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Calcium and vitamin D have been shown to be of benefit in the prevention and treatment of osteoporosis in both men and women. Mechanisms include improved intestinal absorption of calcium and decreased parathyroid hormone levels, resulting in decreased bone resorption. This results in the decrease of fractures secondary to osteoporosis. It is of particular importance in postmenopausal women in whom there is no longer a positive action of estrogen on the gastrointestinal absorption and renal tubular resorption of calcium. Those at highest risk are those who are housebound or with decreased exposure to sunlight, where 25-OH vitamin D declines and serum PTH increases. Calcium absorption is also decreased in smokers. The combination of calcium and vitamin D has also been shown to prevent bone loss at the lumbar spine and forearm in corticosteriod treated patients. Of interest is that continuous low-dose hormone replacement therapy combined with adequate calcium and vitamin D provides a bone-sparing effect that is similar or superior to that provided by other, higher-dose hormone replacement therapy regimens in elderly women. There is also support for the hypothesis that high intake of calcium may be beneficial in the prevention of rectal cancer.


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