- All About Calcium Supplements (PDF)
Why is calcium important?
Calcium is a nutrient that is essential for strong bones. Ninety-nine percent of your body's calcium is stored in your bones and teeth. The other one percent of your body's calcium is found in blood. Blood calcium is necessary to support your body's critical functions such as controlling your blood pressure and maintaining your heartbeat.
The calcium in your bones makes up your bone bank. Throughout your lifetime, the calcium from the foods you eat is "deposited" in and"withdrawn" from your bone bank, depending on your needs. When your calcium intake is too low to keep your blood calcium normal your body will "withdraw" the calcium it needs from your bones. 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.
How do I know if I am getting enough calcium in my diet?
It is important to know the amount of calcium you need each day. You will find your recommended daily calcium intake on the chart below, listed according to your age and gender.
|If this is your age||Then you need this much calcium |
each day(mg = milligrams)
|Birth to 12 months||Supplied by formula or breast milk|
|Men 19 – 70 |
Women 19 – 50
|*Recommended Dietary Allowances, Institute of Medicine, 2015|
The preferred way to get calcium is from the food you eat. Visit the NYSOPEP website (www.NYSOPEP.org) to help you find out if you are consuming the amount of calcium you need in the foods you eat in a usual day.
If I am not getting enough calcium, what should I do?
- Most people can easily get at least half of the calcium they need from food.
- If your usual calcium intake is too low, first try to eat more calcium-rich foods each day. There are many calcium-rich foods to help you get the recommended calcium from diet alone.
- If you are unable to change your diet to get the recommended amount of calcium each day, speak to your health care provider about taking a calcium supplement.
- If you need a supplement, it is important to select one that contains the proper amount of calcium. Your recommended daily calcium intake minus the estimated daily calcium in your diet will determine how much calcium you need to take from a supplement.
|Recommended Daily Calcium Intake (mg)|
|Minus (-)||Estimated Calcium in your Diet (mg)|
|Equals (=)||Calcium Needed from Supplement (mg)|
Is more calcium better?
Some health care providers may suggest slightly more calcium for people with certain medical conditions that interfere with the body's ability to use calcium efficiently. It is important to speak to your health care provider about your calcium requirements and not to consume too much calcium on a regular basis. Chronic high calcium intakes, particularly from calcium supplements, may be harmful.
It is also important not to consume too much calcium at one time. For the most ecient calcium absorption, it is best to consume calcium(from food and/or supplements) in amounts of 600mg or less at one time. Your body uses calcium best when it is spread out through the day. Try including a calcium-rich food at each meal or snack.
How do I choose a calcium supplement?
- 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 others.
- Different calcium compounds have similar bioavailability (the amount of calcium that the body can use) when supplements are taken with food. The presence of food in the stomach causes the release of acid that is necessary to break down most calcium supplements. When calcium is taken with food, it slows down the movement of calcium in the intestines allowing more time for calcium to be absorbed. Therefore, it is best to take calcium supplements with food.
- Calcium citrate is an exception to the rule: it can be taken with or without food. It is the one calcium compound that does not require acid to break it down. If you take acid-blocking medications (H2 blockers or proton pump inhibitors that are sold over-the-counter or by prescription) and cannot get enough calcium in the foods you eat, calcium citrate is the calcium compound of choice.
- In selecting the right supplement for you, it is important to consider how you intend to take the supplement. Calcium supplements are available as liquid, powder, chewable or tablets.
- Taste may also be a consideration; since it may determine if you will regularly take calcium.
What do the symbols on the labels of calcium supplements mean?
There are symbols to look for on the labels of calcium supplements that indicate that an independent laboratory has tested the product The symbols pictured below from left to right include the Consumer Labs International insignia, the Natural Products Association symbol the NSF (NSF International) mark, and the USP (United States Pharmacopeia) verified mark.
When one of the above symbols is found on a calcium supplement, it means the calcium supplement was properly manufactured contains the ingredients listed on the label, breaks down and is released into the body in a specified amount of time, and does not contain harmful levels of lead or specified contaminants. The symbols do not guarantee that a product is safe or eective. It is important to understand that independent laboratory testing is voluntary and costly so many acceptable products may not display a symbol.
