For Women Only: Calcium and Vitamin D for Osteoporosis and Cancer Prevention

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It’s long been de rigueur for health care professionals to tell their female patients who have gone through menopause to take calcium and vitamin D supplements every day. But what is de rigueur is not necessarily rigorously established, and the United States Preventive Services Task Force (USPSTF), a government-appointed independent panel of experts in primary care and prevention, made that distinction abundantly clear in its new recommendations regarding calcium and vitamin D supplementation for postmenopausal women. In essence, the word is: don’t bother.

After reviewing the results of 137 studies, the USPSTF concluded that there was insufficient  evidence to support the use of calcium and vitamin D supplements in preventing cancer and osteoporotic fractures in postmenopausal women.

The typical doses evaluated in the studies were 1,000 mg of calcium and 400 IU of vitamin D, doses that are often recommended today. Although side effects are rare, combined supplementation is associated with a slightly increased risk of kidney stones, from 2.1% in women who took a placebo to 2.5% in those who took supplements. To put these numbers in perspective, only 1 person out of 273 who take calcium and vitamin D supplements will get kidney stones.

There is one group that appears to benefit from supplementation. Vitamin D, at an average dose of 800 IU, does reduce the risk of falls in community-dwelling adults (that is, people who don’t live in assisted living or a nursing home) over the age of 65 who are at increasing risk of falling. Therefore, people at risk of falling because of issues such as underlying arthritic conditions, balance issues, or poor vision, should take extra vitamin D daily.

For all other postmenopausal women, the anticipated benefits of supplementation with calcium and vitamin D just haven’t been proven. Women who have osteoporosis should see their primary health care providers to learn what can be done to prevent fractures–there are medications that can substantially reduce the risk. As for cancer risk, based on the medical community’s current understanding, vitamin D and calcium supplementation don’t appear to be helpful. Will higher doses be beneficial? We have no idea.

So until there have been studies that examine the risks and benefits of higher doses, stick to low-fat yogurt and grilled salmon for your calcium and vitamin D. They taste a heck of a lot better than supplements, anyway!

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The One Medical blog is published by One Medical, an innovative primary care practice with offices in Boston, Chicago, Los Angeles, New York, Phoenix, the San Francisco Bay Area, Seattle, and Washington, DC.

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