What you
will find on this page:
Calcium information on calcium carbonate and
other forms of calcium
Calcium supplement product
MultiVit Rx with Calcium - comprehensive
doctor-formulated daily multivitamin-mineral supplement
A calcium supplement is derived from natural products, such as oyster shell or bone. Calcium carbonate and calcium phosphate preparations have the highest concentration of elemental calcium, about 40 percent. Calcium citrate contains 21 percent elemental calcium, and calcium lactate and calcium gluconate contain 13 and 9 percent, respectively. Absorption of calcium citrate is higher than that of calcium carbonate. However, for practical purposes, any form of a calcium supplement, such as calcium citrate, calcium gluconate, or calcium carbonate should be satisfactory for general health purposes. Although it is well accepted that calcium supplements reduce the risk for osteoporosis, there is concern that high calcium dosages may increase the risk for hardening of the arteries and kidney stones. To balance the benefits versus risks, perhaps one should limit daily calcium supplement dosage to no more than 600 or 800 mg.
If
your diet does not include an adequate amount of calcium, a high quality
calcium supplement could provide you with health benefits. It's the easy way to keep your bones healthy and strong.
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calcium supplement research, and
their practical interpretation by Ray Sahelian, M.D.
Calcium Supplement Facts
Amount per 2 tablets:
Vitamin D (as
cholecalciferol) -
200 IU
- 50% daily value
Calcium (calcium carbonate) - 600 mg - 50% daily value
Suggested use: Take one to three calcium supplement tablets a day or as
recommended by your health care professional.
Food Sources of Calcium - Calcium in
Food
Calcium is found in a wide variety of foods, but some foods
are more rich in calcium than others. The food group with the most calcium is dairy - milk,
yogurt and cheese. For instance, one cup of milk has about 300 mg of calcium.
One ounce of cheese has about 200 mg. Other food sources rich in calcium include
beans, almonds, oysters, and dark green leafy vegetables such as spinach and
kale.
The NIH recommends milk and other
dairy products as a primary source of calcium. By eating a
wide variety of foods with calcium, you can help make sure to get the calcium
you need each day.
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Calcium suppllements and heart attacks
When we all thought calcium supplements were relatively safe, we now find out
that perhaps high dosages of calcium supplements may adversely influence
vascular health.
Did you see this worrisome headline? "Older women who take calcium
supplements to maintain bone strength may have an increased risk of heart
attack." Researchers at the University of Auckland in New Zealand evaluated 1,471 healthy post-menopausal women, average age 74,
for a period of five years. Of them, 732 were given a daily calcium supplement
and 739 were given a placebo. Participants received either 1 g of elemental
calcium daily as the citrate (Citracal; Mission Pharmacal, San Antonio, TX) or
identical placebo. They were asked to take two tablets (each containing 200 mg
elemental calcium) before breakfast and three in the evening. Over the next few
years, heart attacks were more common in the women taking the calcium
supplements.
Comments: Many women take calcium supplements to try to prevent
osteoporosis. Calcium supplements elevate blood calcium levels possibly
accelerating vascular calcification. Doctors and patients are now presented with
a very difficult challenge. At what level of calcium supplement intake do the
benefits of osteoporosis prevention or treatment outweigh the possible risks of
kidney stones are heart attacks? Firstly, I would like to see a few more studies
regarding the role of calcium supplements and heart attack rate. Perhaps the
results of this study were a fluke and other studies may not find the same
association. Assuming that there is such an association, recommending calcium
supplements for post menopausal osteoporosis prevention becomes quite difficult.
I don't have absolute answers on this issue, but, for the time being, a
reasonable balance would be to reduce one's calcium intake from supplements. If
you are taking 1,200 mg a day, you may wish to drop to 800 or 1,000 mg. If you
are taking 800 a day, you may wish to drop to 600 mg. Discuss with your doctor
the results of this study and both of you could come to a mutually satisfying
decision regarding the appropriate dosage in your particular case. Different
doctors and researchers are likely to have different opinions on this topic.
Vascular events in healthy older women receiving
calcium supplementation: randomised controlled trial.
BMJ. 2008 Jan 15. Bolland MJ, Barber PA, Doughty RN, Mason B, Horne A, Ames
R, Gamble GD, Grey A, Reid IR.
Department of Medicine, Faculty of Medical and Health Sciences, University of
Auckland, Private Bag 92019, Auckland, New Zealand.
