Vitamin D is added to some calcium supplements. Proper vitamin D status is important because vitamin D is converted to a hormone in the body which then induces the synthesis of intestinal proteins responsible for calcium absorption.
- The absorption of calcium from most food and commonly-used dietary supplements is very similar. This is contrary to what many calcium supplement manufacturers claim in their promotional materials.
- Milk is an excellent source of dietary calcium because it has a high concentration of calcium and the calcium in milk is excellently absorbed.
- Calcium carbonate is the most common and least expensive calcium supplement. It should be taken with food. It depends on low pH levels for proper absorption in the intestine. Some studies suggests that the absorption of calcium from calcium carbonate is similar to the absorption of calcium from milk. While most people digest calcium carbonate very well, some might develop gastrointestinal discomfort or gas. Taking magnesium with it can help to avoid constipation. Calcium carbonate is 40% elemental calcium. 1000 mg will provide 400 mg of calcium. However, supplement labels will usually indicate how much calcium is present in each serving, not how much calcium carbonate is present.
- Antacids, such as Tums, frequently contain calcium carbonate, and are a very commonly-used, inexpensive calcium supplement.
- Coral Calcium is a salt of calcium derived from fossilized coral reefs. Coral calcium is composed of calcium carbonate and trace minerals.
- Calcium citrate can be taken without food and is the supplement of choice for individuals with achlorhydria or who are taking histamine-2 blockers or proton-pump inhibitors. It is more easily digested and absorbed than calcium carbonate if taken on empty stomach and less likely to cause constipation and gas than calcium carbonate.
- It also has a lower risk of contributing to the formation of kidney stones. Calcium citrate is about 21% elemental calcium. 1000 mg will provide 210 mg of calcium. It is more expensive than calcium carbonate and more of it must be taken to get the same amount of calcium.
- Calcium phosphate costs more than calcium carbonate, but less than calcium citrate. It is easily absorbed and is less likely to cause constipation and gas than either.
- Calcium lactate has similar absorption as calcium carbonate, but is more expensive. Calcium lactate and calcium gluconate are less concentrated forms of calcium and are not practical oral supplements.
- Calcium chelates are synthetic calcium compounds, with calcium bound to an organic molecule, such as malate, aspartate, or fumarate. These forms of calcium may be better absorbed on an empty stomach. However, in general they are absorbed similarly to calcium carbonate and other common calcium supplements when taken with food.
- The 'chelate' mimics the action that natural food performs by keeping the calcium soluble in the intestine. Thus, on an empty stomach, in some individuals, chelates might theoretically be absorbed better.
- Microcrystalline hydroxyapatite (MH) is marketed as a calcium supplement, and has in some randomized trials been found to be more effective than calcium carbonate.
- Orange juice with calcium added is a good dietary source for persons who have lactose intolerance.
Prevention of fractures due to osteoporosis
Such studies often do not test calcium alone, but rather combinations of calcium and vitamin D. Randomized controlled trials found both positive and negative effects. The different results may be explained by doses of calcium and underlying rates of calcium supplementation in the control groups. However, it is clear that increasing the intake of calcium promotes deposition of calcium in the bones, where it is of more benefit in preventing the compression fractures resulting from the osteoporotic thinning of the dendritic web of the bodies of the vertebrae, than it is at preventing the more serious cortical bone fractures which happen at hip and wrist.Possible cancer prevention
A meta-analysis by the international Cochrane Collaboration of two randomized controlled trials found that calcium "might contribute to a moderate degree to the prevention of adenomatous colonic polyps".More recent studies were conflicting, and one which was positive for effect (Lappe, et al.) did control for a possible anti-carcinogenic effect of vitamin D, which was found to be an independent positive influence from calcium-alone on cancer risk (see second study below).
- A randomized controlled trial found that 1000 mg of elemental calcium and 400 IU of vitamin D3 had no effect on colorectal cancer
- A randomized controlled trial found that 1400–1500 mg supplemental calcium and 1100 IU vitamin D3 reduced aggregated cancers with a relative risk of 0.402.
- An observational cohort study found that high calcium and vitamin D intake was associated with "lower risk of developing premenopausal breast cancer."
Overdose
Exceeding the recommended daily calcium intake for an extended period of time can result in hypercalcemia and calcium metabolism disorder, as well as kidney stones.| < Prev | Next > |
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