Calcium and vitamin D – two of the most important nutrients you need for healthy bones. Unfortunately, a number of people fall short of meeting their vitamin D and calcium requirements, especially people who eat a vegan diet. If you’re over the age of 60, have darker skin, are obese or live in an area with little direct sunlight during parts of the year, you’re at greater risk for vitamin D deficiency. No wonder so many people take calcium or vitamin D supplements – but is this a good idea? A new study questions this wisdom for older women.
Should Some Women Avoid Calcium and Vitamin D Supplements?
A recent study published in the journal Menopause questions whether it’s safe for all women to take calcium and vitamin D supplements. In this study, 163 Caucasian women age 57 and older took vitamin D in various doses along with calcium citrate 1,200 milligrams a day to fulfill their calcium and vitamin D requirements.
Despite the fact the women were taking “normal” doses of calcium and vitamin D, not mega-doses, 9% developed a high blood calcium level. That’s a problem. High levels of calcium in the blood can lead to muscle weakness, bone pain, fatigue, and irregular heart rhythms. Almost a third of the women in this study developed abnormally high levels of calcium in their urine, a finding that places them at greater risk for kidney stones.
Researchers found the best predictor of who would develop abnormal calcium levels were women that had a high 24-hour urine calcium level. A 24-hour urine calcium is a measure of how much calcium you excrete into your urine over a 24 hour period. This isn’t a test doctors routinely do when you get a physical exam.
Because of this, some women that take calcium and vitamins D supplements may be at greater risk for kidney stones and other problems and not be aware of it. As the authors of this study point out, for some women, taking even small doses of supplemental calcium may increase their risk for an elevated calcium level. They suggest checking a urine and blood calcium level prior to taking a calcium supplement and monitoring calcium status closely.
What role does vitamin D play in this? Vitamin D increases absorption of calcium from the gut and kidney so more enters your bloodstream. That’s good for bone health, but when calcium levels rise too high, it can be problematic. Women taking certain medications and those with certain health conditions are more likely to develop a high calcium level when taking calcium supplements. This study also suggests that even normal, healthy older women can experience a rise in blood or urine calcium from taking supplements.
Should You Take a Calcium or Vitamin D Supplement?
Before reaching for a supplement, monitor how much calcium you’re already getting in your diet. If you consume dairy products, you may be meeting your calcium requirements and not need a calcium supplement. A single glass of milk has around 300 milligrams of calcium, enough to supply a quarter of your daily needs. A cup of plain yogurt has a whopping 450 milligrams of calcium. Although higher in protein and lower in carbs, Greek yogurt is lower in calcium than non-Mediterranean yogurt.
Look beyond the dairy aisle when choosing calcium sources. Non-dairy sources of calcium include green, leafy vegetables, calcium-fortified soy milk, tofu, canned salmon, sardines black-eyed peas and broccoli. Even if you eat a vegan diet, you can often meet your daily calcium requirements with a little planning.
Meeting Vitamin D Requirements
What about vitamin D? Low and borderline-low vitamin D levels aren’t uncommon. The best source of vitamin D isn’t food but exposure to sunlight. If you’re not getting 15 minutes of sun exposure three times a week you may not be supplying your body with the amount of vitamin D you need. Foods that contain respectable amounts of vitamin D include canned salmon, sardines and fortified milk, orange juice and cereal. Before taking a vitamin D supplement, ask your doctor to check a vitamin D level. There’s no point in taking a supplement if your vitamin D levels are in the optimal range.
If you do take a vitamin D supplement, get your vitamin D level checked periodically to see how you’re responding. Having your vitamin D level in the normal range is important for overall health. Vitamin D supports a healthy immune system and may offer protection against some health problems including autoimmune diseases and, possibly, some forms of cancer, based on preliminary research. More research is needed in this area.
Vitamin D deficiency may only cause vague symptoms like muscle weakness, joint aches and pains and fatigue and many doctors don’t routinely check a vitamin D level when you have these symptoms. If you have these symptoms, take charge of your own health and get a vitamin D level checked.
The Bottom Line?
Calcium and vitamin D are important for healthy bones but, for some women, taking supplements may be too much of a good thing. Whenever possible, get your calcium from healthy food sources rather than supplements. If you eat a vegan diet, you may need more than the recommended amount of dietary calcium since non-dairy based calcium isn’t as well-absorbed. By planning your diet carefully and including fortified soy milk and tofu in your diet, most people can still meet your calcium requirements through diet.
For vitamin D, don’t take a supplement until you know how high your vitamin D level is. As always, talk to your doctor about what the best approach to keeping your bones healthy is.
References:
Medical News Today. “Some Older Women Taking Calcium and Vitamin D Supplements May Need to Reduce the Dose” (2014)
The Vitamin D Council. “Am I deficient in vitamin D?”
Medscape.com. “Vitamin D Deficiency and Related Disorders”
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