To determine the effect of calcium supplementation on myocardial infarction,
stroke, and sudden death in healthy postmenopausal women. 1471 postmenopausal
women (mean age 74): 732 were randomised to calcium supplementation and 739 to
placebo. Myocardial infarction was more commonly reported in the calcium group
than in the placebo group (45 events in 31 women v 19 events in 14 women). The
composite end point of myocardial infarction, stroke, or sudden death was also
more common in the calcium group (101 events in 69 women v 54 events in 42
women). Calcium supplementation in healthy postmenopausal women is associated
with upward trends in cardiovascular event rates. This potentially detrimental
effect should be balanced against the likely benefits of calcium on bone.
Q. Re: Possible danger of kidney stones and heart
attacks from calcium supplements. What about for men? Do you have any info /
speculation as to weather these same "cautions" would apply to men taking a
calcium supplement for bone loss? Are there different chemistries involved that
might make a difference? Any research on men?
A. I am not aware of any research in men taking calcium supplements
and the risk for increased heart attacks. Most men don't take very high dosages
of calcium supplements. My guess it that, if it is true that high dosages of
calcium increase the risk for atherosclerosis in women, that the effects would
be similar in men.
Calcium and
Osteoporosis Study - April 2006
Effects of calcium supplementation on clinical fracture and bone
structure: results of a 5-year, double-blind, placebo-controlled trial in
elderly women.
Arch Intern Med. 2006 Apr 24;166(8):869-75. Prince RL, Devine A, Dhaliwal SS, Dick IM.
School of Medicine and Pharmacology, University of Western Australia,
Australia.
Five-year, double-blind, placebo-controlled study of 1460 women
recruited from the population and older than 70 years (mean age, 75 years)
who were randomized to receive calcium carbonate, 600 mg twice per day, or
identical placebo. Among our patients, 16% sustained 1 or more
clinical osteoporotic fractures. In the intention-to-treat analysis,
calcium supplementation did not significantly reduce fracture risk.
However, 830 patients (56%) who took 80% or more of their tablets
(calcium or placebo) per year had reduced fracture incidence in the
calcium compared with the placebo groups (10% vs 15%). Calcium-treated
patients had improved quantitative ultrasonography findings of the heel,
femoral neck and whole-body dual x-ray absorptiometry data, and bone
strength compared with placebo-treated patients. Of the 92 000 adverse
events recorded, constipation was the only event increased by the
treatment. Supplementation with calcium
carbonate tablets supplying 1200 mg/d is ineffective as a public health
intervention in preventing clinical fractures in the ambulatory elderly
population owing to poor long-term compliance, but it is effective in
those patients who are compliant.
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Physician Formulas
Developed by Ray Sahelian, M.D.
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Manufactured by a FDA-approved and GMP-certified facility.
Vitamin A
Beta Carotene
Retinyl Palmitate
Vitamin C with Rose hips (ascorbic acid)
Vitamin D
Vitamin E (mixed tocopherols)
Vitamin B-1 (thiamine hcl)
Vitamin B-2 (riboflavin)
Niacinamide 25 mg
Vitamin B-6
Folic acid
Vitamin B12
Biotin vitamin is also available for sale separately
Pantothenic acid (d-calcium pantothenate)
Calcium from citrate
Iodine (potassium iodine)
Magnesium (oxide)
Zinc (oxide)
Selenium (amino acid chelate)
Copper (amino acid chelate)
Manganese (carbonate)
Chromium (amino acid chelate)
Molybdenum (amino acid chelate)
Potassium (carbonate)
Green Tea (leaves)*
Inulin (Jerusalem artichoke plant fiber extract-inuflora)
N-Aceytl-L-Cysteine
Inositol
PABA (para aminobenzoic acid)
Rutin
Citrus Bioflavonoid Complex
Choline (bitartrate)
Betaine (HCI)
Beta Glucan 1/3-Beta, 1/6-Glucan (insoluble form from cell walls of Saccharomyces cerevisiae)
Lycopene (from tomato) - you can purchase
Lycopene here.
Lutein (from marigold extract)
Astaxanthin
Zeaxanthin
Octacosanol
Health Claim for Calcium
allowed by FDA
Regular exercise and a healthy diet with enough
calcium helps teens and young adult white and Asian women maintain good bone
health and may reduce their high risk of osteoporosis later in life.
