Calcium and Vitamin D After 40: How Much Do You Need?

How much calcium and vitamin D do women need after 40 and menopause? See Health Canada's amounts, the best food sources, upper limits and when to supplement.

Bone strength peaks in early adulthood, then slowly declines. After menopause, lower estrogen levels speed up bone loss, which raises the risk of osteoporosis and fractures. Getting enough calcium and vitamin D will not prevent osteoporosis on its own, but it is a key part of protecting your bones.

Check how your daily intake compares with our free calcium and vitamin D calculator, then use this guide to fill any gaps.

How much calcium do you need?

Health Canada's Recommended Dietary Allowances (RDAs) for women are:

• Ages 19 to 50: 1,000 mg of calcium a day
• Ages 51 and older: 1,200 mg of calcium a day

The higher amount after 50 reflects faster bone loss after menopause. Calcium from food is preferred, because it comes with other nutrients and is less likely to cause side effects.

How much vitamin D do you need?

Vitamin D helps your body absorb calcium and supports muscle strength. Health Canada's RDAs are:

• Ages 19 to 70: 600 IU a day
• Ages 71 and older: 800 IU a day

These amounts assume minimal sun exposure. In Canada, the sun is too weak from roughly October to March for your skin to make much vitamin D, and few foods are naturally rich in it. For this reason, Health Canada advises that everyone over 50 take a daily vitamin D supplement of 400 IU, in addition to eating vitamin D-rich foods. Younger adults who do not regularly eat vitamin D sources may also benefit from a 400 IU supplement. Osteoporosis Canada supports these recommendations and notes that some people at higher risk of low vitamin D may need more, as advised by their provider.

Food sources of calcium

Approximate calcium in common foods (amounts vary by brand, so check labels):

• 250 ml (1 cup) milk: about 300 mg
• 250 ml (1 cup) fortified soy or other plant-based beverage: about 300 mg (shake well)
• 175 g (3/4 cup) plain yogurt: about 200 to 300 mg
• 50 g (1.5 oz) cheddar cheese: about 350 mg
• 75 g canned salmon or sardines with bones: about 180 to 280 mg
• 150 g tofu made with calcium sulphate: about 200 to 400 mg
• 60 ml (1/4 cup) almonds: about 90 mg
• 125 ml (1/2 cup) cooked bok choy, kale or collard greens: about 70 to 140 mg

Spinach contains calcium, but very little is absorbed because of natural compounds called oxalates.

Food sources of vitamin D

• fatty fish such as salmon, trout, mackerel and sardines
• cow's milk, which is fortified in Canada (about 100 IU per cup)
• fortified plant-based beverages and some margarines and yogurts
• egg yolks, in smaller amounts

Getting the most from calcium

• Spread it out. Your body absorbs calcium best in amounts of about 500 mg or less at a time.
• Count food first. Many people get more from food than they think. Add up your intake before reaching for a supplement.
• Supplement only the gap. If you need a supplement, take just enough to reach your target. Calcium carbonate is best absorbed with food. Calcium citrate can be taken with or without food.
• Watch for interactions. Calcium can affect absorption of some medications, such as thyroid medication and certain antibiotics. Ask your pharmacist about timing.
• Support your bones in other ways. Weight-bearing and strength exercises, enough protein, not smoking and limiting alcohol all help.

Don't overdo it: upper limits

More is not always better. Health Canada's Tolerable Upper Intake Levels for adults, from food and supplements combined, are:

• Calcium: 2,500 mg a day for ages 19 to 50, and 2,000 mg a day for ages 51 and older
• Vitamin D: 4,000 IU a day

Too much calcium from supplements has been linked with kidney stones and constipation. Very high vitamin D intakes can raise calcium in the blood to harmful levels.

When to get medical advice

Talk to your doctor or nurse practitioner about your bone health if you:

• are 50 or older and have broken a bone from a minor fall or bump
• have lost height, or notice your upper back becoming more curved
• went through menopause before age 45
• take medications that affect bones, such as long-term steroids
• have a condition that affects absorption, such as celiac disease or inflammatory bowel disease
• have a history of kidney stones, or are thinking of taking more than the recommended amounts

Your provider can assess your fracture risk and may recommend a bone density test. Seek urgent care for sudden severe back pain after a minor strain, or if you think you may have broken a bone.