I’ve made the argument before that some supplements may be necessary even within the context of a nutrient-dense, whole-foods diet. Some nutrients are challenging to get through food alone, especially if you’re not digesting food optimally or you’re struggling with a disease that increases your need for particular nutrients. I routinely recommend supplements to many of my patients, and have seen the benefits of proper supplementation in my own life as well.
That said, there are several supplements that are commonly recommended by conventional doctors and healthcare practitioners that are unnecessary at best, and potentially harmful at worst. Perhaps the best example of this is calcium.
Are you taking a common supplement that may increase the risk of heart disease, stroke, and death?
Calcium has become extremely popular to supplement with, especially amongst older women, in the hope that it will prevent osteoporosis. We’ve all seen the products on the market aimed at the “worried-well”, such as Viactiv and Caltrate, suggesting that supplementing with calcium can help maintain bone health and prevent osteoporosis, a serious condition affecting at least 10% of American women. (1) Yet the evidence that calcium supplementation strengthens the bones and teeth was never strong to begin with, and has grown weaker with new research published in the past few years. A 2012 analysis of NHANES data found that consuming a high intake of calcium beyond the recommended dietary allowance, typically from supplementation, provided no benefit for hip or lumbar vertebral bone mineral density in older adults. (2) And a 2007 study published in the American Journal of Clinical Nutrition found that calcium supplements don’t reduce fracture rates in older women, and may even increase the rate of hip fractures. (3)
Beyond being ineffective for bone health, calcium supplements are associated with some pretty serious health risks. Studies on the relationship between calcium and cardiovascular disease (CVD) suggest that dietary intake of calcium protects against heart disease, but supplemental calcium may increase the risk. A large study of 24,000 men and women aged 35–64 years published in the British Medical Journal (BMJ) in 2012 found that those who used calcium supplements had a 139% greater risk of heart attack during the 11-year study period, while intake of calcium from food did not increase the risk. (4) A meta-analysis of studies involving more than 12,000 participants also published in BMJ found that calcium supplementation increases the risk of heart attack by 31%, stroke by 20% and death from all causes by 9%. (5)
An analysis involving 12,000 men published in JAMA Internal Medicine found that intakes of over 1,000 mg of supplemental calcium per day (from multivitamins or individual supplements) were associated with a 20% increase in the risk of death from CVD. (6) Researchers suspect that the large burst of calcium in the blood that occurs after supplementation may facilitate the calcification of arteries, whereas calcium obtained from food is absorbed at slower rates and in smaller quantities than from supplements. (7) It is also suspected that extra calcium intake above one’s requirements is not absorbed by bones, but rather excreted in the urine, increasing the risk of calcium kidney stones, or circulated in the blood, where it might attach to atherosclerotic plaques in arteries or heart valves. (8)
The Office of Dietary Supplements at the National Institutes of Health has compiled a comprehensive review of the health risks associated with excess calcium, particularly from supplementation. (9) For example, daily supplementation of calcium at 1000 milligrams is associated with increased prostate cancer risk and an increase in kidney stones. (10) Additionally, a recent Swedish study reported a 40% higher risk of death among women with high calcium intakes (1400 mg and above), and a 157% higher risk of death if those women were taking a 500 mg calcium supplement daily, compared to women with moderate daily calcium intakes (600-1000 mg). (11) A Consumer Lab analysis found that many of the calcium supplements they analyzed failed quality testing, including lead contamination and mislabeled contents. (12)
Even if you’re not popping a calcium supplement every morning, that doesn’t mean you’re not consuming supplemental calcium. Many commonly consumed foods in the United States are fortified with supplemental forms of calcium, including orange juice, breakfast cereals, non-dairy milks, breads, instant oatmeal, graham crackers, and other staples of the standard American diet. While these foods are typically eliminated on a whole foods or Paleo diet, it’s important to pay attention to whether some of your fridge staples, such as commercial almond, coconut, or other non-dairy milks, are fortified with calcium. You may be consuming more supplemental calcium than you realize. In addition, many multivitamins contain significant amounts of calcium—so be sure to check the label if you’re taking one. (This is one reason I advise against multivitamins in most cases: they contain too little of the right nutrients and too much of the wrong ones.)
If you’re concerned about maintaining healthy bones, you’re better off ensuring adequate calcium intake from foods like dairy products, sardines, salmon, dark leafy greens and bone broth. 600 milligrams per day from food (approximately two servings of dairy products or bone-in fish) is plenty to maintain adequate levels of calcium in the body. Healthy bone formation also depends on vitamin D and vitamin K2, both of which regulate calcium metabolism. There are also other minerals besides calcium involved in supporting bone health, such as silica and magnesium. If you have adequate levels of these nutrients, and regularly perform weight-bearing exercise, there is no need for calcium supplementation, which will likely do more harm than good.
