How to get your calcium and magnesium balance right

© Kristina. Avocado: 29 mg magnesium per 100 g
© Kristina. Avocado: 29 mg magnesium per 100 g. Avocados are also a super source of vitamin E and folate.

Your calcium to magnesium ratio is a very big deal indeed, and over the long term, will affect your health in dramatic ways — for your heart, your bones, your energy, and your mind.

Nearly everyone is magnesium deficient

Magnesium is critical, and yet nearly everyone is deficient. It’s hard to get optimal amounts in your diet unless you carefully plan it. And our food has less than it should because of intensive farming and the use of herbicides like glyphosate that bind to magnesium and other minerals in soil. 

We need magnesium for over 700 enzymes, we need it to make energy, DNA, RNA and proteins. and it’s a structural part of healthy bone. Muscle energy in your body is solely in the form of Mg2-ATP — magnesium-adenosine triphosphate.

I believe in getting nutrients from food, because nutrients come with their natural cofactors, other elements that help the body use them, but magnesium is one nutrient that may be wise to supplement.

A hundred years ago, our diet might have had around 500 mg of magnesium a day. These days, it could be as low as 200 mg. And magnesium is so easily lost in sweat if you train hard, it’s lost if you’re stressed, take drugs, drink alcohol or caffeine, smoke and so on. Hard to get and easily lost.

Deficiency of magnesium can cause a whole array of symptoms… anxiety and panic attacks, irritability, agoraphobia, depression, fatigue, sensitivity to bright light and loud noise, cramps, restless legs syndrome, constipation, high blood pressure, heart palpitations and arrhythmias and insomnia — tired and wired. These are the most common symptoms but there is hardly a disease state that magnesium deficiency isn’t implicated as a causal factor.

Balance is critical to health

To add to the problem, magnesium needs to be in balance with calcium. They have opposite functions — for example calcium contracts muscles, magnesium relaxes muscles. The ideal ratio of calcium to magnesium is thought to be 1:1 to 2:1 so if you’re getting say 800 mg calcium, you’d need 400 – 800 mg magnesium. That’s a whole lot more than 200 mg. Most people’s ratio is 5:1 or higher and that’s a major problem over the long term.

A lot of people take calcium supplements because they believe it’s good for bones. The truth is that calcium supplementation is now clearly understood to have been a serious error. The real culprits in osteoporosis are deficiencies in magnesium and vitamins D and K2. Our diets and lifestyles have become unbalanced, our bodies aren’t getting what they need — not enough sun for example, and the wrong foods, that mean our bodies lose the ability to maintain the best health over the long term.

What troubles me most is the excessive calcium recommendations in the US — above 1000 mg a day for adults, because high calcium is dangerous when magnesium and vitamin K2 is low, and people aren’t stopping at 1000 mg. It’s quite easy to be getting 2000 mg a day with a combination of a dairy rich diet, fortified foods like orange juice and coconut milk, and supplements.

Harvard School of Public Health agree:

“Currently, there’s no good evidence that consuming more than one serving of milk per day in addition to a reasonable diet (which typically provides about 300 milligrams of calcium per day from non-dairy sources) will reduce fracture risk. Because of unresolved concerns about the risk of ovarian and prostate cancer, it may be prudent to avoid higher intakes of dairy products.”

Compare and contrast the US recommendations to the UK (700 mg) and the World Health Organization (WHO) (500 – 700 mg). The high calcium recommendations appear to be a reflection of poor lifestyles, e.g. poor vitamin D status, magnesium deficiency, acid load diet, lack of exercise, high sodium intakes etc, but upping the calcium is not the answer, getting all lifestyle factors working together naturally, is.

It’s calcium balance that is a critical factor for bone health. The acid-base status of the total diet rather than calcium intake or excretion determines calcium balance.1 When the diet has an overall net acidic load, the body breaks down bone as a calcium buffer for blood.2

In a healthy diet where there is a net base load from lots of fruits and vegetables, less calcium is desirable. It seems to me that the UK and WHO recommendations in the context of a healthy lifestyle are about right.