Calcium Dosage recommendations
A high dietary calcium intake combined with vitamin D can increase bone
density and perhaps reduce fractures in older women and, probably, men. The
research indicating calcium reduces bone fracture is not consistent. The Institute of
Medicine recommends that persons 19 to 50 years of age consume 1,000 mg per day
of calcium and that persons older than 50 years consume 1,200 mg per day. The
average American consumes less than 800 mg of calcium per day. However, other
studies indicate that if enough vitamin D is ingested, the daily calcium
supplement dosage need not exceed 800 mg. My personal opinion is that daily
doses of 300 to 600 mg of calcium are adequate for most people. See below for
more calcium dosage controversy research.
Taking a calcium supplement with food in dosages
of 500 mg or less increases absorption. Calcium preparations must be dissolved
before they can be absorbed; the absorption rate for calcium is about 20 to 30
percent. The absorption of calcium supplements differs by preparation. Foods
such as spinach, rhubarb and wheat bran can decrease calcium absorption. Calcium
can interfere with absorption of iron, zinc, bisphosphonates and tetracycline.
Absorption also requires adequate doses of vitamin D. The recommended daily
intake of vitamin D is 200 IU for adults younger
than 50 years and 600 IU for those older than 70 years. Vitamin D
supplementation is especially important in elderly persons because skin
synthesis and absorption of vitamin D may be impaired.
Calcium supplements given to healthy children to
improve their bone density are unlikely to prevent broken bones. Therefore it
does not appear to be necessary to give children calcium supplements.
Calcium dosage controversy
Professor Heike Bischoff-Ferrari, of University Hospital Zurich, Switzerland
combined data from randomized controlled trials involving over 5,600 mostly
postmenopausal women aged 58 years and older, and found that calcium
supplementation by itself without vitamin D or phosphorus may increase the risk
for hip fracture. Other nutritional deficiencies, involving phosphate and
vitamin D, appear to affect calcium absorption and, in turn, influence bone
health. Earlier studies documented that calcium supplements (citrate and
carbonate) may reduce the phosphate absorption needed to build calcium into
bone. The combined effect may enhance bone loss, especially among frail older
individuals. Calcium absorption is enhanced significantly with better vitamin D
status. It may be that current recommendations are too low for vitamin D, and
too high for calcium. American Journal of Clinical Nutrition, December 2007
Function of Calcium in the Body
Calcium is a mineral that is the chief supportive element in bones and
teeth. Calcium salts make up about 70 percent of bone by weight and give that
substance its strength and rigidity. About 99 percent of the calcium in the
human body is found in the bones and teeth. The remaining 1 percent circulates
in the bloodstream, where it performs a variety of important functions. Caclium
helps to contract muscles and to regulate the contractions of the heart. Caclium
plays a role in the transmission of nerve impulses and in the clotting of blood.
Calcium is involved in the stimulation of contractions of the uterus during
childbirth and in the production of milk. It also regulates the secretion of
various hormones and aids in the functioning of various enzymes within the body.
Calcium supplement side effects
The most common adverse effects of calcium supplements are
constipation, intestinal bloating and excess
gas. Adverse effects occur most frequently with calcium carbonate. Switching
preparations or increasing fluid intake may relieve symptoms. Patients who form
calcium-containing stones are generally advised not to take calcium supplements.
It is possible that a very, very low intake of calcium can aggravate the risk of stone formation by
increasing absorption and urinary excretion of oxalate. However, a very high intake
of calcium through supplements could also increase the risk for
kidney stones.
Therefore, it is best not to exceed 600 mg a day of a calcium supplement. Calcium is best taken
during meals.
Another worrisome calcium side effect on higher dosages is an
increased risk for hardening of the arteries and heart attacks.
Hyperparathyroidism
Excessive secretion of parathyroid hormone can
lead to
hyperparathyroidism and elevated blood calcium levels. Very high calcium
levels lead to a condition known as
hypercalcemia.
Additional benefits of Calcium
Many calcium supplements are marketed primarily
as antacids. A calcium supplement may be helpful in
premenstrual syndrome. The
rational for calcium supplementation in women with PMS lies in several studies
suggesting that PMS patients have altered calcium homeostasis and increased risk
of osteoporosis. Calcium may also lower risk for colon cancer.
Forms of Calcium
Calcium is found in several forms including calcium carbonate, calcium
chloride, calcium citrate, calcium gluconate, calcium pyruvate, and others.
