Calcium, Vitamin D and Vitamin K Overview
Calcium is the most abundant macro mineral in our body; we can absorb up to 500 mg of calcium at a time; therefore, calcium doses should be divided into separate doses. The main goal of this article is to highlight the specific nutrients for bone health, their effect on bones, and the influence of supplementing each nutrient.
Low bone mineral density and osteoporosis affect millions of people worldwide; the majority of adults have insufficient intake of calcium and vitamin D, which are essential for the maintenance of bone health. Specific nutrients improve calcium metabolism and bone formation. While several nutrients, such as manganese, zinc, and copper, are readily available in the average diet, some multivitamins provide excess quantities of nutrients that are unnecessary or potentially harmful.
Benefits of Calcium
Calcium is the major component of 99% of mineralized tissues and participates in different biological functions providing skeletal structure and strength. Sufficient calcium intake is essential for bone development and maintenance throughout life.
- Bone is a connective tissue mainly mineralized by calcium which resembles bone structure.
- Required for bone Strength, normal growth, and development.
- Nerve impulse transmission.
- Energy for Muscle contraction.
- Activates numerous enzymes.
- Essential for neurotransmitters release.
- Required for blood clotting (with vitamin K).
- Supports vitamin B12 absorption.
- Sex hormones synthesis.
- Regulates ion transportation in cells.
Signs and Symptoms of Calcium Deficiency
Moderate low levels of calcium can exist without causing any symptoms. That’s why optimal daily intake must be maintained, while prolonged calcium deficiency will lead to
- Muscle cramps commonly involving the back and legs.
- Brittle nails, dry skin, and coarse hair.
- Psychological or neurological symptoms (confusion, depression, memory loss, delirium, and hallucinations) which disappear when calcium level is restored.
Extreme low levels of calcium can develop due to calcium deficiency for extended long periods and can cause:
- Muscle stiffness, aches, and spasms (tetany).
- Breathing difficulty.
- Tingling in the lips, tongue, fingers, and feet.
- Abnormal heart rhythms.
- Bone loss (osteoporosis/osteopenia).
Best Forms of Calcium Supplements
Calcium hydroxyapatite is a mineral form of calcium apatite found in human bones; it accounts for 65% to 70% of the weight of human bone. Calcium hydroxyapatite contains almost 40% calcium and around 18% phosphorus.
DiCalcium Malate contains around 29% calcium with optimal absorption compared to other forms of calcium which yields more calcium concentration in each capsule.
Calcium Bisglycinate is better absorbed by the body than inorganic forms of calcium and it’s used to enrich dairy products by additional calcium to compensate for the amount lost during pasteurization.
Calcium Citrate provides 19% elemental calcium and does not require acid to dissolve so it can be taken at any time for people who have difficulty absorbing medications will benefit from utilizing calcium citrate.
Calcium Carbonate contains 29% elemental calcium but dissolves better in an acidic environment, so it should be taken with meals.
- Calcium Carbonate has higher elemental calcium than Calcium Citrate, but the bioavailability of Calcium Citrate is 2.5 times than Calcium Carbonate, so in case of calcium-related kidney stones, only calcium citrate form is recommended.
Choosing The Right Calcium Supplement Depends on The Following Factors:
- Elemental calcium indicates the amount of calcium in the supplement.
- Bioavailability of calcium that defines the body’s ability to absorb calcium from the supplemental form.
- Prescription Medications interact with calcium supplements, including antibiotics, synthetic thyroid hormones, bisphosphonates, and blood pressure medications.
Recommended Calcium Doses
Life Stage Group
0 – 6 months
6 – 12 months
1 – 3 years
4 – 8 years
51–70 years (males)
51–70 years (females)
Who Should Use Calcium Supplements?
Calcium supplements can support the daily requirements of calcium intake if it’s maintain enough calcium levels especially if you’re:
- Lactose intolerant.
- Avoiding dairy products.
- Following corticosteroids regimen.
- Having digestive diseases such as inflammatory bowel disease (IBD) or Celiac disease.
- Suffering from osteoporosis or low bone mineral density (BMD).