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{ 91 comments… read them below or add one }
So how do I find a mineral supplement that doesn’t include calcium? I am taking mineral supplements prescribed by my functional nutritionist temporarily while I fix my gut problems, but I don’t want to have to buy 10 individual mineral supplements!
I cannot find any mineral supplements that do not include calcium, either. Most likely because there is a demand for calcium in supplement form, so it is added to EVERY multivitamin and multi-mineral out there! Perhaps that will change at some point soon, but what to do now?
I, personally, get my “mineral supplement” from bone broth because it is always recommended to get nutrients from food, and the minerals in bone broth are very bio available. I realize that you can’t always have bone broth, especially if you travel a lot, so supplementation is important. Lets hope that that demand changes.
I’m also curious if supplementation of other minerals could pose a problem, like calcium, as well. Hair analysis mineral testing is available for a couple hundred, but you need to understand how to interpret the results or have a practitioner who is experienced enough to interpret it. Always better to test, not guess. Then you can supplement only the minerals that you need.
By the way, do we know each other, Marisa?
Very timely. My doctor asked me to take calcium supplements and I looked at him skeptically and asked if there was really any proof that they helped. He said yes, but he would. I’ll stop them now. One less pill to take.
Fantastic! I wrote an article on this just last week, this is definitely something everyone needs to know about!
Where are you getting 600 mg a day? That’s just over half what I understand the RDI of calcium to be.
How much vitamin D should I be taking, especially during the winter months? Recently my blood work indicated I was somewhat deficient?
Thank you.
Our chiropractor recommend temporarily taking a calcium supplement after a mild back injury, claimed it would help the healing process. Do you support that?
I doubt it’s necessary.
Weight bearing exercises won’t do ANY good if you are not properly aligned. Bones must be aligned vertically in order to receive the benefit of gravity’s force on them. So stop wearing heeled shoes! Read hereandhere andherefor more info.
At my recent yearly checkup my doctor, too, gave me a script for calcium tablets. When I asked her some questions about nutrition, she referred me to the nurse-practitioner. This is why I rely on this site and others for the correct information.
Timely article, I’ve always believed that Calcium deficiency was more of a result of a poor digestion (due to food sensitivities/allergies, etc), vitamin D deficiency, and a lack of liberal quantities of dark leafy greens in the diet. We’ve been brainwashed to believe that we need a multivitamin, Cal-Mag supplement when women become older, or that we need to consume lots of milk and cheese – nice to see the other side being discussed.
You are spot on Doc, but keep in mind that the type of calcium being supplemented is critical. Calcium citrate and calcium lactate are highly bioavailable, while the mosts commonly used and cheapest to produce, calcium carbonate takes 12 steps to be converted to calcium bicarbonate (the form the body can use). Hence a myriad of studies showing Ca supps are harmful are testing the WRONG calcium. Devils in the details. Impaired digestion is the first challenge (stomach too alkaline) then Vit D is needed to pull the (converted) calcium out of digestion into blood serum, then EFAs are needed to pull the calcium out of serum into the tissues where it is needed.
Calcium of course is also more a factor of your acid/alkaline balance as your body will tend to deplete itself of calcium if there is too much acid, and the modern diet is certainly acid heavy.
In terms of nutrient supplementation my personal philosophy is that there are so many nutrients that we don’t know about yet. So many important ones have only really been discovered and I think this is the tip of the iceberg. I try to consume nutrient powerhouses so that I know I am getting all the known and unknown nutrients. i wrote a post where I came up with a micronutrient factor which is a number that identifies those foods with the most nutrients in them. It seems organ meats, and green vegetables (almost exclusively) can give you 99.9% of your nutrients and in huge quantities so my new goal is to aim for these predominantly.
I don’t think there’s good evidence for acid-base theories of osteoporosis are they relate to acidity/alkalinity from the diet
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114717/
Especially in regards to protein
http://jn.nutrition.org/content/141/3/391.long
http://link.springer.com/article/10.1007%2Fs394-001-8350-8?LI=true
We can regulate our pH by the bicarbonate buffering system and simply breathing out more CO2, both systems seem very simple. If you were to make a case for acidity >> osteoporosis, you might want to begin with pathology (metabolic acidosis, respiratory acidosis and lactic acidosis (not from exercise))
http://thepaleopremise.blogspot.com.au/2012/05/calcium-in-calcium-out.html
Hi Chris, what is your opinion about collagen supplements. My mother bought collagen drops that were being sold on a radio health program. When I looked at the label, I found a lot of added chemicals and an incomplete nutritional facts sheet. Does supplementing with collagen help the bones of older women? Do you recommend any collagen supplements or advise against them?
