Menopause Mondays: Vitamin D and Calcium Controversy

There’s a controversy brewing over your bones.

In 2013,  the United States Preventive Services Task Force recommended that postmenopausal women refrain from taking supplemental calcium and vitamin D, saying little evidence exists that these supplements prevent fractures in healthy women.

“There is a tremendous amount of confusion among not only you, but your health care providers, too,” says Diane L. Schneider, MD, MSc, author of The Complete Book of Bone Health and co-founder of 4BoneHealth.org.  Vitamin D and calcium are essential for bone health. “The real question is how much is enough?”

The answer depends on whom you ask. “The debate is far from settled. What is the right amount of vitamin D for calcium absorption, bone mineral density, muscle strength, and fracture reduction remains controversial,” says Schneider.

The U.S. Preventive Services Task Force’s  recommendation on vitamin D and calcium supplementation gave a thumbs-down to supplementation with 400 IU or less of vitamin D3 and 1,000 mg or less of calcium for the prevention of fractures in postmenopausal women. It’s important to point out that this recommendation does not apply to the treatment of those with osteoporosis or vitamin D deficiency.

Although multiple studies contributed to the latest recommendation, the results were driven from the largest study, the Women’s Health Initiative calcium and vitamin D trial that included more than 36,000 women between the ages of 50 and 79 years who were randomly assigned to take 1000 mg of calcium with 400 IU of vitamin D daily or placebo pills. At the end of seven years, the number of fractures was similar in each group. However, among the women assigned to the supplements, those who actually took the pills 80 percent or more of the time had a 29 percent lower rate of hip fractures. If you took the supplements they worked! “Long-term use of calcium and vitamin D appears to confer a reduction that may be substantial in the risk of hip fracture among postmenopausal women,” the researchers later wrote.

Whatever the verdict on supplementation and doses, the first line of defense against osteoporosis is a healthy lifestyle. Calcium is readily available through the foods we eat—or at least should eat. When it comes to vitamin D, the sun is a primary source of the nutrient. However, everything from your age, location you live, use of sunscreen to weight, can affect how much vitamin D you produce.  Most Americans fall short of meeting the recommended daily amounts of the necessary vitamin D and calcium, compounding perimenopausal and menopausal women’s already-increased risk of osteoporosis and fractures, according to Schneider.

During perimenopause and menopause, plummeting estrogen levels can cause loss of bone mass. After menopause, bone breakdown outpaces the building of new bone in women, making women over the age of 50 at the greatest risk for developing osteoporosis, according to the Cleveland Clinic.

Women older than 50 need to consume 1,200 milligrams of calcium every day to keep their bones strong, according to Schneider. As vitamin D helps your body absorb this calcium, most women need 600 IU of the vitamin a day, while women older than 70 need 800 IU. However, your individual needs may vary. Have your vitamin D level checked to know what you need. The best sources of calcium include dairy, almonds, broccoli, kale, salmon, and soy products, such as fortified tofu. If you focus on a healthy diet filled with these foods, you can hit your daily bone-fortification quota, making calcium supplements and all of their controversy a moot point. Count your food first and only use supplements to supplement your diet. Don’t take the entire recommended amount in supplements.

While the top sources of vitamin D include oily fish, egg yolks, and fortified milk, according to the National Institutes of Health, the recommended amount of vitamin D is harder to achieve with diet alone. Most likely you will need a supplement, especially during the winter months when the necessary radiation from the sun is not available. When sun is plentiful, our sunscreen blocks its production.

Calcium and vitamin D are essential to maintaining healthy bones straight through perimenopause and menopause. Luckily, if you eat a healthy diet, they are more than attainable—they are inevitable!

Learn more about bone health and menopause in my FREE eBook, MENOPAUSE MONDAYS: A Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause. You can download the book here! Help me spread the word!

Suffering in silence is OUT! Reaching out is IN!