Vitamin D status is a major factor when it comes to calcium needs. People don’t get enough sun and are deficient, but with normal blood levels of 25-hydroxyvitamin D above 30 ng/ml, calcium intakes of 600 mg a day maximize bone health.3 So vitamin D status is far more important for bones than overdosing on calcium, which has negative effects for heart and vascular health. Vitamin D improves calcium absorption by activating calcium-binding proteins in our intestinal cells and regulates the vitamin K2-dependent proteins osteocalcin and matrix gla which are essential to get calcium into bones and out of arteries. So calcium and vitamin D are intimately connected, and calcium needs depend on vitamin D status.

BUT trying to correct vitamin D deficiency in a magnesium deficient state will make matters worse because magnesium is needed in vitamin D metabolism. And without adequate vitamin K2 to get calcium in the right places, it leads to calcification of soft tissues and arteries. The clear answer is to optimize calcium, magnesium, vitamin D and vitamin K2 together.

Getting your ratio right with support from vitamins A, D and K2

All nutrients work synergistically. People with bone health issues need a holistic approach that might look something like this:

  • Net base diet. Lots of fruits and vegetables. Human food.
  • Calcium intake around 700 mg a day. For people who eat some dairy products, this is easy to get from food. E.g. just 1 cup milk and 2 oz Brie (rich in K2) is 380 mg calcium, and will mean overall daily calcium at around 700 mg where we want it. So you see how easy it is to get too much.
  • Magnesium intake 700 mg a day, from a good diet and 300 – 400 mg magnesium supplement — magnesium citrate, glycinate or threonate. I think it’s a good idea to vary the type. Take with meals 2 or 3 times a day e.g. 2 x 200 mg, or 3 x 100 mg.
  • Vitamin A as retinol from animal source foods, also called preformed vitamin A, is very important e.g. for removing excess calcium but needs to be limited for balance e.g. 4 oz liver once a week or liver pâté (I add ½ oz to my salad most days instead of having liver) and pastured eggs. Liver and eggs are also great sources of choline and B12, which most people are deficient in so it’s good to get these in your diet habitually. Vitamin A precursors like carotenoids which your body can convert to retinol come from fruits and vegetables and don’t need to be limited. Don’t take supplements with retinol/preformed vitamin A, or take into account in your overall plan.
  • Vitamin D (actually a hormone) through summer sun exposure, 30 minutes if you have fair skin with as much skin exposed as possible. Darker skin will need longer. Close to noon is best, but between 10 a.m. and 3 p.m. when UVB is strongest. There’s an app called D minder, that estimates how much vitamin D you make outside depending on where you are, skin type, time of year, time of day etc.  In winter, I suggest supplementing vitamin D3 2000 IU a day based on the latest advice from endocrinologist Michael Holick who’s been researching vitamin D for 40 years. Another option for winter, and probably the best one is to use a safe tanning bed, which have electronic ballasts. Ideally, test your blood 25 hydroxy D levels every 3 to 6 months and aim for 40-50 ng/ml (100-125 nmol/l). This appears to be the natural level for humans e.g. the Hadza in Tanzania were tested at 43.6 ng/ml.5 Each 100 IU of oral vitamin D3 raises blood levels by approximately 1 ng/ml. If you have any symptoms of magnesium deficiency when changing your D habits by sun or supplements, like palpitations or anxiety, you need to correct magnesium first.
  • Vitamin K2. Optimal dose hasn’t been established but I suggest 5 mg menaquinone-4 (MK-4, menatetrenone) as an initial therapeutic dose. Vitamin K2 comes in MK-4 and MK-7 forms in supplements, needed to get calcium in the body where it needs to be, in bones and teeth, not arteries, and it protects against vitamin D toxicity. Like magnesium, nearly everyone is deficient, because our eggs and butter and other natural sources are either missing from the diet or come from industrially raised animals not fed on grass. The MK-7 K2 derived from natto can build up in the system in some people and cause heart palpitations. It also stays in the blood longer than MK-4 and some experts believe that’s because the MK-4 K2 is getting into tissues where it needs to be. MK-4 is the form found naturally in the diet in animal products like pastured butter, eggs, liver, and meat. MK-4 is the type used in studies showing great benefit of K2 for bone health — it’s been more thoroughly studied. For these 4 reasons I recommend MK-4. Vitamin K2 supplementation dramatically reduces fracture rates5 and even reverses arterial calcification.6 I’ve even read reports of varicose veins disappearing with K2 supplementation. I like Thorne Research MK-4 drops — each drop has 1 mg MK-4. 1 mg a few times a week seems like a good maintenance dose.
  • Exercise. Stressed bones get stronger.
  • Homemade bone broth if you have the time and inclination, to use in sauces, soups and stews — rich in collagen and extracellular matrix. What I do is use the bones from roast chicken, in a pot with carrot, onion, celery, sea salt and pepper. Boil for 2-6 hours (6 is best) making sure the bones and veg are covered at all times. Strain and freeze in ice cube trays, then put the cubes in a bag to save freezer space. Then you have real “stock cubes” to make a quick sauce with butter and garlic, add to stews etc. If you want to go the extra mile, you can get bones and joints from your butcher.