Collagen helps maintain joints, hair, and nails, not bone. The best and cheapest way to get collagen is from bone broths that use the bones of pasture-raised animals, because they always include all the mineral co-factors required to integrate the collagen into joints. The next best and cheapest way to get collagen is with powdered, beef gelatin, bought online.
What about the drugs prescribed for osteoporosis such as Actonel? Are they safe?
What form of “calcium” were used in these studies? citrate? chelated? lactate? carbonate? oyster shell?
gluconate? or some other form?
This is mindful of the report that came out that vitamin E was useless. Turns out the researcher used synthetic E, formulated in a lab, which is totally useless. The natural E has been saving lives for decades.
There are so many different studies of calcium presented here. The reporting is an all inclusive indictment.
It is too bad. The truth lies somewhere between the extremes you present.
I think you make a great point Mary and that was my question too!
I recently read the book Vitamin K2 and the Calcium Paradox, which I think adds insight to this.
I occasionally recommend calcium supplements to my clients, but very specifically, and not without the needed magnesium, vitamin D, and K2 in complement.
I’m far from being an expert but I do think that you make a good point as well. There are forms that are probably more easily absorbed by the body than others and those should not be put into the same category. Of course getting vitamins and minerals from food sources is always best. The problem is that our fruits and vegetables where you would get a good portion of your vitamins and minerals are sorely depleted of what we need., unless of course you grow your own or can purchase organic. I’ve just started on this water supplement x2o that has highly active minerals in it and is helping my body to become more alkaline then acidic. I strongly believe I’m getting the minerals I need from the sachet I put in my water and am so glad for it, but again, not being a chemist or an expert I don’t know. I just know how it makes me feel.
Chris,
Great article!
Your readers need to know that Magnesium is Nature’s physiologic Calcium Channel Blocker. This has been widely studied and documented in numerous peer-reviewed articles that start in the 1960′s (Altura/Altura, Iseri, etc.) and proceed all the way to the present day with Bolland & Reid (2010, 2011, 2012). The gig is up on Calcium as a supplement. In fact, it’s the fastest way to calcify the human body.
As you well know, there are at least 18+ nutrients needed to make healthy bone matrix. Calcium is but one of them, and the mineral that is ALWAYS overlooked is Magnesium! Why?… It does too much in the human body. There are 3,571 proteins that MUST have Mg to work, there are 350-500 enzymes that won’t work without Mg, in fact, ALL 150 Kinase Enzymes MUST have Mg to work — these are the enzymes that make all 100 trillion cells of our body work, btw, and finally, 98% of the ATP that runs our body & cellular functions MUST be attached to Mg. Why? It doesn’t work otherwise. Period.
Now the key to Osteoporosis is fascinating… Osteoblasts ONLY build bone matrix in an alkaline environment. In order to ensure that the bone stays alkaline requires the use of a key enzyme called: Alkaline Phosphatase. Any one want to guess what divalent, non-oxidant, metabolic mineral is REQUIRED?!? Yup, you guessed it: Magnesium!
It’s worth noting in your next blog on bone loss… It’s all about Magnesium…
Cheers!
I concur. Magnesium appears to be the poor cousin of calcium and to a less extent Vitamin D, mostly because of the media and industry advertising. And yet, it’s used in life-saving procedures in trauma, obstetrics and more. There are plenty of reasons for this. For one, Magnesium is a muscle mineral – affecting smooth muscles such as the heart. It’s found in the soft tissues and organs mostly, hence blood tests are not an accurate diagnosis of deficiency. Magnesium \ Calcium ratios are not balanced properly in many people. Soils are used and reused and contain less and magnesium – and magnesium is not always a common component in commercial fertiliser either.
If anyone knows of Mark Hyman MD, one of his secret weapons for patients is magnesium. I’ve also been put on a course of Mg myself and it was potentially life changing!
The dairy lobby and has a lot to answer for in my opinion.
Great information and I will certainly be forwarding on to certain family members…
What are your thoughts on calcium citrate supplementation to limit oxalate absorption? I’m hoping that my over-absorption of oxalates is a temporary issue, due to leaky gut and fat malabsorption – but I’m trying to balance the risk/benefit of taking calcium citrate for a time to help lower it.
Erin, I have the exact same question. My urinary oxalate levels were more than 3 times above normal, and I’ve had 3 kidney stones. I’ve been using 100-200 mg calcium citrate with most meals to help bind the oxalates in my food. But, having had my gallbladder removed, I’m wondering if fat malabsorption might be a big factor for me, along with leaky gut. (I also have a major autoimmune disease.)
