After stopping postmenopausal estrogen therapy, what is the best instruction for calcium supplementation?

• A. Take 1 tablet with each meal.
• B. Take 3 tablets at once to reach 1500 mg.
• C. Ensure vitamin D is sufficient; it alone will suffice.
• D. Take all calcium tablets at bedtime.

Answer: (A)

Calcium absorption happens best in smaller portions, and taking it with meals boosts uptake because the stomach acid generated during eating helps dissolve calcium carbonate. Spreading the daily amount across meals improves overall absorption and minimizes GI upset, so taking one tablet with each meal helps you reach the typical target around 1500 mg daily in a way your body can actually use. Vitamin D must be sufficient to allow calcium to be absorbed, but having enough vitamin D doesn’t provide the calcium itself. Taking all the calcium at bedtime misses the meal-related absorption window and is less effective. So, taking one calcium tablet with each meal aligns with how the body absorbs calcium and supports bone health after stopping estrogen therapy.