Calcium Supplements. National Osteoporosis Foundation Web site. PDR Health Web site. Accessed June 3, Getting the Right Amount of Calcium.
July 11, Yvette C. Treating Calcium Deficiency Although calcium is best obtained through dietary sources, many individuals do not obtain sufficient calcium through diet alone. PT Ms. Coronary calcium is part of the development of atherosclerosis; it occurs exclusively in atherosclerotic arteries and is absent in normal vessel walls.
The amount of calcium in the walls of the coronary arteries, assessed by a calcium score, appears to be a better cardiovascular disease risk predictor than standard factors. Risks of Low Calcium Intake: As mentioned above, calcium is important for healthy bones and teeth, as well as for normal muscle and nerve function. There are health problems associated with low calcium levels: Children may not reach their full potential adult height, and adults may have low bone mass, which is a risk factor for osteoporosis and hip fracture.
Normal blood calcium levels are maintained through the actions of parathyroid hormone, the kidneys, and the intestines. The normal adult value for serum calcium is 4. Only ionized calcium is transported into cells and metabolically active. Decreases in the ionized free fraction of calcium cause various symptoms. Hypocalcemia, or low-level calcium, most commonly occurs with low calcium absorption, vitamin D or K 2 deficiency, chronic renal failure, and hypoparathyroidism.
Risks of High Calcium Intake: Many factors can increase blood calcium levels. Although the body has a built-in regulatory process for calcium absorption and maintenance, underlying diseases, medication interactions, or overuse of supplements can cause high calcium levels.
An abnormally high calcium concentration can cause damaging health problems and requires medical treatment. Although dietary calcium is generally safe, excessive calcium does not provide extra bone protection. In fact, if calcium from diet and supplements exceeds the tolerable upper limit, it could cause kidney stones, prostate cancer, constipation, calcium buildup in blood vessels, and impaired absorption of iron and zinc.
Taking calcium supplements and eating calcium-fortified foods may increase calcium above normal levels. As a result, it is very important to stick to the RDA and not exceed the recommended dosage. The best way to treat calcium deficiency is to prevent its occurrence. Modification of risk factors is imperative, and pharmacists can play a large role in this area.
They can recommend appropriate calcium and vitamin D supplements. Individuals, particularly women, at risk of low calcium should take foods and drinks rich in calcium and vitamin D, quit smoking, and increase weight-bearing and muscle-strengthening exercise. Estimation of total usual calcium and vitamin D intakes in the United States. J Nutr ; 4 Straub DA.
Calcium supplementation in clinical practice: a review of forms, doses, and indication, Nutr Clin Pract. Bunyardatavej N, Buranasinsup S. J Med Assoc Thai. Saljoughian M. The emerging role of vitamin K 2. US Pharm. Baun L, Russell TM. Reprinted with permission from Medical Letter consultants. Calcium supplements. Med Lett Drugs Ther ;42 Calcium supplements are derivatives of natural products, such as oyster shell or bone. Some are marketed primarily as antacids. Calcium carbonate and phosphate preparations have the highest concentration of elemental calcium, about 40 percent.
Calcium citrate contains 21 percent elemental calcium, and calcium lactate and gluconate contain 13 and 9 percent, respectively. A recent meta-analysis found that absorption of calcium citrate was 27 percent higher than that of calcium carbonate when taken on an empty stomach and 22 percent higher when taken with meals.
It did not make a difference which preparation of calcium was taken or in which dosage. Taking calcium with food in dosages of 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. Office of Dietary Supplements. Rosen HN. Calcium and vitamin D supplementation in osteoporosis. Department of Health and Human Services and U. Department of Agriculture. Dietary Guidelines Advisory Committee. Department of Agriculture, Agricultural Research Service. What people with celiac disease need to know about osteoporosis.
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