Mid-life can bring about a number of changes for a woman's physiology. A growing number of women experience very drastic hormonal issues as they move into peri-menopause and menopause. Often they complain of low libido, hair loss, weight gain, sluggishness, anxiety, hot flashes and insomnia. Natural herbal compounds can help improve hormonal regulation and quality of life in menopausal women.

Both estrogen and progesterone decline naturally through the aging process. From the age of thirty-five to fifty years of age, there is a 75% reduction in the production of progesterone in the body. During that same age range, estrogen only drops by about 35% (1).

So by menopause, the body maintains about half the amount of estrogen but has around a quarter the amount of progesterone it once had. This reduction in progesterone creates a hormonal imbalance and a state of estrogen dominance. This is the common condition for women in peri-menopause (mid-forties) and menopause.

Symptoms of estrogen dominance during menopause:

Night sweats
Hot flashes
Headaches
Decreased libido
Tiredness
Lethargy
Irritability
Hair loss
Anxiety
Nervousness
Depression
Weight gain
Sleep difficulties
Inability to concentrate
Fibrocystic breasts
Cancer (Breast, Uterine & Ovarian)
Specific herbs and nutrients to support healthy hormonal balance

There are many natural herbal compounds that work to balance estrogen and progesterone levels. These herbal compounds are called sex hormone modulators as they have the ability to coordinate the release of major sex hormones based on the conditional needs.

Here are a few herbs that regulate the formation of bad estrogen metabolites and balance sex hormone production and utilization.

Korean ginseng

Ginseng has been given the Greek name, Panax, which means "all curing" as it has remarkable adaptogenic qualities that benefit individuals no matter their phase of life or what stressors they are encountering.

Research has shown that ginseng has the ability to stabilize blood sugar by improving fatty acid metabolism.(2) This reduces stress on the adrenals and improves stamina, energy and physical performance. The compounds in ginseng also improve oxygenation throughout the body and improve the immune system.(3)

Black cohosh

Black cohosh contains triterpene glycosides that have estrogen modulating impacts on metabolism (4). These components have been shown to improve estrogen deficient type symptoms without the adverse risks of estrogen replacement therapy.

Black cohosh has been shown to decrease hot flashes, increase blood flow to the pelvic area, relieve spasms and improve hormone related mood depression (5). This substance does not stimulate the uterine tissue and promote the formation of fibroids the way estrogen replacement does (6). This is a very safe and natural compound to use in support of estrogen balance.

Don Quai

This herb, otherwise known as Angelica Sinensis, has the ability to modulate the way the estrogen receptor functions. It is believed to have compounds that have estrogenic expression but in significantly reduced potency as human estrogens in the ratio of 1:400. This herb helps to ensure optimal estrogen expression in the body.

In estrogen deficient cases, it is able to bind and influence the estrogen receptor to improve estrogen interaction with the tissue cells. In estrogen dominant patterns it competes with estrogen receptor binding and lowers the potency of estrogen on the bodily tissues. This is because its potency is so much lower than human estrogen (7).

Dong Quai also improves iron absorption in anemic cases and has anti-inflammatory and pain relieving qualities (8). It also improves cardiac function and increases vaginal lubrication (9)

Taking carnitine with omega-3 fish oil is one of the simplest things you can do to lose weight and raise your energy levels. The cool thing about carnitine is that by elevating the amount of carnitine stored in your muscles, you will see improvements in your quality of life. Fat loss and more energy are two of these benefits, but taking carnitine is known to improve all of the following:

• High-intensity work capacity

• Increase athletic performance

• Speed your recovery from intense exercise

• Make your brain work better

• Prevent oxidative stress that leads to longer term health problems such as cardiovascular disease, diabetes, and chronic inflammation

A recent study in The Journal of Physiology provides groundbreaking evidence that carnitine supplementation can improve athletic performance, something that researchers have had trouble proving for years. Emerging research on the benefits of carnitine for health in conjunction with evidence that clarifies the best ways to take carnitine (insulin must be present in the body for carnitine to be delivered into the muscle), make it time to revisit this amino acid. Let’s look at the top ten health benefits of elevating your carnitine levels with a focus on achieving optimal body composition.

