![]() ![]() ![]() Rickets was first described more than 300 years ago (Glisson, 1599–1677), but the essential role of vitamin D with regards to bone metabolism only became clear following animal experiments with liver oil supplements by McCollum ( 2). The essential role of calcium for bone metabolism has been known since the animal studies (in 1928) and calcium balance studies (in 1946) performed by Albright ( 1). Probably only well-designed prospective randomized controlled trials will be able to allow definite conclusions on this subject. ![]() Concern has arisen about a possible link between calcium supplementation and an increased risk of myocardial infarction. Data on difference between calcium absorption with calcium carbonate compared to calcium citrate with simultaneous use of proton pump inhibitors are lacking. The intestinal absorption of calcium citrate is approximately 24% better than that of calcium carbonate independent of intake with meals. Calcium supplementation should be tailored to the patient’s need: usually 500 mg per day is required. There are no data on additional effects of loading doses of vitamin D on fracture or fall prevention. Daily supplementation with 800 IU is advocated in most guidelines, appears to be safe, and with this approach it is generally not necessary to determine vitamin D levels. An adequate calcium intake and vitamin D supplementation is recommended in most guidelines xon fracture prevention. ![]()
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