And really, it’s going to be a similar program for everyone, because we want to prevent bone problems, and calcium and magnesium are not only about bones, they are involved in countless biochemical functions. Understanding the synergy of nutrients is the answer to the calcium paradox, the fact that people in developing countries and Asia, where calcium intakes are low, have low rates of osteoporosis. The fact is that other factors in their lifestyles are protecting them, like plenty of sunshine or traditional use of fermented foods like natto that provide lots of vitamin K2. It was never just about calcium.

The diet in Happy Guide will typically give you 350 to 450 mg magnesium a day for 2000 to 2500 calorie intakes. If you’re not stressed, or have any other lifestyle depleters of magnesium, and you limit dairy to the recommended types and get roughly the right amount of calcium, all is well.

BUT if you’re currently not having an optimal diet, exercising hard, stressed, OR have any symptoms of magnesium deficiency, then I recommend taking 200 to 400 mg a day of magnesium in the citrate or chelated form.

For chronic health issues, test and optimize

If you have chronic health issues, it’s imperative to get this right. I recommend tracking your diet on Cronometer and see how much calcium and magnesium you are getting. Some types of dairy like milk, yogurt and cheese are very rich in calcium and it doesn’t take that much to push your intake way too high. It’s also a good idea to test your 25 hydroxy D levels and get a magnesium RBC test every 3 months and optimize. Optimal vitamin D levels to aim for are 40-50 ng/ml (100-125 nmol/l) and optimal magnesium RBC is 6.0 – 6.5 mg/dl in a normal range of 4.2 – 6.8 mg/dl.

For everyone

I like to get and recommend all nutrients from food, but I think magnesium is a special case. Most people will benefit from a 200 mg insurance of magnesium a day. That’s my current thinking. So say you normally have around 2000 calories, and shoot for 700 mg calcium a day, then you’d be getting around 350 mg magnesium on a healthy diet plus 200 mg supplement. 700 mg Ca : 550 mg Mg. These numbers feel very good to me for the long term.

Magnesium is certainly one nutrient we need to be aware of because it’s so important to get right, and get in balance with calcium, A, D and K2, and of course everything else, because everything affects everything else.


  • If you have kidney disease, be sure to talk to your healthcare provider before taking magnesium supplements.
  • If you are taking Warfarin, please click here to read about Warfarin and vitamin K, and talk to your healthcare provider before altering your vitamin K2 (or vitamin K1) habits.
  • All data in this article refers to adults not pregnant or breast-feeding.

Best wishes,
Michael Kinnaird

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1. Barzel US. The skeleton as an ion exchange: implications for the role of acid-base imbalance in the genesis of osteoporosis. J Bone Miner Res. 1995; 10: 1431-36

2. Barzel US, Massey LK Excess dietary protein can adversely affect bone. J Nutr 1998; 128:1051-53

3. Bischoff-Ferrari HA et al. Dietary calcium and serum 25-hydroxyvitamin D status in relation to BMD among U.S. adults. Journal of Bone and Mineral Research 2009 May;24(5):935–42. doi:10.1359/jbmr.081242

4. Luxwolda MF et al. Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115 nmol/l. British Journal of Nutrition 2012 Jan 23:1–5, [epub ahead of print]. doi:10.1017/S0007114511007161

5. Cockayne S et al. Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. Archives of Internal Medicine 2006 Jun 26;166(12):1256–61,

6. Schurgers LJ et al. Regression of warfarin-induced medial elastocalcinosis by high intake of vitamin K in rats. Blood 2007 Apr 1;109(7):2823–31,