1) Take Carnitine to Burn Fat: The Basics

Carnitine is an amino acid composite that is made from lysine and methionine. There are a couple of different forms of carnitine, such as acetyl-L-carnitine and L-carnitine tartrate, and we’ll look at which forms you should be taking and when. In this article, unless otherwise stated, “carnitine” will be used to refer to L-carnitine tartrate.

Carnitine is a potent fat burner because it is responsible for the transport of fats into the cells to be used for energy in the body. By raising the level of muscle carnitine, you support the fat burning process, and because your body becomes more efficient at processing fuel, it will increase your energy levels. Elevating carnitine will also improve physical performance by burning more fat, sparing glycogen, clearing muscle lactate, and increasing anabolic hormone response.

2) Pair Carnitine and Omega-3 Fish Oils For Fat Loss

For carnitine to be effective, you need to ensure you have adequate levels of omega-3 fish oils in the body. In order for your body to actually “load” carnitine that you take in supplement form into the muscles where you want it, it has to be accompanied by insulin.

Omega-3 fatty acids come into the equation because they will improve the health of every cell in your body if you get enough of them. The cells are made up of two layers of lipids or fats, which will be composed of good fats or bad fats depending on the type you eat. If the cell lipid layers are made up of omega-3s, the cell will be generally healthier, and it will also make them more sensitive to insulin. Having your cells be more sensitive to insulin allows your body to get the most energy production out of supplemental carnitine.

I mention this relationship between omega-3s and carnitine because you won’t optimally benefit from taking carnitine unless you have already attended to your omega-3s. In working with obese clients, I’ve found that using high doses of fish oil with carnitine tartrate will allow the fat to start to come off.

Omega-3s increase metabolic rate by increasing cell activity and fat burning. Carnitine is the delivery system for long chain fatty acids such that the less carnitine you have in the body, the fewer fatty acids that get into the cell, meaning you don’t burn them for energy. Instead, the fatty acids go into a depository and are stored as fat. By elevating carnitine, fat burning increases and you give the cell the right genetic machinery to raise metabolism. You’ll have more energy, feel more motivated, and any excess fat begins to come off.

3) No Need For Carbs: Carnitine with Omega-3s for Fat Loss

The new study in The Journal of Physiology, which we will highlight below starting with #5, showed that taking carnitine with carbs is effective for elevating muscle carnitine levels and improving athletic performance. But carbs aren’t necessary as long as you get adequate omega-3s. A study in the Annals of Nutrition and Metabolism showed that combining carnitine, omega-3s, and polyphenols resulted in lower blood lipid levels and better cellular energy production, which has the implication of fat loss if the study had been of longer duration—it was only 12 weeks.

Researchers found that triglycerides were lowered by 24 percent and free fatty acids decreased by 29 percent compared to a placebo group that had no changes. These changes indicate healthier markers of cholesterol, better energy use, and fat burning that will lead to fat loss. Additionally, genes that increase fat burning in the body were “activated” indicating a better metabolic profile. Take note that the polyphenols were included to raise antioxidant levels and fight oxidative stress that leads to chronic inflammation and poor cardiovascular health, among other things. They are not necessary for the carnitine to work its magic.

4) Carnitine Fights Visceral Belly Fat

Visceral belly fat is one of the toughest fats to lose once you’ve got it, and it causes numerous health problems. Once you begin to gain visceral fat around the belly, it will lead to fat gain within the organs such as the liver, the heart, or even in muscle. Fat gain in the liver leads to non-alcoholic fatty liver disease, while epicardial fat is a type of visceral fat that is deposited around the heart and is considered a metabolically active organ, altering heart function.

Raising your carnitine levels will fight this visceral fat gain because it increases fat burning, which has the effect of taking triglycerides and low-density lipoproteins out of the system so that they don’t build up causing high cholesterol and atherosclerosis. A new research study in the journal Food and Chemical Toxicology illustrates this. Researchers gave a carnitine supplement to mice who were fed a high-fat diet in order to make them gain weight. In comparison to a group of mice fed a placebo, the carnitine group gained substantially less visceral and subcutaneous fat (fat that is right below the surface of the skin that you can pinch with your fingers). The placebo group exhibited the beginning stages of non-alcoholic fatty liver disease and atherosclerosis, neither of which were evident in the carnitine group.

5) Take Carnitine To Improve Performance

The study in The Journal of Physiology is the first to show that muscle carnitine content can be increased in humans through diet . Once carnitine is elevated, metabolism in the body is dependent on the intensity of exercise, allowing for better energy use and performance.

