Contemporary Strategies for Prevention and Treatment of Osteoporosis: Role of Calcium and Vitamin D


І. Ю. Головач


Combinations of calcium and vitamin D are currently at the forefront of strategies for the prevention of osteoporosis, as well as for replenishing calcium deficiency in adolescence, in the elderly, during pregnancy and lactation. The combination of calcium and vitamin D is significantly and more effective than their monotherapy in slowing bone loss and reducing the risk of fractures, strengthening skeletal muscles and reducing the likelihood of falls.

Based on the analysis of modern scientific data, it can be unequivocally argued that calcium and vitamin D deficiencies are widespread, and their adequate intake from food sources or drugs should be an obligatory part of the prevention and treatment of osteoporosis and osteoporotic fractures. The best results in reducing the risk of fractures are observed with the appointment of a combination of calcium at a dose of 1000–120 m0 g per day and vitamin D at a dose of 800 IU/day.

The drug Azvestiv (JSC “Kyiv Vitamin Plant”), which has appeared on the market of Ukraine, can be used in the programs for the prevention and treatment of osteoporosis in young adult groups, and it is possible to take an adequate dose of calcium and vitamin D deficiency in patinets with osteoporosis. D.


For practicing physicians
Author Biography

І. Ю. Головач, Feofaniya Clinical Hospital of State Management of Affairs of Ukraine

Iryna Yu. Golovach,

Head of the Center of Reumatology


Кочиш А.Ю., Лесняк О.М., Зоткин Е.Г., Иванов С.Н., Сафонова Ю.А. Создание служб профилактики повторных переломов костей у пациентов с остеопорозом. Остеопороз и остеопатии. 2015;3:30–35.

Марченкова Л.А., Тевосян Л.Х. Роль кальция и витамина D в профилактике остеопороза и переломов (обзор литературы). РМЖ. 2015;8:454.

Поворознюк В.В., Григорьева Н.В. Препараты кальция и витамина D в профилактике и лечении остеопороза. Раціональна фармкотерапія. 2006; 1(1):18–24.

Bonnick S., Broy S., Kaiser F. et al. Treatment with alendronate plus calcium, alendronate alone, or calcium alone for postmenopausal low bone mineral density. Curr Med Res Opin. 2007;23(6):1341–1349. doi: 10.1185/030079907X188035.

Chapuy M.C., Pamphile R., Paris E. et al. Combined calcium and vitamin D3 supplementation in elderly women: confirmation of reversal of secondary hyperparathyroidism and hip fracture risk: the Decalyos II study. Osteoporos. Int. 2002;13(3): 257–264. DOI: 10.1007/s001980200023.

Chen P., Krege J.H., Adachi J.D. Vertebral fracture status and the World Health Organization risk factors for predicting osteoporotic fracture risk. J Bone Miner Res. 2009;24(3):495–502. doi: 10.1359/jbmr.081103.

Compston J., Cooper A., Cooper C., et al. UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos. 2017;12(1):43. doi:10.1007/s11657-017-0324-5

Ganda K., Puech M., Chen J.S., et al. Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis. Osteoporos Int. 2013;24(2):349–406. doi: 10.1007/s00198-012-2090-y.

Harvey N.C., Biver E., Kaufman J.M., et al. The role of calcium supplementation in healthy musculoskeletal ageing: An expert consensus meeting of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Foundation for Osteoporosis (IOF). Osteoporos Int. 2017;28(2):447–462. doi:10.1007/s00198-016-3773-6

Hernlund E., Svedbom A., Ivergård M., et al. Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2013;8(1-2):136. doi: 10.1007/s11657-013-0136-1.

Kanis J.A., Cooper C., Rizzoli R., Reginster J.Y; Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2020;31(1):209. doi:10.1007/s00198-018-4704-5

Kanis J.A., McCloskey E.V., Johansson H., Cooper C., Rizzoli R., Reginster J.Y. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2013; 24:23–57.

Morris H.A. Osteoporosis prevention – a worthy and achievable strategy. Nutrients. 2010;2(10):1073–4. doi: 10.3390/nu2101073.

Nowson C.A. Prevention of fractures in older people with calcium and vitamin D. Nutrients. 2010;2(9):975–84. doi: 10.3390/nu2090975.

Reid IR, Ames RW, Evans MC, Gamble GD, Sharpe SJ. Long-term effects of calcium supplementation on bone loss and fractures in postmenopausal women: a randomized controlled trial. Am J Med. 1995 Apr;98(4):331–5. doi: 10.1016/S0002-9343(99)80310-6.

Rozenberg S., Body J.J., Bruyère O., et al. Effects of Dairy Products Consumption on Health: Benefits and Beliefs-A Commentary from the Belgian Bone Club and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases. Calcif Tissue Int. 2016 Jan;98(1):1–17. doi: 10.1007/s00223-015-0062-x.

Shea B., Rosen C.J., Guyatt G. et al. A meta-analysis of calcium supplementation for the prevention of postmenopausal osteoporosis. Osteoporosis Int. 2000;11 (Suppl. 2):114. DOI: 10.1210/er.2001-7002

Sunyecz JA. The use of calcium and vitamin D in the management of osteoporosis. Ther Clin Risk Manag. 2008;4(4):827–836. doi:10.2147/tcrm.s3552.

Weaver C.M., Alexander D.D., Boushey C.J., et al. Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporos Int. 2016;27(1):367–376. doi:10.1007/s00198-015-3386-5

Weaver C.M., Bischoff-Ferrari H.A., Shanahan C.J. Cost-benefit analysis of calcium and vitamin D supplements. Arch Osteoporos.2019;14(1):50. doi:10.1007/s11657-019-0589-y

WHO Scientific Group on the Prevention and Management of Osteoporosis (2000: Geneva, Switzerland). (2003). Prevention and management of osteoporosis : report of a WHO scientific group. World Health Organization.

World Health Organization Assessment of osteoporosis at the primary health care level. WHO, Geneva, 2007. Available from :