Guide to Buying Calcium Supplements

Do NOT buy Calcium if you have not read a good source showing you which Calcium is best for you. Please read this before you make a choice.

Fine, so you need a Calcium supplement. Well there are some things you should know BEFORE you make the purchase. There are so many and they are NOT all the same. I am not selling any of the products but I will shoot straight with you. Most Calcium supplements are fine but are indicated for different populations, and other supplements are simply substandard.

What does Calcium do for me?

• 99% of your body's calcium is stored in your bones. Bones allow us to stand against gravity, like beams in a sky scraper. Without bones we would be a pile of squishy flesh. Bones also give our muscles something to pull against when they flex, allowing us mobility.
• Muscle cells use calcium to contract (or flex) and nerve cells use calcium to help them talk to each other.
• For these reasons calcium is tightly regulated in the body. Too much or not enough can be detrimental and even fatal.

So what does Vitamin D have to do with it?

• Vitamin D is a hormone produced from cholesterol (yes cholesterol actually plays a big role in normal body functioning within certain healthy limits) and regulates blood levels of calcium, phosphate and parathyroid hormone.
• Vitamin D activates calcium absorption in the gut. When given with a calcium supplement it will maximize the amount of calcium the gut is able to absorb at one time, which is limited.

What should I know about calcium absorption?

• The gut can only absorb 200-400 mg of calcium at one time. This is important because taking a calcium supplement with much more than 500 mg of calcium will simply fill your toilet with calcium that wasn't absorbed. Vitamin D is important in maximizing the absorption of calcium, so please do NOT think Vitamin D will give you super-absorption.
• Individual doses of calcium should be roughly 500-650 mg, and Vitamin D should roughly 100 IU in a single tablet.
• Usual daily doses of calcium will be around 1200 mg which means you will be taking a 500 mg calcium supplement 3 times a day.
• Doses exceeding 2000 mg in a day can cause constipation, nausea, vomiting and renal stones.

So how much calcium do I need? And how much Vitamin D should be in a supplement to maximize my absorption?

Daily Dosing for Males and Females ages 25 and up

25-50 (M/F): Calcium 1000 mg per day w/ Vitamin D 200 IU per day

Post-menopausal (w/ estrogen): Calcium 1000 mg per day w/ Vitamin D 200-600 IU per day

Post-menopausal (no estrogen): Calcium 1500 mg per day w/ Vitamin D 200-600 IU per day

M/F > 65 or w/ osteoporosis: Calcium 1500 mg per day w/ Vitamin D 200-600 IU per day

REMEMBER: These doses are NOT single daily doses. You will not be taking this much all at one time. Remember I said your gut cannot absorb more than 200-400 mg of calcium per dose? This is where you need to apply that knowledge. The doses shown should be divided into 2 or 3 doses per day. So a 1200 mg daily doses would mean you take a 500 mg calcium tablet 3 times a day. You would not take them all at the same time and you would not try to find a 1200 mg tablet (I have seen them) to take once a day. It won't work! The total dose listed above must be spread out over the course of the day, at least a few hours apart.

It should go something like this: 500 mg morning + 500 mg noon + 500 mg evening = 1500 mg total daily dose

Each tablet should contain about 100 IU of Vitamin D.

Okay, I understand the dose, so now tell me about the supplements. Which one is right for me?

• Calcium phosphate, carbonate and oyster shell calcium are not easily absorbed and REQUIRE an acid pH in order to be absorbed. Most people have no problem getting an acid pH (very acidic) in the stomach, but patients on acid suppression therapy (for acid reflux or GERD) should NOT take these products because they will not absorb it well. However, these are fine for people who are not on acid suppression therapy. Take any of these with food to increase the contact of the tablet with stomach acid. Food stimulates digestion, which stimulates acid production which makes the calcium more absorbable.
• Calcium gluconate, citrate and lactate do NOT require an acid pH so patients on acid suppression therapy like proton pump inhibitors (Prilosec and Nexium) or H2 blockers (Zantac, etc...) would be able to take these and get benefit. They tend to be more expensive but they can be taken without regard to meals.
• Neither supplement type has been proven to be better than another in trials so just choose based on what works for you. And I think the calcium chews are just fine if you can't handle swallowing big 'ole pills 3 times a day, my wife thinks they are quite tasty, especially the chocolate ones.

How do I find out what kind of calcium a supplement has in it?

Some will tell you on the box, like Oyster Shell calcium. But if it only says it contains calcium then you can look at the ingredients, this is a different section than the table that lists amounts, and the kind of calcium will be listed there. The amount of calcium and Vitamin D will be listed in a special table that shows the amounts of the products being advertised. The label may also list it as %Daily Value or %DV. If these terms are confusing please visit the FDA website on how to read a product label and you will get a good idea of what you are looking at when you pick up a supplement bottle.

I sincerely hope this guide has been a help.