Researchers gave a placebo or a supplement of carnitine tartrate and carbs (2 g carnitine with 80 g of carbs twice a day) to experienced athletes who were training for a triathlon three to five times a week. At various points throughout the study subjects performed the following exercise tests: two thirty-minute repeated bouts of exercise (the first at 50 percent of maximal oxygen uptake and the second at 80 percent), followed by an all-out 30-minute performance trial.

After 24 weeks of supplementation, the carnitine group increased performance from baseline by 11 percent in the exercise trials compared to no improvement in the placebo group. Participants who took carnitine also rated the trial and the exercise bout they performed at 80 percent of max to be easier than at baseline, while the placebo had no difference in rating of perceived exertion (RPE).

Two key points from this study are essential for making carnitine supplementation effective at elevating performance. First, it takes a long supplementation period to raise muscle carnitine levels and reap the benefits of improved energy production. In this study after three months there were no changes in performance or RPE from baseline, but after 6 months those improvements were pronounced and statistically significant. Somewhere between 3 and 6 months is the magic number, meaning taking carnitine is a lifestyle supplement just like omega-3s are.

Second, carnitine doesn’t accumulate or “load” in muscle unless accompanied by high insulin concentrations. This explains why many previous studies have NOT shown increases in muscle carnitine after taking it in multi-gram doses. In this study the carnitine was taken with carbs because the carbs triggered insulin release, which allowed the carnitine to load into the muscle. Take note that there is a big focus in the health world on minimizing insulin secretion from carbs for optimal body composition. This is critical, but be aware that insulin is actually a potent anabolic hormone if the cells are sensitive to it and if appropriate levels are present.

Pairing carnitine with carbs is one option, but as shown in #3, carnitine can also be paired with omega-3s, which may be more appropriate for individuals whose primary goal is to lose fat. In my experience, best fat loss results come from a 5 to 1 ratio of omega-3s to carnitine. If you’re taking 20 grams of omega-3s, you’d pair it with 4 grams of carnitine. But, if you’re more conservative with your omega-3 supplementation, you can start with 1 to 2 grams of carnitine and work up to 4 grams, which was the dose used in this study.

6) Increase Work Capacity With Carnitine

Another benefit of raising carnitine levels is that you’ll have a greater work capacity, but it will not feel as physically difficult. You’ll be able to lift more weight, complete more reps, or run faster and longer, but with more ease. This is because higher muscle carnitine levels help decreases pain, muscle damage, and markers of metabolic stress from high-intensity exercise by decreasing lactic acid production.

A higher level of carnitine increases energy production, but it also has the effect of accelerating muscle buffering by maintaining the pH of the muscle and minimizing the accumulation of hydrogen ions. Basically, carnitine helps eliminate the byproducts of intense exercise that cause pain and muscle damage (the burning you may feel when training hard), allowing you to work harder.

In the Journal of Physiology study, results show how higher muscle carnitine levels increase work capacity by reducing lactate accumulation in the muscles. Following the exercise bout at 80 percent of maximal, muscle lactate buildup was 44 percent lower in participants that supplemented with carnitine compared to the control group. Following the exercise bout at 50 percent of maximal, the carnitine group used 55 percent less muscle glycogen than the control group indicating that they burned more fat for fuel and had improved energy production. ??

The combination of less lactate buildup and greater fat burning in the two exercise bouts allowed the carnitine group to increase work output by 35 percent, while having a lower RPE. In simple terms, taking carnitine is a no-brainer if you want to improve body composition by burning more fat and be able to train at a higher level!

7) Enhance Recovery with Carnitine

Take carnitine to speed both short- and long-term recovery from intense training and you’ll have less pain, soreness, and feel more energized. Muscle lactate buildup is a limiting factor that inhibits performance and causes muscle pain, meaning that if you produce less of it and are able to clear it faster, you will have a faster recovery.

Taking carnitine will also support an anabolic response to exercise by up-regulating the androgen receptors, which will “help to mediate quicker recovery,” according to one research group. Two studies led by William J. Kraemer tested the hormonal response to taking carnitine tartrate. In one of these studies, supplementing with carnitine for 21 days produced an increase in the resting content of the androgen receptors that bind with testosterone, indicating a better anabolic environment. Following resistance exercise, participants also had increased androgen receptor content that indicated greater cellular uptake of testosterone and increased protein synthesis. Enhanced protein synthesis allows tissue that was damaged during training to regenerate faster and speed recovery.

