broken boneHow Much Calcium, Magnesium, and Vitamin D Should You Take?

There appears to be a lot of conflicting information regarding the optimal amounts of calcium, vitamin D and magnesium for athletes. Recommendations for calcium intake varies across the world, with the United States having one of the highest recommendations and yet also one of the highest rates of osteoporosis and fractures. The athlete’s demand is going to range based on individual (sweat loss, diet, and stress) and environmental aspects (extreme heat and cold). Calcium supplementation recently got a scare because one study that came out showed that excess calcium supplementation led to calcification of the arteries, while another one came out saying “no it doesn’t.” This is standard in the research world and one should never take the results of a supplement study with more than a grain of salt. It’s much more accurate to look at populations as a whole and look at the statistics.

The current recommendation is a roughly 2:1 ratio of calcium to magnesium, usually 1000mg of calcium and 400-500mg of magnesium in the U.S. Bones and teeth contain 99 percent of the body’s calcium, while roughly 55-60 percent of magnesium is in bone with 20-25% in soft tissues. Studies of pre-agricultural diets actually show a 1:1 ratio of calcium to magnesium, and I would argue that this is the correct amount with an optimal diet and outdoor lifestyle. The theory that dairy is needed for healthy bones is nonsense, evident by the teeth and bones from the hunter gathers being in much better shape than their agricultural counterparts.

Highest Dairy = Highest Rates of Osteoporosis

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Current statistics have shown that countries with the highest dairy consumption including Finland, Sweden, England and U.S. also have the highest rates of fractures and osteoporosis and are most likely the most vitamin D deficient. The highest incidence of osteoporotic fractures is found in northern Europe, where dietary intake of vitamin A (retinol) is unusually high. A Swedish study found that the higher rates of vitamin A may be linked to osteoporosis.

A proposed reason was a high intake of cod liver oil and dairy products. But if you read the study, you see that margarine is fortified with vitamins A and D in many countries, but Sweden is the only European country that fortifies low-fat milk products with vitamin A. Fortified milk in Sweden contains 0.45 mg of retinol per liter, almost twice the level found in normal, 3% fat milk. Vitamin A deficiency results in poor bone growth, but the most prominent features of excessive A are accelerated bone resorption, bone fragility, and spontaneous fracture.

Bone health is dependent on estrogen status in women, vitamin D levels, magnesium, calcium, boron, inositol, silicon, and K2. In post-menopausal women, estrogen levels that become too low drastically affect bone density. Vitamin D absorption and utilization goes down after age 50 and supplementation may be necessary based on your sun exposure. Research shows that the estrogenic qualities of hops in beer promote bone density in post-menopausal women. This shows that phytoestrogen-rich food may help promote bone density by enhancing estrogen activity.

Building Healthy Bones

Fish with bones, sea vegetables, wild greens, bone broths and days in the sun provided plenty of bone-building materials for the hunter-gatherers. In fact, rickets showed up in the Neolithic age from a deficiency of vitamin D and impaired calcium metabolism despite the introduction of dairy into the diet. We now know that bones require much more than calcium, magnesium, and vitamin D. They also require vitamin C, boron, inositol, silicon, K1 and K2

This isn’t to say that healthy bones and teeth haven’t been found in societies with grains and dairy. Books written about the various indigenous people that Weston Price studied were sturdy with perfectly straight, cavity-free teeth and consumed both. But its introduction does not prove a cause and effect with better bone health. So what happened? My theory is that the people of the Neolithic age consumed unleavened bread and porridge without fermentation, creating a high phytic acid diet that blocked absorption of calcium, magnesium, and other minerals. More work moved indoors, creating less sun exposure for vitamin D, further affecting calcium metabolism.

Calcium is notoriously hard to absorb (75% for children, only 30% for adults and only 30% from dairy), making any other factors affecting absorption especially problematic. A similar scene appeared in the early 1900’s when more than 80 percent of children in industrialized Europe and North America had rickets. It was during this time that the exposure to sunlight, cod liver oil and vitamin D fortification treated the problem. Interesting enough, this was the time when the diet was changing towards white flour, sugar, and processed foods and the connection between diet and disease was becoming clear. Weston Price was making his way around the world proving that indigenous cultures had 10x the amount of vitamins A and D in their diet compared to industrialized societies and were virtually free of disease. He also found that these people became riddled with health issues in only one generation when switching to a western diet. But there was something else present in these indigenous diets; something called the “x factor” which would later be discovered as vitamin K2 and is now becoming a star in the research world for its role in calcium metabolism.

