Vitamin D and calcium: A dynamic duo in the maintenance of strong bones

The Bottom Line

  • Daily vitamin D + calcium supplements help to reduce the risk of bone breaks in older adults

  • The benefits of vitamin D + calcium supplements may not outweigh the risks for some people. Check with your doctor before taking any new medications or supplements.

  • Avoiding falls is the first step to prevent broken bones. See our featured resources for tips to keep you on your feet.

Updated Dec 2016

Most of us learned at a young age about the importance of calcium in building strong bones(1) and teeth, which is why we drank our milk whether we wanted to or not. Vitamin D is equally important to the development of dense, healthy bones (2) as it makes it possible for our bodies to absorb the much needed calcium (3).

So it stands to reason that - taken together - calcium and vitamin D have the potential to be a powerful tag team when it comes to keeping bones healthy and strong throughout our lifetime and ideally, resistant to breaks. According to several studies conducted since the early 1990s, these supplements help to reduce fractures a small degree in women over the age of 65 (4). That was of some solace to older women: since they lose bone mass at a faster rate than men, they’re even more likely to suffer broken bones (5).

But supplements cost money. Is it worth it to take vitamin D + calcium?

What the research tells us

A systematic review of 53 studies found reliable evidence that vitamin D with calcium taken regularly slightly reduces the chance of hip and other fractures in older men and women, whether they live in the community or institutional settings (6). And calcium plays a key role: taking vitamin D without calcium does not appear to provide the same benefits for bone health. Most trials used a dose of 400 - 800 IU vitamin D3 daily with 1000mg calcium.

Even more recently, the National Osteoporosis Foundation’s analysis of eight randomized controlled trials showed statistically significant improvements (15% reduced risk of total fractures and 30% reduced risk of hip fractures) with vitamin D + calcium supplements (7). These results were also significant for both men and women living in the community or in institutional facilities.

In other words, the calcium/vitamin D combo would appear to be a good first line of defense for many older adults seeking to avoid broken bones.

As always, check with your doctor before taking any new medications or supplements, including vitamins. The risks of these supplements may outweigh the benefits for people with (or at risk of) kidney stones or kidney disease, high blood calcium levels, gastrointestinal disease or heart disease (6). More research is also needed about the effectiveness of vitamin D + calcium supplements for people with chronic illnesses and people with different levels of sun exposure.

One last thing to remember: avoiding falls is the first step to prevent broken bones! Check the Featured Resources box below for more helpful tips to keep you on your feet and in one piece.

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Author Details



  1. Eunice Kennedy Shriver National Institute of Child Health and Human Development. Children's Bone Health and Calcium [Internet]. Washington (DC): National Institutes of Health, U.S. Department of Health & Human Services; 2014. Available from:
  2. Cranney A, Horsley T, O'Donnell S, et al. Effectiveness and safety of vitamin D in relation to bone health. Evid Rep Technol Assess (Full Rep). 2007;158:1-235.
  3. Aloia JF, Dhaliwal R, Shieh A, et al. Vitamin D supplementation increases calcium absorption without a threshold effect. Am J Clin Nutr. 2014; 99(3): 624-631
  4. Chung M, Lee J, Terasawa T, et al. Vitamin D with or without calcium supplementation for prevention of cancer and fractures: An updated meta-analysis for the U.S. Preventive Services Task Force. Ann Intern Med. 2011; 155:827-838.

  5. Cawthon PM. Gender differences in osteoporosis and fractures. Clin Orthop Relat Res. 2011; 469:1900-1905

  6. Avenell A, Mak JC, O’Connell D. Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database of Syst Rev. 2014; DOI: 10.1002/14651858.CD000227.pub4.
  7. Weaver CM, Alexander DD, Boushey CJ et al. Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporos Int. 2016; 27(1)367-376.


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