The second study also had participants take carnitine or a placebo for 21 days and found that after intense resistance training, the carnitine group had reduced muscle tissue damage (assessed by MRI) and increased IGFBP-3 levels (a binding protein that promotes tissue synthesis). Researchers suggest carnitine supplementation helps promote recovery by producing “more undamaged tissue, (and a) greater number of intact receptors that would be available for hormonal interactions.”

8) Improve Cognitive Performance with Acetyl-L-Carnitine and Increase Motivation

A form of carnitine called acetyl-l-carnitine will give you superior brain function and increase motivation, meaning it’s a great supplement for people who want to lose weight but feel unmotivated to exercise. Acetyl-l-carnitine helps DHA omega-3 fish oils work their magic on the brain—just like carnitine tartrate, this form needs to be taken with omega-3s in order to facilitate fat burning for energy in the brain.

Acetyl-l-carnitine is a powerful antioxidant and can detoxify the brain of heavy metals we suggest pairing it with Alpha Lipoic Acid along with DHA because all together they support dopamine levels, while increasing attention span and motivation. For depressed people or those who need to lose weight, it works wonders on motivation and self-initiative, both with training and work-related tasks. And by taking acetyl-l-carnitine, you’ll still benefit from improved energy, physical performance, work capacity, and a speedy recovery, all benefits to help you achieve a lean physique.

A number of research studies support the use of acetyl-l-carnitine for a better brain. For example, a new study in the Scandinavian Journal of Gastroenterology found that giving patients with liver dysfunction acetyl-l-carnitine significantly improved their physical function, general health, overall mood, and well-being. They also reported less depression and anxiety.

9) Prevent Type 2 Diabetes and Improve Insulin Health With Carnitine

Carnitine is emerging as a supplement that can prevent type 2 diabetes because of how it improves fat metabolism. It can counter the diseases of metabolic syndrome by preventing atherosclerosis, and supporting cardiovascular health, while inducing fat loss.

Plus, raising carnitine levels will fight related type 2 diabetes factors because it has antioxidant properties, meaning it abolishes free radicals and reduces oxidative stress. The key to improving your insulin health and losing fat with carnitine is to understand that the following interrelated factors must be present for this method to be effective:

A) Take carnitine with omega-3 fish oils. Remember, a 1 to 5 ratio is suggested.

B) Adopt this supplementation protocol as a lifestyle habit, not a one time thing. Research shows androgen receptors are up-regulated after three weeks, triglycerides are improved after three months, but muscle carnitine level isn’t elevated for close to six months.

C) A high-protein diet and exercise will make it much more effective

10) Carnitine Supplementation Counters Cachexia or Wasting Disease

Raising carnitine levels can counter cachexia or wasting syndrome that is associated with diseases including cancer, AIDS, heart disease, and lung disease. Although this is not a common problem among the Poliquin readership, it should be mentioned here because carnitine supplementation is able to restore metabolic parameters in individuals with cachexia and thereby help fight the progression of life-threatening diseases.

Cachexia is characterized by progressive weight loss, muscle loss, cognitive decline, poor insulin health, inflammation, and poor organ function, among other things. Emerging evidence shows that in patients with cancer cachexia, carnitine is depleted and metabolism is impaired. A new study in Nutrition Journal found that giving carnitine to men with pancreatic cancer who were suffering from cachexia improved their lean mass, increased energy metabolism, and improved their quality of life. Using carnitine produced a trend to increased survival over the course of the study and towards reduced hospital stays.

11) Take Carnitine to Improve Male Fertility

Having adequate carnitine levels has been shown to be necessary for male fertility. One study found that fertile males had higher levels of carnitine and this was associated with healthier sperm. The men who were classified as infertile had lower carnitine and compromised sperm health. This study suggests that ensuring you have get adequate carnitine in conjunction with healthy lifestyle practices can support fertility.

12) Use Carnitine for Better Skin

A topical carnitine cream can improve the health of your skin by decreasing the amount of oil released by the pores. A new study in the Journal of Cosmetic Dermatology found that a carnitine cream increased the amount of fat that entered the cell, which decreased the oil secreted by the skin. This led to less oily skin and a smoother overall appearance. It also indicates the value of using carnitine to improve the transport of carnitine across the cellular wall to be burned for fat because Beta fat oxidation, or burning, was enhanced.

