About ConsumerLab.com. Pregnancy Hypertens 2014;4:97-104. [, Chen C, Ge S, Li S, Wu L, Liu T, Li C. The effects of dietary calcium supplements alone or with vitamin d on cholesterol metabolism: a meta-analysis of randomized controlled trials. The societies therefore concluded that calcium intakes that do not exceed the UL are safe "from a cardiovascular standpoint.". Amounts of calcium in supplements vary widely; multivitamin/mineral supplements commonly contain about 200 to 300 mg, and common amounts in calcium or calcium plus vitamin D supplements are 500 or 600 mg [14]. Calcium carbonate supplements can interfere with the absorption of levothyroxine (Synthroid, Levoxyl, and others), a thyroid hormone used to treat hypothyroidism and thyroid cancer [103-105]. [, Boaventura RM, Mendonca RB, Fonseca FA, Mallozi M, Souza FS, Sarni ROS. Absorption of calcium as the carbonate and citrate salts, with some observations on method. Dietary interventions on blood pressure: the Dietary Approaches to Stop Hypertension (DASH) trials. Similarly, a systematic review of 11 RCTs in 51,419 adults aged 50 and older found that supplementation with vitamin D and calcium for 2 to 7 years had no impact on risk of total fractures or of hip fractures [39]. Cochrane Database of Systematic Reviews 2015. Osteoporos Int 2016;27:367-76. [, Yao X, Hu J, Kong X, Zhu Z. These values, which vary by age and sex, include: Table 1 lists the current RDAs for calcium [1]. In children with rickets, the growth cartilage does not mineralize normally, which can lead to irreversible changes in the skeletal structure [1]. Other studies have found no association between calcium supplements and CVD risk or CVD outcomes. Effects of sevelamer hydrochloride and calcium acetate on the oral bioavailability of ciprofloxacin. Calcium carbonate is cheapest and therefore often a good first choice. Hypertension in pregnancy. Flushing or Sweating You may experience unusual skin reactions as a side effect of taking this type of calcium supplement. Review/update the For example, research has shown . A 4-year study of 1,500 mg calcium and 2,000 IU (50 mcg) vitamin D or placebo daily for 4 years in 2,303 healthy women aged 55 years and older showed that supplementation did not reduce the risk of all types of cancer [41]. [, Candelas G, Martinez-Lopez JA, Rosario MP, Carmona L, Loza E. Calcium supplementation and kidney stone risk in osteoporosis: a systematic literature review. [, Song X, Li Z, Ji X, Zhang D. Calcium intake and the risk of ovarian cancer: a meta-analysis. Am Heart J 2019;209:68-78. The USPSTF also determined the evidence on the benefits of calcium supplementation alone or with vitamin D to be inadequate to assess its effect on preventing fractures in men and premenopausal women. The normal range of ionized calcium in healthy people is 4.6 to 5.3 mg/dL (1.15 to 1.33 mmol/L) [7]. [, Chen M, Pan A, Malik VS, Hu FB. [, Zhao JG, Zeng XT, Wang J, Liu L. Association between calcium or vitamin D supplementation and fracture incidence in community-dwelling older adults: a systematic review and meta-analysis. The effect of vitamin D on calcium absorption in older women. Constipation can occur from a high-fibre diet if insufficient water is consumed. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice. Heaney RP. Fosamax (alendronate) works by inhibiting osteoclasts which are responsible for breaking down and reabsorbing bone (by a process known as bone resorption). [, Tai V, Leung W, Grey A, Reid IR, Bolland MJ. [, Wallace RB, Wactawski-Wende J, O'Sullivan MJ, Larson JC, Cochrane B, Gass M, et al. In this meta-analysis, ovarian cancer risk was 20% lower in participants in the highest category of dietary calcium intakes (more than 8201,500 mg/day, depending on the study) than the lowest intake category (less than 362800 mg/day, depending on the study). Food Chem Toxicol 2017;109:585-648. All varieties of calcium supplements are better absorbed when taken in small doses (500 mg or less) at mealtimes. No evidence for posttreatment effects of vitamin D and calcium supplementation on risk of colorectal adenomas in a randomized trial. However, serum levels do not reflect nutritional status because of