Osteoporosis

Calcium

How much calcium should a young healthy person take daily?

The optiomal amount has not been established, but it has been recommended to have 1000 mg of calcium daily. This amount includes the dietary and supplementary. 

How much calcium should someone with osteoporosis or osteopenia take?

The current guidelines recommends people wiht osteoporosis or ostepenia to have 1200 mg of calcium daily.  Sometimes we might need more depending on other medical conditions.

Can I take all calcium from food?

Sure, if you are taking enough dietary calcium then you do not need to take supplement. This 1200 mg calcium does not mean you need to take 1200 mg OTC calcium supplement. 

What food have rich calcium?

If your diet have enough calcium, then you do not need extra calcium supplement.

How much OTC calcium supplement should I take?

The following is the top 10 OTC brand of calcium and vit D. Estimate how much dietary calcium you consume, then use the follow calcium supplement for the rest to make to 1200 mg calcium daily.

Who should take Citracal instead of Caltrate?

Choosing between Citracal and Caltrate, or any calcium supplements, depends on individual health needs, preferences, and sometimes medical advice. Here are some factors that might influence the choice to take Citracal (which typically contains Calcium Citrate) instead of Caltrate (which typically contains Calcium Carbonate):

1. Stomach Acid Considerations: Calcium citrate (Citracal) is absorbed well on an empty or full stomach, whereas calcium carbonate (Caltrate) requires stomach acid for absorption and is best taken with food. Therefore, people with low stomach acid levels (like older adults or those taking proton pump inhibitors) might prefer Citracal.

2. Risk of Kidney Stones: Calcium citrate is often recommended for individuals who are at risk for kidney stones since it's less likely to contribute to stone formation compared to calcium carbonate.

3. Digestive Tolerance: Some people may experience gastrointestinal side effects like gas or bloating from calcium carbonate. In such cases, calcium citrate can be a better option as it is less likely to cause these issues.

4. Absorption Efficiency: Calcium citrate can be a good choice for individuals who need a form of calcium that's easier to absorb, especially those with absorption disorders.

5. Convenience and Compliance: If taking a supplement with meals is inconvenient, calcium citrate, which can be taken without regard to meals, might be a preferred option.

6. Dosage and Frequency: Calcium citrate supplements often contain less calcium per pill than calcium carbonate, so more pills might be needed to achieve the desired daily intake. This could influence the choice based on convenience and cost.

Vit D supplement

How much vit D should I take?

For healthy adult, it is advisable to take 800 IU (20 ug) daily including dietary and supplemental sources.  For patients with osteoporosis or with some medical conditions, I usually decide based on the laboratory test to decide. I want to keep vit d level between 30-50 ng/ml , definately below 100 ng/ml.

How to estimate how much vit D I am ingest from dietary source?

1. Look at the food portions you consume regularly.

2. Then times the amount of vit D per portion.

3. Example, if you consume 1 portion of mile daily and one portion of egg, then you are consume 120 + 44 IU =164 IU daily. Other food has lower amount vit d. If your recommended vit d intake is 800 IU, then you need to take vit d supplement as leat 600 IU. If you are not consume any of the following food, then you need to take vit D supplement at least 800 IU.

4. Again, for patients with osteoporosis or other medical conditions, I decide the dose depending the blood level of vit d and sometimes parathyroid hormone (PTH).