Vitamin C is best known for strengthening the immune system. This potent antioxidant also has many other important roles that control significant aspects of our health. Vitamin C helps detoxify our bodies, protects and promotes healing of all of our cells, and helps us deal with both mental and physical stress. It also supports healthy bacteria in our gut, neutralizes free radicals, is anti viral and anti bacterial, prevents and kills cancer cells, and so much more. Most people, especially children, would benefit from more vitamin C.

Natural vitamin C complexes from wholefoods are more potent than store-bought vitamin C tablets. Yellow and red peppers, guavas, dark green leafy vegetables like kale, kiwi (especially with skin), broccoli, strawberries, and watermelon all have more vitamin C than a citrus fruit without the peel.

Full disclosure, I meant a fully-grown, large watermelon. I assume I'm not the only one who can eat a large watermelon every day?

Rosehips, parsley, cilantro, and coriander are also very potent vitamin C suppliers.

The best vitamin C is the vitamin C that comes as food. It's not about how many milligrams of vitamin C you take, it's how much vitamin C your body assimilates. Citrus peels are very high in vitamin C; 100 g of citrus-peel provides around 130 mg of vitamin C. The fruit of an orange provides just 71 mg per 100 g of fruit. Citrus peels also benefit due to enzymes, phytonutrients, and important nutrition we don't even know about yet.

Save money with your own vitamin C supplement

Any organic orange, lime, or lemon peels left over from the fruit you buy will do the trick. Save all of your peels after you eat the inside of the fruit, and then cut the peels into thin strips. Place them on a plate on your dining room table and let them dry at room temperature for a couple of days until they are dry and crisp. You can also dehydrate the peels with a food dehydrator and then store them for up to a year in a dry container. For consumption, you can break up peels into smaller pieces and mix them with your favorite tea. This makes the tea taste great, but the downside to this approach is that heat destroys the enzymes. A better option is to place the peel strips into your blender or some sort of grinder and grind them into a powder (which won't hurt the enzymes). Throw the powder into your smoothie or fresh juices. One rounded teaspoon will supply you with more organic vitamin C complex, rutin, hesperidin, and bioflavonoids than your body needs for the day, regardless of your size.

This is perfect for anyone who's about to start a lemonade detox, considering the leftover lemon peels (see first source). Also look at these homemade nutrition, nutrition, calcium, and toothpaste recipes.

Beta carotene is a member of the carotenoid family belonging to the isoprenoid compounds, which are polyunsaturates with antioxidant properties. The formula for beta carotene is C40H56 and it can exist as cis- or trans-isomers. Most of the naturally-occurring and synthesized forms of beta exists as the all-trans isomer.
Where is beta carotene found?

Beta carotene is produced by plants and microorganisms, with the main sources being yellow or orange and green-leaved vegetables or fruits such as sweet potato, spinach, carrots, pumpkin, butternut squash and apricots.

Beta carotene is also available as supplements, which may be synthetic or derived from palm oil, algae or fungi. When taken as a vitamin or mineral supplement, the dose ranges form 0.4 mg to 20 mg per day.

When used as a medicine to treat vitamin A deficiency, a dose of up to 6 mg/day may be given and in cases of erythropoietic protoporphyria (EPP), up to 300 mg/day may be taken. Beta carotene is also widely used as a yellow colouring agent (EC160a) in food and drink.

Although beta carotene is not classed as an essential nutrient, it is a precursor to vitamin A and the recommended daily intake is expressed as part of the reference nutrient intake (RNI) for vitamin A as retinol equivalents (RE).
Beneficial effects of beta carotene

As a provitamin of vitamin A, the importance of beta carotene in an individual depends on their level of pre-formed vitamin A. It is therefore difficult to define a beta- carotene deficiency. Beta carotene also interacts with other carotenoids during absorption and metabolic processes.

Studies have shown an association between high dietary intake of beta carotene and a reduced risk of heart disease and cancer. This may be due to the antioxidant properties of the molecule.
Properties

The absorption of beta carotene is facilitated by dietary fats and bile salts in the small intestine. Around 10% to 90% of the total dietary beta carotene is thought to be absorbed in the gut, with absorption decreasing, the higher the intake is. Low fat diets also reduce the amount of beta carotene absorbed.