Calcium must dissolve in your stomach before it can be absorbed in your intestines and used by your body. If your supplement is not marked with a symbol that indicates that it has been quality tested, you can test it yourself to find out if it will dissolve. Simply put the supplement into a glass of lemon juice. It is very similar to stomach acid. Stir the solution well then occasionally repeat over a 30-minute period. If the calcium supplement breaks down within 30 minutes, it should do so in your stomach, too. If the supplement does not completely dissolve, choose another calcium supplement. Be sure to discard the calcium/lemon juice solution after the test.
How do I read the label of a calcium supplement?
Reading the label of a calcium supplement is as simple as 1, 2, 3:
- Check the serving size (the number of tablets per serving)
- Read the calcium (mg) per serving. The label may refer to calcium as elemental calcium. This distinguishes the weight (mg) of calcium alone from the weight(mg) of the calcium compound on the ingredient list (such as calcium carbonate, calcium citrate, tricalcium phosphate, or others)
- Determine the calcium (mg) per tablet
Do I need to be concerned about lead in my calcium supplement?
One of the above symbols on the label of a calcium supplement means that it does not contain lead or other metals. However, it seems that lead in calcium supplements is less of a concern than some people believe. 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 absorbed well because calcium blocks lead absorption.
Do I need vitamin D in combination with my calcium supplement?
It is important to get the vitamin D that you need each day. Getting the recommended amount of vitamin D helps your body absorb calcium and helps strengthen muscles, too! There are only a few good natural sources of vitamin D including fatty fish such as catfish eel, mackerel, salmon, sardines, and tuna. Small amounts of vitamin D are added to all milk and to some types of nondairy beverages and other foods. Check the food labels of almond, coconut, rice, and soy beverages as well as juices, yogurt, cheese, and nutrition bars to find out if vitamin D is added. Most people need a vitamin D supplement to get enough vitamin D each day. Vitamin D is available in supplemental form in multivitamins, in combination with calcium in many calcium supplements, and alone in vitamin D supplements Vitamin D is fat-soluble and can be stored by the body. It does not need to be taken in combination with calcium as long as you get the recommended amount of vitamin D each day. It is important to speak to your health care provider about how you can get the vitamin D you need to promotes strong bones.
Do I need magnesium in combination with my calcium supplement?
Most healthy people do not need magnesium supplements. Magnesium is found in many foods but especially in green leafy vegetables potatoes, tomato products, seafood, peas, beans, nuts, seeds, bran and whole-wheat products. However, certain individuals may be at risk for magnesium deficiency. At-risk individuals include those with gastrointestinal diseases that cause poor absorption or increased losses of magnesium, people with diabetes, frail elderly individuals eating poor diets, alcoholics, individuals receiving chemotherapy, and people who take high-dose diuretics (water pills) that cause magnesium loss. Your health care provider will prescribe a magnesium supplement if it is necessary or if you have a condition that causes magnesium deficiency.
Do I need additional vitamins or minerals with my calcium supplement?
For most healthy individuals, additional vitamins or minerals (such as boron, vitamin K, selenium or others) in the form of supplements are not needed for strong bones. The best way to get these nutrients is by following the 2010 Dietary Guidelines for Americans to help you eat a varied, nutrient-rich diet including plenty of fruits and vegetables.
How do I take my calcium supplement?
It is important to read the labels of calcium supplements and follow the directions for use. Chew chewables or swallow tablets as directed along 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 food and/or supplements throughout the day In fact, for most ecient absorption, it is recommended to consume 600 mg of calcium or less at one time. If you take more than 600 mg of calcium from supplements each day, the dose should be split to improve calcium absorption.
Are there any special considerations if I take an iron supplement?
For the best absorption of both iron and calcium, it is recommended that you eat foods rich in calcium or take calcium supplements two hours before or after your iron supplement. You should not consume calcium and iron at the same time.
Is it a problem to take a calcium supplement with antibiotics?
