The Use of Calcium and Vitamin D in the Management of Osteoporosis

Overview

Journal Ther Clin Risk Manag

Publisher Dove Medical Press

Date 2009 Feb 12

PMID 19209265

Citations 90

Authors

John A Sunyecz

Affiliations

Soon will be listed here.

Abstract

Osteoporosis poses a significant public health issue, causing significant morbidity and mortality. Calcium and vitamin D utilization in the optimization of bone health is often overlooked by patients and health care providers. In addition, the optimal standard of care for osteoporosis should encompass adequate calcium and vitamin D intake. Dietary intake or supplementation with calcium and vitamin D will be reviewed, including recent recommendations for increased vitamin D intake. Compliance to calcium and vitamin D therapy is paramount for effective prevention of osteoporotic fractures. A recently released algorithm (FRAX) estimating absolute fracture risk allows the health care provider to decide when pharmacologic therapy is warranted in addition to calcium and vitamin D. When pharmacologic therapy is advised, continued use of calcium and vitamin D is recommended for optimal fracture risk reduction. A 'bricks and mortar' analogy is often helpful when counseling patients and this analogy will be explained. This manuscript reviews relevant data related to calcium and vitamin D use for patients at risk for fracture due to bone loss.

Citing Articles

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References

Bischoff-Ferrari H, Willett W, Wong J, Giovannucci E, Dietrich T, Dawson-Hughes B . Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA. 2005; 293(18):2257-64. DOI: 10.1001/jama.293.18.2257. View

Shea B, Wells G, Cranney A, Zytaruk N, Robinson V, Griffith L . Calcium supplementation on bone loss in postmenopausal women. Cochrane Database Syst Rev. 2004; (1):CD004526. DOI: 10.1002/14651858.CD004526.pub2. View

Dawson-Hughes B, Dallal G, Krall E, Sadowski L, Sahyoun N, Tannenbaum S . A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. N Engl J Med. 1990; 323(13):878-83. DOI: 10.1056/NEJM199009273231305. View

Jackson R, LaCroix A, Gass M, Wallace R, Robbins J, Lewis C . Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med. 2006; 354(7):669-83. DOI: 10.1056/NEJMoa055218. View

. Management of osteoporosis in postmenopausal women: 2006 position statement of The North American Menopause Society. Menopause. 2006; 13(3):340-67. DOI: 10.1097/01.gme.0000222475.93345.b3. View

MacLAUGHLIN J, Anderson R, Holick M . Spectral character of sunlight modulates photosynthesis of previtamin D3 and its photoisomers in human skin. Science. 1982; 216(4549):1001-3. DOI: 10.1126/science.6281884. View

OConnell M, Madden D, Murray A, Heaney R, Kerzner L . Effects of proton pump inhibitors on calcium carbonate absorption in women: a randomized crossover trial. Am J Med. 2005; 118(7):778-81. DOI: 10.1016/j.amjmed.2005.02.007. View

Heaney R, SAVILLE P, Recker R . Calcium absorption as a function of calcium intake. J Lab Clin Med. 1975; 85(6):881-90. View

Curhan G, Willett W, Speizer F, Spiegelman D, Stampfer M . Comparison of dietary calcium with supplemental calcium and other nutrients as factors affecting the risk for kidney stones in women. Ann Intern Med. 1997; 126(7):497-504. DOI: 10.7326/0003-4819-126-7-199704010-00001. View

10.

Bischoff H, Stahelin H, Dick W, Akos R, Knecht M, Salis C . Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res. 2003; 18(2):343-51. DOI: 10.1359/jbmr.2003.18.2.343. View

11.

Grant A, Avenell A, Campbell M, McDonald A, MacLennan G, McPherson G . Oral vitamin D3 and calcium for secondary prevention of low-trauma fractures in elderly people (Randomised Evaluation of Calcium Or vitamin D, RECORD): a randomised placebo-controlled trial. Lancet. 2005; 365(9471):1621-8. DOI: 10.1016/S0140-6736(05)63013-9. View

12.

Dawson-Hughes B, Harris S, Krall E, Dallal G . Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med. 1997; 337(10):670-6. DOI: 10.1056/NEJM199709043371003. View

13.

LeBoff M, Kohlmeier L, Hurwitz S, Franklin J, Wright J, Glowacki J . Occult vitamin D deficiency in postmenopausal US women with acute hip fracture. JAMA. 1999; 281(16):1505-11. DOI: 10.1001/jama.281.16.1505. View

14.

Heaney R, Dowell M, BIERMAN J, Hale C, Bendich A . Absorbability and cost effectiveness in calcium supplementation. J Am Coll Nutr. 2001; 20(3):239-46. DOI: 10.1080/07315724.2001.10719038. View

15.

Borghi L, Schianchi T, Meschi T, Guerra A, Allegri F, Maggiore U . Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. N Engl J Med. 2002; 346(2):77-84. DOI: 10.1056/NEJMoa010369. View

16.

Deluca H . Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr. 2004; 80(6 Suppl):1689S-96S. DOI: 10.1093/ajcn/80.6.1689S. View

17.

Heaney R . Absorbability and utility of calcium in mineral waters. Am J Clin Nutr. 2006; 84(2):371-4. DOI: 10.1093/ajcn/84.1.371. View

18.

Vieth R . Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr. 1999; 69(5):842-56. DOI: 10.1093/ajcn/69.5.842. View

19.

Moore C, Murphy M, Keast D, Holick M . Vitamin D intake in the United States. J Am Diet Assoc. 2004; 104(6):980-3. DOI: 10.1016/j.jada.2004.03.028. View

20.

Holick M . Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004; 80(6 Suppl):1678S-88S. DOI: 10.1093/ajcn/80.6.1678S. View