I wanted to mention this too. I see an abundance of comments with a lot of varied questions that will be hard for Dr. Kresser to address them all, but my own direct concern is about oxalates.
I’ve been keeping track of my nutrient intakes and always noticed that Calcium tended to be “low” when compared to the RDA (Recommended Daily Allowance), precisely around 650mg in my case and always convinced myself it was Ok because I take in sufficient vits. D & K, other minerals qne sunshine, but was blindsided by the high intake of oxalates too, which the food-tracking software I use ignores completely. But I realized I took plenty of them, from Spinach and other dark-leafy greens, nuts and even dark chocolate.
I have been studying the possibility of supplementing Ca, but for now trying bone-in canned sardines once weekly, Salmon and also have taken to occasionally drink milk, which I didn’t before, in order to increase Ca, but still remain under the RDA.
Others I can’t seem to get in enough quantities (according to RDA) are Potassium, Vit E and often too Mg.
I’m curious what calcium supplements were used in these studies- were they limestone based or foodbased? I’m not arguing with the idea that people oversupplement on everything, including calcium, but am mainly curious of the forms of calcium supplementation. For example, there are some that are algae based, and include Vitamin K in the claim that it will direct the calcium to the bone and not the arteries. Thoughts?
Why not just get calcium from food, rather than food-based supplements? The studies covered a variety of forms of supplemental calcium, but they weren’t designed to detect differences between the forms.
I agree with Chris that synthetic calcium supplements are questionable. That said, I could not argue with the results that people got through calcium supplements doing RBTI. From an RBTI standpoint, using calcium supplements without regard to body chemistry is a hit or miss game. For example, people using using calcium lactate with an acidic pH are doing more harm than good in that it will tend drive down the pH.
I had two parathyroid adenomas removed a few months ago, and the Drs there recommend Citrical for life. I am more worried about the consequences of taking calcium supplements than I am about whatever risk there may be to me in not taking them, so am drinking raw milk, not taking calcium supplements. Otherwise following the PHD with recommended supplements. Hope this is an okay path for me to follow. I do get that low calcium tingling in my gums and mouth pretty frequently.
Eating fish bones is a great option for those that need additional calcium. This study (http://www.ncbi.nlm.nih.gov/pubmed/20646299) showed that calcium in salmon bones are well absorbed. The easiest way to do this is to buy canned salmon with the bones still in it from a place like Vital Choice.
Chris, what is your opinion on taking a calcium supplement temporarily in order to block cortisol levels (to lose weight)? This is regarding my husband who is working on tactics to get stress-levels under control, and the calcium supplement was recommended for him to try.
Thanks!
I did a paper on the risk of CVD in 65 yr + women talking Ca supplements in nursing school. I wish I had some of this info. It is validating to see we shared some studies! Thanks for this!
Thanks for the article! But what about when you are breastfeeding? I keep getting told that breastfeeding is sucking the calcium from my bones so I need extra at this time. I have had 2 children close in age and been breastfeeding the whole time. Does one need extra calcium in that situation? Thank you!
See my reply above. Eat salmon with the bones. Or bone broth. Or fermented, full-fat dairy. Or all of the above.
What about whole-food based calcium supplements, which contain algae etc rather than calcium carbonate/ citrate?
I’ve been asking myself this very question. I KNOW that while on a strict Paleo diet my calcium intake is low and I do eat/drink bone broth, but not every day. So, how should a strict Paleo person get enough calcium without dairy if they don’t eat 2 servings of fish and bone broth every day?!
What we women do if we are also pregnant and breastfeeding while on Paleo (no dairy)?
Canned salmon with the bones still in it.
Eating a lot of canned fish though will mean higher intakes of potentially oxidized PUFA. Will it not?
Yes, it’ll be oxidized, but I’m just wondering how much compared to just cooking salmon fillets? I wonder if routine consumption of canned salmon could eventually cause issues, but I’m just guessing balancing it out with anti-oxidants from other foods would be fine.
Hi Chris,
Thanks so much for your work.
My kids (ages 5 and 8) are dairy-intolerant and get no dairy. Getting dietary sources of calcium into kids is hard, although I try! I give them chewable supplements of 500 mg twice per day (total 1000 mg) since they are in the process of growing bones. Should I stop giving it to them? Cut back?
We eat mostly paleo plus rice. They are okay eaters, not great.
I take magnesium glycinate but if I take a decent dose (anything above 300-400mg daily) for a while I start getting nocturnal calf muscle cramps and twitching. The only thing that stops this is Lifestream Natural Calcium powder. I don’t like taking calcium because of all the anti-calcium stuff I’ve read but when I put my paleo-ish diet into FitDay I see that I don’t get enough calcium. I’m hoping that the form I’m taking is food-like enough to be ok. It’s produced from a certified organic sea vegetable called Lithothamnium calcareum and “demonstrates advanced bioavailability. Lifestream Natural Calcium contains 32-34% elemental calcium and other important co-factor minerals including boron, magnesium, zinc, copper, iodine and sulphur.”
