From the Guidelines
Bris calcair is not a recognized medical term, and without additional context, it is impossible to provide a specific answer. If you're referring to "calcium supplements" or "calcium intake," the current evidence suggests that calcium supplements can reduce the risk of total fracture and vertebral fracture, but not hip or forearm fracture 1. However, when considering data only from high-quality trials with low risk of bias, there was no effect of supplementation on the risk of fracture at any site 1. It is essential to note that the combination of vitamin D and calcium supplementation may result in a small reduction in hip fracture risk and a reduction in the incidence of new nonvertebral fractures 1. The recommended daily intake of calcium is 1,000 to 1,200 mg per day, and patients should figure out the calcium content from their dietary sources and use supplements only to get the total recommended dose 1. In terms of cardiovascular disease, there is moderate-quality evidence that calcium with or without vitamin D intake from food or supplements has no relationship to the risk for cardiovascular and cerebrovascular disease, mortality, or all-cause mortality in generally healthy adults 1. The most important consideration is to consult with a healthcare provider to determine the best course of treatment based on individual health needs and medical history. Some key points to consider include:
- Calcium supplements can reduce the risk of total fracture and vertebral fracture, but not hip or forearm fracture
- The combination of vitamin D and calcium supplementation may result in a small reduction in hip fracture risk and a reduction in the incidence of new nonvertebral fractures
- The recommended daily intake of calcium is 1,000 to 1,200 mg per day
- Calcium intake from food and supplements that does not exceed the tolerable upper level of intake is considered safe from a cardiovascular standpoint 1
From the Research
Osteoporosis Treatment and Calcium
- The treatment of osteoporosis often involves the use of calcium and vitamin D supplementation, as seen in the study 2, which found that combination therapy of denosumab with vitamin D and calcium stopped the decrease in calcium caused by denosumab and increased bone mineral density.
- Calcium and vitamin D intake should be sufficient, but not too high, as stated in the study 3, which discussed the antifracture effects and side-effects of antiresorptive and osteoanabolic drugs.
- The combination of calcium and vitamin D was able to reduce the risk of falling and hip fracture risk, as shown in two meta-analyses mentioned in the study 4.
Denosumab and Osteoporosis Treatment
- Denosumab has been shown to reduce new vertebral, nonvertebral, and hip fractures in postmenopausal women with osteoporosis, as stated in the study 5.
- Denosumab was associated with greater gains in bone mineral density and decreases in bone turnover markers when compared with alendronate-treated subjects, as seen in the study 5.
- The study 2 found that denosumab monotherapy and combination therapy with vitamin D and calcium both significantly increased bone mineral density, but the combination group had a greater increase in hip bone mineral density.
Polypharmacy and Osteoporosis
- Polypharmacy is increasingly recognized as a risk factor for hip and fall-related fractures, as stated in the study 6.
- The selection of osteoporosis treatment should be individualized and based on a variety of factors, including underlying fracture risk, medical comorbidities, medication burden, and fracture risk reduction profiles, as discussed in the study 6.