Although there are variations in absorption between the different calcium
supplement forms, whether in the long run they make much of a physiological
difference is not fully clear. I don't think we need to worry much about which
form of calcium we are ingesting. Even if one form of calcium, such as calcium
citrate, may be better absorbed than another form, such as calcium carbonate,
there is a possibility that too much calcium ingestion may not be such a good
thing or necessary. A very high amount of calcium ingestion may actually lead to
the possibility of kidney stones. You will also find many supplements that include
calcium with magnesium.
The following are the most common forms of a calcium
supplement : Calcium Carbonate is available as capsules, tablets, oral
suspension, and chewable tablets; Calcium Citrate is often sold as tablets;
Calcium Glubionate often as syrup; Calcium Gluceptate and Calcium Gluconate as
oral solution, Calcium Gluconate as tablets and chewable tablets; Calcium
Lactate as tablets; Calcium Lactate-Gluconate; Dibasic Calcium Phosphate as
tablets; and Tribasic Calcium Phosphate as tablets.
Raw material suppliers often sell calcium in bulk in
the following forms. Calcium Caseinate, Calcium Chloride, Calcium Chloride
Anhydrous, Calcium Chloride Dihydrate, Calcium Formate.
Calcium Deficiency
A low level of calcium in the blood is called hypocalcemia. Calcium
deficiency can make the nervous system highly irritable causing spasms of the
hands and feet, muscle cramps, abdominal cramps, and overly active reflexes.
Chronic calcium deficiency contributes to poor mineralization of bones, soft
bones (osteomalacia) and osteoporosis. In children, calcium deficiency causes
rickets and impaired growth.
Calcium Supplements or Calcium
from Food?
Young girls who get extra calcium from food tend to gain more bone mass
than those who get it from tablet supplements, but children who already receive
adequate amounts of calcium in their diets do not benefit from any form of extra
calcium. "We conducted the study to learn how to maximize the children's peak
bone mass during the rapid-growth period of puberty -- in which 60 percent of
the adult bone mass accumulates -- and thus prevent osteoporosis in adulthood,"
said Dr. Sulin Cheng from the University of Jyväskylä in Finland. For two years,
Cheng and her colleagues followed a group of 195 healthy girls, ages 10 to 12,
whose calcium intake was under the National Nutrition Council recommended levels
(less than 900 mg a day.) They randomly assigned the children to receive 1000 mg
calcium tablets, 1000 mg calcium plus 200 IU vitamin D tablets, low-fat cheese
(1000 mg of calcium), or placebo tablets. The researchers measured the effects
of calcium supplementation on bone mass and body composition. They found that
the cheese group showed more beneficial effects in their bones than any of the
other groups, but when they took into account the individual growth speed, no
beneficial effect was found with any of the interventions -- calcium alone,
calcium plus vitamin D, or even cheese supplementation. This means that if you
exceed certain levels of your dietary calcium intake, it doesn't matter how much
you take; you won't get any benefits.
The Varied Functions of Calcium -
Benefit of Calcium
Calcium is important for bone strength. But as medical doctors are now
learning, calcium doesn't work by itself. Healthy bones require a combination
of calcium, phosphorus and magnesium. They also need adequate protein to form
their basic framework, vitamin K to maintain structural proteins, and two other
bone strengtheners: vitamin D (for calcium absorption) and exercise (to
stimulate bone-building cells). But calcium does more than build strong bones.
It is crucial for transmitting nerve impulses and maintaining a regular
heartbeat. It stimulates
hormone secretions and activates
enzymes. It may even help
protect against colon
cancer. Only about half of Americans are getting the required amount says
the National Osteoporosis Foundation. Recommended intake is 1,000 milligrams a
day for adults — 1,200 for women older than 50 and 1,300 for teens.
Calcium and Children - Calcium
Supplement for a Child
Many American children do not consume enough milk or other calcium-rich
foods like yogurt and cheese, or dark green leafy vegetables, that build strong bones. A calcium deficiency --
whether blamed on children's finicky diets or teenagers choosing soft drinks
instead of milk -- could pose risks later on of broken bones or osteoporosis.
Just one out of 10 adolescent girls consumes the recommended daily calcium
intake of 1,200 milligrams per day. Between the ages of
12 and 19, children generally consume between 700 and 1,000 milligrams a day --
often under recommended levels. Calcium is particularly important during early
adolescence when more of the mineral is needed during a three- to four-year
period when peak bone growth occurs and 40 percent of total lifetime bone mass
is accumulated. Low bone mass has also been shown to contribute
to fractures in children. A calcium supplement in a child may be beneficial if
it is suspected that dietary calcium intake from food is low. For a child with
low calcium intake, a daily calcium supplement dose of 300 mg of calcium
carbonate or calcium citrate should be helpful.
