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Calcium Supplementation Risks — SCE Rheumatology MCQ

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ModerateMetabolic Bone DiseaseCalcium Supplementation RisksSCE Rheumatology

A 72-year-old woman taking calcium and vitamin D supplements for osteoporosis develops hypercalcaemia (corrected calcium 2.78 mmol/L). She is also on Alfacalcidol for hypoparathyroidism. What is the risk of excessive calcium supplementation?

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Correct answer: D — Excessive calcium (particularly with active vitamin D metabolites like Alfacalcidol) can cause hypercalcaemia nephrocalcinosis renal stones and potentially increased cardiovascular risk

Excessive calcium supplementation particularly in combination with active vitamin D metabolites (Alfacalcidol Calcitriol) carries risks of hypercalcaemia nephrocalcinosis and renal calculi. Some meta-analyses have suggested a possible association between calcium supplements and increased cardiovascular events though this remains debated. NOGG guidelines recommend dietary calcium as the preferred source with supplements used only when dietary intake is insufficient. Total calcium intake should generally not exceed 1500 mg daily. Regular calcium monitoring is essential when using active vitamin D preparations.

Reference: NOGG 2021 UK guidelines; Bolland MJ et al 2010 calcium supplements and CV risk