I'm in menopause. Should I take a calcium supplement?

Dr Jen Gunter's blog, January 2022

Do we really need 1,200 mg of calcium/day?

Getting it from diet alone is a challenge. So there must be robust data that calcium supplements are a boon to our bones? NO!
50% of postmenopausal women take a calcium supplement ... BUT they haven’t been shown to help reduce the risk of fracture!
- The Women’s Health Initiative - compared a supplement (1,000mg calcium + 400IU vitamin D) to placebo. There was no change in hip fractures.
- six large randomized controlled trials of calcium (with or without vitamin D) versus placebo (2005-2010) - none of them showed a reduction in hip fractures.
- a 2017 review of 33 randomized clinical controlled trials - no benefit from calcium supplements, calcium plus vitamin D, or vitamin D alone.
- diets high in calcium (food or food plus supplements) - no link to better bone health.
- bone density for postmenopausal women seems unrelated to calcium intake after menopause.
- the only possible benefit: calcium supplements may slightly slow bone reabsorption, but this doesn’t impact fractures.

Calcium Supplements
- a large dose of calcium is not something we have evolved to use (excess calcium goes into the urine, increasing kidney stones risk).
- associated with a 15% increased risk of cardiovascular disease for post-menopausal women.
- like so many things in medicine, guidelines are established, and yet when new data comes along, changing seems like an impossibility.

Calcium from food
- spread throughout the day, mixed with fiber and protein, so absorption is slower giving the body time to use it.
- the best way to get calcium is from the food you eat.

So should the average postmenopausal woman be aiming for 1,200 mg of calcium a day?
For the general population, there is no data to suggest that postmenopausal women need more than 800mg daily calcium, from diet.

In addition, it's important to state that dairy is detrimental to health.

Nutritionfacts: Milk Good for Our Bones?

- A review of the best studies found no association between milk consumption and hip fracture risk.
- Even milk consumption during the teenage years was not associated with a lower risk of hip fracture in adults.
- hip fracture rates are highest in populations with the greatest milk consumption.

Looking at milk intake and mortality (as well as fracture risk) - a hundred thousand men and women were followed for 20 years.
Milk-drinking women had higher rates of death, more heart disease and more cancer, for each glass of milk. Three glasses a day was associated with nearly twice the risk of death. And they had significantly more bone and hip fractures too.

The galactose in milk may explain why milk consumption is associated with significantly higher risk of hip fractures, cancer, and premature death.

What can we do for our bones, then?

Weight-bearing exercise such as jumping, weight-lifting, and walking with a weighted vest or backpack may help, along with getting enough calcium (Alkaline Diets, Animal Protein, & Calcium Loss) and vitamin D (Resolving the Vitamin D-Bate).

Eating beans (Phytates for the Prevention of Osteoporosis) and avoiding phosphate additives (Phosphate Additives in Meat Purge and Cola) may also help.

• Calcium supplementation and bone mineral density in females from childhood to young adulthood.
• Milk intake and risk of hip fracture in men and women: a meta-analysis of prospective cohort studies.
• Milk consumption during teenage years and risk of hip fractures in older adults.
• Early-Life Milk and Late-Life Fracture
• Milk intake and risk of mortality and fractures in women and men.
• Skeletal health in adult patients with classic galactosemia.
• CM Schooling. Milk and mortality.
• Milk may not be very good for bones or the body - The Washington Post