Calcium Supplements
Why is calcium important?
Calcium is a nutrient that is essential for strong bones and for supporting
your body's vital functions such as controlling your blood pressure
and maintaining your heart beat. 99% of your body's calcium is stored
in your bones and teeth. This calcium makes up your bone bank. Throughout
your life, calcium is deposited and withdrawn from your bone bank depending
on your needs. When your calcium intake is too low, your body
will withdraw the calcium it needs from your bones to support your
vital body functions. Over time, if more calcium is taken out of your
bones than is put in, the result may be thin, weak bones that may break
more easily as you age.
How do I know if I am getting the right amount of calcium in my diet?
It is important to know your daily recommended calcium intake. The
amount that you need each day varies according to your age.
*mg= milligrams
(Dietary Reference Intakes, National Academy of Science, 1997)
Meeting the daily recommended intake for your age (listed above) is the goal for most people. Some individuals with medical conditions or who take medications that interfere
with their body's ability to use calcium efficiently may be recommended by their healthcare provider to consume slightly more calcium. It
is important to speak to your healthcare provider about your personal medical history, your bone health and determine the right amount of calcium for you. The preferred way to get your recommended calcium is by eating varied, nutrient-rich foods
Is more calcium better?
- Excess calcium is not stored by your body so taking more calcium than you need does not benefit your bones. Your intestines and kidneys will be called on to process extra calcium that your body cannot use.
- Consuming too much calcium on a regular
basis may be harmful. The adverse effects of chronic excessive calcium
intake are being studied and may include high blood calcium levels, kidney complications,
kidney stone formation, and potential heart problems.
If I am not getting the recommended calcium in my diet, what should I do?
- Most people can easily get at least half of the calcium
they need from food. If your calcium intake is too low,first try to
increase the calcium in your diet. There are many calcium-rich
foods to help you meet your calcium needs through diet alone.
- If
you need expert advice about nutrition, consider consulting with a registered
dietitian/certified dietitian-nutritionist (RD, CDN). To find a registered dietitian in your area, click on the American Dietetic Association.
- If you are unable to get enough dietary calcium on a daily basis,
you may need a calcium supplement. If you need a supplement, it is
important to select one that contains the proper amount of calcium.
Your daily recommended calcium intake minus the estimated daily calcium
in your diet will determine how much calcium you need from a supplement.
What is the difference between the various calcium supplements?
Calcium supplements may contain different calcium compounds such
as calcium acetate, calcium carbonate, calcium citrate, calcium
citrate malate, calcium gluconate, calcium lactate, calcium lactogluconate,
tricalcium phosphate and many others. Recent studies compared different calcium
compounds and found little differences in the bioavailability (the amount
of calcium that the body can use) when supplements were taken
with food. It is very important to take most calcium supplements with food. Food
stimulates acid to break down the calcium supplement and slows down the movement of the gastrointestinal tract so that it has
more time to absorb more calcium.
Calcium citrate is the only form of calcium that can be taken with or without food. This type of calcium does not require acid in the stomach for the body to use it well. For that reason, calcium citrate is the form of calcium recommended for people who take acid blocking medications or for individuals who choose not to take calcium with food.
How do I read the label of a calcium supplement?
Supplement A Supplement B
Reading the label of a calcium supplement will help you choose the right one for you. It is important to know how much calcium is in each pill, tablet or dose to make sure you get the right amount of calcium.
1. Each
supplement label lists the serving size. It
tells you how many pills, tablets, capsules, chewables or teaspoons are in a serving.
For example: One serving of a Supplement A contains 2 tablets and One serving of Supplement B contains 1 tablet.
2. The calcium content is listed in milligrams (mg) of calcium per serving.
For example:One serving of Supplement A contains 400 mg of calcium and One serving of Supplement B contains 600 mg of calcium.
3. To find the milligrams of calcium per tablet, divide the amount of calcium per serving by the serving size.
For example: Supplement A contains 400mg per 2 tablets = 200 mg per tablet. Supplement B contains 600 mg per tablet .
The dose of a calcium supplement is
important to know. For most efficient calcium absorption, it
is best to take the calcium supplement of your choice in doses of
600 mg or less.
In selecting the right supplement for you, it is important to consider
how you intend to take the supplement. Calcium supplements are available
in liquid powder, chewable or tablet forms. Taste may also a consideration;
the taste of the supplement may determine whether you will take it
on a regular basis.
What do the symbols on the labels of some calcium supplements mean?
There are a number of symbols to look for on the labels
of calcium supplements. These symbols mean that a non-profit, scientific
laboratory has tested the supplements.
