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PENACAL – C as Calcium supplements may be used if patients are unable to consume adequate amounts of calcium through foods. The two most common calcium supplements are calcium carbonate. Calcium carbonate contains 40% elemental calcium, the highest amount available among calcium formulations; it should be taken with food to maximize absorption capacity by providing an acidic environment. This option is cost-effective and may be preferred for most patients.
Adequate intake of calcium and vitamin D is necessary to maintain bone integrity throughout life. Calcium is critical for osteoporosis prevention because it can decrease bone turnover and decelerate bone loss. Calcium needs grow as women reach menopause because the ability to efficiently utilize dietary calcium decreases as a result of declining ovarian estrogen production. Intestinal calcium absorption decreases with aging to about 50% of that of adolescents.
Postmenopausal women desiring to reduce the risk of osteoporosis should consume 1000-1500 mg of elemental calcium and 400-800 IU of vitamin D daily. This may present a challenge, since most postmenopausal women consume only 600 mg of elemental calcium per day. Additional problems face women who are lactose intolerant, are vegetarians, or do not consume a well-balanced diet.
Vitamin D is critical for the prevention and treatment of osteoporosis because it maximizes the intestinal absorption of calcium. The first step in the activation of vitamin D occurs in the skin through the conversion of 7-dehydrocholesterol to vitamin D3 (cholecalciferol) by ultraviolet light. Subsequent activation occurs through the liver and kidneys. Vitamin D deficiency is common with aging and is due to a combination of factors, including a reduced ability to convert 7-dehydrocholesterol to vitamin D3, inadequate exposure to sunlight, and decreased absorption of vitamin D from the gastrointestinal tract. Most patients require 400 IU of vitamin D daily. Older patients with severe osteoporosis need 800 IU of vitamin D per day. If vitamin D requirements cannot be met through sunlight exposure, exogenous vitamin D can be obtained from milk, green vegetables, vitamin D supplementation, or multivitamins. The safe upper limit of vitamin D intake is 2000 IU/day.
In general, ensuring a well-balanced diet and supplementation with a daily multivitamin may help prevent deficiencies in these vitamins.