Most experts recommend that adults get 800 IU to 2000 IU of vitamin D daily for the best health benefits.

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