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The concentrations of calcium and inorganic phosphorus in the blood are usually normal. Slight hyperphosphatemia occurs in women who are past the menopause.

Calcium supplements

Women who are estrogen-deprived require an average oral intake of 1500 mg/d of elemental calcium to remain in calcium equilibrium.

The recommendation of the National Institute of Health of 1000 mg elemental calcium per day for women on estrogen replacement and for men is reasonable.

In postmenopausal women unable to take estrogens, the use of 1500 mg/d of oral calcium may have minor benefit in preserving cortical bone but has no effects on trabecular bone mass.

Adequate calcium intake before age 30 to 35 may enhance peak bone mass, however. The content of elemental calcium of available preparations.

Vitamin D preparations have been used in osteoporosis because calcium absorption is impaired and levels of the active metabolite, 1, 25(OH)2D , are marginally low in serum.

Subclinical vitamin D deficiency and associated secondary hyperparathyroidism are common in elderly women, particular those confined to nursing homes.

In these women, low doses of vitamin D (800 IU daily) combined with calcium supplements are effective in maintaining bone mass and decreasing incidence of hip fractures.

Oral administration of calcitriol [1, 25(OH)2D] also may improve intestinal calcium absorption suppress bone reabsorption, and prevent bone loss in postmenopausal osteoporosis.

In any case, calcium supplements with or without vitamin D are necessary to prevent bone mineralization defects that accompany the use of sodium fluoride alone.

Lower doses of sodium fluoride may be effective in lowering fracture risk in subjects with osteoporosis without loss of bone quality.

 

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