To Your Good Health: Osteoporosis and calcium intake

DEAR DR. ROACH: My doctor told me to take calcium and vitamin D to prevent osteoporosis. However, I attended a women’s health seminar where the speaker stated that calcium, even with vitamin D, is ineffective. I am 84 years old and do not have osteoporosis, although my doctor says I have pre-osteoporosis. I have some arthritic pain in my back and hips, but am otherwise in excellent health. Should I discontinue the calcium with vitamin D? — A.D.M.

ANSWER: There remains considerable controversy about whether calcium and vitamin D are effective at preventing or treating osteoporosis. There have been at least 11 trials — some have shown benefit, others have not. The U.S. Preventive Services Task Force has determined that there is still not enough evidence to estimate the benefits of calcium and vitamin D in post-menopausal women without osteoporosis or vitamin D deficiency (although low doses, less than 400 IU of vitamin D or 1,000 mg of calcium, are likely to be ineffective).

In absence of clear evidence, clinicians must make their own decisions based on their knowledge of their patients. Your doctor has made a common and reasonable recommendation (a typical dose in a woman your age is 1,200 mg calcium and 1,000-2,000 IU of vitamin D daily). I personally recommend getting calcium through diet if possible. However, since it’s almost impossible to get vitamin D through diet, for people at high risk of vitamin D deficiency (especially those who are indoors most of the time) or those with proven deficiency by blood levels, I do recommend supplementation.

I generally would recommend listening to your doctor, who knows you, rather than a person at a seminar (or even a doctor writing a column).

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