General

Do you prescribe calcium supplements?

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21 Aug 2016 - General
 

Since I started medical practice, I did not take up the habit of prescribing any form supplements unless it is written in a practice guideline or if there is a clear indication i.e. folic acid supplementation for pregnant women. There are a lot of times that aging women ask for calcium supplementation to prevent osteoporosis, but I usually refuse to prescribe this. I always advise them to take liberal amounts of food rich in calcium such as milk, cheese etc. Current available evidence for calcium supplementation are contradicting. Some promote it together with vitamin D supplementation for prevention of osteoporosis for people age 50 and above, while some studies criticize this because of unwanted side effects. In fact, a new study links calcium supplementation to increasing the risk factor for dementia in women. Do you prescribe calcium supplements and which subset of patients of patients benefit from it?

In order to know the long term effects of calcium supplementation you would have to isolate those effects from all other food/supplement/lifestyle interactions. Without knowing how much A,D,K,Mag, etc.. they were getting, you can’t apply any sort of reproducible science. It should be obvious that supplementing with calcium ONLY will have deleterious long term effects, if for no other reason than by displacing other minerals and depleting vital co-factors. Try adding just calcium to a salt water ...
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I would prescribe 1500 mg of calcium with 1000 IU Vitamin D for post-menopausal women since there is no longer bone-protecting properties from estrogen. For osteopenic (Bone Mineral Density -1 to -2.49), I would prescribe 1200mg calcium with 1000 IU Vitamin D. For osteoporotic (Bone Mineral Density -2.5) patients, I would advise the same amount of calcium and vitamin D as with osteopenic patients plus bisphosphonates. Of course, this is under the impression that there are no allergies to calciu...
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I don't know about the doctors here, and I'm not a doctor myself, so I'll just be playing the role of patient :) Right now I am prescribed with calcium supplements (along with iron and folic acid) as I am pregnant. However, I don't take them everyday. I only take them on days when I think I don't get enough calcium from my diet. I drink milk everyday, eat yogurt, and also other dairy food like cheese. So when I think I get enough of these foods in a day, I prefer to skip the ...
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