Benefits of Vitamin D
Vitamin D is a fat-soluble vitamin, and it’s crucial for calcium absorption and bone mineralization which is responsible for bone mineral density. Sunlight is the main source of vitamin D by photo-production through the skin, but limited exposure and sunscreens inhibit its absorption. Vitamin D deficiency and insufficiency are the major causes of osteomalacia, which can exacerbate osteoporosis.
Vitamin D Has Two Main Forms:
- Vitamin D2 (ergocalciferol), which can be obtained from plants and fungi.
- Vitamin D3 (cholecalciferol) that is obtained from animal products such as fish oils, eggs, and dairy.
- Vitamin D is stored and converted to its active form in the liver.
- Enhanced calcium absorption from the small intestine.
- Increases calcium uptake into the cells.
- Maintains optimal balance between calcium in bones and circulatory calcium
Symptoms of Vitamin D Deficiency
- Impaired calcium absorption.
- Muscle weakness, aches, or cramps.
- Bone and joint pain.
- Mood changes (confusion or depression).
- Rickets in children.
What Are The Side Effects of Taking Calcium and Vitamin D ?
- Nausea, vomiting, or constipation.
- Increased thirst or urination.
- Confusion, lack of energy, or feeling tired.
- Metallic taste or dry mouth.
- Weakness, drowsiness, or headache.
- Muscle or bone pain.
- Hypercalcemia (high levels of calcium in the blood).
Can I Take Vitamin D Supplements Without Doctor Consultation?
Vitamin D can generally be taken without a prescription, especially if it’s included in a multivitamin product, but taking vitamin D alone should be decided by your physician, who will require a laboratory test to measure serum vitamin D and then decide if you need extra vitamin D intake as excess levels of vitamin D can contribute to kidney stone, nephritis and increased risk of calcium deposition in soft tissues.
How to Increase Calcium and Vitamin D Intake?
- Supplementing calcium (carbonate or citrate) and vitamin D3 (cholecalciferol).
- Dairy products (cheese, milk, and yogurt).
- Dark green leafy vegetables (broccoli and kale).
- Fish (sardines, tuna, and salmon).
- Calcium-fortified foods (soy products, cereal, and fruit juices).
Calcium, Vitamin D and Your Bones
Since vitamin D is responsible for the absorption of calcium from the gastrointestinal tract, it’s essential to maintain the required intake of daily vitamin D along with maintaining calcium intake to prevent bone loss, especially for individuals with a high risk of bone/hip fractures due to osteoporosis, low bone mineral density or corticosteroids treatment.
Calcium and Vitamin D Supplementation in Osteoporosis
Calcium and vitamin D are generally recommended in the treatment of osteoporosis, especially for the patient receiving corticosteroids therapy, as corticosteroids in the long term contribute to bone breakdown and reduce calcium absorption, thus supplementing with calcium and vitamin D is critical along with the treatment regimen.
Vitamin K2 Can Make a Significant Difference in Bone and Heart Health
Vitamin K is a fat-soluble vitamin, and it’s essential for the coagulation of blood; also it’s important for bone health. Vitamin K has different forms, but the naturally occurring forms are vitamin K1, and K2, the naming of vitamin K originates from the german word “Koagulations vitamin” as it’s essential for blood coagulation.
Forms of Vitamin K:
- Vitamin K1 (phylloquinone) is mainly found in green leafy vegetables and dairy products.
- Vitamin K2(menaquinone or MK)
- Consists of subtypes from MK-2 to MK-14.
- Synthesized by specific bacteria present in the gastrointestinal tract and fermented foods (Cheese and Natto) except MK-4.
- MK-4 is synthesized from vitamin K1 in the liver.
- MK-4 is the predominant vitamin K form in the body.
- MK-7 has the highest bioavailability and bioactivity.
Vitamin K3 (menadione) is a water-soluble synthetic form that is converted to MK-4 in the liver.
Vitamin K deficiency is associated with an increased fracture risk due to improper function of vitamin K-dependent bone proteins responsible for bone remodeling, bone strength, and bone turnover. Vitamin K has different mechanisms of action in maintaining bone health, including
- Essential for the carboxylation of bone-related proteins such as Osteocalcin, Matrix G1a Protein, Protein S, Periostin, and Gas 6.
- Regulating bone reabsorption by transcription of osteoblasts (bone-building protein).
- Osteocalcin binds to calcium and hydroxyapatite to regulate bone shape and size during bone mineralization.