Calcium Benefit Research Update
Higher milk and calcium consumption is
linked with reduced odds of developing colorectal cancer, according to an
analysis of ten studies. calcium carbonate. However this relationship is still
being evaluated and not all studies have confirmed this finding.
Calcium- and vitamin D3-fortified milk reduces
bone loss at clinically relevant skeletal sites in older men: a 2-year
randomized controlled trial.
J Bone Miner Res. 2006 Mar;21(3):397-405. Epub 2005 Dec 19. Centre for
Physical Activity and Nutrition Research, School of Exercise and Nutrition
Sciences, Deakin University, Melbourne, Australia.
In this 2-year randomized controlled study of 167 men aged 50
years of age and older, supplementation with calcium-vitamin D3-fortified milk
providing an additional 1000 mg of calcium and 800 IU of vitamin D3 per day was
effective for suppressing PTH and stopping or slowing bone loss at several
clinically important skeletal sites at risk for fracture. CONCLUSIONS:
Supplementing the diet of men >50 years of age with reduced-fat calcium- and
vitamin D3-enriched milk may represent a simple, nutritionally sound and
cost-effective strategy to reduce age-related bone loss at several skeletal
sites at risk for fracture in the elderly.
Calcium plus vitamin D supplementation and the
risk of fractures.
N Engl J Med. 2006 Feb 16;354(7):669-83. Jackson RD, LaCroix AZ, et al.
Division of Endocrinology, Ohio State University, 485 McCampbell, 1581 Dodd Dr.,
Columbus, OH
The efficacy of calcium with vitamin D supplementation for preventing
hip and other fractures in healthy postmenopausal women remains equivocal. We
recruited 36,282 postmenopausal women, 50 to 79 years of age, who were already
enrolled in a Women's Health Initiative (WHI) clinical trial. We randomly
assigned participants to receive 1000 mg of elemental [corrected] calcium as
calcium carbonate with 400 IU of vitamin D3 daily or placebo. Fractures were
ascertained for an average follow-up period of 7.0 years. Bone density was
measured at three WHI centers. RESULTS: Hip bone density was 1.06 percent higher
in the calcium plus vitamin D group than in the placebo group.
Intention-to-treat analysis indicated that participants receiving calcium plus
vitamin D supplementation had a hazard ratio of 0.88 for hip fracture (95
percent confidence interval, 0.72 to 1.08), 0.90 for clinical spine fracture
(0.74 to 1.10), and 0.96 for total fractures (0.91 to 1.02). The risk of renal
calculi increased with calcium plus vitamin D (hazard ratio, 1.17; 95 percent
confidence interval, 1.02 to 1.34). Censoring data from women when they ceased
to adhere to the study medication reduced the hazard ratio for hip fracture to
0.71 (95 percent confidence interval, 0.52 to 0.97). Effects did not vary
significantly according to prerandomization serum vitamin D levels. CONCLUSIONS:
Among healthy postmenopausal women, calcium with vitamin D supplementation
resulted in a small but significant improvement in hip bone density, did not
significantly reduce hip fracture, and increased the risk of kidney stones.
Bioavailability of calcium: comparison of calcium
carbonate and milk and the effect of vitamin D, age, and sex using 24-hour urine
calcium as a method.
Calcif Tissue Int. 2005 Dec;77(6):361-6.
Medical Department, Roskilde University Hospital, Koge, Denmark
The aim of the present study was to compare the bioavailability of
calcium from calcium carbonate and milk and to investigate if 1,200 IU of
cholecalciferol ( vitamin D ) a day increased intestinal absorption of calcium
carbonate. Both young women and a group of older persons of both sexes were
included to study the influence of age and sex. In total, 53 healthy women and
men were included: a group of 23 younger women (median age 30) and an older
group of 15 women and 15 men (median age 66). The study period was 4 weeks; each
participant completed four treatment regimens randomly: calcium carbonate,
calcium carbonate + vitamin D, milk, and placebo. All regimens were distributed
three times a day and consisted of 1,200 mg of elementary calcium carbonate. The
24-hour urine calcium excretion was used as a method. Total urinary calcium
excretion rates (mmol/day) were as follows (mean +/- SD): placebo 4.41, milk
5.17, calcium carbonate 5.83, and calcium carbonate + vitamin D 6.06. All
regimens compared to placebo were significant. Addition of vitamin D to the
calcium carbonate regimen increased calcium excretion but insignificantly. The
bioavailability of calcium carbonate and milk was demonstrated. Additional
vitamin D to individuals in positive calcium balance with serum 25(OH)D levels
>50 nmol/L only marginally increased calcium absorption from calcium carbonate
in a short-term intervention.
