From the Guidelines
Calcium supplements can decrease phosphate levels in a healthy population.
Effect of Calcium Supplements on Phosphate Levels
- The evidence suggests that calcium supplements can reduce phosphate absorption in the gut, leading to decreased phosphate levels 1.
- Phosphate supplements should not be given together with calcium supplements or foods with high calcium content, as precipitation in the intestinal tract reduces absorption 1.
- The optimal approach is to keep nutritional calcium intake within the normal range for age, and supplements are not recommended given the potential risk of hypercalciuria 1.
- In the context of treating X-linked hypophosphataemia, calcium supplements are not recommended, and a dietary evaluation of daily calcium intake should be performed instead 1.
- The focus should be on maintaining adequate phosphate levels through phosphate supplements and active vitamin D, rather than relying on calcium supplements 1.
From the Research
Effect of Calcium Supplements on Phosphate Levels
- The effect of calcium supplements on phosphate levels in a healthy population has been studied in several research papers 2, 3, 4, 5, 6.
- A meta-analysis of 12 studies found that phosphate supplements decreased urine calcium excretion and increased calcium balance, regardless of the level of calcium intake or the degree of protonation of the phosphate supplement 2.
- Another study found that calcium phosphate supplementation increased faecal calcium and phosphorus, urinary calcium, and positively modulated blood lipids, while sole phosphate supplementation increased urinary phosphorus and decreased urinary calcium 3.
- The absorption of tricalcium phosphate was compared to calcium carbonate in 10 women, and it was found that calcium absorption was adequate, and despite a rise in serum phosphorus, it did not stimulate parathyroid activity 4.
- A study evaluating the effect of calcium intake on phosphorus absorption found that increasing calcium intake without a corresponding increase in phosphorus intake decreased phosphorus absorption, and high Ca:P ratios can occur with the use of non-phosphate calcium supplements 5.
- A study on the digestive absorption of calcium phosphates in elderly patients found that calcium balance remained positive under calcium phosphate treatment, and these salts, especially tricalcium phosphate, may be useful for therapy and mass prevention of senile osteoporosis 6.
Key Findings
- Phosphate supplements can decrease urine calcium excretion and increase calcium balance 2.
- Calcium phosphate supplementation can have positive effects on blood lipids and gut-related parameters 3.
- Tricalcium phosphate is absorbed adequately and does not stimulate parathyroid activity 4.
- Increasing calcium intake without a corresponding increase in phosphorus intake can decrease phosphorus absorption 5.
- Calcium phosphates may be useful for therapy and mass prevention of senile osteoporosis 6.