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Calcium and Vitamin D Requirements

As new scientific research emerges, recommendations change. We are now rethinking how much calcium and vitamin D is needed for good bone health. There is increasing evidence that too much calcium from supplements is not likely to be a benefit — and worse, can be harmful. This was underscored in the 2010 and 2018 reports from the US Preventive Service Task Force (USPSTF) recommending that premenopausal women and men may not benefit from calcium supplements.

The recommended daily allowances (RDA) are goals established by the Institutes of Medicine — the RDA varies with age, gender, and other factors. These amounts would be sufficient for 97% of the US population.

Mounting evidence shows that too little calcium in the diet (less than 500–600 mg a day) is harmful, but too much calcium (adding calcium supplements when the intake is already 1,000 mg) may be harmful.

Institutes of Medicine Recommendations

Life stage group

Calcium
mg
RDA

Vitamin D
mcg (IU)
RDA

Supplement?

Infants 0 to 6 months

200

10 (400)

No

Infants 6 to 12 months

260

10 (400)

No

1–3 years old

700

15 (600)

No

4–8 years old

1,000

15 (600)

No

9–18 years old

1,300

15 (600)

Maybe

14–18 years old, pregnant or nursing 1,300 15 (600) Maybe

19–50 years old

1,000

15 (600)

No

19–50 years old, pregnant or nursing

1,000

20 (800)

No

MEN: 51–70 years old

1,000

15 (600)

Maybe

WOMEN: 51–70 years old

1,200

15 (600)

Maybe

71+ years old

1,200

20 (800)

Maybe

Girls age 9–18

The risks of taking calcium and vitamin D supplements are not known in this group, however, during the bone building years, girls need extra calcium and might benefit from vitamin D supplements as well.

Premenopausal women

There is not enough scientific evidence to define the risks and benefits of taking calcium and vitamin D supplements in premenopausal women. If a premenopausal woman meets her RDA through food, she should not take a calcium supplement. If a premenopausal woman does not eat any dairy foods, she likely needs to take a calcium supplement — 500 mg is probably enough to get her into a reasonable range.

Men

There is not enough scientific evidence to define the risks and benefits of taking calcium and vitamin D supplements in men.

Men or women at risk for fracture or osteoporosis

1,200 mg calcium (diet + supplements) and 1,000 – 2,000 IU’s of vitamin D

There is evidence of risks (stroke and heart attack) of taking too much calcium through supplements. However, postmenopausal women at increased risk for fractures or osteoporosis need more calcium and vitamin D. If a woman with these characteristics is meeting her RDA through food, it is best that she not add a calcium supplement. If she does not eat dairy, she may need a supplement. If she has a balance diet, she may only need an additional 500 mg of calcium and 600 – 1,000 IUs of vitamin D.

How can you be sure?

Use the CALCIUM RULE OF 300. Take the number of servings of dairy or calcium fortified juices per day and multiply that by 300. Then add 300 to account for all the calcium you would get from the rest of your diet. The total is your calcium intake from diet. Determine your RDA and add a supplement — if necessary — to avoid calcium deficiency. NOTE: you might be able to reach this goal by simply adding another serving of dairy or fortified juice.


Posted: 9/28/2016; Revised:  4/10/19, 01/22/20. 
As a service to our readers, American Bone Health provides access to our library of archived content. Please note the date of the last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician

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