Someone Forgot to Open a History Book on Nutrition

Later in the 20th century, the government created the food pyramid. They proclaimed that everyone should consume 6-11 servings of grains a day. This turned into cold cereal for breakfast, sandwich for lunch, crackers for a snack, pasta for dinner and cookies for dessert. Foods that contained saturated fat and cholesterol including liver, beef, eggs, cheese, cream and butter were shunned, and instead, lean meat, fortified juice, cereal, skim milk and hydrogenated fats like margarine were recommended instead. There are many problems here: the one related to this article is that they shunned foods rich in vitamin D, not to mention all the other fat-soluble vitamins including vitamin K2. Somehow we came full circle back to the Neolithic age with even worse additions! Either no one involved in the food pyramid had any anthropological and dietary knowledge, food corporations gained lobbying control, or it appeared to be the only way to feed an exploding population. Nutrient dense food was considered blasphemy, sugar, and vegetable oils were considered Godly, while the education of how to prepare grains to make them suitable for consumption was ignored in favor of fast production. Bravo (insert slow dramatic golf clap here).

Somehow we came full circle back to the Neolithic age with even worse additions! Either no one involved in the food pyramid had any anthropological and dietary knowledge, food corporations gained lobbying control, or it appeared to be the only way to feed an exploding population. Nutrientdense food was considered blasphemy, sugar and vegetable oils were considered Godly, while the education of how to prepare grains to make them suitable for consumption was ignored in favor of fast production. Bravo (insert slow dramatic golf clap here).

How Grains Almost Ruined Our Future Skeleton

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According to the book Neolithic by Susan Foster McCarter:

Like most people, you may have always assumed that hunter-gatherers were usually hungry, tired and sick; and that things were much better once people began producing their food and living in permanent villages. In fact, the opposite is true: hunter-gatherers were extremely healthy and Neolithic farmers were not. Paleopathologists tell us that foragers had excellent teeth, they were rarely malnourished, they were taller than most people today, and they didn’t suffer from endemic or epidemic diseases.

We know this because the evidence is in the skeletal remains. The skeletons of the early Neolithic farmers show scurvy (vitamin C deficiencies), rickets (vitamin D deficiencies), poor dental health, bone infections and a stature roughly 6 inches shorter than the hunter-gatherers. So despite an abundance of food, people were often hungry and malnourished. Why? Because the diet shifted to a grain based diet of porridge and unleavened bread. A diet that is very acidic (high in unleavened grains, hard cheeses, high sodium processed food, legumes, and grain-fed meat) without the presence of fruits and vegetables causes a net acid load and forces the bones to release calcium to buffer the acids. The sodium/potassium ratio is also what leads to a lot of health disorders.

As you can see, there is a delicate balancing act being played with calcium, and flooding the body with one mineral does not show a thorough understanding of its role. The absorption rate of calcium is kept small by foods and our body, albeit as a protective mechanism. I believe the evidence points towards a lopsided dose of calcium doing more harm than good, and that in fact it is our vitamin D status, K2, magnesium and trace mineral consumption that facilitates calcium reaching its proper destination.

Vitamin/Mineral Ratios Based on Healthy Cultures

In the book Nutrition and Physical Degeneration, Dr. Weston A. Price gathered some very interesting data on nutritional profiles from healthy, indigenous cultures from around the world. He was particularly interested in A, D, calcium, phosphorus, iron, magnesium, copper and iodine. Finding this data gave me some incredible insight into understanding possible optimal ratios. Each one listed is the amount multiplied by the western diet.

1. Native Eskimos: 5.4x calcium, 1.5x iron, 7.9x magnesium, 1.8x copper, 49x iodine, 10x vitamin A, 10x vitamin D

2. Indians of Northern Canada: 5.8x calcium, 5.8x phosphorus, 2.7x iron, 4.3x magnesium, 1.5x copper, 8.8x iodine,10x vitamin A, 10x vitamin D

