Should you take a calcium supplement

Q: Should I be taking calcium pills for my bones?

65-year-old Janet has fallen several times in the past 5 years. Unfortunately, each of those falls caused broken bones. She has broken both her right and left thigh and left wrist, each requiring surgery to put them back together. 

Janet has osteoporosis, or “thin bones." She went through menopause at age 40, and ever since, she has been losing bone mass. After her second fracture, Janet’s doctor started her on a bone-building medicine and recommended that she take a calcium supplement every day. 

Calcium helps keep our bones healthy, but it has other critical jobs: your muscles, nerves, and blood vessels depend on calcium to work properly. Each time your heart beats and you take a breath, your heart and chest muscles are working to keep you alive and well.

However, suppose you don’t have enough calcium available for your muscles. When that happens, your body will grab for more calcium, taking it from your bones. Your skeleton is like a cash machine, but for calcium,  instead of $20 bills.

If your body needs to find more calcium frequently, those withdrawals of calcium will eventually weaken your bones. As your bones become thinner, you will be more likely to break your wrist, hip, or other bones when you fall.

How much calcium do you need?

The Institute of Medicine recommends 1000mg daily of calcium for men and women up to age 50 and 1200mg for all adults over age 50. Most postmenopausal women get only 600-900mg of calcium daily through their food and need an additional 300-600mg of calcium daily from some other source.

More calcium is NOT necessarily better. Recent studies have shown that you can actually get TOO MUCH calcium, increasing your risk of heart attack or stroke. It’s suspected that taking a calcium supplement may damage blood vessels when concentrated calcium tablets cause your blood calcium level to spike.

Taking large doses of calcium supplements can also encourage the formation of painful kidney stones. For best results, get as much of your calcium from your food as possible instead of just from calcium pills.

Calcium carbonate is the most concentrated form of calcium supplement available but can cause constipation. Calcium citrate is absorbed better and also a better choice if you take an acid-blocking medicine like Prilosec® (omeprazole) for heartburn.

Weight-bearing exercises like walking and eating dried plums also improve your bone strength. 

Here are 5 tips on building bones with calcium:

1.     Eat calcium-rich foods.

Most people get about 300mg of calcium daily from non-dairy sources. There is 300mg of calcium per serving of dairy products, including milk, yogurt, and cheese. Green vegetables, oranges, and figs also contain calcium. You also can use the Calcium Calculator, available both as a phone app for iPhone and Android phones and online at The International Osteoporosis Foundation website www.iofbonehealth.org at their Quick Links.

2.     If you take a bone-building medicine like Fosamax® (alendronate), Actonel®(risedronate), or Boniva®, you should also take a calcium supplement.

Bone-building medicines increase how much bone your body puts into your skeleton. You need enough calcium in your blood for these medicines to work for you. For most women, it means taking a calcium supplement.

3.     Avoid taking more than 500mg of calcium supplement at the same time.

Your body will absorb calcium better at this lower dose. This limit will also prevent a “spike” in your calcium levels. This helps avoid increasing your risk of heart attack and stroke from elevated calcium levels in your blood.

4.     Get 400 IU of Vitamin D every day.

Vitamin D is necessary to help your body absorb calcium and may help prevent falls in the elderly. You can get vitamin D from exposing your skin to the sun. Foods rich in calcium include salmon (800 IU per 3 ounces), canned tuna (150 IU per 3 ounces), fortified milk (about 120 IU per 4 ounces), and fortified orange juice (80 IU per 4 ounces). 

5.     Consider dried plums to build bone.

In multiple studies over the past 7 years, postmenopausal women who ate 50 grams of dried plums daily (5-6 large dried plums) had very little bone loss. Despite the extra calories, their weight and blood sugar remained stable, most likely because of the high fiber content of the plums. Janet wanted to add plums (also called prunes) to her diet. Because of their laxative effect, I suggested she start out eating 1-2 plums daily, increasing it by 1-2 plums every week.

Dr. Louise Achey, Doctor of Pharmacy, is a 43-year veteran of pharmacology and the author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Get clear answers to your medication questions at her website and blog, TheMedicationInsider.com.

©2022 Louise Achey