Calcium supplements are a $6.4 billion global industry — and demand is increasing. According to the market research firm Future Market Insights, a major driver behind the continuing growth of calcium supplements is their “established use in [the] daily bone-health routines” of millions of consumers.

But studies have shown that calcium supplements don’t do much to prevent osteoporosis or bone fractures in healthy people. (Some clinical studies have demonstrated that supplements can help older people at high risk of fracture or developing osteoporosis, but more research is needed.) 

“Supplementing implies deficiency,” says Kendall Moseley, M.D., medical director of the Johns Hopkins Metabolic Bone and Osteoporosis Center in Baltimore. If you’re eating a balanced diet and getting enough calcium from food, “why supplement when you’re getting it naturally?” she adds.

Here’s what the latest research has found.

Little Benefit for Healthy People

A recent study from Canadian researchers published in The BMJ found “little to no benefits” from taking supplements of calcium, vitamin D, or a combination of both to prevent falls and fractures in a healthy population. Calcium is the main building block of bone, and vitamin D helps the body absorb calcium. 

The researchers conducted a meta-analysis and systematic review of 69 randomized controlled trials, encompassing 153,902 adult participants, that studied the effects of calcium, vitamin D, or combo supplements against a placebo or no treatment to reduce falls and fractures. A majority of the participants were older (with a median age of about 71), were not at high risk for falls (73%), and were not living in a nursing home or long-term care facility (87%). None was taking medications for osteoporosis. 

Because the study population largely wasn’t calcium- or vitamin D-deficient, it’s not surprising that supplements had little impact on reducing falls and fractures, says Andrea Singer, M.D., division director of women’s primary care and medical director of bone densitometry at MedStar Health Georgetown University Hospital in Washington, D.C. “The results reinforce the concept that supplementation in low-risk populations is unlikely to make a difference in preventing falls and fractures,” she says.

Age-Related Risks

The study authors note their results may not apply to people with “specific bone disorders or to those receiving drug treatment for osteoporosis,” who may have a high risk for falls and fractures.

As we age, we lose bone and muscle mass, which can affect balance and gait. Unsteadiness can lead to falls, and if bones are weakened due to osteoporosis, fractures can occur. Women tend to lose bone mass and density at an earlier age and at a faster rate than men due to menopausal hormone changes; about 80% of the 10 million Americans with osteoporosis are women. But not everyone experiences the same level of risk as they age, Moseley says. Genetics, family history, previous injuries, and other factors can contribute to your chance of falls.

Among older people, fractures from falls can lead to long recovery periods or further complications like infections, blood clots, or pneumonia, impacting quality of life and independence.

Before popping any supplements, Moseley advises asking your health care provider about your risk of developing osteoporosis or experiencing falls, and doing a risk assessment first. A full rundown of your diet and all the vitamins and supplements you take should always be a part of the discussion, she says, because some multivitamins already contain supplemental calcium or vitamin D, and you don’t want to overdo it.

That’s because there are some side effects of taking too much calcium, Moseley says. Megadoses of the mineral can cause brain fog, cognitive dysfunction, abdominal pain, nausea, and constipation. You could also experience kidney stones or even kidney failure as the organs work overtime to excrete the extra calcium. You and your doctor can decide whether additional calcium or vitamin D intake would be useful along with other treatment options.

The Importance of Strong Bones

There are steps people can take to ensure bone health earlier in their lives before age-related issues arise. 

A healthy diet including sufficient amounts of calcium and vitamin D “is always our first go-to,” Singer says. Recommended daily intakes range from 1,000 to 1,200 milligrams of calcium (depending on sex and age) and 15 micrograms of vitamin D for adults up to age 70 or 20 micrograms for those 70 and older. Younger people need between 200 to 1,300 milligrams of calcium and 10 to 15 micrograms of vitamin D per day, depending on age. Foods containing both calcium and vitamin D include whole eggs, cheese, canned fish with bones (like sardines and salmon), and D-fortified milk and yogurt. Calcium is also abundant in dark leafy greens, broccoli, and edamame.

Weight-bearing or resistance exercise is essential for healthy bones because it strengthens both the bones and the muscles that support them, helping to grow and repair tissue throughout your lifespan. Older people can add balance exercises for building strong bones and reducing falls, Singer says. Of course, it’s important to speak with your health care provider before beginning any diet or exercise plan.