3. High Mountain Swiss: 3.7x Calcium, 2.2x phosphorus, 2.5x magnesium, 3.1x iron, 10x vitamin A, 10x vitamin D

4. Gaelics in the Outer Hebrides: 2.1x calcium, 2.3x phosphorus, 1.3x magnesium, 1x iron, 10x vitamin A, 10x vitamin D

5. Aborigines of Austrailia: 4.6x calcium, 6.2x phosphorus, 17x magnesium, 50.6x iron, 10x vitamin A, 10x vitamin D

6. New Zealand Maori: 6.2x calcium, 6.9 phosphorus, 23.4x magnesium, 58.3x iron, 10x vitamin A, 10x vitamin D

7. Polynesians: 5.6x calcium, 7.2x phosphorus, 28.5x magnesium, 22.4x iron, 10x vitamin A, 10x vitamin D

8. Coastal Indians of Peru: 6.6x calcium, 5.5x phosphorus, 13.6x magnesium, 5.1x for iron, 10x vitamin A, 10x vitamin D

9. Indians of the Andean Mountains of Peru: 5x calcium, 5.5x phosphorus, 13.3x magnesium, 29.3x iron, 10x vitamin A, 10x vitamin D

10. Cattle Tribes of Africa: 7.5x calcium, 8.2x phosphorus, 19.1x magnesium, 16.6x iron, 10x vitamin A, 10x vitamin D

11. Agricultural Tribes of Central Africa: 3.5x calcium, 4.1x phosphorus, 5.4x magnesium, 16.6x iron, vitamin A 10x, 10x vitamin D

“All of the above primitive diets also provided a large increase in water-soluble vitamins (B-complex, vitamin C) over the number provided in the displacing modern diets.” – Dr. Price


What can we extrapolate from this sample of diets from around the world? The calcium levels remain fairly constant but higher than our intake, while the magnesium levels can fluctuate dramatically higher or slightly below calcium. But in not one example do you see a 2:1 ratio of calcium to magnesium as the majority of calcium/magnesium supplements often provide, and magnesium in multivitamins is barely present.

What Blocks Calcium Absorption?

There are other elements that block calcium absorption, like oxalic acid-rich foods including beets, rhubarb, celery, swiss chard, spinach, eggplant, greens, okra, squash, currants, strawberries, blackberries, blueberries, gooseberries, pecans, peanuts, tea and cocoa. Interesting enough, some of these are high in magnesium, illuminating the importance in balancing calcium status. Too much calcium affects the absorption of magnesium, while higher amounts of magnesium increase the absorption of calcium.

Calcium loss can be a problem with excessive sweat, poor dietary intake and female athletes that are not menstruating. This is a problem not only for muscle contraction but also for fracture risk. While studies have found that protein promotes urinary calcium loss, other studies have found that protein actually increases calcium absorption and decreases calcium secretion in the gastrointestinal tract to cause no change in total body calcium.1 Many of these protein foods are also high in phosphorus, which decreases calcium excretion.

Fermentation in the large intestine also plays a role and may release calcium that has bound to fermentable fibers like pectin (apples), with up to 10% of calcium being absorbed by the colon. Another reason to drink and eat fermented foods and avoid antibiotics when possible.

How Does Coffee and Alcohol Affect Calcium and Bone Health?

Caffeine in coffee pulls calcium from the bones, weakening the bone matrix and making it more prone to fractures. coffeeCaffeine also stimulates the adrenal glands to release cortisol, which can affect muscle tone, decrease bone formation and increase bone breakdown. Anything over 1 small cup of coffee per day can dramatically affect bone health. Our diet has also become very low in magnesium, due to losses in top soil from poor agricultural practices and low in water due to heavy treatment. Magnesium is a natural calcium channel blocker and needs to be in a 1:1 ratio or higher to ensure proper placement of calcium.

With just 2-3 ounces of alcohol per day, the stomach does not absorb calcium and vitamin D adequately due to interference with the pancreas. Alcohol also decreases estrogen, which is already decreasing in post-menopausal women and leads to bone loss. Hops in beer, however, help retain bone density.

The Disappearance of Magnesium and the High Need for Athletes

We have established the importance of vitamin D and K2 in the diet as major players of calcium metabolism. Now let’s look at magnesium. It is believed up to 80% are magnesium deficient in the United States. It is responsible for over 300 chemical reactions including muscle relaxation and preventing cramps. Magnesium raises testosterone levels, helps build muscle, decreases inflammation and maximizes protein synthesis, making this mineral one of the most important for athletes.

