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  • Writer's pictureAnna Rathbun, NC

The Calcium Supplement Question

One of my tasks is to help clients to access the best quality supplements recommended by their doctor.   Just a year ago some of my clients' doctors recommended 1200 mg calcium and now clients are telling me that their doctor said don't take calcium.  What’s up? 

Calcium is tricky – yes, it’s the main building block for your bones, but it takes a lot of work for calcium to get from that pill into your bones and it's easy for calcium to deposit in other places – joints, kidneys, heart. Weight bearing exercise plus Vitamin D3, K2, magnesium, and a range of trace minerals are required to get that calcium into the bones where it belongs.

PubMed has published two different analyses in the last 30 days that review 25 years of studies on calcium and Vitamin D3 for bone health – one shows some benefit for bones with no benefit for overall longevity and the other shows no benefit for bones?  The problem is that we don't know which form of calcium and if they took any other nutrients to get the calcium into the bones.

My holistic recommendation is to look at diet, exercise, doctor’s recommendation and symptoms to guide which types of supplements for bone support will be the most helpful while avoiding problems that can occur from too much calcium or other supplements.

Read on for the specifics around bone building vitamins.

  • Calcium - For those with the highest risk of weak bones I look at food and other nutrients first before considering  500 mg food-based calcium supplement.  Specific symptoms can give us a hint as to how much and which form of calcium can be helpful – high calcium food, calcium citrate, hydroxyapatite etc. all have different benefits.

  • Magnesium is important to get calcium into the bones and for muscle cramps, headaches, bowel function and more.  Stress, exercise, caffeine, and life itself use up magnesium and it’s hard to get enough from food.  Magnesium supplements all have different effects that manifest as different symptoms. Would magnesium oxide, citrate, malate, or another version be helpful for you?

  • Vitamin D3 – helps absorb calcium from the gut into the bloodstream.  Fortunately, your doctor can test Vitamin D3 status, so we don’t have to rely on my educated guess.   Vitamin D3 has a range of other essential functions for the whole body so it’s worth asking your doctor for a blood test.

  • Vitamin K2 – the most often overlooked vitamin.  While Vitamin D3 helps get calcium into the body, it doesn’t get it into the bones.  Vitamin K2 is required to get calcium into the bones and the specific form of vitamin K2 is important. The main food source for Vitamin K2 is grass fed butter or Japanese Natto which is a fermented soybean condiment that smells like blue cheese. In our culture these foods are difficult to get.    Don’t take Vitamin K2 if you take a blood thinner medication.

  • Trace minerals for bone health include zinc, silica, boron, manganese, copper and more.  This is a fun category because each mineral has a specific set of symptoms that we can track and specific foods that contain high amounts.  We can watch your symptoms change as you enjoy more trace mineral foods or supplements.


My own example of symptom-based food therapy. 

I started to have knee problems and evaluated, based on symptoms, that manganese might help.  I began taking manganese pills and my knees got better.  Pecans are the highest food source of manganese.  I stopped taking pills and began eating pecans and my knees felt great.  If I forgot and ran out of pecans my knees would start to hurt within a few weeks. 

I get to watch this type of transformation each week as clients feel better and alleviate symptoms by providing missing nutrients.  Most bone building vitamins and minerals have a specific set of symptoms that we can track and are safe to take as a supplement to test our theory.  If the supplement makes a difference, then we continue for with the supplement for optimum levels and then switch to food when possible.  If the supplement doesn’t make a difference, then our guess was wrong, and we look for other causes.

Bone building requires more than just calcium and Vitamin D3.  In my experience food and supplements for Magnesium, Vitamin K2 and trace minerals can be chosen based on current food and symptoms.  Vitamin D3 status can be determined by your doctor and taking or increasing calcium food or supplements is individualized depending on doctor recommendations and symptoms.

Sources of recent analyses

Role of calcium &/or vitamin D supplementation in preventing osteoporotic fracture in the elderly: A systematic review & meta-analysis

Nutritional therapy of older osteoporotic people with supplemental calcium and vitamin D: side effects, fracture rates, and survival - an internationalized meta-analysis

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