What supplements are recommended for bone health?

[Music] what supplements are recommended for bone health all patients should be treated with making sure they have adequate calcium vitamin D vitamin D is typically about a thousand international units a day I'm comfortable giving patients up to 2,000 international units a day of vitamin D for calcium typically about a thousand maybe 1,200 milligrams each day that can mean divided doses to pick the three to four to 500 take them with a meal it can be through either supplements or through calcium provided through meals there's not much data about it's basically just a recommendation that comes from osteoporosis treatment when elderly individuals have also paralysis we recommend that they take vitamin D usually our vitamin D is produced by our skin exposed to sun the problem is that often times I mean we should protect ourselves from the Sun because of skin cancer risk therefore we protect ourselves which is good but on the other hand we don't have enough vitamin D so we should supplement vitamin D that's one recommendation and if myeloma patient is on a bone strengthening agent like denosumab or solid Roenick acid then we recommend to also take calcium to provide enough calcium in the blood to to be built into the bone by the bone building cells problem bears if a patient is progressing they might have calcium coming out of their bones because of the over activation of the bone eating cells the osteoclasts if we then take calcium in addition to that that might be dangerous because it might be a too high level usually we recommend bone supplements with vitamin D and calcium while a patient is in remission and while the patient is getting a bone strengthening agent [Music]