From the Guidelines
Vitamin D and calcium supplementation is crucial for 65-year-old women to prevent osteoporosis and fractures, with recommended daily doses of 1000-1200 mg of calcium and 800-1000 IU of vitamin D. The primary goal of this supplementation is to maintain bone health, prevent bone loss, and reduce the risk of fractures, which are associated with chronic pain, disability, loss of independence, and increased mortality 1. Short-term benefits of vitamin D and calcium supplementation include:
- Improved calcium absorption
- Enhanced muscle function
- Reduced fall risk Long-term benefits include:
- Prevention of bone loss
- Reduced fracture risk
- Maintenance of bone density It is essential to note that the US Preventive Services Task Force (USPSTF) recommends against daily supplementation with 400 IU or less of vitamin D3 and 1000 mg or less of calcium for the primary prevention of fractures in noninstitutionalized postmenopausal women 1. However, a more recent study published in 2025 suggests that the USPSTF recommends against supplementation with vitamin D with or without calcium for the primary prevention of fractures in community-dwelling postmenopausal women and men 60 years or older 1. Considering the most recent and highest quality study, the current recommendation is to avoid vitamin D and calcium supplementation for the primary prevention of fractures in community-dwelling postmenopausal women and men 60 years or older 1. Despite this, calcium and vitamin D supplements are still essential for overall health, and women should consult their healthcare provider to determine the best course of action for their individual needs. For those who do require supplementation, it is recommended to take calcium supplements with food and vitamin D supplements with meals containing some fat for better absorption. Additionally, individuals with kidney disease or a history of kidney stones should consult their healthcare provider before starting these supplements.
From the Research
Benefits of Vitamin D and Calcium for 65-year-old Women
- The combination of vitamin D and calcium is essential for maintaining bone health in postmenopausal women, as it helps to maximize peak bone mass and minimize bone loss 2.
- Vitamin D and calcium supplementation has been shown to reduce the risk of fractures in older postmenopausal women, with a clearer benefit in women over 65 years old 3.
- A daily intake of 800-900 IU of vitamin D and 1200-1300 mg of calcium has been found to increase bone mineral density, decrease bone turnover, and decrease nonvertebral fractures in women over 65 years old 3.
Short-term Benefits
- High-dose calcium supplementation can modestly reduce cortical loss from long bones in the first five years after menopause 2.
- Vitamin D appears to enhance the effectiveness of supplemental calcium, and late postmenopausal women are generally more responsive to added calcium 2.
- Vitamin D and calcium supplementation has been found to reduce the risk of distal forearm fractures by 30% and the risk of any upper extremity fractures by 25% in women aged 65-71 years 4.
Long-term Benefits
- Long-term vitamin D and calcium supplementation can help to prevent osteoporosis and reduce the risk of fractures in older postmenopausal women 3, 5.
- A daily intake of at least 600 IU of vitamin D and 1200 mg of calcium is recommended for individuals over 70 years old to maintain bone health 5.
- Vitamin D and calcium supplementation can also help to reduce the risk of falls and fractures by improving muscle health and reducing body sway 6.