_{Featured Image Credit: © Alexandr Kolesnikov—Moment/Getty Image}

Taking supplemental vitamins is an essential part of so many people’s daily routine, but this begs the question — can you consume too many vitamins? We all know how easy it is to eat too much pizza or drink one too many beers, which leaves our stomachs feeling worse for wear. But overdoing your vitamins can have an even greater impact from head to toe, affecting far more than just the stomach. If you’re one of the many people taking daily vitamins for nutritional deficiencies, then it’s worth being aware of which vitamins may cause complications if you consume too much.

Water-Soluble vs. Fat-Soluble Vitamins

We often take two common types of vitamins — water-soluble vitamins and fat-soluble vitamins. The former category includes vitamins B and C. In contrast, the latter includes vitamins A, D, and E. While consuming too much of either category is possible, excessive amounts of water-soluble vitamins will come out in urine and sweat. Fat-soluble vitamins, however, are absorbed in their entirety, meaning their potential impact on the body is potentially far greater.

Vitamin A

Taking vitamin A assists with eye health, but too much vitamin A may result in nausea, irritability, drowsiness, and even an increased risk of lung cancer. It’s advisable to exceed no more than 900 micrograms for most adults, though the exact limits depend on your individual age, sex, and other medical conditions such as pregnancy.

B Vitamins

Vitamin B3 is essential for heart health and good metabolism, but consuming too much (over 14 to 16 mg) can cause itchy skin and impaired vision. Vitamin B6 is another equally essential vitamin that helps anemia, but consuming more than 1.3 to 1.7 mg each day may result in vomiting, heartburn, and light sensitivity. Then there’s folic acid, the synthetic form of vitamin B9. Folic acid is essential for proper immune function, but taking more than 1 mg daily may cause bloating and loss of appetite.

Vitamin C

Vitamin C is a necessary tool for developing muscle and cartilage, and it also plays a critical role in the body’s healing process. But taking even a single vitamin C pill each day is inadvisable according to some, as it’s been tied to an increased likelihood of developing kidney stones in males. It also causes diarrhea and heartburn, regardless of a person’s sex. As with everything vitamin on this list, discuss dosage, frequency, and usage with your healthcare provider.

Vitamin D

Vitamin D helps the body with calcium absorption, meaning it’s critical for maintaining good bone health. But taking too much may result in an increased risk of hypercalcemia, which manifests as nausea, twitching muscles, general fatigue and confusion, and even fragile bones that are more vulnerable to breaks. Keep your daily vitamin D intake below 20 micrograms.

Vitamin E

Vitamin E supports a wide variety of bodily functions and is even believed to delay the onset of Alzheimer’s disease and prevent liver disease. But too much vitamin E can lead to blood clots, hemorrhages, and an increased risk of prostate cancer. Stick to around 15 milligrams of vitamin E each day for the average adult.

What About Minerals?

Vitamins and minerals generally go hand in hand in the world of daily supplements. It should come as no surprise that there’s also such a thing as taking too much of any given mineral, and here are some of the ones that are worth being cautious about.

Calcium

Calcium is essential for bone strength and better muscle function. But taking too much calcium may result in the aforementioned hypercalcemia. It’s recommended that you stick to an average of 1,000 t0 1,300 mg of calcium daily — depending on your age and other medical conditions. If you’re 51 or older, you should never exceed 2,000 mg of calcium in a single day, as doing so increases the risk of medical complications.

Iron

Many people suffer from conditions such as iron-deficient anemia, and in turn, they rely on iron supplements to get more into their system. Maintaining good iron levels is key when it comes to energy production, and also helps support the body if you’re pregnant or undoing an active menstrual cycle. But taking too much iron can lead to constipation, vomiting, liver failure, low blood pressure, and even damage to the lungs. This is why it’s so careful to limit yourself to between 7 and 27 mg of iron, depending on your age, sex, and other medical conditions.

Zinc

You need zinc for proper immune function, as it can help fight off harmful bacteria. But be careful not to exceed 14 mg per day if you’re an adult male and only eight if you’re an adult female. Taking too much zinc may lead to cramping and vomiting.

Concerned? Talk to a Doctor

If you’re concerned about your daily vitamin intake, reach out to a medical professional who can help guide you down the right path. Going for annual physicals is an excellent way to keep tabs on your body’s vitamin and mineral levels, which can help manage your supplements. If any levels seem out of whack, your doctor can advise you about taking more or less supplements going forward.