For years, calcium by itself has been portrayed as being the key nutrient for bone health. But that is only part of the story. Magnesium and vitamins D and K are also important.* Most studies have found a combination of bone health nutrients to be superior to any single nutrient alone.

For example, a study in postmenopausal women found that while vitamin D supported bone health in women who took supplemental vitamin D3, an even greater benefit was seen when calcium was included.*1

Vitamin D is an important part of the picture, in part because it is essential for calcium absorption. But deficiencies or insufficiencies of vitamin D have both been well documented during the past decade. National survey data indicates that more than 40 percent of U.S. adults are vitamin D deficient2,3 – defined as less than 20 ng/mL of serum 25(OH)D. On the bright side, data shows that 37 percent of U.S. adults report taking supplemental vitamin D.2-4

Vitamin D and calcium are not the only nutrients that are dependent on each other for their efficacy. Vitamin K and magnesium play significant roles.

While vitamin D increases the absorption of calcium to provide important support for bone health, vitamin K directs that absorbed calcium to the bones and out of the soft tissues, such as the blood vessels and the kidneys.* Although diets tend to contain enough vitamin K to support blood clotting, the average diet might not provide enough vitamin K to support healthy bones. In addition to inadequate amounts in the diet, low vitamin K can occur because of malabsorption, liver disease, alcoholism, and use of anticoagulant medication, such as warfarin.5

And don’t forget magnesium. A review published in The Journal of the American Osteopathic Association has determined that vitamin D is not metabolized efficiently without an adequate level of magnesium being present.6

But according to World Health Organization statistics, as much as 75 percent of the U.S. adult population does not meet the U.S. Food and Drug Administration’s Recommended Daily Intake of magnesium – 420 mg per day.7

It is very clear that individuals who supplement with vitamin D should also consider their magnesium status as well. Failure to maintain an adequate level of magnesium in the body could lead to inadequate vitamin D metabolism.* Furthermore, individuals with an adequate magnesium level were found to require less vitamin D supplementation to maintain a normal level of that vitamin.*6 Research has correlated diets higher in magnesium to lower incidences of vitamin D deficiency.*8

Consider these supplements to augment a bone-healthy diet and lifestyle: Calcium-Magnesium Malate, Vitamin D, and Vitamin K. Or if you are looking for a non-encapsulated form to provide easy supplementation for kids or adults who have trouble swallowing capsules, consider Vitamin D + K2 liquid, which can be mixed with water or your favorite beverage.

References

  1. Bergman G, Fan T, McFetridge J, Sen S. Efficacy of vitamin D3 supplementation in preventing fractures in elderly women: a meta-analysis. Curr Med Res Opin 2010;26(5):1193-1201.
  2. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010. 
  3. Forrest K, Stuhldreher W. Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res 2011;31(1):48-54.
  4. Bailey R, Dodd K, Goldman J, et al. Estimation of total usual calcium and vitamin D intakes in the United States. J Nutr 2010;140:817-818.
  5. Rodríguez-Olleros Rodríguez C, Díaz Curiel M. 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. J Osteoporos. 2019;2019:2069176. doi: 10.1155/2019/2069176. 
  6. Uwitonze A, Razzaque M. Role of magnesium in vitamin D activation and function. J Am Osteopath Assoc 2018;118(3):181-189.