Trash the Calcium, Save the Patient

A Best Evidence Review

Charles P. Vega, MD


March 07, 2013

In This Article

Commentary: The Gender Gap

No one should be more invested in the concept of wellness than the individual. Each patient has the autonomy to select health treatments, and clearly many adults use calcium to stay healthy. However, it is time for physicians to actively intercede of behalf of their patients' safety when they make this choice regarding calcium.

The current study emphasizes the risk for CVD mortality associated with the use of calcium supplements among men, and any potential benefit of calcium supplementation is now outweighed by the risk for CVD in this group. The rate of osteoporosis among men is one-fifth that of women, and less than 40% of osteoporotic fractures occur among men.[11] Although we cannot discount the potential grave impact of fragility fractures among older men, calcium supplements do not seem to be the answer to reducing this risk, particularly given their association with CVD.

Among women, the current study suggests a neutral effect of both dietary calcium and calcium supplements on the risk for CVD. Physicians should keep in mind, however, that vitamin D and not calcium is principally responsible for preserving bone and preventing osteoporosis among women. Vitamin D at a dose of at least 800 IU/day should be the primary treatment for women at average risk for osteoporosis. Until the questions regarding the long-term safety of calcium supplements in both sexes are better understood, it is reasonable to withhold calcium among women receiving preventive treatment for bone health.