Had the same experience. Greater than 300mg/day of magnesium glycinate caused late night calf cramps. Taking about 200mg/day calcium bisglysinate resolved. Looking at the study Chris Kresser quoted wrt salmon bones showed rough 1/4 of the content absorbed from cod bones, salmon bones, and calcium oxide. Considering spinach’s oxalates only lets 5-6% of it’s calcium be absorbed, it could be that the magnesium glycinate’s good absorption unbalanced the extra/intra cellular Ca/Mg ratio. Some of the crucifers (e.g. broccoli) have about 50% of their calcium absorbed.
Thanks Eric. How much magnesium glycinate do you take most days?
This is so timely! I just had a Dr appt this morning and my blood Ca level was L…well…1.11 and the low-range cut-off is 1.12!! She didn’t even ask me about my diet and proceeded to write me a Rx for Ca-Mg. I just kept my mouth shut, thinking to myself “As if I’m taking this”.
I don’t eat dairy and I don’t regularly consume bone broth, and umm..never sardines…but I eat lots of veggies and I just presumed I didn’t have to worry much about it. I’m 28, active…..just wondering if this “low calcium” is even something I need to worry about? Is blood Ca to be looked at differently than bone mineral density?
My mom was diagnosed with osteoporosis, but she’s trying to heal that with diet & supplements (and not the Rx the same Dr gave her!)
At the age of 40 I was diagnosed post menopausal and severe osteoporosis. I refused traditional biphosinates and took Bone Power a calcium boron supplement. In 2 years significant improvement to osteopenia and 4 years later borderline normal bone density. I felt this calcium reversed my osteoporosis. Once normal bone test I plan to reduce my dose but faithfully have taken 1250- 1500 daily…..
Dear Chris!
My experience is, that only exercises can prevent osteoporosis, and not calcium intake. I am a 57 years old woman, and 10 years ago I had to face the problem, that I am loosing bone density, and I have osteopenia. Calcium intake didn’t help at all, just my joints become aching.
Then I read, that as strong your muscles are, as strong are your bones too, and I did exercises or ran every day at least one hour. The consequence was that I gained 5% bones density within a year according the bones density test. So I never have taken calcium supplement since then.
Chris,
What are your thoughts on calcium (dietary or any type of calcium supplementation) during pregnancy? I heard from a midwife that a woman can increase her bone density during pregnancy only (after the age of 18)? Any weight to that?
I’m also curious about calcium in pregnancy. I don’t do well with dairy. I eat leafy greens about 4 times per week, and sardines and canned salmon weekly. A midwife told me that the fetus will take calcium from the mother’s bones if there is not enough intake. How many mg should pregnant women get daily?
Women require 5-7 times more mineral than men do in their childbearing years and 80% of that amount is calcium (Biological Ionization As Applied to Human Nutrition, p.80).
What If You Have Had Two Kidney Transplants, And A Parathyroidectomy!!! My Little Sister Has The Same Disease As I Do… She To Has Had Two Kidney Transplants, But Has Here Parathyroid Glands… She Had 87% Bone Loss In Her Hip N 85% In The Lower Lumbar!!! I Take Over 2400mgs. Calcium Carbonate Trough Out The Day, And 1600mgs. Magnesium Split Up With The Calcium… I Take An Anti Rejection Drug, That Leaches The Mag. Out Of Your System (prograf)… I’m A Raw Paleo Person!!! I Noticed A Huge Increase In My Calcium Levels (complete blood tests once every month), As Soon As I Started Eating A Quart Of My Own Raw Milk Yogurt, And 3/4 Of A Quart Of Raw Milk Everyday… By The Way, The Dexa Scans Show NO Bone Lose For Me!!! Of Course I Am A Bodybuilder As Well… I Put So Much Stress On My Bone Structure, It Is Unbelievable… I Suppose It Is All This Torque On The Bones That Help Keep Em’ Strong!!! I Did Back Off The Calcium Carb. 600mgs… Maybe I Should Do More!!! I Walk A Fine Line My Friend… I Enjoy Your Facebook Comments…
Thank You, Tom P.S. When I Had My Last Transplant, They Told Me I Had To Take Fosamax, Because Every Person That Had Been Transplanted For The Last Ten Years Got Osteoporosis… I Said, “Well, I Hate To Burst Your Bubble, But I Don’t Have It, And I Have No Parathyroids”… They Were Shocked… I Said, “You Can Hang On To You Fosamax”
My naturopath has recently suggested that I take a cal-mag powder at night. I’ve read a lot of information stating that both calcium and magnesium cannot be at the same level in the body, one must be higher than the other. So what is the point of taking the powder if the milligrams is the same for both? And is it doing more harm than good? I am new to eating Paleo, and so far have been really strict, so would it be more beneficial to me to start including a small amount of dairy back into my diet to ensure I get the nutrients I need from food instead of supplements? I haven’t been brave enough to try organ meats yet!
