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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/17191

Title: Calcium and vitamin D supplementation: state of the art for daily practice
Authors: van der Velde, Robert Y.
Brouwers, Jacobus R. B. J.
Lems, Willem F.
Issue Date: 2014
Abstract: Background: Calcium and vitamin D play an essential role in bone metabolism but deficiency and/or inadequate intake are common. Objectives: To describe a practical approach based on the literature regarding clinically important aspects of calcium and vitamin D supplementation. Methods: A systematic evaluation of relevant literature in Medline was conducted. We included physiological studies, publications on relevant guidelines, meta-analysis, randomized clinical trials, and cohort studies. Results: An adequate calcium intake and vitamin D supplementation is recommended in most guidelines xon fracture prevention. Daily supplementation with 800 IU is advocated in most guidelines, appears to be safe, and with this approach it is generally not necessary to determine vitamin D levels. There are no data on additional effects of loading doses of vitamin D on fracture or fall prevention. Calcium supplementation should be tailored to the patient's need: usually 500 mg per day is required. The intestinal absorption of calcium citrate is approximately 24% better than that of calcium carbonate independent of intake with meals. Data on difference between calcium absorption with calcium carbonate compared to calcium citrate with simultaneous use of proton pump inhibitors are lacking. Concern has arisen about a possible link between calcium supplementation and an increased risk of myocardial infarction. Probably only well-designed prospective randomized controlled trials will be able to allow definite conclusions on this subject. Conclusion: Daily supplementation with 800 IU vitamin D is a practical and safe strategy without the need for prior determination of vitamin D levels. Calcium supplementation should be tailored to the patient's need based on total daily dietary calcium intake. In most patients 500 mg per day is required to achieve a total intake of 1,200 mg, or in some 1,000 mg per day. More calcium is absorbed from calcium citrate compared to calcium carbonate.
Notes: [van der Velde, Robert Y.; van den Bergh, Joop P. W.] VieCuri Med Ctr North Limburg, Dept Internal Med, NL-5912 BL Venlo, Netherlands. [Brouwers, Jacobus R. B. J.] Ephor UMC Utrecht, Expertise Ctr Pharmacotherapy Elderly, Dept Geriatr Med, Utrecht, Netherlands. [Geusens, Piet P.; van den Bergh, Joop P. W.] Maastricht UMC, CAPHRI, Dept Rheumatol, Maastricht, Netherlands. [Geusens, Piet P.; van den Bergh, Joop P. W.] Univ Hasselt, Biomed Res Ctr, Diepenbeek, Belgium. [Lems, Willem F.] Vrije Univ Amsterdam Med Ctr, Dept Rheumatol, Amsterdam, Netherlands.
URI: http://hdl.handle.net/1942/17191
DOI: 10.3402/fnr.v58.21796
ISI #: 000341109200001
ISSN: 1654-6628
Category: A1
Type: Journal Contribution
Validation: ecoom, 2015
Appears in Collections: Research publications

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