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Vitumln

S helps us nhsurh cnlcium, proffilotimg the

devel*pmsnt and mnintenanee nf strnng hsnes.


How mueh vitamin $ de I need tm take?
Studies have shown that optimal bone health reouires the vitamin D blood level to be within
is the form we make in our skin in response to

Calcium
is

sunlight. Prescription vitamin D is usually Dr. Most supplements contain Dr. Vitamin D, is
metabolized more effectively than vitamin

the normal range, yet it is estimated that at least one-third of Americans have low vitamin D levels.l lndividuals with low bone
density should have their vitamin D level
checked. This is a simple blood test that your

D'
D.3

Vitamin

less likely to result in toxicity, and is considered

the superior supplemental form of vitamin

What else sh*uld I louk for in x high-

doctor can order.


To increase a

quality supplemrenrt?
Look for products that have been independently

low vitamin D level and then

tested and certified by a non-profit program such


as NSF@ lnternational or
USP@.

maintain it in the normal range, a higher daily


dose of vitamin D is needed than the amount

These programs

test supplements for content accuracy, purity, and freedom from contaminants. An NSF or USP seal
assures consumers that oroducts contain what

typically found in most calcium/vitamin


supplements. The current Recommended

Dietary Allowance (RDA) set by the lnstitute

their labels say they contain, disintegrate properly


in the body, do not contain any contaminants,

of Medicine's Food and Nutrition Board


upper limit is set at 4,000

is

600-800 lU per day depending on age, and the


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and have been manufactured in accordance with current GMPs (Good Manufacturing Practices) in
a
G

Vitamin D experts

consider the RDA doses to be conservative and generally recommend higher intakes for adults,

MP-certified facility.

particularly those who have low vitamin


much vitamin D you need.

levels. Speak to your doctor to determine how

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Rete ren*ns 1. Looker et al. NCHS Data Briel No. 59. March 201 1. 2. lnstitute of Medicine. Food and Nutrition Board. National
Academy Press. November 20.l 0.

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There are two forms of vitamin D available: D,

and Dr.Vitamin D, (ergocalciferol) is derived from plants, while vitamin D. (cholecalciferol)

3. Houghton and Vieth. Am

J Clin Nutr.2006;84(41:694-1.

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dequate intake of calcium
and vitamin D bioavailability. lt is well-absorbed with or without food, and acid-reducing medications (such
as Prilosec@, Protonix@, Nexium@, Aciphex@,
Zantac@, etc.) do

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throughout life
is necessary for

not interfere with calcium

Bisphosphonates (Fosamax@, Actonel@, Bon


Reclast@, Zometa@) are

citrate absorption. Calcium carbonate, a form

prescription medications

bone health, and can help reduce

found in many supplements, is absorbed only in


the presence of stomach acid and must be taken

that slow the rate of bone loss and decrease


bone fracture risk by slowing the natural process that breaks down bone tissue.

the risk of osteoporosis. The amount of calcium


recommended for adults is 1,000 to 1,200 mg per day, from food and supplements. Three to

with food. When calcium carbonate supplements


are taken without food, or by individuals on

Bisphosphonates are designed to be taken along with calcium and vitamin D, not in place of these nutrients. Therefore, if you are taking a bisphosphonate, you should also take a

acid-reducing medications, the calcium is not well-absorbed.

four servings of dairy foods daily meet these


needs. Examples of one serving of dairy include
B oz.

of milk or yogurt or 1 .5 oz. cheese.

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calcium and vitamin D supplement. Because calcium supplements can interfere with your body's ability to absorb bisphosphonates if taken at the same time, they should be taken

Calcium supplements are needed when people

Calcium is a very bulky nutrient, and it is impossible to fit a substantial dose of calcium

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into a small tablet. All calcium or bone health


supplements require multiple tablets per day,

at least 30 minutes after taking a swallowed


bisphosphonate like Fosamax, Actonel, or Boniva.

which vary in size depending on the amount


and type of calcium used.

Studies show that only about 500 mg of calcium can be absorbed in a single dose. Therefore, individuals who are recommended more than

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Vitamin D helps us absorb calcium, promoting the development and maintenance of strong bones.

500 mg of calcium from a supplement each day


need to separate it into multiple doses.

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lf you have difficulty swallowing large tablets,


you can try breaking the tablets in half with a

Without adequate vitamin D bones can become thin and brittle, raising the risk of osteoporosis
and fractures. Our bodies are built to make all

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pill cutter or crushing the tablets and sprinkling


on food. lf that doesn't work, other chewable or

the vitamin D we need. Vitamin D is produced in the skin, in response to sunlight. The problem
is

Look for a brand that contains calcium citrate,

liquid forms of calcium are an option.

which has been shown to have superior

that very few of us get enough sun exposure to


keep our vitamin D levels normal, and few foods

contain much vitamin D so the best answer is to take a vitamin D

supplement.