their tight homeostatic control [4]. Other Cancers. History of changes to this fact sheet, U.S. Department of Health & Human Services, Division of Program Coordination, Planning, and Strategic Initiatives, Strengthening Knowledge and Understanding of Dietary Supplements, My Dietary Supplement and Medicine Record, Analytical Methods and Reference Materials (AMRM), NIH Consortium for Advancing Research on Botanical and Other Natural Products (CARBON) Program, Computer Access to Research on Dietary Supplements (CARDS) Database, Dietary Supplement Ingredient Database (DSID), ODS Participation in NIH Funding Initiatives, Administrative Supplements for Research on Dietary Supplements, Administrative Supplements for Validation Studies of Analytical Methods, Frequently Asked Questions About ODS Grants & Co-funding, Resources for Investigators Submitting Natural Products Research Grant Applications, Staff Bios, Publications, and Presentations, Federal Working Group on Dietary Supplements, NIH Dietary Supplement Research Coordinating Committee, Food Labeling: Revision of the Nutrition and Supplement Facts Labels, Small Entity Compliance Guide: Health Claims on Calcium and Osteoporosis; and Calcium, Vitamin D, and Osteoporosis, Sardines, canned in oil, with bones, 3 ounces, Tofu, firm, made with calcium sulfate, cup***, Salmon, pink, canned, solids with bones, 3 ounces, Tofu, soft, made with calcium sulfate, cup***, Breakfast cereals, fortified with 10% of the DV for calcium, 1 serving, Frozen yogurt, vanilla, soft serve, cup, Chinese cabbage (bok choi), raw, shredded, 1 cup, Apple, golden delicious, with skin, 1 medium. Taking Hydroxyapatite supplements can result in constipation. Dietary intake of calcium and magnesium and the metabolic syndrome in the National Health and Nutrition Examination (NHANES) 2001-2010 data. [, Chlebowski RT, Johnson KC, Kooperberg C, Pettinger M, Wactawski-Wende J, Rohan T, et al. A systematic review of the evidence. However, a systematic review and meta-analysis of four RCTs (not including the 2013 study by Cauley and colleagues) found that daily supplementation with 1,200 to 2,000 mg elemental calcium for 36 to 60 months reduced the likelihood of recurrent adenomas by 11%, although the supplements had no effect on risk of advanced adenomas [56]. Your body must be able to absorb the calcium for it to be effective. Supplementation with both calcium and vitamin D or consumption of dairy products fortified with both nutrients increased total BMD as well as BMD at the lumbar spine, arms, and femoral neck. Vitamins for MS: Do supplements make a difference? Am J Clin Nutr 2010;92:1017-22. Seek care from your doctor if you experience recurrent or chronic episodes of constipation. You may need to try a few different brands or types of calcium supplements to find one that you tolerate the best. Can a lack of vitamin D cause high blood pressure? Symptoms can be alleviated by switching to a supplement containing a different form of calcium, taking smaller calcium doses more often during the day, or taking the supplement with meals. Nutr Rev 2021. Regardless of which calcium supplement the patient is taking, there may still be the possibility of constipation. Institute of Medicine SCotSEoDR, Intakes,. Net absorption of dietary calcium is as high as 60% in infants and young children, who need substantial amounts to build bone, but it decreases to about 25% in adulthood and continues to decline with age [1]. Dietary supplement use and colorectal cancer risk: a systematic review and meta-analyses of prospective cohort studies. Doxycycline & Calcium Nutrition Benefits of Calcium Before Bed Health Differences Between Magnesium Chelates and Magnesium Citrate Those at risk for magnesium deficiency include men over 70 and teenage girls, and the effects of low magnesium include heart disease, Type 2 diabetes, osteoporosis and migraines. https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/. Consider taking calcium citrate in doses of 500 milligrams or less at one time to limit the . Ann Intern Med 2016;165:867-8. Accessed Oct. 18, 2020. [, Paik JM, Curhan GC, Sun Q, Rexrode KM, Manson JE, Rimm EB, et al. The Dietary Guidelines for Americans