Interesting article - combining calcium and vit d

Calcium and vitamin D are important for maintaining adequate nutrition, especially if someone is deficient, but, based on this analysis, they are not sufficient as a fracture-prevention treatment for postmenopausal osteoporosis on their own. I wish it was this simple!!!

How depressing! I have been vigilant in getting enough calcium and vitamin D, on the understanding it will help improve BMD!! Oh, well. I assume there are other benefits.

@sebutler The calcium & Vit D story may be more complicated. As usual, there are no clear easy answers on these complex subjects around osteoporosis. Based on other things that I have read it does seem that, unless you have a deficiency, merely taking calcium & Vit D will not help bone building. A recent RCT trial concluded the same thing about protein; protein does not help in isolation. But if you suddenly start doing LIFTMOR type weight lifting then those nutrition elements may play a role.

I cannot read the actual main article due to paywall, only the abstract. But the AI says, when asked:
"No, vitamin K supplements were not used in the studies referenced by this meta-analysis. The systematic review and meta-analysis focused specifically on evaluating the efficacy of isolated combined calcium and vitamin D supplementation."

But this next article describes a BMD effect of calcium & Vit K.
The combined effect of vitamin K and calcium on bone mineral density in humans: a meta-analysis of randomized controlled trials
https://link.springer.com/article/10.1186/s13018-021-02728-4
EXCERPT: "Conclusion
The combination of vitamin K and calcium has a positive effect on lumbar BMD and decreases the level of UcOC."

Personally, I plan to concentrate on actions with better proof of effectiveness, such as impact + heavy-for-me weight/resistance training exercise and Vitamin MK-4 & MK-7. I will continue other modest steps such as trying to get 1200 mg of calcium per day, supplementing food intake with inexpensive calcium citrate when what I eat falls short. When my T-scores get bad enough (all of mine are better than -2.9) I plan for teriparatide (e.g. brand Forteo) followed by romosozumab (brand name Evenity). Maybe oral teriparatide will be proven and approved by then!

@kfhoz Indeed a complicated story. Thank you so much for sharing your research. Amazing how doctors (mine) that specialize in osteoporosis push calcium and vitamin D but never mention K. My situation now seems to be similar to yours, that is, all numbers -2.9 or better. I am taking K2 (says on the label), but ingredients say K7 (menaquinone-7). Is that what is recommended?

@sebutler MK-7 and MK-4 are both forms of Vitamin K2 and both/either are recommended depending on the research that you read and your approach. What you are doing may be the best.

You can see exchanges of information about the forms and dosing of Vit K2 on this Mayo Clinic Connect discussion:
https://connect.mayoclinic.org/discussion/vitamin-k-high-doses-of-mk-4-and-mk-7-show-promising-results/

@babs10 just read this in medical news today. Once again, seems like we really don’t have complete knowledge yet of dealing with bone health. Meds, supplements, high impact exercise, weight training, which ones, which combination. Then there is “testing”; bone markers or not, nutrition testing, DEXA accurate or not, once a year or not. FRAX score important or not ( no FRAX for me as I have one hip replacement). Then there is HRT or not. Many are using it with great results. Medicine is a creative field, and all patients are different and we all have different health needs depending on our conditions but it seems like we are just throwing darts to see what sticks!

@kfhoz Thank you so much for the link! Amazing how much good info is on this forum.

@jozer, That does seem to be the case. The FRAX score is important for most in order to get an idea of fracture risk. I'd make a very strong case for bone turnover marker testing to establish a baseline and as a way to see if a particular treatment is working. If a doctor refused that, I'd walk straight out of the office. My understanding is that increased bone density is slow and that makes once a year too soon so insurance companies pay every 2 years. However, if I wanted to know sooner, I'd pay out of pocket for the scan after getting a good faith estimate ahead of time which prevents them from over billing.

@babs10 my doctor did first bone markers (CTX, NTX) after taking fosamax for a year, and again a year after reclast. He said the most recent tests indicate reclast is working, thus no DEXA. (First CTX after year of fosamax was 52, after reclast 78; no idea what those numbers actually mean other than meds are working per doc). Unfortunately I have tried to get a dexa for my peace of mind (and to see if the exercise, diet, supplements, heel drops etc. are doing anything) but I’ve been quoted anywhere from $400-$1200 depending on cash discounts. And nothing in “writing” to confirm; they said they don’t do that. Very frustrating.

@jozer A CTX (C-telopeptide) test measures the rate of bone resorption, which is the speed at which your body breaks down bone tissue. Both of your scores are considered "low normal." Yay! Wow, that's expensive. I got one early and it was $236.

If you do not use insurance, healthcare facilities are legally required to give you a Good Faith Estimate for a DEXA scan, as long as you schedule it at least three business days in advance. If you are using health insurance to pay for the scan, however, providers are not federally required to give you this specific legal document yet, though you can still ask them for a regular cost estimate.