38 thoughts on “How to get your calcium and magnesium balance right

  1. Nice article, so much is about JUST magnesium and calcium and forget the regulators – K2 and Vit D!
    Im going to shoot for a product with all 4 (called Osteo4) as Magnesium wasnt sufficient by itselfs (bad diet probably lacking in all vitamins!):

    Vitamin D 5µg 100
    Calcium 800mg 100
    Magnesium 375mg 100
    Vitamin K 75µg 100

    1. The vit D amount there is quite tiny. The calcium is not usually going to be needed for most people and 800 mg would cause serious overdose for most. 300 mg comes from healthy diet, and even small amounts of dairy or fish bones or stock mean easily meeting calcium needs. Most people are short on magnesium and vitamin K2 to balance things. The magnesium there is in the ballpark, but the K2 is on the low side if it’s MK-7 and very low if it’s MK-4 based on current info, although data is emerging.

  2. Great article…thanks! I have palpitations from taking MK-7, 100mcg…..should I switch to MK 4? I cannot have dairy, due to intolerance (lactose, I think), so I take Calcium citrate 500mg, Magnesium 200mg, and Vit D 2000 IU (my Mg level is 42). I have hip bursitis, so Im wondering if I have calcium build up there. Any thoughts/feedback for me? I would appreciate it!

    1. Hi Maya, I would switch to MK-4 yes, all the other stuff seems great if you are not getting other non-dairy sources of calcium like fish bones, broth, or from huge amounts of vegetables. I’m not familiar with hip bursitis but K2 seems to work wonders with all “calcium in the wrong places” issues.

  3. I eat good servings of veggies 2x/day, like spinach and brocolli, but not huge amounts. I was making and consuming bone broth daily, but for some reason it makes me feel horribly exhausted…ugh! Thank you for your feedback!

    1. You’re welcome Maya. I like to track my diet on Good to do even for a week or two to see that you’re getting all your nutrients and balancing calcium/magnesium, omega-3 and 6, etc.

    2. Maya, how do you eat your portion of 2 veggies daily? Because all these healthy veggies, green leaves, pulses, nuts and grains contain huge amount of oxalic acid, phytic acid, they do contain calcium and magnesium as well, but these portions need more calcium to bind all the minerals and it is a good option to have them with dairy for example goat cheese, cheddar etc and if you are eating fruit then it would good to have them with yogurt with mascarpone cheese. If we don`t have the calcium intake just right and big enough, the magnesium naturally present in food cannot be utilized because it competes with phosphorus for binding. To have dairy with vegetables is important especially because of calcium and zinc content in the dairy. As we know, magnesium is depleted by added sugar, alcohol, medication and also by too high dosages of supplemented minerals which interfere with the right balance of trace minerals. Therefore, to have coffee and dark chocolate with milk is a good option, also to have herbal teas with a little bit of milk. For example the black tea is so full of oxalates which bind with calcium and calcium cannot be utilized then and therefore we utilize even less magnesium. Too much fibres and plant based food is not good either, it gives you a weird feeling in the gut and a headache and extreme thirst. If you have levels of magnesium and zinc high enough, you don`t have sugar cravings and don`t lose even more zinc and magnesium, therefore it is useful to get of rid of factors which deprive us of magnesium first.

  4. Hi I wondered if you could give me some advice? Im new to all this balancing and finding it all rather confusing… I am wanting to up my magnesium to help with anxiety and also want to take a vitamin D3 supplement as I believe i could be vitamin D deficient, I know that i need calcium and K2 to be in balance to allow these to work but really dont know how much to take of any of it! I have a pretty good diet and am planning on improving it further with lots of foods rich in minerals and vitamins I also eat dairy and some chicken and fish. Thank you for posting this helpful article. Kind regards, Lisa.

    1. Hi Lisa, welcome!

      The article contains recommended amounts for calcium, magnesium, vitamin D3 and vitamin K2. I highly recommend reading the Happy Guide book for the finer points of human nutrition. It’s an area Mike has researched for over 20 years and it will ensure you’re getting all the required vitamins and minerals in the right quantities, while avoiding the harmful stuff. In the meantime, you can see an overview of the Happy Guide diet, with some sample meal ideas, here:

      Hope this helps Lisa. Please let me know if you have any questions, or to let me know your progress!

