Calcium And Vitamin D Supplements

What Are Vitamin D And Calcium

Vitamin D and calcium are nutrients that sustain healthy bones. They are also needed for:

• Muscle movement

• Absorption of calcium and phosphorous

• Immune system responses

• Signaling between cells

• Hormonal secretion

• Blood vessel flow

Without enough vitamin D or calcium, your parathyroid glands compensate by producing too much of their hormone, a condition called hyperparathyroidism. That can lead to bone weakening and increased fracture risk. Other problems from calcium and vitamin D deficiencies include:

• Skeletal deformities in children ages 6-24 months

• Muscle weakness in children and the elderly

Given the crucial role of both nutrients in bone health, The Endocrine Society and the Institute of Medicine recommend certain consumption levels based on age and health. They have not yet found, however, that taking vitamin D provides cardiovascular protection.

What Is The Vitamin D Status Of Canadians

Vitamin D status can be measured in two ways – vitamin D dietary intakes, and vitamin D blood levels. It is the blood level data that gives a true picture of the vitamin D status in the body. Vitamin D is unique in that there is another source besides diet and supplements, namely, sunlight. So even if dietary intakes do not appear to be adequate, overall vitamin D status may be much different.

Dietary intake data were collected in the 2004 Canadian Community Health Survey . At a national level, there seems to be a very high prevalence of inadequate vitamin D intakes from food sources

Data on vitamin D intakes from food and supplement sources combined show a lower prevalence of inadequate vitamin D intakes, although still above 50% .

However, estimates of inadequate intakes of vitamin D must be interpreted with caution because the reference values to assess adequacy assume no vitamin D is contributed to the body by sun exposure. For this reason, data on vitamin D intakes from food and supplement sources cannot stand alone and consideration must be given to serum 25-hydroxy-vitamin-D D) levels, a well-established biomarker for vitamin D status.

Health Canada continues to recommend that people over the age of 50 years take a daily vitamin D supplement of 400 International Units .

How Much Vitamin D Should You Supplement

To figure out how much vitamin D you need from a supplement, subtract the total amount of vitamin D you get each day from the recommended total daily amount for your age. For example, a 55-year-old woman who gets 400 IU of vitamin D from her calcium supplement should take between 400 and 600 additional IU of vitamin D to meet the 800 1,000 IU recommended for her age.

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Calcium And Vitamin D Supplements In The Prevention Of Osteoporosis And Osteoporotic Fractures

Numerous trials have convincingly shown that an inadequate intake of calcium and vitamin D is an important risk factor for the development of osteoporosis and osteoporotic fractures . Vitamin D deficiency is common in older people, and together with a poor dietary calcium intake leads to negative calcium balance, which in turn contributes to age-associated secondary hyperparathyroidism. As this is key in the pathogenesis of osteoporosis, calcium and vitamin D supplementation is generally recommended as the baseline therapy, as this has been shown to enhance bone mineral density and reduce fracture risk in both men and women, although the benefit may be reduced by poor compliance . Vitamin D supplementation may also reduce the risk of falling, but only in a dose of at least 700 IU per day . Trials that assessed the effect of calcium or vitamin D alone have failed to show a reduction in fracture risk . This is not surprising because the negative calcium balance in older people is often the result of low calcium intake and vitamin D deficiency. Supplementation therefore typically consists of combined supplementation with 1,0001,200 mg calcium and 800 IU vitamin D .

Importantly, the inhibitory effects of calcium and vitamin D on bone resorption are shortlived and cease when supplementation is discontinued. Therefore, continued compliance and persistence with supplementation are essential to obtain therapeutic benefit.

Can Medications Cause A Vitamin D Deficiency

Yes. Vitamin D levels can be lowered by certain medications. These include:

• Cholesterol-lowering drugs .
• Seizure-control drugs .
• A tuberculosis drug .
• A weight-loss drug .

Always tell your doctor about the drugs you take and any vitamin D supplements or other supplements or herbs/alternative health products that you take.

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Getting Enough Calcium And Vitamin D

You can get enough calcium and vitamin D from foods and supplements. Food should be your primary source when possible.

When calcium or vitamin D is available in food, a food label will read percent daily value. The percent daily value is the percentage amount of a nutrient contained in that food. That percentage does not necessarily reflect the amount of that nutrient you should be getting.

It is much easier to look at the number of milligrams of calcium in food. For example, a glass of milk has around 300 mg of calcium. Most adults and children need around 1,000 mg per day so, that glass of milk means you need at least 700 more milligrams of calcium for the day to meet the daily recommended amount.

British Columbia Specific Information

Calcium is important to building strong, healthy bones and your body needs vitamin D to absorb calcium. The amount of calcium and Vitamin D you need each day depends on your age and if you are male or female. Fortified food is the best source of vitamin D and calcium.

