Dr. Ahmed
Calcium supplements have been associated with increased cardiovascular risks including myocardial infarction, heart failure, and stroke.
The proposed mechanism of calcium causing cardiovascular diseases is the increased chances of ectopic vascular calcification which leads to the stabilization and propagation of atherosclerotic plaques.
Vitamin D is usually given with calcium supplements to increase their absorption from the gut. In addition, Vitamin D alone has been studied in multiple studies to have numerous benefits including prevention of osteoporosis, cancers, and Diabetes.
However, because vitamin D is being thought of as a SUPER VITAMIN, it is commonly taken in higher than the recommended doses nowadays.
The maximum tolerable daily limit of Vitamin D intake is 4000 IU [Ref]. However, it is commonly prescribed as 50,000 IU weekly or 10,000 IU daily which are more than twice the recommended dose.
Furthermore, as per the National Academy of Medicine and the Endocrine Society, 25-OH Vitamin D levels of 20 to 50 ng/ml are adequate levels and more than that increase a person’s risk of developing side effects.
This is in contrast to most laboratory ranges which label test reports as adequate when the levels are between 30 and 100 ng/ml.
A recent study published in the Annals of Internal Medicine looked into the cardiovascular health of older individuals using long-term calcium and vitamin D supplements.
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Key points of the Study:
- Researchers investigated the effects of calcium and vitamin D supplements on the health of women who have gone through menopause.
- Their initial conclusion was that women who consumed these supplements had a 7% lower chance of death from cancer when compared to those who didn’t take them.
- Unfortunately, these subjects also faced a 6% higher chance of death from cardiovascular diseases. But the chances of all-cause mortality were not altered.
- The research on the long-term effects of many supplements is low, which is why the new evidence poses several questions. This is a call for more similar studies and guidance to avoid such cases.
Why Vitamin D and Calcium are Increasingly Being Used?
Vitamin D and calcium are essential for our bodies. 99% of calcium is stored in the human skeleton, which is why taking these supplements is so important to us.
Besides supporting our musculoskeletal system, it plays a role in maintaining hormonal balance, transmitting nerves, and engaging in vascular activities.
In the same way, vitamin D is crucial to maintaining calcium metabolism. So, these two supplements complement each other.
Without vit.D, your bone structure will become brittle and cause conditions like osteoporosis and osteomalacia.
So, it is obvious why so many people take these drugs. The benefits are more than any loss or harm.
However, these supplements are commonly used in toxic doses because people think they are the cause of their fatigue, lethargy, and weakness.
And their beliefs are further strengthened when they get some initial benefit. However, data from my clinic found that most people (67%) who are using vitamin D and calcium have associated mood disorders (depression and anxiety) or fibromyalgia.
In addition, about 40% of these patients are on concomitant antidepressants as well.
However, research needs to evaluate the potential harms as well since the data is somewhat limited.
Vitamin D and calcium supplements are essential for people with malabsorption, rickets, osteomalacia, hyperparathyroidism, and those who are on thyroxine or long-term prednisolone therrapy.
A recent study evaluated the long-term effects of vitamin D and calcium supplements and found a rather shocking conclusion.
“Vitamin D and calcium drugs can lower the risks of cancer while raising the chances of CVD in postmenopausal women after over 20 years of follow-up” [ref]
This evidence raises questions about the consumption of other supplements and what harm they can bring in the long run.
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Methods and Analysis:
Over 36,000 subjects were included; they were postmenopausal without any history of breast or colorectal cancer.
After being divided into two groups, one received the CaD supplement, and the other got a placebo.
The investigation lasted for 20 years, and the participants were regularly checked if they had cancer, hip fractures, or heart problems.
They concluded that women who took vitamin supplements had fewer cancer deaths but more deaths from heart issues.
However, this did not affect the all-cause mortality. The study could not separate the effects of calcium and vitamins or both together.
Also, they found that the impact of the calcium and vitamin D supplements on cancer rates varied among people who took such drugs before joining.
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Side Effects of Taking Calcium and Vitamin D:
If you experience the following side effects, you are advised to inform your doctor as soon as possible.
- Increased thirst
- Higher amount of urination
- Confusion
- Nausea
- Vomiting
- Weakness or fatigue
- Muscle aches
- Skin rash
- Itchiness
- Swollen face, tongue, throat, or lips
- Hives
Specific side effects do not require medical attention, such as constipation and upset stomach.
Vitamin D: Benefits, Toxicity, Sources and Deficiency symptoms
Adverse Effects of Calcium Supplementation
Even though Ca only has sound effects on health, in some cases, overconsumption has only led to harm.
A cohort study from 2011 found that Ca intake of over 751 mg/d enhances the chances of osteoporosis-related bone fractures, while intakes over 1137 mg/dl can do it for hip fractures in women [ref]. So, consuming a moderate amount is important to prevent reversing beneficial effects.
In the same way, a study from 2010 found adverse impacts of Ca on heart health, stating that the supplement can raise the likelihood of myocardial infarction by 30%. [ref].
Also, another research with 1,471 healthy postmenopausal women found that taking 1,000 mg of calcium supplements every day increased the chances of having heart problems [ref].
While relating to GIT issues, side effects like constipation, nausea, flatulence, and bloating are rather common and must be dealt with with ease.
However, the case of kidney stones is different. The drugs have been associated with good kidney health, but a study says otherwise.
According to research from 1997, people who took supplements in any form were more likely to develop stones than those who did not. [ref]
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Vitamin D Toxicity
Excessive intake can lead to the accumulation of vitamin D beyond normal levels. Particularly if these levels are not monitored regularly, and a new dose is prescribed. Even abnormal fortification can lead to harmful serum vitamin D levels.
In 2015, the FDA recalled multivitamin capsules made by Glades Drugs as they contained excessive doses of vitamin D3 [ref].
Also, since exposure to the sun is a chief source of this vitamin, no amount of exposure can lead to toxicity. However, skin cancers are still possible, so any sort of sun protection must be applied to the skin.
Furthermore, vitamin D intoxication can be related to hypercalciuria and higher chances of developing multiple sclerosis [ref].
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