describes a healthy eating pattern as one that: This fact sheet by the National Institutes of Health (NIH) Office of Dietary Supplements (ODS) provides information that should not take the place of medical advice. JBMR Plus 2020;4:e10246. Calcium intake from diet and supplements and the risk of coronary artery calcification and its progression among older adults: 10-year follow-up of the Multi-Ethnic Study of Atherosclerosis (MESA). Calcium from foods and dietary supplements is absorbed by both active transport and by passive diffusion across the intestinal mucosa [1,3]. [, Hofmeyr GJ, Betran AP, Singata-Madliki M, Cormick G, Munjanja SP, Fawcus S, et al. Calcium absorption varies by type of food. Even if you eat a healthy, balanced diet, you may find it difficult to get enough calcium if you: In these situations, calcium supplements may help you meet your calcium requirements. Metabolic syndrome is a set of at least three risk factors for heart disease, stroke, and diabeteslarge waistline, high triglyceride level, low high-density lipoprotein cholesterol level, high blood pressure, and high fasting blood sugar level. Present Knowledge in Nutrition. Vitamin D is required for calcium to be absorbed in the gut by active transport and to maintain adequate calcium levels in blood [1]. A similar controversy surrounds calcium and prostate cancer. U.S. Pharmacopeial Convention. Am Fam Physician 2016;93:121-7. In another secondary analysis of data on 16,801 WHI participants, the supplements had no association with atrial fibrillation risk [70]. [, Wallace TC, McBurney M, Fulgoni VL, 3rd. If you are a Mayo Clinic patient, this could It is a naturally occurring mineral that is a large component of bones and teeth.. U.S. Department of Health and Human Services and U.S. Department of Agriculture. Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. The effect of calcium or calcium and vitamin d supplementation on bone mineral density in healthy males: a systematic review and meta-analysis. Blumberg JB, Frei B, Fulgoni VL, III, Weaver CM, Zeisel SH. Ask ODS 11th ed. A few examples are provided below. [, Khan B, Nowson CA, Daly RM, English DR, Hodge AM, Giles GG, et al. Calcium intake and breast cancer risk: meta-analysis of prospective cohort studies. Check food and supplement labels to monitor how much total calcium you're getting a day and whether you're achieving the RDA but not exceeding the recommended upper limit. The following groups are among those most likely to need extra calcium. Am J Kidney Dis 2003;42:1253-9. Limits foods and beverages higher in added sugars, saturated fat, and sodium. Dairy calcium intake, serum vitamin D, and successful weight loss. In people with low levels of stomach acid, the solubility rate of calcium carbonate is lower, which could reduce the absorption of calcium from calcium carbonate supplements unless they are taken with a meal [3]. Estimated Average Requirement (EAR): Average daily level of intake estimated to meet the requirements of 50% of healthy individuals; usually used to assess the nutrient intakes of groups of people and to plan nutritionally adequate diets for them; can also be used to assess the nutrient intakes of individuals. When signs and symptoms do occur, they can range widely because low serum calcium levels can affect most organs and symptoms [24]. Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%98%) healthy individuals; often used to plan nutritionally adequate diets for individuals. Ann Intern Med 2017;166:686-7. Medicines Nutr Rev 2006;64:S53-6. For the most part, the observational evidence does not show that increasing calcium intakes reduces the risk of fractures and falls in older adults. ConsumerLab.com. Rates of cancer incidence and cancer mortality did not differ between those who did and those who did not receive calcium supplements. SOMANZ guidelines for the management of hypertensive disorders of pregnancy 2014. Calcium. Each compound contains varying amounts of calcium referred to as elemental calcium. An expert panel convened by the National Osteoporosis Foundation and American Society for Preventive Cardiology determined, on the basis of moderate-quality evidence, that calcium intakes with or without vitamin D from foods or supplements neither increase nor decrease the risk of CVD or CVD mortality [73]. In 12 trials in 2,334 women, doses of less than 1,000 mg/day (usually 500 mg/day) reduced the risk of high blood pressure by 47% and of preeclampsia by 62%. Talk with your doctor or dietitian about whether calcium supplements are right for you. The most common symptom is increased neuromuscular irritability, including perioral numbness, tingling in the hands and feet, and muscle spasms [23]. [, Yang B, Campbell PT, Gapstur SM, Jacobs EJ, Bostick RM, Fedirko V, et al. More evidence, including from well-designed clinical trials, is needed to determine whether higher intakes of calcium can reduce the risk of metabolic syndrome. [, Hofmeyr GJ, Manyame S, Medley N, Williams MJ. Weaver CM, Heaney RP. Accessed Oct. 18, 2020. Yulia Reznikov/Getty Images. Some studies have shown that high calcium intake from dairy products and supplements may increase risk, whereas another more recent study showed no increased risk of prostate cancer associated with total calcium, dietary calcium or supplemental calcium intakes. In general, calcium carbonate is the most constipating. In contrast, a longitudinal study in 2,159 participants in Portugal evaluated at ages 13 and 21 years found no association between total dietary and supplemental calcium intake at age 13 and body mass index (BMI) at age 21 after the analysis was adjusted for energy intake [87]. Nutr Cancer 2009;61:47-69. Br J Nutr 2015;114:924-35. Effects were greatest in adults younger than 35 years and with doses higher than 1,500 mg/day calcium. Menopause leads to bone loss because decreases in estrogen production reduce calcium absorption and increase urinary calcium loss and calcium resorption from bone [1]. [, U. S. Preventive Services Task Force, Grossman DC, Curry SJ, Owens DK, Barry MJ, Caughey AB, et al. In: Coates PM, Betz JM, Blackman MR, et al., eds. Nutr Cancer 2011;63:827-41. As a result, absorption of calcium is only 5% for spinach, whereas it is much higher, at 27%, for milk [3]. Geneva: World Health Organization; 2018. However, be aware that adults only tend to absorb about 15 to 20 percent of the calcium found in food . [, Hidayat K, Chen GC, Zhang R, Du X, Zou SY, Shi BM, et al. Calcium carbonate is more often associated with constipation, bloating, and flatulence. However, two subsequent systematic reviews of the evidence from 10 studies in more than 8,000 adults with osteoporosis who took 120 to 1,500 mg supplemental calcium daily for 3 days to 3 years [98] and 11 RCTs in 51,419 adults 50 years and older who took 1,000 to 1,600 mg calcium with or without vitamin D for 2 to 7 years [39] found no such association. A diet containing more calcium than the typical U.S. diet because of added low-fat or non-fat dairy products lowered systolic blood pressure by an average of 5.5 mmHg and diastolic blood pressure by 3.0 mmHg [66]. [, Fong J, Khan A. Hypocalcemia: updates in diagnosis and management for primary care. Sixty percent of your bone weight is made from a mineral complex of calcium, phosphate, and hydroxy groups known as calcium hydroxyapatite. Calcium supplements aren't for everyone. How much calcium you need depends on your age and sex. Calcium deficiency can reduce bone strength and lead to osteoporosis, which is characterized by fragile bones and an increased risk of falling [1]. Other forms of calcium in supplements include gluconate and lactate. Geneva: World Health Organization; 2013. Calcium plus vitamin D supplementation and height loss: findings from the Women's Health Initiative Calcium and Vitamin D clinical trial. Calcium supplements and cancer risk: a meta-analysis of randomised controlled trials. U.S. Department of Agriculture, Agricultural Research Service. However, not all research supports this claim. Hypercalciuria, too much calcium in your urine, is associated with 90 percent of kidney stone cases. Accessed Oct. 18, 2020. Elemental calcium is listed in the Supplement Facts panel, so consumers do not need to calculate the amount of calcium supplied by various forms of calcium in supplements.
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