For more information about vitamin D, including a list of what foods contain vitamin D, see HealthLinkBC File #68n Vitamin D and Your Health. To learn more about calcium and foods that contain calcium, see HealthLinkBC File #68e Calcium and Your Health. You may also call 8-1-1 to speak to a registered dietitian, Monday to Friday 9:00 a.m. to 5:00 p.m., or you can Email a HealthLinkBC Dietitian.

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How We Select Supplements

Our team works hard to be transparent about why we recommend certain supplements you can read more about our dietary supplement methodology here.

We support supplements that are evidence-based and rooted in science. We value certain product attributes that we find to be associated with the highest quality products. We prioritize products that are third-party tested and certified by one of three independent, third party certifiers: USP, NSF, or ConsumerLab.

It’s important to note that the FDA does not review dietary supplements for safety and effectiveness before they go to market. Our team of experts has created a detailed, science-backed methodology to choose the supplements we recommend.

Can You Ever Have Too Much Vitamin D

Yes. You can get too much vitamin D if you overdo the supplements. Interestingly, you cannot get too much vitamin D from the sun. Vitamin D toxicity is, thankfully, quite rare but can lead to hypercalcemia and together the symptoms can include:

• Confusion.
• Ataxia .

Do not take higher-than-recommended doses of vitamin D without first discussing it with your doctor. However, your doctor might recommend higher doses of vitamin D if he or she is checking your blood levels and adjusting your dose accordingly. Also, be cautious about getting large doses of vitamin A along with the D in some fish oils. Vitamin A can also reach toxic levels and can cause serious problems.

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What Are The New Dris For Calcium

The DRIs for calcium are based on evidence related to bone health, largely from the results of calcium balance studies. Calcium balance, which can be positive, neutral or negative, compares total calcium intake with urinary and fecal excretion of calcium. It is used to determine the accumulation and level of bone mass.

The DRIs for calciumFootnote 1, which can also be found in the DRI tables, are as follows:

The IOMreport states that there are no additional health benefits associated with calcium intakes above the level of the new RDA.

Total calcium intake should remain below the level of the new UL to avoid possible adverse effects. Long-term intakes above the UL increase the risk of adverse health effects, such as kidney stones.

Why We Need Vitamin D

Vitamin D, which is important for children and adults, also plays a part in protecting bones and helps support your muscles. Without adequate levels of vitamin D, you have an increased risk of breaking bones as you get older, the National Osteoporosis Foundation says.

Among the most popular ways to get vitamin D is going outside. When sunlight reaches your skin, your body makes vitamin D and stores it. Additionally, you can get it from fatty fish, including wild-caught mackerel, tuna, and salmon. Vitamin D can also be found in orange juice, fortified cereals, soymilk, and dairy products, including milk.

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Advice For Adults And Children Over 4 Years Old

During the autumn and winter, you need to get vitamin D from your diet because the sun is not strong enough for the body to make vitamin D.

But since it’s difficult for people to get enough vitamin D from food alone, everyone should consider taking a daily supplement containing 10 micrograms of vitamin D during the autumn and winter.

Between late March/early April to the end of September, most people can make all the vitamin D they need through sunlight on their skin and from a balanced diet.

You may choose not to take a vitamin D supplement during these months.

What Is Vitamin Ds Role In The Body

Vitamin D has many different and important roles in our body. It helps regulate calcium and other minerals, increases calcium absorption from our food, influences our immune system, and helps in cell differentiation, blood pressure regulation, and insulin secretion.

High dose vitamin D can be dangerous, as it can lead to something called hypercalcemia, a.k.a. high levels of calcium in the blood. This condition is rare, as it would require very high doses of vitamin D, in the range of 30,000-40,000 IU per day, which is much higher than the recommended daily intake. .

However, even lower doses may be potentially dangerous. High vitamin D levels increase calcium levels in the body. These high levels may show up as Hypercalciuria, otherwise known as kidney stones. This occurs when the body tries to excrete excess calcium via the kidneys.

Excreting excess calcium is not the only way that the body manages this – the mineral may deposit itself throughout the soft tissues of the body, including muscles and arteries.

Given the risks of high calcium levels in the body, supplementing vitamin D should be done with care. Kidney stones, myofascial pain, and heart disease are serious problems.

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How Is Vitamin D Deficiency Treated

The goals of treatment and prevention are the sameto reach, and then maintain, an adequate level of vitamin D in the body. While you might consider eating more foods that contain vitamin D and getting a little bit of sunlight, you will likely be told to take vitamin D supplements.

