Vitamin D, Calcium and Your Bones

Jennifer Rackley Health Pro
  • As we discussed in the article "IBD and Vitamin D" it is quite common to find patients with Inflammatory Bowel Disease (IBD) to be deficient in vitamin D.  The role this plays in the maintenance of bones is a very important discussion.


    That having been said, it would be an incomplete story to fail to address the role that calcium plays as well.  While vitamin D helps to increase the absorption and mobilization of calcium in the bone, calcium balance is essential in bone mineral density.


    For many of the same reasons vitamin D status may be altered in IBD so can calcium status.  Restrictive diets, active inflammation, absorptive issues and GI surgeries that remove portions of the intestine can all contribute to the problem.   The use of corticosteroids can also further diminish the body's capacity to absorb this vital mineral.

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    There are many things you can do to help protect your bone mineral density.  The first step is consuming adequate amounts of foods that contain calcium and vitamin D.  There are very few foods that naturally contain vitamin D but fortification has helped to lessen the problem of obtaining food sources.  Some sources of vitamin D include: salmon, mackerel, tuna, sardines, fortified milk, fortified margarine and fortified cereals.  It is also important to note that moderate sun exposure is also needed for the proper utilization of vitamin D.


    While calcium can be found in several food sources there are some dietary sources that are more easily absorbed by the body.  Some good sources of calcium include: yogurt, milk, cheese, fortified OJ, fortified soy, tofu some greens and cabbage.


    If you are not consuming any of these food items and have one or more of the above risk factors for deficiency it is important to discuss the issue with your physician.  They may wish to prescribe a supplement to offset poor intake.


    Should you be prescribed a supplement it is important to note that calcium citrate is more readily absorbed than calcium carbonate.  This is due to the fact that calcium carbonate requires an acidic environment to be properly absorbed while calcium citrate contains its own acid to reduce this need.  You need to work with your doctor to determine which form would be better for your needs.  Calcium carbonate is significantly cheaper so that may also play a role in patients already purchasing expensive medications.


    Be an active participant in the nutritional care of your bones and discuss these issues with your physician.  Early intervention in these areas can be essential to preventing painful fractures and other problems!


    Read more about the importance of proper nutrition:

    IBD and Vitamin D

    Anemia Part I: Iron Deficiency

    Anemia Part 2: B12 and Folic Acid


Published On: August 18, 2008