Calcium interferes with the body's ability to use certain antibiotics such as tetracycline or ciprofloxin. If your health care provider prescribes an antibiotic that interacts with calcium, it is important for you to take it properly. You should not take calcium supplements(and not eat calcium-rich foods) at the same time as taking certain antibiotics. Your antibiotic will work best if you take your calcium supplement (or eat calcium-rich foods) at the right time. It is always important to talk to your pharmacist about the proper way to take your medication.
Can calcium supplements cause constipation?
Some people who take calcium supplements complain about constipation but it can usually be prevented. To prevent constipation eat more fiber in your diet (from fruits, vegetables, and whole- grain products), drink six to eight of water each day, and be physically active. 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. If you need to take calcium supplements, read the label to find out the amount of calcium in each dose. For example calcium carbonate has the highest amount of calcium per dose. Calcium citrate has less calcium per dose and calcium gluconate is one of the lowest dose options. A low-dose calcium supplement may be better tolerated than a high-dose supplement.
NYSOPEP Resource Center
Helen Hayes Hospital, West Haverstraw, NY
Publication 1980, Version 4/2015
The recommended upper limit for calcium is 2,500 mg a day for adults 19 to 50. For those 51 and older, the limit is 2,000 mg a day.What are the risks of taking calcium supplements? ›
Calcium supplements may increase the incidence of constipation, severe diarrhea, and abdominal pain. It highlights that calcium carbonate is more often associated with gastrointestinal side effects, including constipation, flatulence, and bloating.What is the best form of calcium to take? ›
Calcium carbonate supplements tends to be the best value, because they contain the highest amount of elemental calcium (about 40% by weight). Because calcium carbonate requires stomach acid for absorption, it's best to take this product with food.What are the benefits and disadvantages of taking a calcium supplement? ›
Calcium supplements may offer benefits in reducing the risk of certain diseases, including colon cancer and high blood pressure. But there is no conclusive evidence of these benefits. Taking too much calcium has its own risks too. Among them is the potential to interfere with medications you already take.Is it better to take calcium in the morning or at night? ›
Calcium should be taken in the morning (about 1 hour after breakfast) or in the afternoon with plenty of water, giving us the opportunity to be exposed to more sunlight (the skin synthesizes vitamin D for the body). ), which helps to absorb calcium more efficiently.Why calcium is taken at night? ›
Bone resorption follows a circadian rhythm that peaks at night, reflecting the circadian rhythm of serum parathyroid hormone. Our previous studies in early postmenopausal women have established that 1000 mg of calcium given at 9 p. m. reduced bone resorption markers overnight, but not during the day.What happens if you take calcium everyday? ›
Consuming more than 2,000 mg of calcium a day from your diet or supplements is also linked to an increased risk of kidney stones, according to the Institute of Medicine ( 2 ). Other sources say that the risk of kidney stones increases when calcium intake exceeds 1,200–1,500 mg per day ( 28 ).How do you know your calcium is low? ›
Untreated low calcium can lead to more severe symptoms, such as:
- anxiety and depression.
- dry, itchy skin.
- fits (seizures), this is very rare.
- finger and toe nail changes.
Calcium can decrease the absorption of other drugs such as tetracycline antibiotics (for example, doxycycline, minocycline), bisphosphonates (such as alendronate), estramustine, levothyroxine, and quinolone antibiotics (such as ciprofloxacin, levofloxacin).Which fruit is rich in calcium? ›
Five dried or fresh figs provide your body with 135 mg of calcium. Papayas and oranges are two other fruits high in calcium.
- Seeds. Seeds are tiny nutritional powerhouses, and many are high in calcium, including poppy, sesame, celery, and chia seeds. ...
- Cheese. Most cheeses are excellent sources of calcium. ...
- Yogurt. ...
- Sardines and canned salmon. ...
- Beans and lentils. ...
- Almonds. ...
- Whey protein. ...
- Leafy greens.
Excess calcium makes your kidneys work harder to filter it. This can cause excessive thirst and frequent urination. Digestive system. Hypercalcemia can cause stomach upset, nausea, vomiting and constipation.Which calcium is best for seniors? ›
Calcium citrate, calcium carbonate and calcium with vitamin D are some of the more popular supplements used by seniors to stay healthy and strong.Is it better to drink milk or take calcium supplements? ›
Milk naturally provides nutrients such as protein, vitamin B2 and B12 and minerals including calcium, phosphorus, potassium and iodine. Therefore calcium supplements are not an adequate replacement of milk and other dairy products.Which calcium is best for bone strength? ›
- Calcium citrate.
- Calcium carbonate.
- Calcium gluconate.
- Calcium lactate.
- Calcium phosphate.
For eg, if you are dehydrated, then an electrolyte supplement will work within minutes. However, if you have bone density issues, calcium will take 6 weeks to make a difference, and calcium needs a lot of other things for your body to truly absorb and reap the benefits.Does calcium affect sleep? ›
Calcium helps the body use the amino acid tryptophan to make melatonin, a hormone that helps you fall asleep and stay asleep. A study first published in 2013 found that calcium is linked to less trouble falling asleep and having a truly restful sleep.Can calcium supplements affect your heart? ›
Calcium supplements are usually taken to treat or prevent bone disease, such as osteoporosis. A recent analysis of peer-reviewed, double-blind studies concluded that calcium supplements increased the risk of heart disease, particularly in healthy, postmenopausal women.What time of day is calcium highest? ›
Time of Day
PTH levels can then again peak around 6 a.m., decline to baseline at 8:00 a.m. and then again peak at about 10:00 a.m. Morning represents the best time to accurately measure calcium in the blood. This can increase the likelihood of getting accurate calcium blood test results.
However, research published in August 2019 in the Annals of Internal Medicine found that taking calcium and vitamin D supplements together might increase your risk of having a stroke. This finding was published in a review of what's currently known about the effects of supplements on our health.
You need to take calcium carbonate with food, because it's easier for your body to absorb that way. You can take calcium citrate on an empty stomach or with food. To maximize your absorption of calcium, take no more than 500 mg at a time. You might take one 500 mg supplement in the morning and another at night.How often should you take a calcium supplement? ›
Total daily dose. Calcium is best absorbed when it's taken in smaller doses (typically less than 600 milligrams at one time). If you take 1,000 mg of calcium a day, split it into two or more doses over the day.Can calcium tablets be taken long term? ›
However, there is emerging data from various studies (observational, an RCT and a meta-analysis) that long-term use of calcium supplements in healthy older adults, particularly women, may not be safe because it could have an adverse effect on cardiovascular outcomes [20,21,22].At what age should you stop taking calcium? ›
Adults ages 19 through 50 should not get more than 2,500 mg calcium total per day (including food and supplements). Adults over age 50 should not exceed 2,000 mg total per day. Dietary calcium is considered safe, but too much calcium in the form of supplements might have some health risks.What are the symptoms of calcium deficiency in adults? ›
- confusion or memory loss.
- muscle spasms.
- numbness and tingling in the hands, feet, and face.
- muscle cramps.
- weak and brittle nails.
- easy fracturing of the bones.
- Calcium citrate.
- Calcium carbonate.
- Calcium gluconate.
- Calcium lactate.
- Calcium phosphate.
Calcium has been shown to play a significant role in our sleep cycles, particularly the REM stage of sleep. Because calcium helps the body use the amino acid tryptophan (the oft-cited culprit of the supposed post-turkey sleepiness on Thanksgiving), it has a sedative effect that helps ease the body into sleep.How many months calcium tablets should be taken? ›
For this reason, there are daily Recommended Adequate Intakes set for calcium: 0 to 6 months - 210 mg. 7 to 12 months - 270 mg. 1 to 3 years - 500 mg.How can I increase my calcium naturally? ›
The best sources of calcium are dairy products, including milk, yogurt, cheese, and calcium-fortified beverages such as almond and soy milk. Calcium is also found in dark-green leafy vegetables, dried peas and beans, fish with bones, and calcium-fortified juices and cereals.What are the side effects of taking calcium and vitamin D tablets? ›
- nausea, vomiting, constipation;
- increased thirst or urination;
- muscle weakness, bone pain; or.
- confusion, lack of energy, or feeling tired.