Some of these symbols
include:
The symbols indicate
that the calcium supplement has been tested to ensure it contains the
ingredients listed on the label, that it is pure from lead and
other metals and that it will break down in your stomach. Calcium
must dissolve in your stomach before it can be absorbed in your intestines
and used by your body.
It is important to know that the application for any of these symbols
is voluntary so many acceptable products may not display a symbol. If
your supplement is not marked with a symbol, you can easily test it
to find out if it will break apart. Simply put the supplement
into a glass of clear vinegar. Stir the solution occasionally. If the
calcium supplement disintegrates within 30 minutes, it should do so
in your stomach, too. If the supplement does not completely break
apart, choose another calcium supplement. Be sure to discard
the calcium/vinegar solution after the test.
Do I need to be concerned about lead in my calcium supplement?
One of the above symbols on the label of a calcium supplement indicates
that it does not contain lead or other metals. However, it seems
that lead in calcium supplements is less of a concern than some believe.
According to a recent laboratory analysis, calcium supplements, in
the dosage prescribed for prevention and treatment of osteoporosis,
contain much less than the safe level of lead. A further safeguard
is that lead in calcium supplements is usually not well-absorbed
because calcium blocks lead absorption.
Do I need vitamin D in combination with my calcium supplement?
Vitamin
D is a fat soluble vitamin that helps your body absorb calcium (among its many functions). Your body can store vitamin D so It does not have to be taken along with or in combination with your calcium supplement as long as you get enough vitamin D during the day. Vitamin D is available from natural food sources (limited), fortified foods, multivitamins and separate vitamin D supplements, in addition to calcium/vitamin D combination supplements.
Do I need magnesium in combination with my calcium supplement?
Magnesium supplements
are not required by most healthy individuals. Magnesium is plentiful in a varied, healthful diet.
However, certain individuals may
be at risk for magnesium deficiency including:
- people with gastrointestinal
diseases that cause poor absorption or increased losses of magnesium;
- frail elderly individuals eating poor diets;
- alcoholics;
- people receiving chemotherapy; and
- individuals taking high dose diuretics (water
pills) that deplete magnesium.
A healthcare provider can
prescribe magnesium in combination with calcium or as a separate supplement if it is necessary or if you have
a disease or condition that causes magnesium deficiency.
Do I need additional vitamins or minerals in combination with my
calcium supplement?
A varied nutrient-rich diet following the food-pyramid approach
to good eating including adequate calcium and vitamin D is what
you need to achieve and maintain strong bones. For most healthy individuals,
additional vitamins or minerals (such as magnesium, boron, vitamin
K, selenium or others) in the form of supplements are not required
for healthy bones. In fact, many of these nutrients will be present
in a healthful diet including five or more servings of fruits
and vegetables each day.
How do I take my calcium supplement?
- It is important to read the labels of calcium supplements and follow
the directions for use. Chewable calcium supplements should be chewed
thoroughly and all calcium supplements should be taken with a full
glass of water. For best absorption, most calcium supplements should
be taken with food. Calcium citrate is an exception; it may
be taken with or without food.
- It is best to spread out the calcium you consume from diet and/or
supplements throughout the day. In fact, for most efficient absorption,
it is recommended to consume 600mg of calcium or less at one time.
For individuals who take more than 600mg per day of calcium from
supplements, the dose should be split to improve calcium absorption.
Are there any special considerations if I take an iron supplement?
If your healthcare provider recommends an iron supplement and you
are also taking a calcium supplement, it is important that your body
absorbs both nutrients. For the best absorption of both iron and calcium,
it is recommended to take your calcium supplement 2 hours before or
after your iron supplement. You should not take them at the same time.
Is it a problem to take a calcium supplement while I am taking antibiotics?
Calcium interferes with the body's ability to use certain antibiotics such as
tetracycline or Cipro. If your doctor or healthcare provider prescribes
an antibiotic, it is important for you to take it properly. It is always important
to speak to your pharmacist about the proper way to take your medication. It may be necessary for you to wait to take calcium supplements or to eat calcium rich foods for a specific amount of time after taking your antibiotic.
Can calcium supplements cause constipation?
Some people who take calcium supplements complain about constipation
but it can usually be prevented. The best ways to prevent constipation include:
- Eating more fiber in your diet from fruits, vegetables, and whole
grain products
- Drinking 6 to 8 glasses of water each day.
- Getting regular physical activity help
If these simple steps are not helpful enough, take a closer look at
your diet to try to get more calcium from foods and less from supplements.
Read the label to find out the amount of calcium in each dose. A lower dose
calcium supplement may be better tolerated than a higher dose supplement.
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