- Vitamin K is responsible for the carboxylation of Matrix G1a Protein (MGP) which prevents the deposit of calcium in soft tissues such as blood vessels and arteries.
- Clinical studies demonstrated that high levels of under-carboxylated Matrix G1a Protein (MGP) is a biomarker for cardiovascular disease.
- Clinical trials concluded that low levels of serum vitamin K1 and K2, low dietary intake of vitamin K and high levels of under-decarboxylated Matrix G1a Protein contributes to higher risk of bone fracture.
Can Too Much Vitamin K Cause Blood Clots?
Vitamin K does not contribute to blood clots. Still, supplementation of vitamin K should be avoided by the patient taking Warfarin drug, which is an anticoagulant drug that works by inhibiting vitamin K synthesis.
Will Vitamin K2 Clear Calcium From The Arteries?
Vitamin K is responsible for the carboxylation of Matrix G1a Protein (MGP) which prevents the deposit of calcium in soft tissues such as blood vessels and arteries.
Can I Take K2 and D3 and Calcium Together ?
Vitamin D3 and K2 are important mediators that function synergistically to maintain bone and heart health providing proper calcium function and metabolism.
- Vitamin D3 is essential for calcium absorption, balance, and deposition on bones.
- Vitamin K2 is important for the proper utilization of calcium by guiding it into the bones and preventing its deposition in arteries, joints, or organs.
- Calcium is the building block that resembles bone structure and strength.
Accordingly, combining Calcium, Vitamin D3, and Vitamin K2 maximizes efficiency in maintaining bone health.
When Should I Take Vitamin D3 and K2?
Vitamin D3 and K2 are both fat-soluble vitamins, and they require fat intake in order to be absorbed properly from the gut; therefore, they’re best taken after meals that contain healthy fats.
What Are The Side Effects of Taking Vitamin D and K ?
- Constipation or diarrhea.
- Change stool color to green.
- Belly pain.
- Nausea or upset stomach.
What Happens If You Take Vitamin D3 Without K2?
Since vitamin K plays an important role in utilizing calcium in bones, taking vitamin D3 only can enhance the probability of soft-tissue calcification due to the improper function of vitamin K-dependent proteins.
What Happens If You Take Vitamin D3 Without K2?
Welltopia Pharmacy offers high-quality combinations of Calcium, Vitamin D3, and Vitamin K2 that are tailored to address everyone’s needs in both Capsule and Liquid dosage forms.
- Calcium Select features four unique forms of highly absorbable calcium for maximum bioavailability and the highest rate of absorption in the market.
- Calcium hydroxyapatite, Di-calcium malate, Calcium Citrate, and Calcium Bisglycinate.
- Vitamin D3 as Cholecalciferol.
- Phosphorus as Calcium hydroxyapatite.
- D-K Forte is backed by the most clinically studied form of vitamin K2 as MenaQ7® PRO providing vitamin K2 as MK-7 and vitamin D3 as Cholecalciferol in capsule dosage form while D-K Liquid provides the potent formula in liquid form.
- D3 Liquid ideal delivery of 1,000 IU vitamin D3 as Cholecalciferol per drop, making it a great alternative to capsules.
- Vitamin D 5000 IU meets the variety of individual needs by delivering pure and potent vitamin D3 as Cholecalciferol.
- Osteoporosis: Prevention With Calcium Treatment
- What is the function of hydroxyapatite in bone?
- The Synergistic Interplay between Vitamins D and K for Bone and Cardiovascular Health: A Narrative Review
- Calcium and vitamin D combination
- Calcium and vitamin D supplementation in osteoporosis
- Calcium and calcium supplements: Achieving the right balance
- Hypocalcemia (Low Level of Calcium in the Blood)
- The influence of the dose of calcium bisglycinate on physicochemical properties, sensory analysis and texture profile of kefirs during 21 days of cold storage
- Vitamin D and Bone Health; Potential Mechanisms
- Vitamin K and Bone Health: A Review on the Effects of Vitamin K Deficiency and Supplementation and the Effect of Non-Vitamin K Antagonist Oral Anticoagulants on Different Bone Parameters
- Calcium Intake in Bone Health: A Focus on Calcium-Rich Mineral Waters
- Essential Nutrients for Bone Health and a Review of their Availability in the Average North American Diet