Calcium and Vitamin D
What are Calcium and Vitamin D?
Calcium and vitamin D are essential nutrients throughout our lives. They are needed to maintain bone strength and
density. Calcium is also needed for blood clotting, muscle contraction and normal nerve function. Vitamin D is
needed for calcium absorption and transport to the bones.
How much do I need?
Calcium: A measurement of calcium in the blood does not tell us if we are receiving enough of this nutrient in our
diet. Therefore, we use the recommended intake levels which are listed below.
Vitamin D: Vitamin D levels are measured with a lab test called 25-hydroxy vitamin D.
The SCCA normal reference range for 25-hydroxy vitamin D is 30-50 ng/ml.
Calcium and vitamin D needs are greater in certain groups of people, including:
 People taking prednisone, decadron or a similar corticosteroid drug
 People with osteopenia or osteoporosis
 Children and teens
 Post-menopausal females
Daily calcium and vitamin D requirements
Age and Gender:
Males and Females:
1-3 years
4-8 years
≥ 9-18 years
19-50 years
50-70 years
Over 70 years
Post-menopausal females not receiving hormone replacement
therapy
Children receiving steroid therapy
1-5 years
6-8 years
≥ 9-18 years
Adults diagnosed with osteopenia, osteoporosis or receiving
steroid therapy
Calcium
Adequate Intake
700 mg
1000 mg
1300 mg
1000 mg males
1200 mg females
1200 mg
1200 mg
Vitamin D
Adequate Intake
600 IU
600 IU
600 IU
600 IU
600 IU
600 IU
800 IU
1500 mg
600-800 IU
1000 mg
1200 mg
1500 mg
600 IU
600 IU
800 IU
1500 mg
1000 IU
Choosing a calcium/vitamin D supplement
If you are unable to get enough calcium or vitamin D from food, consider a supplement. Vitamin D can either
come in a calcium supplement or taken separately. Discuss with a dietitian which one is a better choice for you.
If




taking a supplement remember:
Take supplements 2-3 times a day for better absorption. We only absorb up to 500 mg at one time.
Do not take a calcium supplement within 2 hours of MMF or Myfortic.
Calcium citrate products such as Citracal can be taken with or without food.
Calcium carbonate products such as Caltrate, calcium chews and Tums must be taken with food for best
absorption and prevent stomach and/or intestinal upset.
Calcium content of selected supplements
Calcium supplement
Serving
Size
Calcium (mg)
Vitamin D (IU)
Caltrate 600 + D
1
600
400
Citracal + D
1
315
200
Calcium/Vitamin D chews
Regular Strength
*Tums:
E-X
Ultra
500 Calcium Supplement
1
1
1
1
1
500
200
300
400
500
200
0
0
0
0
* Not generally recommended since they do not contain vitamin D
The majority of multivitamins contain 200 mg calcium and 400 IU vitamin D. The remainder of calcium and
vitamin D needs can be met with diet and/or supplements. See tables below for information of calcium and
vitamin D content of foods.
How to read a food label for calcium and vitamin D content
Calcium: Multiply the % calcium by 10 to know the milligrams calcium per serving. For example, a food product with
20% calcium has 200 mg per serving.
Vitamin D: The % vitamin D shown on a food label is based on a recommended daily intake of 400 IU. For example,
if the label states that the product contains “25% Daily Value” of vitamin D, this would equal 100 IU vitamin D.
Vitamin D in supplements and food is measured in international units (IU).
Calcium Content of Selected Food (actual amount varies with brand)
Food
Serving size
Mg Calcium
Ricotta cheese
½ cup
300
Swiss cheese
1 ounce
270
Cheddar cheese, mozzarella, Monterey jack
1 ounce
200
String cheese stick
1 ounce
150
Parmesan cheese
1 Tablespoon
70
Cottage cheese
¼ cup
35
Cream cheese
1 Tablespoon
12
Milk, calcium fortified
1 cup
400
Milk (nonfat, 1%, 2%, whole, buttermilk)
1 cup
300
Soy milk, calcium fortified
Yogurt (soy or cow’s milk)
1 cup
6-8 ounces
300
200-500
Macaroni and Cheese
1 cup
100-300
Tofu
Soybeans (cooked)
½ cup
1 cup
130
175
Ice cream
Other plant foods:
Blackstrap Molasses
½ cup
60
2 Tablespoons
400
Total Cereal
1 cup
500
Juice, calcium-fortified
1 cup
300
Energy bar
1 each
200-350
Brewer’s yeast*
3½ ounces
210
Watercress
3½ ounces
150
Bok Choy
1 cup
160
1 cup
3½ ounces
3½ ounces
1 cup
2 Tablespoons
2 Tablespoons
¼ cup
½ cup
½ cup
150-180
120
110
100
130
85-100
100-150
65
50
Cheese products:
Milk and Soy products:
Greens (turnip, collard, beet, dandelion, mustard)
Sunflower seeds
Sesame seeds
Broccoli
Tahini
Almond butter, Sesame butter
Nuts (almonds, chestnuts, filberts, walnuts)
Beans (legumes):
kidney, garbanzo, black-eyed
baked or refried
Vitamin D content of selected foods (actual amount varies with brand)
Food
Serving size
IU Vitamin D
Herring
3 ounces
1385
Halibut
3 ounces
510
Canned Salmon
3 ounces
500
Mackerel
3 ounces
300
Canned Tuna
3 ounces
200
Shrimp
3 ounces
150
Sardines
2 each
65
Milk (nonfat, 1%, 2%, whole, buttermilk)
1 cup
100
Soy milk, calcium/vitamin D fortified
1 cup
100
Tofu
⅓ cup
130
Other foods:
Juice, calcium/vitamin D fortified
1 cup
100
3 ounces
90
Fish/seafood:
Milk and Soy products:
Sunflower seeds
* Not all foods on this list are allowed on the Immunosuppressed diet. If you have questions about foods on this list, please contact your
SCCA dietitian or call 206.288.1148 to be directed to a dietitian.
Notes:
References/for more information:
National Institutes of Health, Office of Dietary Supplements:
Calcium: http://ods.od.nih.gov/factsheets/Calcium-Consumer/
Vitamin D: http://ods.od.nih.gov/factsheets/VitaminD-Consumer/
The Vegetarian Resource Group
http://www.vrg.org/nutrition/calcium.htm#table1
The material in this handout was intended to be given as part of a nutrition consult by a SCCA registered
dietitian. For information about how to schedule a nutrition consultation, please call SCCA Nutrition Services
at 206.288.1148.
©2011 Seattle Cancer Care Alliance