Smokers have a low blood level of beta carotene, as do individuals with a high alcohol intake and those with HIV infection. People with impaired fat absorption from diet due to conditions such as jaundice, liver cirrhosis and cystic fibrosis also have a low blood level of beta carotene. Beta carotene is excreted in the feces and sweat.

Getting enough calcium and vitamin D is essential to building strong, dense bones when you're young and to keeping them strong and healthy as you age. The information included here will help you learn all about calcium and vitamin D - the two most important nutrients for bone health.


Calcium is a mineral that is necessary for life. In addition to building bones and keeping them healthy, calcium helps our blood clot, nerves send messages and muscles contract . About 99 percent of the calcium in our bodies is in our bones and teeth. Each day, we lose calcium through our skin, nails, hair, sweat, urine and feces, but our bodies cannot produce new calcium.

That’s why it’s important to try to get calcium from the food we eat. When we don’t get enough calcium for our body’s needs, it is taken from our bones.

    Too many Americans fall short of getting the amount of calcium they need every day and that can lead to bone loss, low bone density and even broken bones.

How Much Calcium Do You Need?

The amount of calcium you need every day depends on your age and sex.

Women

Age 50 & younger
    

1,000 mg* daily

Age 51 & older
    

1,200 mg* daily

Men

Age 70 & younger
    

1,000 mg* daily

Age 71 & older
    

1,200 mg* daily

*This includes the total amount of calcium you get from food and supplements.


    How Much Calcium Do You Need?

    Use the International Osteoporosis Foundation's Calcium Calculator to find out.

Sources of Calcium
Calcium-Rich Food Sources

Food is the best source of calcium. Dairy products, such as low-fat and non-fat milk, yogurt and cheese are high in calcium. Certain green vegetables and other foods contain calcium in smaller amounts. Some juices, breakfast foods, soymilk, cereals, snacks, breads and bottled water have calcium that has been added. If you drink soymilk or another liquid that is fortified with calcium, be sure to shake the container well as calcium can settle to the bottom.

    A simple way to add calcium to many foods is to add a single tablespoon of nonfat powdered milk, which contains about 50 mg of calcium. About two-to-four tablespoons can be added to most recipes.

Reading Food Labels - How Much Calcium am I Getting?

To determine how much calcium is in a particular food, check the nutrition facts panel of the food label for the daily value (DV) of calcium. Food labels list calcium as a percentage of the DV. This amount is based on 1,000 mg of calcium per day. For example:

    30% DV of calcium equals 300 mg.
    20% DV of calcium equals 200 mg of calcium.
    15% DV of calcium equals 150 mg of calcium.

Calcium Supplements

The amount of calcium you need from a supplement depends on the amount of calcium you get from food. Aim to get the recommended daily amount of calcium you need from food first and supplement only if needed to make up for any shortfall. If you get enough calcium from the foods you eat, then you don’t need to take a supplement. In fact, there is no added benefit to taking more calcium than you need in supplements and doing so may even have some risks.  

In general, you shouldn’t take supplements that you don’t need. Calcium supplements are available without a prescription in a wide range of preparations (including chewable and liquid) and in different amounts. The best supplement is the one that meets your needs based on convenience, cost and availability. When choosing the best supplement to meet your needs, keep the following in mind:

    Choose brand-name supplements with proven reliability. Look for labels that state “purified” or have the USP (United States Pharmacopeia) symbol. The “USP Verified Mark” on the supplement label means that the USP has tested and found the calcium supplement to meet certain standards for purity and quality.
    Read the product label carefully to determine the amount of elemental calcium, which is the actual amount of calcium in the supplement, as well as how many doses or pills to take. When reading the label, pay close attention to the “amount per serving” and “serving size.”
    Calcium is absorbed best when taken in amounts of 500 – 600 mg or less. This is the case when you eat calcium rich foods or take supplements. Try to get your calcium-rich foods and/or supplements in smaller amounts throughout the day, preferably with a meal. While it's not recommended, taking your calcium all at once is better than not taking it at all.
    Take most calcium supplements with food. Eating food produces stomach acid that helps your body absorb most calcium supplements. The one exception to the rule is calcium citrate, which can absorb well when taken with or without food.
    When starting a new calcium supplement, start with a smaller amount to better tolerate it. When switching supplements, try starting with 200-300 mg every day for a week, and drink an extra 6-8 ounces of water with it. Then gradually add more calcium each week.
    Side effects from calcium supplements, such as gas or constipation may occur. If increasing fluids in your diet does not solve the problem, try another type or brand of calcium. It may require trial and error to find the right supplement for you, but fortunately there are many choices.
    Talk with your healthcare provider or pharmacist about possible interactions between prescription or over-the-counter medications and calcium supplements.

