Making Sense of New Vitamin D and Calcium Supplement Guidelines

The current thinking that vitamin D and Calcium supplements together offer protection against bone fractures in post-menopausal women is once again being questioned following the release of new recommendations by the U.S. Preventive Services Task Force (USPSTF), a panel of sixteen independent medical experts that review research studies and make recommendations to primary care clinicians. You can read a summary of their recommendations here.

Based on an analysis of existing scientific evidence the panel’s recommendations included these three statements;

In postmenopausal women, there is adequate evidence that daily supplementation with 400 IU of vitamin D3 combined with 1,000 mg of calcium has no effect on the incidence of fractures. However, there is insufficient evidence to assess the balance of the benefits and harms of a dose greater than 400 IU of vitamin D3 and greater than 1000 mg of Calcium in post menopausal women.


Adequate evidence indicates that supplementation with 400 IU or less of vitamin D3 and 1,000 mg or less of calcium increases the incidence of renal stones. However, The USPSTF assessed the magnitude of this harm as small.


Clinicians should understand the evidence but individualize decision making to the specific patient or situation.

This last statement acknowledges that recommendations made for a general population doesn’t fit every individual’s circumstances. There are several factors that you and your physician should consider when determining whether to take these supplements. For example:

  • Do you have a family history of osteoporosis?
  • Are you taking medication, such as Prilosec, or another anti-reflux aid that can hinder the absorption of calcium?
  • Are you on hormone therapy, which offers bone protection?
  • Do you drink a lot of cola?  Studies have suggested a link with lower bone density.

Also, there is ample evidence that an adequate level of the hormone vitamin D3 – some say between 40 and 60 ng/ml – can offer protection against breast and other cancers. (For more information about this link, see the website of Grassroots Health, a vitamin D advocacy group.) Are you consuming enough of this important hormone from fortified food or from its natural source, the sun?

There’s a lot to consider when making a decision to take any supplement. It may not be beneficial for everyone, but it could be vital for you. Discuss it with an informed medical professional.

To learn more about vitamin D, I recommend reading Dr. James Dowd’s, The Vitamin D Cure; and this interview with Carole Baggerly, founder of Grassroots Health.