For maintaining calcium metabolism, intake of calcium levels above 800 milligrams daily is probably unnecessary provided that vitamin D status is adequate, according to a report in the Nov, 2005 issue of Journal of the American Medical Association. The researchers assessed calcium intake and serum vitamin D levels with respect to optimal parathyroid hormone (PTH) levels in 944 healthy Icelandic adults. PTH is a major hormone maintaining normal serum concentrations of calcium and phosphate and is itself regulated through levels of calcium. An insufficiency of vitamin D or calcium is generally associated with an increase in PTH, but the relative importance of each nutrient to this process has not been addressed. In their study, Sigurdsson and colleagues noticed that in the presence of low vitamin D levels, maintaining calcium intake above 800 mg/d seems to help normalize calcium metabolism, as determined by the PTH level. By contrast, in the presence of higher vitamin D levels, there appears to be no benefit for achieving calcium intake above 800 mg/d.
Children who drink more milk do not necessarily develop healthier bones. The U.S. government has gradually increased recommendations for daily calcium intake, largely from dairy products, to between 600 and 1,200 milligrams to promote healthy bones and prevent osteoporosis. But the report, published in the journal Pediatrics, said boosting consumption of milk or other dairy products was not necessarily the best way to provide the minimal calcium intake of at least 400 milligrams per day. Other ways to obtain the absorbable calcium found in one cup of cow's milk include a cup of fortified orange juice, a cup of cooked kale or turnip greens, two packages of instant oats, two-thirds cup of tofu, or 1-2/3 cups of broccoli.
Taking calcium supplements protects against the
development of colon polyps, which can become cancerous, and this benefit
appears to persist for up to 5 years after people stop taking the calcium
supplements.
Stone forming risk of calcium citrate supplementation in healthy
postmenopausal women.
J Urol. 2004 Sep;172(3):958-61.
We evaluated the effect of calcium citrate supplementation alone or in
combination with potassium citrate on the stone forming propensity in healthy
postmenopausal women. A total of 18 postmenopausal women without stones
underwent a randomized trial of 4 phases comprised of 2 weeks of treatment with
placebo, calcium citrate (400 mg calcium twice daily), potassium citrate (20 mEq
twice daily), and calcium citrate and potassium citrate (at same doses). During
the last 2 days of each phase urine was collected in 24-hour pools for complete
stone risk analysis. RESULTS: Compared to placebo, calcium citrate increased
urinary calcium and citrate but decreased urinary oxalate and phosphate. Urinary
saturation of calcium oxalate, brushite and undissociated uric acid did not
change. Potassium citrate decreased urinary calcium, and increased urinary
citrate and pH. It decreased urinary saturation of calcium oxalate and
undissociated uric acid, and did not change the saturation of brushite. When
calcium citrate was combined with potassium citrate, urinary calcium remained
high, urinary citrate increased even further and urinary oxalate remained
reduced from the calcium citrate alone, thereby marginally decreasing the
urinary saturation of calcium oxalate. Urinary pH increased, decreasing urinary
undissociated uric acid. The increase in pH increased the saturation of brushite
despite the decrease in urinary phosphorus. CONCLUSIONS: Calcium citrate
supplementation does not increase the risk of stone formation in healthy
postmenopausal women. The co-administered potassium citrate may provide
additional protection against formation of uric acid and calcium oxalate stones.
A University of Minnesota Cancer Center study found that women consuming more than 800 milligrams of calcium each day reduced their risk of colorectal cancer by as much as 26 to 46 percent.
Calcium Deposit
People use the term calcium deposit to indicate the accumulation of
calcium in a tissue, for instance a tendon. A calcium deposit in a tendon could
cause no problems or it could lead to calcific tendonitis. In severe cases of
calcium deposit, surgical removal is possible. Recently, shock waves have been
used with some success in breaking up the calcium deposit.
Calcium Element
Calcium is the fifth most abundant element in the earth's crust. Calcium
is not found free in nature since it readily forms calcium compounds by reacting
with oxygen and water. About 4% of the earth's crust is made of calcium.
