The role of calcium in the management of osteoporosis

  • An adequate intake of calcium is necessary throughout life both to acquire peak bone mass and to maintain bone health. With age, calcium intake falls (on average to about half that of RDI for those older than 60 years) and both the ability to adapt to a low calcium diet and calcium absorption are decreased.
  • Calcium is known to be weakly anti-resorptive and supplementation has been shown to slow the rate of bone loss by one half to two-thirds.
  • Recent data has demonstrated that supplementation may decrease fracture risk in community based post menopausal women who take supplementation regularly. However, this is not recommended as an adequate strategy alone to either treat osteoporosis or reduce fracture risk.
  • Calcium and vitamin D supplementation has been shown to reduce the risk of hip fracture by 30% in institutionalised frail elderly.
  • Anti-resorptive therapy for the treatment of osteoporosis should be combined with supplementation of 1000mg elemental calcium daily, best given in divided doses. As calcium binds with bisphosphonates, it should not be given on the same morning as oral bisphosphonates.
  • Calcium supplementation should be used with caution in those with a history of calcium containing renal calculi or hypercalcaemia.