From the Guidelines
If your blood calcium levels are normal but you're not getting enough calcium in your diet, you should consider taking a calcium supplement to maintain optimal bone health and prevent potential bone density loss over time. For adults, a typical recommended dose is 1000-1200 mg of calcium daily, divided into two doses of 500-600 mg each for better absorption, as suggested by 1.
Key Considerations
- Calcium citrate can be taken with or without food and is often better absorbed, especially for older adults or those taking acid-reducing medications.
- Calcium carbonate is less expensive but should be taken with food.
- When selecting a supplement, look for ones with added vitamin D (usually 800-1000 IU daily), as vitamin D is essential for calcium absorption, although the provided evidence does not directly address this point.
Dietary Recommendations
- Increase dietary intake of calcium-rich foods, mainly dairy products, as recommended by 1.
- Other dietary sources of calcium include fortified plant milks, leafy greens, and canned fish with bones.
Safety and Efficacy
- Calcium supplements usually have few side effects, although constipation and bloating are common and nephrolithiasis occurs infrequently, as noted in 1.
- Recent studies have raised concern about an increased cardiovascular risk with the use of calcium supplements, but the findings are inconsistent and inconclusive, as mentioned in 1.
Gradual Supplementation
- Start supplements gradually to avoid digestive discomfort like gas or constipation.
- Even with normal blood calcium levels, your body may be maintaining those levels by drawing calcium from your bones, which can lead to decreased bone density over time.
From the Research
Calcium Supplementation for Patients with Normal Blood Calcium Levels
For patients with normal blood calcium levels who have a calcium-deficient diet, the following supplements may be recommended:
- Calcium carbonate or calcium citrate supplements to increase calcium intake [ 2 ]
- Vitamin D supplements, such as vitamin D3, to support calcium absorption and bone health [ 3 ]
Important Considerations
When considering calcium supplementation, it is essential to note the following:
- Excessive calcium intake (more than 2,500 mg/day) can lead to adverse effects on body mineral balance [ 4 ]
- Patients with primary hyperparathyroidism may benefit from modest calcium supplementation (500 mg Ca(2+)) if they have a low calcium intake [ 5 ]
- Calcium supplementation may decrease parathyroid hormone levels and increase bone mineral density [ 5 ]
Potential Interactions and Side Effects
Potential interactions and side effects of calcium supplementation include: