My clinician has encouraged me to take calcium supplements. There are so many kinds of calcium. How do I know I’m taking the right kind and the right amount?
Calcium is one of the cornerstones of developing and maintaining healthy bones. It is important to get adequate calcium in your diet, no matter how old you are.
Table 3 lists the amount of calcium recommended for your age and gender. Your daily intake should never exceed 2500 mg of elemental calcium.
Before your clinician can recommend calcium supple-mentation, you will need to calculate the amount of calcium you take in through your diet on a daily basis.
Table 4 shows the many different dietary sources of calcium. If you have a reasonably healthy diet, you can make it easy on yourself by using a simple formula to determine how much calcium you will need to supplement what you are getting in food. The formula goes like this:
Take the number of dairy servings that you eat or drink every day and multiply that number by 300. Add 290 if you are female, or if you are male and over the age of 60; add 370 if you are a male under 60 (an expected amount of calcium from all other dietary sources except supplements).
Then subtract that total from the recommended daily allowance (RDA) that is correct for your age and sex (see Table 3). The remain-der is the number of milligrams of elemental calcium that you should add through supplements.
Formula for all women and for men over 60: RDA − (300 × number of daily dairy servings) + 290 = Total number of milligrams of elemental calcium you need to take in supplements.
Formula for men under the age of 60: RDA − (300 × number of daily dairy servings) + 370 = Total number of milligrams of elemental calcium you need to take in supplements.
Here’s the tricky part. Not all forms of calcium are created equal. The kind of calcium that your body can absorb and use is called elemental calcium. So the calcium in your regular diet is elemental calcium because it occurs naturally in the foods you eat and drink. The kind of calcium that is added to food is different from the type of calcium that is found naturally in foods.
When you are deciding how much calcium you need to supplement your dietary intake, you have to be aware that the different forms of calcium provide different amounts of elemental calcium (the kind that your body can absorb and use). Table 5 shows how the different types of calcium provide different percentages of elemental calcium.
You need to look at supplement labels carefully, as many now list the elemental calcium that your body can actually absorb. For example, both Citracal® and Tums list the elemental calcium per serving, and a serving is usually two tablets. Similar to foods, elemental calcium amounts are based on a recommended intake of 1000 mg per day (even though intake requirements vary by age and sex). So if a serving provides 600 mg of elemental calcium, the supplement label will also note that it provides 60% of the recommended daily intake.
Because calcium supplements are manufactured in other forms besides tablets, you have more options for getting the right amount of calcium in your diet. This means that if you can’t swallow big tablets, you can use chewable tablets or candy, liquid, or gum, or drink for-tified orange juice.
When you buy calcium supplements, you will need to read the label so that you can get the type that is best for you:
Calcium carbonate is the most commonly manufactured form of calcium. It comes in tablets that you swallow whole, chewable tablets, soft-gel tablets, liquid, flavored chewy candies, and even chewing gum. Calcium carbonate is best absorbed in an acidic environment, so it should be taken with meals.
The main drawbacks to calcium carbonate are constipation and the gastrointestinal gas it can cause. To avoid excessive rumblings, discomfort, and flatulence, try taking it with a preparation that also contains magnesium. Tums, Viactiv®, Os-Cal®, and Mylanta are all examples of calcium carbonate.
Calcium citrate is better tolerated and doesn’t need the high level of acid from your stomach that calcium carbonate does for absorption, so it can be taken at bedtime or on an empty stomach.
Calcium citrate, which comes in tablets and liquid, is a good option for people who tend to have heartburn or chronic stomach upset and for those who take medication to reduce stomach acid. Citracal is an example of calcium citrate.
Calcium phosphate is most often found in fortified beverages like orange juice or by itself in a product called Posture®. Calcium phosphate does not usually cause stomach upset.
Calcium gluconate and calcium glubionate are less commonly used because they have relatively low levels of absorbable elemental calcium. Neo-Calglu-con Syrup® is an example of calcium glubionate. Calcium gluconate is sometimes combined with calcium carbonate in certain products and vitamin preparations.
It may feel like you need a math degree in order to get the right amount of calcium, but once you find the calcium that you like and can tolerate, stick with it and try to take the same number of tablets, chews, or liquid every day.
Don’t forget to add in what you may also take in through a daily vitamin and antacids, both of which commonly contain some form of calcium. As long as you don’t go over the maximum of 2500 mg of elemental calcium per day, don’t worry about getting too much. Besides keeping your bones healthy, calcium has many other benefits:
- It builds and maintains strong teeth.
- It can lower the risk of breast cancer (if you’re pre-menopausal).
- It may reduce the risk of prostate cancer.
- It can reduce the risk of colon cancer.
- When combined with magnesium, it can reduce the occurrence of headaches.
- It can reduce premenstrual syndrome (PMS) symptoms.
- It may reduce the number of hot flashes experienced by peri- and postmenopausal women.
- It can help you lose weight!
- It maintains the mineral balance in all other organs, including your brain and heart, keeping your mental function healthy and your blood pressure normal.
- It helps with muscle contractions and relaxation.
- It helps your blood clot appropriately.
- It helps to regulate hormone secretion.
Keeping up with your calcium is a win-win situation, for both your bones and your overall health. Recently, coral calcium has been touted as a cure-all for many diseases as well as the best source of calcium.
Coral calcium is believed to be taken from the Japanese island of Okinawa where people are thought to live much longer than the rest of the world’s peoples.
Calcium manufactured from sea coral or hard shell sea creatures, however, is actually calcium carbonate, the same calcium that is available and less costly in many calcium supplements. Don’t be misled by the claims that coral calcium can cure you of many diseases, even cancer and Alzheimer’s disease.