Calcium Hydroxide
Calcium hydroxide Ca(OH) 2 , is colorless crystal or white powder
prepared by reacting calcium oxide (lime) with water, a process called slaking.
Calcium hydroxide is usedin liming soil, in sugar refining, and in preparing
other compounds. It is a strong base and is widely used as an inexpensive
alkali, often as a suspension in water (milk of lime).
Calcium Deposit in the Brain
Calcium deposit in the brain, or microcalcification, is seen in a number
of disease conditions, such as vascular dementia, Alzheimer's disease,
Parkinson's disease, astrogliomas, and posttraumatic epilepsy.
Calcium emails
Q. I purchased a calcium supplement.
However, I have long been confused about the best calcium supplement. I am a 40
yr old female, and mother of 2. I have heard of the buzz about coral calcium. Is it less effective than
calcium carbonate or calcium citrate? And, what advice / recommendations can you offer about
coral calcium, best calcium supplement, and which to choose. I've also heard that chelated calcium is the 'best.' Is calcium citrate the only chelated
calcium? I've spoken to pharmacists to try and unravel the
calcium mystery and make the best calcium supplement hoice for me.
A. There is a lot of controversy regarding which form
of calcium - calcium carbonate, calcium citrate, etc - is the best calcium
supplement. Different experts have different opinions. In my judgment,
and for practical purposes, I don't think we need to worry about the form of
calcium ingested. Overall it probably does not make too much difference. One
good option is to purchase a different form of calcium each time you buy a
calcium supplement, and this way you could expose your body to the different
variations.
As to coral calcium, the jury is still out whether if
offers benefits to any significant extent than calcium and magnesium
supplements. However it is difficult to say since we have not seen any human
trials comparing calcium versus coral calcium. Therefore, the best calcium
supplement may be any form of calcium, and might as well choose the cheapest
calcium supplement.
Q. Does calcium influence iron absorption and vice
versa?
A. In short-term studies, dietary calcium and
supplemental doses of calcium chloride or calcium carbonate inhibit iron
absorption. In contrast, long-term studies regarding the effect of calcium
supplementation on iron status in populations at high risk for compromised iron
status failed to show any problems with iron status. Long-term consumption of
calcium supplements does not seem to affect overall iron status.
Q. Why do doctors check a blood calcium level?
A. A test for blood calcium is used by doctors to
diagnose and monitor a range of medical conditions relating to the bones, heart,
nerves, and kidneys. It is difficult to know levels of calcium in your tissues
based on blood calcium level. Blood calcium levels do not directly tell how much
calcium is in the bones, but rather, how much total calcium or ionized calcium
is circulating in the blood. The blood calcium level could be high while the
amount of calcium in the bones could be low. A high blood calcium level is
called hypercalcemia, and low blood calcium is called hypocalcemia.
Q. I'm a post-menopausal woman who needs to take in
calcium. But...I have chronic gastritis and can't tolerate any type of Calcium
supplement on the market...I've tried chelated, liquid chalcium, chewable
calcium ... health food store products ... over the counter pharmacy products,
etc. I do take an enteric coated multi vitamin but there is not very much
calcium in it. I need more....but I'm allergic to milk products. Can you direct
me to an enteric coated calcium supplement?
A. It should be easy to find by doing a google search
for calcium enteric coated.
Q. I was under the impression that calcium loss is due
to consuming too much animal protein. I have been a vegetarian all my life and
also never drink milk. My last bone density test was fine, it showed only a very
slight decline ... but after all, I am 77 now ... and feeling great! I take1500
to 2000mg calcium every night ... and add
Dandelion to help
against gallstones and kidney stones ... this comes from my European training .
Dandelion has always been strong in Austria and Germany ... not like here, where
it is considered an unsightly weed!
A. Although calcium loss could be partially due to
consuming too much animal protein, there are quite a number of factors that are
involved in maintaining healthy calcium levels in the body. Some people may
tolerate high calcium supplement intake of the amount you mention, but others
could increase their risk for kidney stones. I have not seen research on
dandelion and kidney stones, but then again there is not that much research on
herbal medicine.
Q. Does oral calcium disodium EDTA work in iron
overdose?
A. Oral calcium disodium EDTA has limited effect on
iron absorption in iron overdose when ingested an hour later.
Q. You often recommend taking a break from supplements.
Does taking a break from supplements include calcium, especially for women?
Also, it's often said that taking calcium close to whole grains, beans and some
other foods, makes it harder to absorb the calcium. Is it better to take it
between meals for that reason?
