Dr. Amy Nett: Calcium supplementation is pretty iffy. I don’t remember if it was Kelsey or Laura who wrote an article about sources of calcium in a Paleo diet. I’m really hesitant around using calcium supplementation. I think even in the material this week Chris mentioned there are some studies showing some concern around giving as little as 200 milligrams of calcium daily. If you’re really worried about calcium intake, I think maybe you could consider if they’re also getting vitamin D, but I’m just not sure. I would look closely at the diet, see what calcium-rich foods you can get in there, but I have some hesitation around giving a straight calcium supplement, so I would be cautious about that and see where options might be for introducing calcium-rich foods. If you do want to do a supplement, maybe something just like 100 or 200 milligrams every other day, possibly not even every day.
The patient is getting vitamin D. Yeah, it’s low. I understand. It’s a tricky one. If you’re worried about it, do something like 100 milligrams here or there, daily or every other day. Just a small amount is pretty low risk, but at least you’ll feel like at least some calcium is getting in there. I don’t think there’s a good answer right now. I think calcium is one of those that there’s still, at least in my mind, a bit of a question mark. I know when I was growing up, I used to take a ton of calcium because we thought it was good, but now it’s not looking like that’s the case! So I would just be cautious around it. Go with a really low dose if you’re worried about that. Good question, and hopefully we’ll get more information in the next couple of years and can come up with a better, more clear answer in terms of that.