Osteoporosis in women: Doctors reveal how much calcium and vitamin D you really need

Osteoporosis can develop without obvious symptoms and make bones more prone to fractures, particularly after menopause. Here's what experts suggest.

Osteoporosis means your bones are weak and fragile, making them more susceptible to fractures. It can be particularly common in women following menopause as estrogen levels fall and bone loss speeds up. Although you can't always avoid the effects of ageing and hormones, we can all help our bones by getting enough calcium and vitamin D and keeping active.

In an interview with HT Lifestyle, Dr Lalit Modi, director of orthopaedics and joint replacement at CK Birla Hospitals, Jaipur, and Dr Rakesh Rajput, director and HOD of orthopaedics at CK Birla Hospitals, CMRI Kolkata, explained why osteoporosis affects women more and how much calcium and vitamin D they really need.

According to Dr Lalit, for women, attention should be paid not only to fracture prevention but also to the early detection of bone loss and its treatment. Dr Rakesh noted that for many women, the consequences may not be obvious until much later, as osteoporosis can develop without noticeable symptoms.

For women, attention should be paid not only to fracture prevention but also to the early detection of bone loss and its treatment. (Pexel)

“Calcium and vitamin D are important throughout life, but taking supplements without understanding how much the body needs is not the answer,” he added. Here's what both experts suggest:

Calcium: building and maintaining strong bones

Calcium is the primary mineral for bone health, both Dr Lalit and Dr Rakesh stressed. “As a general rule, the amount of calcium that adult women need per day is around 1000 mg and increases to about 1200 mg for women over 50 years of age. But it can differ under specific conditions and in local clinical practice,” Dr Lalit specified.

Whenever possible, calcium should be obtained through the diet, Dr Lalit stressed, recommending foods like milk, curd, paneer, and other calcium-rich foods. For women who avoid dairy, Dr Rakesh recommended including ragi, calcium-set tofu, sesame seeds, certain leafy greens, and calcium-fortified foods.

“If required, additional calcium can be given as a supplement, although excess calcium intake beyond recommended levels does not necessarily prevent fractures,” Dr Lalit cautioned.

Whenever possible, calcium should be obtained through the diet, Dr Lalit stressed, recommending foods like milk, curd, paneer, and other calcium-rich foods. (Shutterstock)

Dr Rakesh warned that excessive supplementation can cause problems, such as kidney stones in some people; therefore, a doctor should help you figure out whether you need supplements and how much.

Vitamin D: helping the body absorb calcium

For vitamin D, Dr Rakesh stressed that the commonly used recommendations for adults range from 600 to 800 IU daily, with needs varying by age and health status. “Women with a deficiency may need a different dose under medical supervision,” he added.

Per Dr Rakesh's guidelines, while calcium provides the mineral structure that keeps bones strong, vitamin D helps the body absorb calcium from food. It is also crucial for maintaining proper function of muscles and bones.

If either is consistently inadequate, the experts warned that maintaining bone strength becomes harder and that you will experience weaker bones, which can increase the risk of falls and fractures.

Dr Lalit highlighted that vitamin D, which the body can produce when sunlight hits our skin, can be increased by getting sun each day (but too much is also unhealthy). Meanwhile, Dr Rakesh stressed that living in a sunny country does not guarantee adequate vitamin D; time spent indoors, clothing, sunscreen use, skin pigmentation, and limited sunlight exposure can all affect how much the body produces.

Consuming foods such as oily fish, egg yolks, and fortified products may help. (Image generated via Google Gemini)

“The correct dose you get depends on all of the above. Additionally, age, dietary intake, risk factors, and vitamin D levels (if measured) should be considered when testing. Do not use high-dose vitamin D supplementation without medical advice,” he cautioned.

Consuming fortified foods and other vitamin D-rich foods, or taking a supplement, is an alternative. Dr Rakesh advises consuming foods such as oily fish, egg yolks, and fortified products, although diet alone may not always provide enough.

Calcium and vitamin D on their own are not enough

Lastly, calcium and vitamin D alone are not sufficient to treat established osteoporosis from an orthopaedic perspective, both experts stressed.

“Weight-bearing exercise, strength training, fall prevention, and, if necessary, prescription medications are also part of the treatment plan,” Dr Lalit stated. Apart from these, Dr Rakesh advised brisk walking.

“Menopausal women, patients with a history of fracture, or those with risk factors for osteoporosis should seek a discussion with their doctor for assessment of bone health. A bone density test (DEXA scan) can be considered based on age and risk. Healthy bones require more than supplements. Eat healthily, stay active, and get checked by a healthcare professional to keep bone loss at bay and protect yourself from fractures,” Dr Lalit advised.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.