      Best wishes,

      1. Please tell me what to take. Calcium–Magnesium–K2–D3–and vitamin A. Also the amounts of each!! And if I should take them together at what time of day!! I am a 78 Year old male.
        Thank You very much!!

  5. Thank you for a very informative blog!

    Could you please tell me what the best balance of Calcium and Magnesium should be for women who have Osteopenia or Osteoporosis. We’ve been told to get about 1200 mg of Calcium from all sources, but not more than 500 mg from a supplement. Is this accurate? If so, how many milligrams of Mg would you suggest to balance it?

    I have purchased Dessicated Liver capsules to meet my Retinol A requirements. I’m unsure about how much to take though. I’ve read that 4 capsules equals 3 grams of grass fed liver (3000 mg). How many capsules should I take daily (along with the other nutrients/vitamins you list in your holistic approach)?

    In your opinion, would you think that following this holistic approach would be enough to improve bone density (without having to add questionable medication – which I had been on for years).

    Thank you for your help!

    1. Hi Ellen, my feeling is that 1200 mg of calcium is too high. As I mentioned in the article, 600 mg optimizes bone health when vitamin D is normal. It is a matter of getting all nutrients optimized, because they work in synergy. The general opinion is that calcium:magnesium should be between 2:1 and 1:1, so at 1200 mg of calcium you’d need a lot of magnesium supplements, and I prefer to minimize supplements and do it with food, because food has co-factors that make nutrients work in context of digestion, absorption, and utilization. K2 is a case in point, without which, excess calcium will not get into bones anyway, but will get deposited into soft tissues. Vitamin D increases the absorption of calcium. So, again, it about getting it all working for you. In your position, I would have a precise, consistent, solid program i.e. for nutrients, sun exposure (I would use a sunbed in winter), testing of vitamin D and magnesium levels, weight-bearing exercise, diet tracking and analysis ( and then see what happens at the next bone scan. Have a crystal clear plan, then see the results of doing it.

      Yes, I do think the holistic approach will improve bone density, and personally, I would not take medication. Also, lots of fruits and vegetables in the plan, so that bone calcium is not used to buffer blood pH.

      If you track your diet on Cronometer as suggested, you can see precisely how much retinol you’re getting, that is definitely worth getting quite accurate as you don’t want too much. The general advice of liver once a week, say 4 oz, is in the right ballpark. I’m not sure how that translates to dessicated liver capsules. I have my retinol target on Cronometer set to 700 to 3000 micrograms. 4 oz lamb’s liver is around 8,400 micrograms, so you see how the once a week thing is in the ballpark. I like to keep it on the low end, because the body will convert carotenes to vitamin A. To my mind at least, it’s probably optimal to be slightly under, and let the body make up the extra it needs as a top up. You must be very careful if you take supplements to account for all retinol intake

      1. Thank you for your detailed and fast reply. You surprised me though with your answer as according to the National Osteoporosis Foundation and the Institute if Medicine, 1200 mg of calcium is recommended daily for post menopausal women. Your recommendation of 600 mg daily is quite low and leaves me confused as to the large difference. Just wondering how you determined that this intake is appropriate for this population when the prominent sources mentioned would disagree.

        Thanks again for taking the time to address this question.

      2. That’s a good question. Firstly, I would ask you why they recommend 1200 mg. Show me the science to support such a high figure. I don’t take what the so-called authorities advise as gospel due to their long history of giving bad advice. For example, for 50 years every authority in the world had been advising to cut saturated fat, that it is “artery-clogging” etc, and now it turns out that it was just a theory that no-one bothered to check. Now, detailed science reviews reveal no link between saturated fat and heart-disease. The authorities told us to replace sat fat with vegetable seed oils, which, it turns out, massively skewed the omega-6 to omega-3 balance in our diets, fats that impact the amount of inflammation in our bodies, inflammation that is at the roots of every chronic disease state.

        The elephant in the room is that countries with low intakes of calcium have no more osteoporosis than countries that are big dairy consumers. Asian and African populations for example. Also, I think the dairy industry promotion is a big factor in the obsession with calcium. Money talks, very loudly.

        Every single disease state is a complex of interacting factors, and it is my belief that correction of all factors restores health. The body is incredible in its ability to restore health, and it blows my mind that medicine uses a drug model to attempt the impossible… to restore health not by correcting all factors, but by unnaturally forcing the body by a single chemical bullet. How can that ever work?

