A version of this post first appeared on LiveWellNewYork.com
October is Bone Health Month. Most people equate calcium with bone health, but that’s really only part of the equation. According to Stewart Greisman, MD, rheumatologist with St. Luke’s and Roosevelt Hospitals, you need the right levels of other nutrients, such as vitamin D, for calcium to be absorbed in the body.

Why vitamin D and calcium?

Bone development happens every day as new cells replace old ones. By age 25, our bone mass peaks and we begin to lose bone much faster than our body can grow it. “As we get older, we’re all at risk for deteriorating bone health, including osteoarthritis or osteoporosis,” Dr. Greisman says.

Calcium can kick-start bone health, but it needs assistance from vitamin D. Without the absorption power of vitamin D by its side, much of the calcium we take in will be flushed out by the kidneys and intestines and won’t find its way into the bloodstream, where it needs to do its work. That’s why you can drink all the milk you want, but it won’t do you much good if you skimp on vitamin D.

How much is enough?

There are essentially three ways to get a useful amount of calcium and vitamin D into your system: through foods, supplements, or natural or ultraviolet light. The key is, getting enough of each.

“Men and women are more likely to lack calcium and/or vitamin D either when they don’t get enough of it from the foods they eat, they don’t include both in their diet, or they have risk factors that inhibit the body from using it,” Dr. Greisman says. “You lend your body a hand by taking supplements.”

Calcium                                  Vitamin D

Healthy adults, age 19-50             1,000 mg daily                        600 IU

Adults, age 51 and older                1,000-1,200 mg                     800-1,000 IU

However, it is possible to go overboard. Too much calcium and vitamin D (2,500 mg and 4,000 IU or greater per day, respectively) can increase your risk of kidney stonesgastrointestinal pain, bone pain, weakness or heart palpitations.

“If you and your doctor decide supplements are a good fit for you, make sure your blood levels are monitored. You want to strengthen your bones, not weaken your body,” Dr. Greisman adds.

Why you may need to supplement

Only you and your doctor can truly determine if you need extra calcium and vitamin D. You might be at risk for weak bones if you are:

Postmenopausal – Women (typically over age 50) are at the highest risk because they have less estrogen to aid in calcium absorption.
A smoker – Smoking impedes the growth of bone cells and inhibits blood from promoting the rebuilding process.
Related to someone with osteoporosis – If you want an indication of your bone health in the future, look at mom, dad or your grandparents. If any have signs of osteoporosis, such as a fractured wrist after a fall, you could be at risk, too.
Petite – Small-boned people have less bone mass to lose.
Lazy – There’s no polite way around it: The less you do, the more you have to lose. Weight bearing and strengthening exercises can actually build bone mass.

One simple way to get a baseline check up on bone health is with a bone density test. You can also determine your risk for bone fractures using an online Fracture Risk Assessment Tool, which assesses lifestyle and genetics. “If either test shows you’re at high risk for bone problems, you can start with lifestyle changes, including supplements,” Dr. Greisman says.

 

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