The loss of bone quality and/or density is a para-physiological phenomenon observed during perimenopause and postmenopause, as well as in other conditions involving ageing, inflammatory and/or autoimmune diseases, chronic drug consumption (e.g., glucocorticoids, chemotherapy, etc.), and/or nutritional deficiencies. Calcium and/or vitamin D supplementation has an important role in the prevention of osteopenia and osteoporosis in people at high risk of fragility fractures and for the treatment of bone strength reduction associated with antiresorptive and anabolic agents, and is key to the management of osteoporosis. And other supplements such as vitamin K2 and magnesium may also be involved in maintaining bone integrity.

Researchers thus summarized the latest data on calcium, vitamin D, vitamin K2, magnesium supplementation, and age-related bone mineral density (BMD), bone quality, fracture risk, and muscle strength. Vitamin D supplementation is essential for patients at risk of fracture and/or vitamin D deficiency. Both vitamin K2 and magnesium also appear to be involved in bone metabolism. Data suggest that vitamin K2 supplementation may improve bone quality and reduce fracture risk in patients with osteoporosis and may enhance the efficacy of calcium and vitamin D. Whereas magnesium deficiency may negatively affect bone and muscle health, some evidence suggests a potential protective effect on bone, although further research is needed.

Therefore, calcium supplementation alone is not recommended for fracture prevention in the general postmenopausal population. Patients at risk of fracture with inadequate dietary intake and absorption could benefit from calcium supplementation, but it needs to be customized, taking into account possible side effects and the degree of adherence.

Capozzi, A., Scambia, G., & Lello, S. (2020). Calcium, vitamin D, vitamin K2, and magnesium supplementation and skeletal health. Maturitas, 140, 55-63. [Link]