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Clinical guidelines recommend the routine use of calcium and vitamin D supplementation for the prevention of fractures, especially at old age. Recent publications highlight the strong debate which has erupted in the past 5 years on the safety profile and efficacy of this treatment. I will try to put things in order for those who were not able to follow the situation more closely. In one review, Dr Weaver explains the problem [1]: ‘Recently, calcium supplementation has been linked to both increased and decreased cardiovascular disease risk, creating considerable uncertainty. Moreover, recent reports have shed uncertainty over the effectiveness of calcium supplements to reduce risk of fracture.’ In another review, Dr Reid took this issue further and summarized his view as follows [2]: ‘… findings suggest that calcium supplements have little role to play in the modern therapeutics of osteoporosis …”. So what actually is going on? Are we heading for another revolution in clinical practice? What ignited the fire?


  • Amos Pines
    Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel


  1. Weaver CM. Calcium supplementation: is protecting against osteoporosis counter to protecting against cardiovascular disease? Curr Osteoporos Rep 2014;12:211-18.
  2. Reid IR. Should we prescribe calcium supplements for osteoporosis prevention? J Bone Metab 2014;21:21-8.
  3. The role of calcium in peri- and postmenopausal women: 2006 position statement of the North American Menopause Society. Menopause 2006;13:862-77.
  4. Management of osteoporosis in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause 2010;17:25-54.
  5. Bolland MJ, Barber PA, Doughty RN, et al. Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial. BMJ 2008;336:2626.
  6. Prentice RL, Pettinger MB, Jackson RD, et al. Health risks and benefits from calcium and vitamin D supplementation: Womens Health Initiative clinical trial and cohort study. Osteoporos Int 2013; 24:567-80.
  7. Theodoratou E, Tzoulaki I, Zgaga L, Ioannidis JP. Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials. BMJ 2014;348:g2035.
  8. de Villiers TJ, Pines A, Panay N, et al. Updated 2013 International Menopause Society recommendations on menopausal hormone therapy and preventive strategies for midlife health. Climacteric 2013;16:316-37.
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