As an athlete, when adrenaline and cortisol are pumping during your sport or heavy training, this stress response is strongly correlated with decreased magnesium. Since magnesium is an integral part of nerve conduction and electrolyte balance, low levels can increase anxiety, depression, and sleep disturbances. Muscle cramps are often a sign of magnesium deficiencies, especially in the calves at night. If you are female and crave chocolate (especially during that time of the month) one of the reasons is – besides being delicious and like a giant hug – that it’s high in magnesium.

One of the reasons magnesium is so low in soils is that when you grow food in the same plot over and over again, the soil gets exhausted and the minerals are gone. Eventually, nothing will grow and you will be left with dust. Farmers adapted to this and found that rotating crops and replenishing the soil with compost helped put in more nutrients than was taken out. This became the basis for organic agriculture.

Chemical agriculture took a different approach and decided they could keep plants growing with synthetic NPK (nitrogen, phosphorus, and potassium) while neglecting all of the trace minerals like magnesium and the microorganisms. Since the plants became susceptible to disease easily due to these deficiencies, chemical agriculture’s solution was to spray the plants with neurotoxins known as pesticides.

Combine the lack of magnesium in the soil with processed foods, a high-grain diet, stress, sweat, alcohol and caffeine and presto! You have a deficiency.

*If you are female and crave chocolate (especially during that time of the month) one of the reasons is – besides being delicious and like a giant hug – that it’s high in magnesium.

No Really, How Much Calcium, Magnesium, and Vitamin D Should You Take??

According to the Physician’s Committee for Responsible Medicine, “increases in dairy or total dietary calcium intake (above 400 to 500 mg per day) are not correlated with – or a predictor of – bone mineral density or fracture rate in children or young adults.” That would make 400-500 of both calcium and magnesium the target for many people. Dr. Carolyn Dean, author of The Magnesium Miracle, claims 6-8mg per kilogram of body weight. 

It is my stance that a 1:1 ratio of calcium to magnesium is most likely optimal, with higher levels of magnesium possibly being even better.

  • 400-600mg of calcium and magnesium
  • 35-50 ng/ml of vitamin D (Sun and 500-5000IU depending on your level)
  • K2 from the diet or supplementation
  • Boron and silica from mineral water and diet

How to Hit Calcium, Magnesium, and Vitamin D Targets 

1. Gerolsteiner Mineral Water and Calcium-Magnesium Citramate 1:1 ratio

For calcium, I utilize Gerolsteiner Mineral Water, dark greens, nuts and grass-fed dairy. This allows me to hit a 500mg calcium intake every day, and get adequate boron and silica. I drink a liter of Gerolsteiner everyday (345mg calcium and 100mg magnesium most days).

The Oslo Health Study found that alkali buffers, whether bicarbonate (in Gerolsteiner), vegetables, or fruits, can reverse urinary calcium loss. The advantage of doing it this way that you get the benefits of all of the other minerals that work in concert together from both the water and diet, especially if you have a high protein diet or drink coffee.

I recommend finding Gerolsteiner in the glass liter bottles in certain grocery stores. If you can’t get it, then online is the second best choice.

If you are interested in electrolyte drinks for performance, check out the article Best and Worst Electrolyte Drinks.

2. Magnesium Citramate, Magnesium Glycinate


I have not been able to tell a difference between the two magnesium supplements. They are both excellent. Or, you can do the 1:1 calcium-magnesium product if you prefer to take both calcium and magensium.

About 40% to 60% of magnesium is thought to be absorbed by adults, putting the range higher than calcium (magnesium oxide only yields 4% absorption!). Vitamin D and the fructose from fruit also helps absorb magnesium (making eating fruit and nuts in the sun a great idea). Citramate is the preferred form that I recommend for athletes because citrate and malate increases energy, decreases muscle pain/soreness and it helps eliminate aluminum. Glycinate is preferred for those with sensitive stomachs or who are more prone to anxiety.

Amount: 6-8 mg per kilogram of body weight (weight divided by 2.2, then take that number and multiply it by 6-8)

3. Vitamin D: Sunshine during the spring and summer, extra virgin cod liver (400IU of vitamin D) during the fall and winter (except if post-menopausal), and Liquid Vitamin D Drops as needed to keep vitamin D levels in the healthy range with 2,000-4,000IU.


1. Advanced Nutrition and Human Metabolism 5th addition.

*Alex is no longer able to answer comments due to very limited time outside of Nutrition Genome. If you are interested in nutrigenomic testing, please check out