What is Vitamin D and What Does it Do?

Vitamin D plays an important role in protecting your bones and your body requires it to absorb calcium. Children need vitamin D to build strong bones, and adults need it to keep their bones strong and healthy. If you don't get enough vitamin D, you may lose bone, have lower bone density, and you're more likely to break bones as you age.
How Much Vitamin D Do You Need?

Women and Men

Under age 50
    400-800 international units (IU) daily**

Age 50 and older
    800-1,000 IU daily**

 **Some people need more vitamin D. According to the Institute of Medicine (IOM), the safe upper limit of vitamin D is 4,000 IU per day for most adults.
Sources of Vitamin D

There are three ways to get vitamin D:

    Sunlight
    Food
    Supplements

Sunlight

Your skin makes vitamin D from the ultra-violet light (UVB rays) in sunlight. Your body is able to store the vitamin and use it later. The amount of vitamin D your skin makes depends on time of day, season, latitude, skin pigmentation and other factors. Depending on where you live, vitamin D production may decrease or be completely absent during the winter.

Because of concerns about skin cancer, many people stay out of the sun, cover up with clothing and use either sunscreen or sunblock to protect their skin. The use of sunscreen or sunblock is probably the most important factor that limits the ability of the skin to make vitamin D. Even an SPF (sun protection factor) of 8 reduces the production of vitamin D by 95 percent. Because of the cancer risk from the sun, most people need to get vitamin D from other sources, including eating foods rich in vitamin D and taking vitamin D supplements.
Food

Vitamin D is naturally available in only a few foods, including fatty fish like wild-caught mackerel, salmon and tuna. Vitamin D is also added to milk and to some brands of other dairy products, orange juice, soymilk and cereals.

Check the food label to see if vitamin D has been added to a particular product. One eight ounce serving of milk usually has 25% of the daily value (DV) of vitamin D. The DV is based on a total daily intake of 400 IU of vitamin D. So, a serving of milk with 25% of the DV of vitamin D contains 100 IU of the vitamin.

It is very difficult to get all the vitamin D you need from food alone. Most people need to take vitamin D supplements to get enough of the nutrient needed for bone health.
Supplements

If you aren't getting enough vitamin D from sunlight and food, consider taking a supplement. But, before adding a vitamin D supplement, check to see if any of the other supplements, multivitamins or medications you  take contain vitamin D. Many calcium supplements also contain vitamin D.

There are two types of vitamin D supplements. They are vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Both types are good for bone health.

Vitamin D supplements can be taken with or without food. While your body needs vitamin D to absorb calcium, you do not need to take vitamin D at the same time as a calcium supplement. If you need help choosing a vitamin D supplement, ask your healthcare provider or pharmacist to recommend one.

    How Much Vitamin D Should You Supplement?

    To figure out how much vitamin D you need from a supplement, subtract the total amount of vitamin D you get each day from the recommended total daily amount for your age. For example, a 55 year old woman who gets 400 IU of vitamin D from her calcium supplement should take between 400 and 600 additional IU of vitamin D to meet the 800 - 1,000 IU recommended for her age.

Vitamin D Deficiency: Are You at Risk?

Vitamin D deficiency occurs when you are not getting the recommended level of vitamin D over time. Certain people are at higher risk for vitamin D deficiency, including:

    People who spend little time in the sun or those who regularly cover up when outdoors;
    People living in nursing homes or other institutions or who are homebound;
    People with certain medical conditions such as Celiac disease and inflammatory bowel disease;
    People taking medicines that affect vitamin D levels such as certain anti-seizure medicines;
    People with very dark skin;
    Obese or very overweight people; and
    Older adults with certain risk factors.

Talk to your healthcare provider if you meet any of these risk factors or  think you might be at risk of vitamin D deficiency. If you have osteoporosis and also have a vitamin D deficiency, your healthcare provider may temporarily prescribe a higher dose of vitamin D.