Once you’ve been diagnosed with osteoporosis, then what? I’m only in my early 50′s. After being diagnosed I declined all the scary treatments, weaned off acid-blocking meds that I suspect contributed to it (although the prescribing doctor denied it), and changed my diet to mostly Paleo. Will bio-identical estrogen (plus progesterone) help?
Hi Chris. I just had extensive preventive blood work and hair testing done. I have a lot of heavy metal issues and the chiropractor suggested using a powdered Vitamin C with Ribose of 4,000mg twice a day while going through chelation to get rid of the metals in my body. What do think of the detoxing effects of Vitamin C and the recommended dosages? I have had fibromyalgia for 20 years and am hopeful that if I eat the right foods, detox my body, and take the right supplements I can reverse the condition. Any suggestions in that area?
I’m suprised that you would endorse dairy as an adequate dairy source. Especially from a paleo perspective. Cows milk is a wonderful source of calcium–for calves. Unfortunately, the calcium it contains doesn’t seem to be bioavailable to humans for a number of reasons. For more info on this check out http://saveourbones.com/osteoporosis-milk-myth/. I would also mention to your readers the herb horsetail which is full of silica and helpful for bone health.
There’s a lot of pseudoscience in that article. Full-fat dairy consumption is linked with several beneficial health outcomes, including a lower risk of cardiovascular disease, obesity, diabetes and metabolic syndrome. (http://link.springer.com/article/10.1007%2Fs00394-012-0418-1)
Rapid genetic selection over the past 10,000 years have increased lactase persistence, the genetic mutation that allows us to digest lactose, to the point where 1/3 of the global population has it. In some Northern European countries, the percentage of people with lactase persistence is approaching 100%.
Even for those that are lactose intolerant, simply choosing full-fat dairy that is low in lactose (like butter, milk and hard cheese) or fermenting milk to make yogurt or kefir eliminates the lactose problem. Casein intolerance/allergy is rare.
This paper (http://www.jacn.org/content/19/suppl_2/119S.long), among many others, shows that calcium in milk is well-absorbed. In fact, calcium from milk is much better absorbed than calcium from green vegetables, because they contain oxalate, phytate, or both—which inhibit calcium absorption.
This is something also confirmed by RBTI practitioners as well as by Ron Schmid in his book The Untold Story of Milk. The dominant calcium compound of milk is calcium gluconate. It is the most easily digested calcium compound for those who have a weak digestion.
Gastric Bypass Relevancy?
Because I had a gastric bypass three years ago, this info on calcium has me concerned.
I’m supposed to take calcium citrate supplements because my rearranged plumbing makes it difficult to absorb dietary calcium (especially the non-citrate variety).
Does anyone have updated calcium intake information pertaining to people in my situation?
Thanks,
–Kirk in MN
Hi Chris,
What about Calcium D Glucarate to help combat high beta glucuronidase activity? Would it be better to just supplement with probiotics? What could be the cause of high beta glucuronidase activity found in the stool?
I eat a 99% compliant autoimmune variant of the paleo diet. Ran a few days worth of my dietary intake through nutritiondata.self.com. I was getting only 25% of the RDI of calcium. I also had symptoms of calcium insufficiency such as annoying cramps in my feet at night. After years of fearing calcium supplements because of bad press in the paleo community I decided to give 500 mg a day a go. The problem resolved within days.
Dr. Kresser,
I’ve been caring for my wife for 7 years now. She is on full time oxygen now. She has COPD, chronic emphysema. For 10 years she was taking “calcichew” which is 1000 iu of vitamin D3 + calcium per tablet. She has been taking 2 tablets a day. I had her vitamin D levels checked and they were deemed “insufficient” at 20 ng/ml. I believe that because she is house bound and takes regular courses of steroids this is why she had such low levels. I upped her intake of vitamin D and raised her levels to 65 ng/ml. She is very underweight at 85 pounds. That’s an increase of 4 pounds from 3 months ago. She drinks around 3 pints of milk a day through milky coffees or chocolate. My logic is that I’ve raised her vitamin D levels and she gets her calcium from her milk consumption, which is more effective than the calcichew tablets. She has no appetite and other than the milk, she eats very little. However she is getting very forgetful and her short term memory is suffering. I just wondered whether the excessive milk consumption could be a factor?
