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    One of the treatments that is recommended for people with low bone mineral densities is a combination of calcium (1200mg/day) and vitamin D (400 to 800ID) per day with a combination of weight bearing, strength and balance gaining exercises (for example walking, dancing and Tai Chi).

    Bone remodeling cycle

    Calcium is well known to be necessary for healthy bone development, and the bone contains more than 90% of the bodies total calcium content. Calcium plays a very important role in bone remodeling. In this process bone is deposited by osteoblasts and resorption is carried out by osteoclasts. In the bone deposition process bone is created by calcium and phosphate ions binding to create hydroxyapatite crystals. In the bone resorption process, the hematopoietic stem cell derived osteoclasts release enzymes that digest the bone and in doing so release the calcium back into the bodies circulation.

    The bone remodeling process results in a constant addition of calcium to the bone and removal of calcium from the bone and into circulation. This bone remodeling process is under the control of hormones.

    Calcium and bone remodeling

    As the body gets older an imbalance in the bone remodeling process appears, with bone not being created at the same rate that it disappears. The vitamin D3 is able to increase the absorption of Gastrointestinal calcium into the bone. As less than 50% of dietary calcium is able to be absorbed the supplementation of Vitamin D can greatly help the efficiency of the bone remodeling cycle.

    An increase in the levels of calcium in the serum leads to calcium being diffused into the bones and it is important that people with osteoporosis have adequate quantities in their diet (this may require supplementation).

    Calcium supplements

    There are many forms of calcium supplements and the percentage of calcium in them is variable.

    1. Calcium Carbonate (40% calcium)
    2. Calcium citrate (21%)
    3. Calcium phosphate (variable between 23 and 39%)
    4. Calcium lactate (18%)
    5. Calcium gluconate (9%)

    It is recommended that calcium salts are taken with meals, this is because calcium salt absorption into the bones is enhanced in an acidic environment. Non salt calciums such as citrate's, lactate's and gluconate's do not require an acidic environment to be absorbed.

    Recommended daily calcium intake

    The amount of calcium that is recommended in the diet is age dependent. people below 50 are recommended to have 1000mg per day, whereas those over 50 should have at least 1200mg. the maximum safe dose is 2500mg per day.

    References
    Mayes (2007) Review of post menopausal osteoporosis pharmacology. Nutr. Clin. Prac. 22:3: 276 to 285