In a nutshell, in wee short words please for my ME/addled brain. What supplements are best - and fastest - for bone health? I can’t have any of the new drugs via infusion etc so need to rely on diet and supplements and I don’t know what to take. The more I research the more muddled I get 
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The main two
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Vitamin D3 – most important. About 800–1,000 IU (20–25 mcg) a day. Ask your GP for a blood test first, as if you’re low they may give a bigger dose to top you up if you are deficient.
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This is one of the most important things to find out and worth getting private blood test if nhs won’t do it.
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Calcium – aim for about 1,000–1,200 mg a day in total, food first (milk, yoghurt, cheese, tinned fish with bones, fortified oat milk). Only take a tablet to fill the gap, and no more than about 500 mg at a time. Too much from pills isn’t good for you.
Maybe helpful
- Magnesium – helps the body use calcium and vitamin D. However to be taken at different times and not in multivitamin. as magnesium and calcium cancel each other out absorption wise if taken together. so you don’t get the benefit and
- if by any chance anyone has a underactive thyroid the timing of taking calcium is important.
- Vitamin K2 – Check first if you take blood thinners.
Also matters
- Enough protein at each meal.
- Gentle weight-bearing movement if your energy allows, even just standing or short walks. I sometimes just do them when resting
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MANY THANKS Catherine, that’s very helpful. I don’t eat yoghurt or cheese or fish, so I will make sure I drink a lot of milk. I take a calcium +vit k pill once a day but am on blood thinners so will watch that, and I’ve been taking vitD for years so that’s ok. Great help tyvm 
Many thanks, Maryem. The only reason I suggest getting a recent vitamin D test is that I took vitamin D for years, and my test came back insufficient and low.
I definitely thought I was well covered, and it has made a huge difference to my energy levels. For some people, 1000 IU does not touch the sides. My endocrinologist has me on 3000 IU daily as a maintenance dose to keep me at an optimal vitamin D level of 80 to 90.
I was put on a weekly dose 50000 UI for 6 weeks as a loading dose first to bring up my levels quickly
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I was taking 4000iu a day but realise I’ve been forgetting. Onnit now!
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Hi, I have a bit of a follow up question regarding supplements if anyone could help… I take a calcium+vit D3 supplement as well as magnesium and iron supplements (they were all prescribed by my doctor following blood tests and I have been taking them for a long time now). I’m starting to be a bit confused about their timing though. The only thing my doctor told me was to take them at least 30 mins before food as otherwise they will not absorb as they should. So I’ve been taking all three of them in the evening at the same time before dinner.
Should I be spacing these apart from each other? I searched online and see in-consistent information regarding supplements canceling each other out. If anyone could offer some advice on this, it would be very much appreciated!!
Yes, my recommendation is you should space them out, especially the iron. Taking all three together probably means they’re absorbing noticeably less iron than intended. This is the advice I was given, but please check with your pharmacy.
The main clash: calcium and iron. Calcium reduces iron absorption quite significantly, so these two should be kept at least 2 hours apart. This is the most consistent advice out there.
Magnesium can also reduce iron absorption, particularly antacid-type forms such as magnesium oxide. At higher doses it competes a little with calcium too. Keeping it separate from both is the tidiest approach.
The “30 minutes before food” rule doesn’t suit all three:
- Iron does absorb best on an empty stomach, so that advice fits. Taking it with vitamin C (a glass of orange juice) helps. Tea, coffee and dairy within an hour or two of it reduce absorption.
- Calcium carbonate (the most common type, e.g. Adcal-D3, Calcichew) actually needs stomach acid and absorbs better with food. Calcium citrate is fine either way. Vitamin D is fat-soluble, so it also does better with a meal.
- Magnesium can be taken with or without food. With food is gentler on the stomach.
A typical schedule would be:
- Iron in the morning, 30–60 minutes before breakfast, with water or orange juice and no tea or coffee
- Calcium + D3 with lunch or dinner
- Magnesium at bedtime, or at a different meal from the calcium
It’s worth checking the exact product names with a pharmacist, who can confirm in two minutes. Some brands differ, and iron and calcium also interact with other medicines such as thyroid tablets and some antibiotics. Anyone taking those would need to space them as well.
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Hi everyone,
We just wanted to drop in with some information, as supplements and nutrition bone health are important topics that can bring up lots of questions. 
Our website has information about food and supplements including calcium, and other vitamins and minerals for bone health.
We also have information about Vitamin D and concerns mentioned here, including:
Do I need to take a Vitamin D supplement?
The NHS also has information about taking iron supplements alongside other medicines and supplements that might be helpful: Taking ferrous sulfate with other medicines and herbal supplements - NHS
@maryem you mentioned that the more you read, the more muddled you feel -something that we’re sure lots of people will relate to. If it would help to chat through your situation, we warmly welcome you to contact our specialist osteoporosis nurse helpline.
It’s been great to see everyone sharing their experiences. Thank you for being part of this thoughtful conversation, and we hope you can keep chatting and supporting one another here
Wishing you all the best,
Lulu
ROS Moderator
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Thank you so much, that is very helpful! 
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Vit D should be taken with a fatty meal.
I’m currently using Vitabiotics Osteocare Original. These are tablets containing Calcium, Magnesium and D3 all in the same tablet. They are endorsed by the Royal Osteoporosis Society. I assume therefore is is ok to take these supplements together.