        When I was looking deeply into calcium, I came across data showing how calcium intakes affect calcium absorption. It is not at all linear. The body is smart and will increase absorption for low intakes, and choke it if intake is high.

        Does the science behind 1200 mg take into account the K2 status or magnesium status of study participants? Or the weight-bearing exercise? Or the acid-base load of the overall diet? Serious, valuable science would have every variable optimized, then tweak the calcium intake to see how it affects bone density. I have never seen such science, and I doubt it exists. What does exist needs to be viewed through this lens… “what are the interacting factors, and how have they been figured into the conclusions.”

        We must take into account the emerging nature of nutritional science. Heart disease, one of the biggest killers is really only now being understood with any real efficacy. For so long the surgeons cut people open when it turns out, lifestyle CAN reverse heart disease. Yes the body is that smart when ALL the factors for health are corrected.

        Finally, we must appreciate that institutions by their nature are slow, plodding beasts that take decades to make a policy change and are most often funded by vested interests who clearly will block change not in their interests.

        The time to overdose a nutrient is when there has been a deficiency over a long time frame, where the daily dose from food would take eons to correct it. This does not apply in the case of calcium. The osteoporosis happened, not in a calcium deficient state, but in a calcium excess state. Nearly everyone is overdosing, calcium is added to so many things, and with dairy and supplements on top of a natural diet, I do not believe at all that more calcium is the answer. At 1200 mg, even at the outer limits of balance, 2:1, you would need 600 mg magnesium and this can’t be achieved even on the healthiest of natural diets. So then it throws into serious doubt that 1200 could be optimal.

        And we must take into account that the calcium:magnesium balance is critical for many functions, not just bone health. What happens when you skew this balance believing it’s good for bones? What happens to blood pressure, to anxiety levels, to the function of the brain over a long time frame? Do they know? Have they looked?

        Until we view health holistically, then there are a million ways to mess things up. I say there is enough to do to get all the things in the article right. I doubt many will, because it takes effort, and focus, and desire, a lot more than popping a pill. I say restore natural balance in all factors, see what happens and tweak from there. I think it’s so easy to get it wrong by not addressing every single factor and by not having a complex but holistic approach to restore health.

        A final note on authorities… I once came across a document listing out all the science resources that fed the decisions that led to the food pyramid and all the general diet advice. I was shocked and horrified, just a house of cards with no depth at all.

        Caveat emptor :-) By all means do your own in-depth research but beware, once you start digging, it gets very very deep indeed, because no nutrient or function is isolated, the body is a complex web of interactions, everything affecting everything else. Even if you only focused on calcium, and the complexity with which it interacts with the body and other nutrients, your head will be spinning very quickly.

        So in conclusion, I strongly feel that correcting and optimizing all the known factors… REDUCING calcium, balancing with magnesium from food as much as possible, ensuring good K2 and sun exposure, plus optimizing retinol and getting regular weight-bearing exercise. There is enough to do. And of course, all this in ADDITION to the rest of it… there are a lot if nutrients and every one matters, and has its own balance with others. Then there are stress levels, sleep and so on. Every single factor has an impact. Everything affects everything else, for example stress increases magnesium needs. Hope this helps explain my point of view.

      3. Though I actually agree with so many of the points you brought up, (Thanks so much for such an in-depth response), it is hard for me to just “jump ship” and decrease my calcium intake by 50%. What if you are wrong ?Are there any researchers or scientists at all that can support your point of view here?

        Also, as you do recommend a 200mg supplement to help reach the Magnesium goal of 550mg, why couldn’t a higher amount be taken (in balance with calcium)to reach 600mg (or even higher)? I presently take a pure Magnesium Glycinate powder, for example, at a higher amount. My body needs it and I don’t think a 200 mg supplement would even be enough for me.

        Anyway, again, thank you for writing a very interesting blog. Lots of food for thought here.

      4. Hi Ellen, science supporting 600 mg calcium is referenced in the article at the end of the statement that 600 mg optimizes bone health when vitamin D levels are normal.

