Calcium and vitamin D supplements for treatment ana prevention of osteoporosis. Should it be widely used?

Osteoporosis is the most common age-related skeletal disease, which characterized by rapid loss of bone mineral density and increased risk of fragility fractures. The social significance of the disease is caused by its complications, which increase disability and mortality rates mostly among elderly people. Inadequate dietary calcium intake and vitamin D deficiency are well-known risk factors for osteoporosis. That is why for many years calcium and vitamin D have been considered crucial in the prevention and treatment of osteoporosis. However, in recent years, the efficacy and safety of calcium and vitamin D has been questioned. Since some conducted randomized clinical trials have reported only a week positive effect of calcium with or without vitamin in reducing fragility fracture risk. On the other hand, besides the gastrointestinal side effects of calcium supplements and the risk of kidney stones related to use of co-administered calcium and vitamin D supplements, other recent data suggested potential adverse cardiovascular effects from calcium supplementation. This article is focused on the evidence regarding both the possible usefulness for bone health and the potential harmful effects of calcium and/or calcium with vitamin D supplementation.