Vitamin D comes in two forms: D2 and D3. D2, also called ergocalciferol, comes from plants. D3, also called cholecalciferol, comes from animals. You need a prescription to get D2. D3, however, is available over the counter. It is more easily absorbed than D2 and lasts longer in the body dose-for-dose. Work with your doctor to find out if you need to take a vitamin supplement and how much to take if it is needed.

What Happens If I Take Too Much Vitamin D

Taking too many vitamin D supplements over a long period of time can cause too much calcium to build up in the body . This can weaken the bones and damage the kidneys and the heart.

If you choose to take vitamin D supplements, 10 micrograms a day will be enough for most people.

Do not take more than 100 micrograms of vitamin D a day as it could be harmful. This applies to adults, including pregnant and breastfeeding women and the elderly, and children aged 11 to 17 years.

Children aged 1 to 10 years should not have more than 50 micrograms a day. Infants under 12 months should not have more than 25 micrograms a day.

Some people have medical conditions that mean they may not be able to safely take as much. If in doubt, you should consult your doctor.

If your doctor has recommended you take a different amount of vitamin D, you should follow their advice.

You cannot overdose on vitamin D through exposure to sunlight. But always remember to cover up or protect your skin if you’re out in the sun for long periods to reduce the risk of skin damage and skin cancer.

Page last reviewed: 03 August 2020 Next review due: 03 August 2023

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What Foods Provide Vitamin D

The major sources of vitamin D are fortified foods. In Canada, cow’s milk and margarine must be fortified with vitamin D. Goat’s milk, fortified plant based beverages , and some calcium-fortified orange juices are permitted to be fortified with vitamin D. Cheese and yogurt can be made with vitamin D-fortified milk, however, the final product does not contain as much vitamin D as fluid milk alone. The only natural sources of vitamin D in the Canadian food supply are fatty fish and egg yolks.

Because it is a commonly-consumed food, fluid milk is a major dietary source of vitamin D.

How Often Do You Need To Get Your Vitamin D Levels Checked

Doctors do not usually order routine checks of vitamin D levels, but they might need to check your levels if you have certain medical conditions or risk factors for vitamin D deficiency. Sometimes vitamin D levels can be checked as a cause of symptoms such as long-lasting body aches, a history of falls or bone fractures without significant trauma.

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What’s The Best Way To Get Vitamin D And Calcium

To reiterate, you shouldn’t stop taking supplements your healthcare provider has recommended. But if you’re worried about your calcium and vitamin D intake, and you currently don’t take either of the supplements, try getting the recommended amount of calcium and vitamin D via lifestyle changes rather than pills, said Dr. Kopecky.

“A pill doesn’t make up for our deficient lifestyle. That’s what every study has shown,” said Dr. Kopecky.

“It’s always better to get it in your diet if you can. People tend to take supplements to make up for their diet. can be a marker of a bad diet.”

What Are Some Other Side Effects Of This Drug

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Upset stomach or throwing up.
• Constipation.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

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What Other Drugs Will Affect Calcium And Vitamin D Combination

Calcium can make it harder for your body to absorb certain medicines, and some medicines can make it harder for your body to absorb vitamin D. If you take other medications, take them at least 2 hours before or 4 to 6 hours after you take calcium and vitamin D combination.

Other drugs may affect calcium and vitamin D combination, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

What Other Factors Can Lead To Vitamin D Deficiency

• Age: The skin’s ability to make vitamin D lessens with age.
• Mobility: People who are homebound or are rarely outside are not able to use sun exposure as a source of vitamin D.
• Skin color: Dark-colored skin is less able to make vitamin D than fair-colored skin.
• Human breast milk: A woman’s breast milk only contains a small amount of vitamin D. Often infant formulas also only include a small amount of D also. Therefore infants are at risk of not receiving enough vitamin D. This is especially true for infants who are only fed breast milk.

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Calcium And Vitamin D Requirements

As new scientific research emerges, recommendations change. We are now rethinking how much calcium and vitamin D is needed for good bone health. There is increasing evidence that too much calcium from supplements is not likely to be a benefit and worse, can be harmful. This was underscored in the 2010 and 2018 reports from the US Preventive Services Task Force recommending that premenopausal women and men may not benefit from calcium supplements.

The recommended dietary allowances are goals established by the Institutes of Medicine the RDA varies with age, gender, and other factors. These amounts would be sufficient for 97% of the US population.

Mounting evidence shows that too little calcium in the diet is harmful, but too much calcium also may be harmful.

What Is The Most Important Information I Should Know About Calcium And Vitamin D Combination

Ask a doctor or pharmacist if this medicine is safe to use if you have:

• kidney disease
• high levels of calcium in your blood
• circulation problems or
• a parathyroid gland disorder.

Ask a doctor before using this product if you are pregnant or breast-feeding. Your dose needs may be different during pregnancy or while you are nursing.

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