Osteoporosis and calcium: Do you need a supplement?

Osteoporosis, which translates to “porous bone”, is a disease that occurs when the body breaks down more of the bone than it rebuilds. It causes bones to become very brittle so that even a mild fall could cause a fracture. While adults 50 and older have a higher risk of developing this condition, another big risk factor is low calcium intake. Foods rich in calcium and calcium supplements can be beneficial in strengthening bones and preventing this condition from worsening. Abby Todt, PharmD, BCPS, Pharmacy, Parkview Health, offers recommendations.

 

Why is calcium so important?

Calcium is a mineral that can be found throughout the body, in certain foods and as a dietary supplement. It is essential for the body because it not only helps in strengthening bones but also is used in muscle contraction, heart contraction and other critical body functions. It is especially important for bone health because 99% of the body’s supply of calcium is stored in the bones and teeth.

 

Which foods are good sources of calcium?

Food is the most important source of calcium. Dairy products, such as milk, yogurt, and cheese, are very rich in calcium. A few non-dairy products that contain calcium include calcium-fortified juices, canned sardines, soybeans and some green leafy vegetables such as collard, turnip greens and kale. You can also check food labels which will list calcium as a percentage of the daily value (DV). The DV is based on 1,000 mg of calcium per day, such that 15% DV=150 mg or 20% DV=200 mg.

 

What is the role of supplementation?

It is recommended to get most of your calcium through food sources and only take a calcium supplement if needed to make up for a lack of calcium from food. If you decide that you do need to take a supplement, it is important to make sure you examine the label on the product and look for the “USP Verified Mark” or the word “purified”. This means the product is approved according to USP standards.

There are two main forms of calcium supplements: carbonate and citrate. Carbonate relies on stomach acid for absorption so it should be taken with food, whereas citrate can be taken with or without food. Each supplement also differs in the amount of elemental calcium they contain; carbonate is 40% calcium and citrate is 21% calcium. It is also important to know that calcium is best absorbed when taken in smaller amounts (≤ 500-600 mg at once) so split the total daily dose between meals if possible. Also, taking calcium along with a vitamin D supplement will increase its absorption.

Side effects can include gas or constipation. You may try to increase fluids intake to minimize these effects or switch to another type of calcium supplement if necessary. It is important to inform your healthcare provider and pharmacist if you are taking a calcium supplement to avoid interactions between other medications.  

 

What’s the proper dosage?

The body does not make its own supply of calcium, so it is important to make sure you are getting the recommended intake through other sources. According to the National Osteoporosis Foundation, women ages ≤ 50 years old need 1,000 mg daily and ≥ 51 years old need 1,200 mg daily. Men ages ≤ 70 years old need 1,000 mg daily and ≥ 71 years old need 1,200 mg daily. These total daily requirements include the amount of calcium you get from food and supplements combined.

 

 

 

Sources:

National Institutes of Health [Internet]. USA.gov. Calcium: Fact Sheet for Health Professionals; [updated 2017 March 2, cited 2018 April 21]

National Osteoporosis Foundation [Internet]. Arlington (VA): NOF; c2018. Calcium and Vitamin D; [updated 2018 Feb 26, cited 2018 April 21]

National Osteoporosis Foundation [Internet]. Arlington (VA): NOF; c2018. What is Osteoporosis; [cited 2018 April 21]

USDA Choose My Plate [Internet]. Washington DC: U.S. Department of Agriculture. Non-dairy Sources of Calcium; [updated 2016 Jan 12, cited 2018 April 21]

 

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