Should You Take Calcium Supplements

Ask Dr. Louise

Q: My doctor told me I may not need all of my calcium supplement. Don’t I need to take calcium pills for my bones?

Last fall, my 75 year old next door neighbor fell down 3 steps, shattering her left ankle into tiny pieces which were painstakingly put back together during a 5-hour surgery. She has osteoporosis, or “thin bones” due to years of taking daily prednisone for an inflammatory condition called lupus. Because she takes a medicine to help build her bones back up, she needs to take a calcium supplement every day, but the rest of us may not need to do that.

We all need to get enough calcium every day to keep our bones strong, but it has other important jobs as well: your muscles, nerves and blood vessels depend on calcium to work properly. Every time your heart beats and you take a breath, the muscles of your heart and chest work to keep you alive and well. However, if you don’t have enough calcium available, your body will take some out of your bones, like an ATM (automated teller machine) for calcium instead of $20 bills.

If you run low on calcium occasionally, this only happens once in a while and it’s no big deal, but if your body pulls calcium out of your bones regularly, those withdrawals eventually weaken your bones, increasing your risk of a hip fracture, or worse.

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 adults older than 50 years of age. Most postmenopausal women get 600-900mg of calcium daily through their food, falling short of that goal unless they make up the difference with a calcium supplement.

Calcium supplements were recommended for as a way to ensure women and men at risk for osteoporosis get their full recommended daily dose of calcium, but recent studies have shown that you can actually get TOO MUCH calcium, which increases your risk of having a heart attack or stroke. It’s suspected that the spike in blood levels of calcium you get by taking a concentrated calcium supplement may actually damage blood vessels.

Taking large doses of calcium supplements also encourages the formation of painful kidney stones, so for bone health, getting ALL of your recommended daily calcium from taking a calcium supplement is no longer encouraged.

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

Weight bearing exercise like walking and eating prunes have also been shown to improve bone strength.  

Here are 5 Tips to Keep Your Bones Strong:
1.Get as much calcium from your diet as you can.
Most people get 300mg of calcium daily from non-dairy sources. You can also get 300mg per serving of dairy products like milk, yogurt and cheese. Green vegetables, oranges and figs also contain calcium.

2.If you take a medicine to treat bone loss such as alendronate (Fosamax®), risendronate Actonel®, or Boniva®, make sure you get enough calcium.

These medicines work by encouraging calcium back into your bones, but if you don’t have enough extra calcium available, they can’t help you.

3.Avoid taking more than 500mg of a calcium supplement at one time.
Your body absorbs calcium better and keeping your blood levels of calcium from “spiking” will help avoid increasing  your risk of heart attack and stroke.

4.Get 400 IU of Vitamin D every day.
Vitamin D is necessary to help your body absorb calcium, and can help prevent falls in the elderly. You can get vitamin D from the sun, but 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) are also good sources.

5.Eat dried plums or prunes to build bone.
In one study, women who ate 100 grams of dried plums daily for a year had measurably stronger bones. Despite the extra calories, none of the women in the year-long study gained weight, possibly because of the very high fiber content of the plums. 100 grams of dried plums is about 9 of those plump plums sold in big bags at places like Costco®. Watch out, though; plums (also known as prunes) have a natural laxative effect, so go slowly at first to avoid embarrassing side effects.

Dr. Louise Achey, Doctor of Pharmacy is a 40-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Your questions and comments are always welcome at ®2019 Louise Achey

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