From the Guidelines
For most adults, the recommended calcium supplementation is 1000-1200 mg daily, with postmenopausal women and men over 70 typically needing the higher end of this range. This recommendation is based on the most recent and highest quality study available, which suggests that calcium supplements can reduce the risk of total fracture and vertebral fracture, but not hip or forearm fracture 1. The study also highlights the importance of accompanying calcium supplementation with vitamin D, as it enhances calcium absorption in the intestines.
Key Considerations
- Calcium supplements are best taken in divided doses of 500-600 mg at a time to maximize absorption, ideally with meals.
- Common supplement forms include calcium carbonate (40% elemental calcium, taken with food) and calcium citrate (21% elemental calcium, can be taken with or without food).
- For optimal absorption, take calcium supplements separately from iron supplements or high-fiber meals by at least 2 hours.
- Vitamin D (600-800 IU daily for adults) should accompany calcium supplementation to enhance calcium absorption in the intestines.
- Side effects may include constipation, gas, and bloating, which can often be minimized by starting with a lower dose and gradually increasing.
Rationale
The recommendation for calcium supplementation is based on the study by 1, which found that calcium supplements can reduce the risk of total fracture and vertebral fracture. The study also suggests that vitamin D supplementation can enhance calcium absorption and reduce the risk of fracture. Another study by 1 recommends a total daily calcium intake of at least 1000 mg per day for individuals under 50 years of age without major osteoporosis risk factors, and at least 1200 mg per day for those older than 50 years. However, the study by 1 is more recent and of higher quality, and its findings are consistent with those of 1 and 1.
Implications for Practice
The recommended calcium supplementation dosage can help maintain bone health, muscle function, nerve transmission, and blood clotting in adults. While dietary sources like dairy products, leafy greens, and fortified foods are preferable, supplements can help bridge nutritional gaps when diet alone is insufficient. It is essential to consider individual patient needs and medical history when recommending calcium supplementation, and to monitor for potential side effects.
From the FDA Drug Label
Directions - Adults and children 12 years and older chew and swallow 1 to 2 chewable tablets every 2-4 hours as needed. Do not exceed 5 chewable tablets in 24 hours. The normal calcium supplementation dosage for adults is 1 to 2 chewable tablets every 2-4 hours as needed, with a maximum of 5 chewable tablets in 24 hours 2.
From the Research
Normal Calcium Supplementation Dosage for Adults
The normal calcium supplementation dosage for adults can vary based on several factors, including age, sex, and physiological state.
- The recommended daily intake for men is 1,000 mg/day (25-65 years) 3, 4.
- For women between 25 and 50 years, the recommended daily intake is 1,000 mg/day 3, 4.
- For postmenopausal women on estrogen replacement therapy, the recommended daily intake is 1,000 mg/day, while for those not on estrogen therapy, it is 1,500 mg/day 3, 4.
- For all women and men over 65, the daily intake is recommended to be 1,500 mg/day 3, 4.
- According to another study, the recommended daily dietary allowance (RDA) for calcium for the elderly population (above age 65) is 700-800 mg/day 5.
- It is also suggested that calcium intake up to a total intake of 2,000 mg/day appears to be safe in most individuals 3, 4, and up to 2000 mg/day of calcium is safe in teenaged children and adults 6.
Factors Influencing Calcium Requirements
Several factors can influence the amount of calcium required for optimal skeletal health, including: