These are doses tested in research, not personal advice. Some exceed the upper limit because they were short courses or given under medical care.
Strong evidenceStrong: meta-analyses of randomised trials or a large trial, with results that agree.Based on 1 meta-analysis.How grades workNo benefit or harm found
Prevent fractures
No single dose
Systematic review (BMJ 2015): calcium from food was not linked to fewer fractures, and supplements gave small, inconsistent benefits that disappeared in the best-quality trials. The authors advised against raising calcium intake just to prevent fractures.
Why: Calcium carbonate is 40% calcium, so you need fewer or smaller tablets. It needs stomach acid, so it only works taken with food. In a trial in people who make no stomach acid, fasting absorption was 4% from carbonate against 45% from citrate; taken with breakfast, carbonate absorbed normally.
Alternatives: Calcium citrate is 21% calcium but needs no stomach acid, so pick it if you take a proton pump inhibitor or another acid blocker, or if you cannot take it with a meal. It also causes less gas, bloating and constipation. Absorption is best at 500 mg or less at a time.
Vitamin DStrong evidenceStrong: meta-analyses of randomised trials or a large trial, with results that agree.Based on 1 official reference.How grades work
Vitamin D is needed to absorb calcium in the gut. Calcium supplements work best when your vitamin D intake is adequate.