Prevention of Osteoporosis with Calcium and Vitamin D Supplementation

Introduction to Recommendations

• The American College of Rheumatology recommends daily supplementation of 800 UI of vitamin D and 1000-1200 mg of calcium to prevent osteoporosis, with monitoring of serum vitamin D levels to maintain concentrations ≥30-50 ng/mL 1

Patient-Specific Recommendations

• For patients on corticosteroids, supplementation with 800-1000 mg/day of calcium and 800 UI/day of vitamin D is essential for those receiving corticosteroids for more than 3 months at a dose ≥2.5 mg/day 1
• For patients with chronic inflammatory diseases, 800-1000 UI/day of vitamin D and 500-1000 mg/day of calcium are recommended 4

Lifestyle Modifications

• Quitting smoking is recommended to prevent osteoporosis 1
• Limiting alcohol consumption to ≤2 drinks per day is recommended to prevent osteoporosis 1
• A balanced diet is recommended to prevent osteoporosis 1
• Maintaining a healthy weight is recommended to prevent osteoporosis 1
• Regular resistance or weight-bearing exercises are recommended to prevent osteoporosis 1

Safety and Efficacy

• Calcium supplementation is associated with an increased risk of kidney stones, with an incidence of 1 case per 273 women supplemented over 7 years 7
• High doses of vitamin D (≥800 UI/day) reduce the risk of hip fracture by 30% and non-vertebral fracture by 14% in adults aged 65 and older 2