A. Each person is different, but as a rule and for
practical reasons one need not worry about the timing of calcium. It should be
taken whenever convenient, sometimes with meals, sometimes on an empty stomach.
As for breaks with a calcium supplement, this probably does not apply to women
who are prone to moderate to severe osteoporosis, it is probably better they
take the calcium quite regularly.
Q. I have been advised to take calcium caltrate. Do you
have any information on it. How does it differ from other calcium. I have
osteoporosis, not too bad and have been taking Actonel which I prefer not to.
A. Calcium Caltrate is the brand name product for calcium
carbonate and vitamin D. Calcium Caltrate contains the following: Calcium
Carbonate, Cholecalciferol (Vitamin D), Starch. Contains Less than 2% of the
Following: Croscarmellose Sodium, Dl-Alpha Tocopherol, FD&C Yellow No. 6
Aluminum Lake, Gelatin, Hydroxypropyl Methylcellulose, Magnesium Stearate,
Partially Hydrogenated Soybean Oil, Sucrose (Adds a Negligible Amount of Sugar),
Titanium Dioxide. May Contain Less than 2% of the Following: Glycerin,
Polydextrose.
Q. Do you know of any ways of decreasing
intracellular calcium in the skeletal muscles (causing spasms) apart from taking
magnesium (which I am doing for a few weeks now).
A. We have not seen any reliable studies with supplements in terms
of their effect on intracellular calcium.
Q. Are there any negative side effects to taking the
full amount of calcium at one time? I have been taking a multivitamin with 450mg
of calcium along with another 500mg calcium supplement in the evenings due to a
medication I have to take in the mornings which shouldn’t be combined with a
either of those supplements.
A. It is difficult to say for sure, but perhaps the risk for kidney
stone could be higher if a very high amount of calcium is taken at one time? We
are not sure, it is just an educated guess.
Q. What do you know about calcium aspartate anhydrous
for osteoporosis? My OBGYN has never heard of it, but I saw their web site (Made
by Elixer Co.) and they make strong claims about calcium aspartate anhydrous for
osteoporosis. I can't find any information on about calcium aspartate anhydrous,
any thoughts?
A. We have not seen any significant human research with calcium
aspartate anhydrous for osteoporosis, therefore any claims that this form of
calcium is superior to other forms of calcium, such as calcium citrate or
calcium carbonate, is premature.
Q. I am a medical doctor from Mumbai, India, and had an
opportunity to visit your website and was impressed with the knowledge base it
offers from a clinician of stature of Dr. Sahelian. I am a physician using
conventional calcium formulations in clinical practice in various indications
including pregnancy, lactation and in osteoporosis. Recently, claims are made
for better absorbable calcium are made for various new formulations e.g.,
calcium aspartate anhydrous (CAA). Unfortunately, the scientific information on
calcium aspartate anhydrous is limited. I am informed that calcium aspartate
anhydrous is perhaps one of the few formulations which provides highest
"absorbable" calcium. Now, this could probably change the rules of the game, as
the conventional calcium formulations always talked about "elemental" calcium,
while calcium aspartate anhydrous is talking about higher "absorbable" calcium.
We have been taught through textbooks, & all guidelines (RDAs/ RDIs/ RNIs) also
tell us to calculate the calcium intake based on "elemental" calcium per tablet,
which however as we know, does not translate into "absorbable" calcium, which
finally is bioavailable. My question simply put is, Whether we can have any
guidelines on daily requirement of "absorbable" calcium? I understand that
calcium supplementation needs to be individualized, but due to new formulations
and new concepts coming up, we need to have this basic information, so as to use
it appropriately. I will very much appreciate if you could kindly send me the
response & related information, which would be a great learning for an
academically oriented clinician like me.
A. Even after several decades of research with well known types of
calcium supplements, such as calcium carbonate and calcium citrate, the ideal
dosage of calcium and frequency of use has not been fully determined for the
treatment of osteoporosis. Many newer forms of calcium are being promoted, such
as calcium aspartate anhydrous. Since long term human studies with calcium aspartate
anhydrous are lacking, it is difficult to make any recommendations. For the time
being, one should rely mostly on calcium carbonate or calcium citrate, although
alternating these with calcium aspartate anhydrous seems to be practical and
reasonable. If a form of calcium, such as calcium aspartate anhydrous, is
claimed to be better absorbed, could it also lead to a higher risk of side
effects, such as kidney stones?