From the Guidelines
The recommended dose of calcium for a patient with osteopenia is 1000-1200 mg per day.
Key Considerations
- The recommended dietary intake of calcium for women 19 to 50 years of age and men 19 to 70 years of age is 1000 mg per day, while women older than age 50 and men older than age 70 require 1200 mg per day 1.
- Calcium intake above 2500 mg per day (or 2000 mg per day in persons over 50 years of age) should be avoided 1.
- Dietary sources of calcium are preferred, and supplements should only be considered when dietary intake is inadequate 1.
- Some studies have raised concerns about an increased cardiovascular risk with the use of calcium supplements, but the findings are inconsistent and inconclusive 1.
Evidence-Based Recommendations
- A high-quality study published in the Journal of Clinical Oncology found that calcium supplements can reduce the risk of total fracture and vertebral fracture, but not hip or forearm fracture 1.
- The same study suggests that vitamin D plus calcium supplementation can result in a small reduction in hip fracture risk and a reduction in the incidence of new nonvertebral fractures 1.
- It is recommended that patients determine their calcium content from dietary sources and only use supplements to get a total calcium dose of 1000-1200 mg per day 1.
The FDA Drug Labels for calcium (PO) do not address this question.
From the Research
Recommended Calcium Intake for Osteopenia
The recommended daily intake of calcium for patients with osteopenia varies, but most studies suggest the following:
- A daily intake of 700-1200mg of elemental calcium is recommended, depending on the endorsing source 2
- The American Institute of Medicine (IOM) recommends 1200mg per day, but 1000mg may be sufficient in the presence of vitamin D sufficiency 3
- Calcium intake below the recommended amount may increase fragility fracture risk, while excessive intake (above 2000mg/day) can be potentially harmful 2
Calcium Sources and Supplementation
- Calcium can be derived from diet or supplements, with dietary sources being preferred 2
- If calcium intake cannot be increased through nutrition, supplements are indicated 3
- Different calcium salts have varying solubility and ionization properties, which can affect absorption 4
- Calcium citrate formulations may be beneficial in preventing abdominal distension and flatulence, as well as minimizing the risk of renal calculus formation 4
Combination Therapy with Vitamin D
- Calcium and vitamin D supplementation is recommended in patients with osteopenia and osteoporosis 5, 4
- The combination of calcium and vitamin D has been shown to be effective in reducing the incidence of non-vertebral and hip fractures 4
- Vitamin D levels are often inadequate in patients with osteoporosis, and supplementation is necessary to achieve optimal treatment outcomes 3, 4