The recommendations above are general and apply to both men and women. As male osteoporosis becomes an increasingly important issue, new guidelines are appearing that specifically target men. Calcium and vitamin D supplements make up part of the so-calledbottom line recommendations in a 2005 review of mens health needs,43 and ensuring adequate intakes has been called the cornerstone of any regimen aimed at treating or preventing osteoporosis in men.2 Supplementation with calcium and vitamin D is at the top of all recent recommendations for treating osteoporosis in men,44 including guidelines issued by the American College of Rheumatology.45 An expert meeting of the Belgian Bone Club concluded, supplemental calcium and vitamin D should be considered as the first-line therapy.46 The same group determined that while combinations of anti-resorptive drugs should not be used, calcium and vitamin D in combination should be encouraged.
An expert panel convened by the World Health Organization Collaborating Center for Osteoporosis Prevention47 issued the following statements about the use of oral supplements of calcium and vitamin D in preventing and treating osteoporosis:
When given in appropriate doses, calcium and vitamin D have been shown to be pharmacologically active, safe, and effective for the prevention and treatment of osteoporotic fractures in all patients (that is, those with and without adequate dietary calcium intake).
In patients with insufficient dietary intake of calcium and vitamin D, supplements are an essential but not sufficient component of an integrated management strategy for the prevention and treatment of osteoporosis.
Supplements are cost-effective in the prevention and treatment of osteoporosis.
Awareness of the efficacy of calcium and vitamin D supplementation is still low and further work needs to be done to increase awareness among patients, physicians, and people at risk. This lack of knowledge was borne out in a US study, in which an extensive review of the records of male veterans at risk for osteoporosis found that only 8% received the recommended calcium and vitamin D supplementation.45