        Here’s the direct link…


        From the abstract… A higher calcium intake was significantly associated with higher BMD (p value for trend: p = 0.005) only for women with 25(OH)D status less than 50 nM, whereas calcium intake beyond the upper end of the lowest quartile (> 566 mg/d) was not significantly associated with BMD at 25(OH)D concentrations >50 nM. Among men, there was no significant association between a higher calcium intake beyond the upper end of the lowest quartile (626 mg/d) and BMD within all 25(OH)D categories. Among both sexes, BMD increased stepwise and significantly with higher 25(OH)D concentrations (<50, 50–74, 75+ nM; p value for trend: women < 0.0001; men = 0.0001). Among men and women, 25(OH)D status seems to be the dominant predictor of BMD relative to calcium intake. Only women with 25(OH)D concentrations <50 nM seem to benefit from a higher calcium intake.

  6. Thanks for sharing great info. I stumbled across this article in my search for advice on how to properly supplement with the appropriate ratios to get vitamin D levels up. I started increasing vitamin D alone and am experiencing joint pain and general aches and soreness and realize I’m probably depleting my (likely) already low magnesium among other things.(blood tests tomorrow to check D) Unfortunately I don’t expect much from our disease-care system and MDs seem so woefully uninformed or uninterested in health or nutrition and say everything is fine until you’re in a horribly diseased state and they can either cut something out or prescribe a drug, so relying on the typical RDAs etc doesn’t inspire a lot of confidence.

    Would you recommend increasing the doses of A, K, and magnesium relative to the D increase? I’m seeing some info suggesting loading doses of up to 50,000iu of D. I’ve been taking only 3-4,000 for a few weeks and feeling the side effects, possibly from other vitamin and mineral imbalances relative to the increased D, or (supposedly) some bone changes as minerals are drawn in and pull water along with them. Hard to know what to believe these days.

    Thanks again for sharing valuable info.

    1. Hi Dani, well we want to get everything in the healthy range, and all these things work together. I would get your magnesium tested as well as vitamin D. Then you have a strategy to get your vitamin D to 40 or 50 ng/ml. All my recommendations are in the article, and I highly recommend tracking your diet using Cronometer so you can see exactly how much calcium, magnesium, retinol and everything else that you are getting. Cronometer can’t track vitamin K2, as that data is not in the USDA database, the source of data for diet tracking, so I just supplement that. I totally agree about the disease-care system.

  7. I am so confused by so many articles and mg supplementation suggestions– please can you tell me more or less the balance/ratio of mg’s I should supplememt for magnesium, calcium, vit K2 and Vit D3 in winter(when not taking in 15 min of daily sun) — it is imperative I figure this out. I more or less daily have 1 or two cups of greek yogurt, veggies, oatmeal, nuts, some chicken– non sugary deserts cacao/carob, nuts, xylitol stevia etc
    Thank you!

    1. I would guess 350mg is good to not get headache, then you’ve your daily intake because vitamin d absorbs and utilize magnesium. The rest of the magnesium you get from the diet so you’re not deprived from the diet because of the vitamin d supplementation.~300-500mg magnesium from supplement. It’s a must to get atlast 1:1 ratio or 2:1 calcium to magnesium or you could experience insomnia like i did. K2 gives me insomnia to, atleast mk-7. I haven’t tried mk4. But i guess vitamin k1 is enough if you eat some meat,liver,eggs and cheese. I mean if i react on it, my body certainly doesn’t want it, and i do use a multivitamin so the co-factors are there.

  8. Hi Michael, thank you for this link. Very helpful :) I’m turning 54 in November. I have tested positive for osteopenia in the last 4 years and there is a history of osteoporosis in my family. I have also been having hot flashes off and on for the last 3 years and have not had time for exercise in the last year. I have also been struggling with candida and leaky gut for years but really nipped it in the bud with diet, broths L-Glutamine and supplements in the last 18 months. I listen to my body and I take supplements as needed.. Right now I am focusing on trying to keep my body alkaline, as I’ve realized that it is the to

  9. Part 2….render my body non hospitable to the candida organisms… Lately I have been getting muscle cramps and major fatigue so I have started to take magnesium chloride. I am also looking at taking Dr. Mercola’s supplement (each cap containing : 4000iu of D3, 120mcg of K2, and 175mg of his grinded organic eggshells) but it contains no magnesium. QUESTION : how many of these capsules should I take per day ? how much magnesium should I add with this supplement? And what kind of magnesium would you suggest ? By the way, our diet is organic and grass fed meats and many organic vegetables.
    Thanks, Mimi

    1. Hi Mimi, it’s very difficult for Michael to have time to give this kind of “one on one” advice unfortunately. All I can really suggest is sticking to the diet / supplement advice in the article above, and of course the book, for the bigger picture. It’s all been very carefully put together. The ratios and amounts mentioned are very important.