How is her sugar intake? I first heard the term from Dr. Mercola and Rosedale: Type 3 Diabetes. That’s what Alzheimers and other such dementia may largely be. As time has gone by, more and more a link between chronic high blood sugar and memory loss is being recognized. And I do believe it’s a causal link. So perhaps go a bit easy on the sugar? Also, coconut oil supplementation, perhaps 2 tablespoonfuls a day, have been purported by the Weston A. Price Foundation to be miraculously helpful for memory loss, even in late stages. Here is the article, I think that you will find the personal story in there to be of great interest:
http://www.westonaprice.org/know-your-fats/land-of-oz-attack-on-coconut-oil
Good luck to your wife, and God bless you for caring for her so passionately for all these years.
Craig, thank you for your suggestions and kind thoughts.
I think the short term memory loss is due to her poor oxygen levels more than anything else. Yes she does have too much sugar and eats so little that I can’t get her to eat healthily. Sadly that seems to be the case with this disease. She’s deteriorated to the point that eating is just too much effort. At least her milk consumption keeps her having some nutrition, and she has gained some weight.
Ironically I eat a grain free, minimal sugar anti inflammatory diet that I have developed to suit me since she became ill.
I follow the WAPF website and take in what they say.
I’ve tried to get her to eat coconut oil, as I do, but she won’t.
I think that I’ll just have to accept that milk is better than no milk in her case. If there is a detrimental effect to her brain, then so be it. I just hoped Chris Kresser had a view on this.
In the past when she has been on courses of steroids, she has had tweaks of pain in her spine. Bone loss is a known side effect. This hasn’t happened since she’s been on so much milk, probably 8 weeks of steroids in the past 26 weeks, so it may help in that way.
I posted this here because of the article being a bout calcium supplements, and her previous long term use of calcichew tablets.
If she’s willing to drink milk, would she be willing to drink milk or yogurt based smoothies? You could maybe get more nutrients for her that way. Although probably not coconut oil, unless you’re careful. It tends to make really nasty clumps in cold liquids.
Just a thought I had reading your post.
Dr. Kresser,
Your knowledge and willingness to share is a blessing. I know you cannot respond to every comment, but my children are dairy/gluten intolerant and I just found out thru homeopathic testing she is allergic to other biggies in our diet as well–salmon and almond (our calcium sources.) Can you please help with any suggestions. I am stressed and frustrated at the thought of giving them adequate nutrition. Thank you so much.
Thank you for this info. I will check my multi vitamin . My mother has always taken calcium and at 70 + years she had open heart to replace two heart valves, one being calcified (having calcium deposits on it??) I’ll be in touch.
I have seen good results using MRM’s Bone Maximizer III with calcium from MCHC , K2 (MK7), vitamin D, and other minerals.
what were your results?
Calcium supplements are dangerous when the calcium is free floating in the blood stream (due to acidity and lack of K2) which then unites with small dense LDL’s (caused by eating vegetable oils). It then lines the arteries (arteriosclerosis) which causes cardiovascular havoc.
When on an alkaline paleo diet, calcium is not pulled from the bones to neutralize the acidity (from high carb foods and sugar) and ingested calcium is put into the bones where it should go, providing there is plenty of K2 from grass fed meats.
When eating a normal diet (ie, high carb, grain fed meats, vegetable oils) don’t take calcium. But then don’t eat a normal diet if you want good health.
I forgot to add when doing a study of water throughout the world the people with the best cardiovascular health were those the water highest in calcium.
What do you think of Joel Wallach take on Calcium ?
http://www.youtube.com/watch?v=tH6N7tHGsi8#t=37m33s
Does this apply to coral calcium as well?
Hi Chris, great article but how do you feel about Standard Process supplements? They are mostly grown on a farm, started by Dr. Royal Lee in 1929, friend of Dr. Weston A. Price.
Clearly you are not well educated on nutrition if you are advocating dairy products for calcium and bone broth. With the exception of an organic animal, bone broth from any other will be very toxic. You also advocate the Paleo diet which is very acidic and not good for bone health or calcium levels. Eating a diet high in legumes and whole grains and vegetables is BEST for bone health and calcium. NOT an animal based diet. You are not educating people well.
All you’ve done here is make pseudoscientific claims not backed by peer-reviewed research. That’s not very convincing.
