Osteoporosis Prevention: Take Calcium. Part 2

Are all calcium supplements alike?
While all calcium supplements will provide calcium, they do differ in reference to how much elemental calcium is present. For example:

Type % of Elemental Calcium
Calcium gluconate 10%
Calcium lactate 10%
Calcium citrate 30%
Calcium phosphate 30-40%
Calcium carbonate 40%

The most frequently used calcium supplements are calcium carbonate and calcium citrate.

Specifics regarding some of the above forms of calcium:
Calcium carbonate — Take with meals since stomach acids help to increase its absorption. It is relatively inexpensive but may be associated with constipation or gas. Note: The gas or constipation can be minimized by increasing fluid intake.

Calcium citrate — Does not need to be taken with meals and less likely to be associated with gas or constipation; however, it is often more expensive.

How much calcium supplementation should I take?
In order to determine how much calcium supplementation is needed, it is important to estimate dietary intake. Once you decide how much you need, then you can calculate “how many pills” you need to take. Most women can assume they will consume about 500 mg in their diet.

The total dosage of a calcium supplement should be based on the amount of elemental calcium present. For example: 1,000 mg of calcium citrate (30 percent elemental calcium) contains 300mg of calcium.

Is more better? 
Regarding medication, rarely is taking more than what is needed a good thing. In fact the “tolerable upper intake level” for calcium is 2,500 mg of elemental calcium. When you take more than that, you increase your risk for “hypercalcemia,” a condition that places you at increased risk for kidney failure and other diseases resulting from excess accumulation of calcium in tissues such as the eyes. Therefore, do not take more than the recommended dosage.

Do I still need calcium supplementation if I’m taking hormone replacement therapy?
Absolutely. However, women taking hormone replacement therapy need, on average, 500 mg less supplemental calcium than do women not taking hormone replacement therapy.

What about Vitamin D?
Vitamin D helps increase intestinal absorption of calcium. Current recommended daily intake for vitamin D is 400 IU for women ages 51 to 70 years and 600 IU for women over age 70. For women who are chronically ill or institutionalized, and others at especially increased risk for suboptimal Vitamin D intake, the National Osteoporosis Foundation recommends 400 to 800 IU/day.

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