  10. What about Mag-tab supplement magnesium l-lactate dihydrate ? It is supposed to be 12-hour sustained release. Is it a good supplement?

    1. Hi Chad, I can’t comment on l-lactate dihydrate specifically but there may be a good reason it’s not one of Michael’s recommendations in the article, so I’d stick to the ones he mentions.

  11. Plz advice on this. I take supplement containing:

    Calcium Citrate – 1000 mg (elemental calcium will come around 200mg)
    Magnesium Hydroxide equivalent to elemental Magnesium – 100 mg
    Vitamin D3 – 200 IU
    Zinc – 4 mg

    I take this tablet twice in a week. I am vegetarian (not vegan). I hope this is ok. I am worried about calcification of arteries and kidney stone.. so I take less in supplements.

  12. Great information! I’ve been having a hard time finding 5mg of K2. I found a 15mg supplement… do you think that’s too high and to go with a lower dose is better? I ask because it’s more affordable than the Thorne Research MK-4 drops. I’m trying to follow all your suggestions here and therefore have to buy a variety of bottles.
    Thanks in advance!

    1. Hi Angela, I’m James, Michael’s brother. You can get 5 mg supplements of K2 on Amazon here: According to Mike’s article on K2 specifically:

      “Early studies used large doses of MK-4 of 45 mg a day (15 mg with each meal) with no ill effect and vitamin K2 has no known toxicity.”

      So that’s good. He says that although optimal doses for supplementation aren’t known yet he’s…

      “hearing good things about 1 mg per 25 lbs body weight a day as MK-4 as a therapeutic dose, perhaps reducing to 1 mg a few times a week for maintenance once we have our beautifully clean arteries sorted.”

      Hope this helps! Here’s the full article if you want to check it out:

      Best wishes,

  13. Great in depth article!! I have just ordered your book :-) I am a 50 year old woman who is perimenopausal and I suffer with stress and anxiety (panic attacks). I had my vit D tested a while back and was very low, I am now taking a supplement DLux 3000iu I weigh 68.5kg, I have also been using magnesium oil which gives me 200mg per 10 sprays and Epsom salt baths (I put approx. 600g in) however I don’t do this every day and I am thinking on the days I don’t I should take a supplement – so my first question is which type of magnesium? you mention citrate, gllycinate and threonate however later in your article you mention citrate and chelated (I am thinking citrate as this is the common denominator in both?!) Also as I suffer from anxiety and panic, I exercise 3-4 times a week do you think 300-400mg is best for me?

    My other question is the vit A – I am a pescetarian (although I do make bone broth) but I couldn’t eat liver!!! I do eat a couple of eggs 3-4 times a week – Is that sufficient, if not what would you recommend?

    Also I have seen K2 supplements with both mk7 and mk4 do I get a mix or just the mk4?

    Many Thanks

    1. Hi Julie, Mike won’t be available to answer comments for the next while but I will do my best to help!

      Which type of magnesium? In the article Mike says “It’s a good idea to vary the type”. Of the types mentioned, I wouldn’t worry too much about which you start with.

      In terms of how much to take, I would stick to the advice in the article. The Happy Guide diet will give you enough magnesium, if all else is well.

      “BUT if you’re currently not having an optimal diet, exercising hard, stressed, OR have any symptoms of magnesium deficiency, then I recommend taking 200 to 400 mg a day of magnesium.”

      There is some controversy over the efficacy of skin-applied magnesium so to be sure, I think it’s best to get your magnesium from food, and then supplements as well if required.

      I’m afraid I wouldn’t like to recommend alternatives to liver because liver is part of the diet in the book. You could certainly Google alternative sources of vitamin A but the Happy Guide diet is designed to be very well balanced nutritionally, so I wouldn’t like to suggest that liver can just be swapped out.

      MK-4 or MK-7? The former. See the “Vitamin K2” section of the article for Mike’s reasons. Hope this helps Julie! Thanks for ordering the book. Things should become clearer once you have it. :-)

      Best wishes,

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