Daily Calcium and Vitamin D Supplementation as a Foundational Pillar in Osteoporosis Management: A Narrative Review

Osteoporosis is a progressive skeletal disorder characterized by decreased bone strength and an increased risk of fractures. It presents a high global prevalence, thus imposing a significant clinical and economic burden. This narrative review includes current evidence on the role of combined calcium and vitamin D supplementation in the management and prevention of osteoporosis, as well as its effect on reducing fracture risk and maintaining bone mineral density. It aims to provide an overview of osteoporosis pathophysiology, the importance of adequate calcium levels and 25-hydroxyvitamin D concentrations and the prevalence of their deficiencies. The review examines the evidence supporting combined supplementation and its importance in patients receiving anti-osteoporotic pharmacological therapies. Current clinical guidelines and consensus statements, along with their recommendations for dosing, formulation, and monitoring of calcium and vitamin D supplements, are included. Barriers to the effective implementation, gaps in clinical practice, patient adherence, and primary care challenges are discussed. Ultimately, this review examines the cost-effectiveness of supplementation and the areas for improvement in real-world evidence and research in the field of osteoporosis. This work aims to provide clinicians and healthcare professionals with an updated, evidence-based framework for optimizing calcium and vitamin D supplementation in the care of patients with osteoporosis.