Don’t feed the troll
Chris,
Excellent work on this topic. I have been reading and researching the role of calcium supplementation and vascular disease and greatly appreciate you tackling this issue. Perhaps another piece to the puzzle that increases vascular calcification is having high vitamin D supplementation as well. Often those who take high calcium supplementation are also taking high levels of vitamin D, and as you have alluded to in the past, excessive vitamin D is troublesome as well. I wrote a piece on this that I would love your thoughts on if you are interested is contemplating the additive effects of calcium and vitamin D supplementation on vascular pathology. Thanks again for all your work!
link to piece: http://evolutionaryhealthperspective.wordpress.com/2013/02/18/vitamin-d-and-calcium-supplements-can-be-hard-on-your-heart/
I agree: I’ve warned against excess vitamin D supplementation and suggest maintaining levels between 35 and 55 or so, while ensuring adequate K2 & A intakes.
Hi Chris, I understand that these are recommendations for maintaining bone health. For those who are already diagnosed with osteoporosis, are the recommendations the same?
What if you are on medications like prednisone? I have been told it is very bad for my bones and I NEED 1200 mg of calcium per day. I take K2 and 4000 mg of E.
I’m lactose intolerant… Not a big soy or almond milk drinker either. I take one calcium pill a day to help with the lack of calcium I get from my diet. Is this not necessary or…
So glad I found this site. Great information is hard to get these days. Diet and exercise. Seems it always goes back to the basics, doesn’t it? So many want to take all the short cuts and it shows in the long run.
Chris, do these studies take into account the needed co-factors (magnesium, K2, D3, boron, silica, etc) needed to metabolize calcium and actually get it into the bone? Because otherwise, it seems any study that only addresses the use of the lone mineral ‘calcium’ would be a bit flawed. Calcium alone would do tons of damage, according to what you’re saying and I’m reading elsewhere. It should never be taken alone. I have one doctor telling me to supplement with calcium/mag, and another doctor saying don’t do it. Thanks for your informative article! I enjoy your site.
Hi Melissa, have you tried fermenting milk into yogurt or kefir ? The bugs will eat the lactose and save you the trouble. I shunned diary for many years because I thought it didn’t agree with me. Now I find I can take raw dairy with no problems, even if it’s not fermented. I believe soy milk is not a good source of calcium because it’s fortified with the cheapest form of Calcium, which is not well absorbed. Why would the manufacturers pay for the most expensive forms, like Calcium Citrate ? I’d rather get my calcium as it occurs naturally in dairy which has the co-factors that aid absorption.
Andrew Kim has some very convincing research that says otherwise, when it comes to Calcium supplementation: http://www.raypeatforum.com/forum/viewtopic.php?f=49&t=503
Mr. Kim seems to be very educated, and I’d like to get your opinion on it.
Hi Bill, if you’re still following. So sorry to hear of your wife’s troubles. Vit B12 can sometimes be helpful with memory loss/brain fog. A couple of informative websites are b12awareness.org and b12d.org.
Hi Bill,
I think that everyone is giving great advice, but I know how hard it can be to get someone to do something. I had a brain injury in May 2011 and was diagnosed with a severe DAI. 90% of patients with this injury never wake from a coma, and of those who do, most are in a vegetative state. I have been researching brain building nutrition, and the use of fish oils and other saturated fats is very important to heal the brain. In fact, they have had amazing results with fish oil in order to bring patients to consciousnesses after a brain injury.
http://t.co/KKyGR4HA
As Chris has said, 60% of the dry matter of the brain is lipid, and DHA and AA are the most abundant fatty acids of brain. AA and DHA are both found in fish oils and the brain needs them to repair itself. I’d recommend Mary Enig’s book: “Know Your Fats” or “Brain Building Nutrition” by Michael A. Schmidt.
I know that your wife did not have a brain injury, but she is having cognitive problems that seem to overlap. I write a blog about my story at http://www.CavinBounce.com. Some of my more recent posts may be helpful reads as far as understanding her thoughts. Good luck, and god bless you!
But if I get off the calcium pills my nails shred and my jaw bone is disappearing. I am trying egg shells. I eat about 15 fruits and veggies a day (salad and smoothies). I can only handle a little dairy. I am in a quandary.
Debra, why is your jaw bone disappearing — did you take an osteoporosis treatment?
What about during pregnancy? Any special or different Calcium recommendations?
Hi Chris, Thanks for the article. As we are all being advised to ensure adequate vit D3 and K2 levels, I just wondered what happens to our calcium absorption if we supplement with D3 as many of us do as we don’t get enough sun? I believed that if our bodies were getting too much calcium that our parathyroid gland downregulated the making of vit D3 so that unneeded calcium was not then absorbed and hopefully excreted.
I am not mentioning this to excuse calcium supplementation, but rather worrying that when supplementing with D3 that the body can no longer use this fail safe method as the parathyroid gland will no longer be able to control the making of D3 and hence calcium absorption. The inevitable result being an excess of calcium swilling about in the bloodstream and being deposited where it is harmful. I would really appreciate your understanding of this Chris. Thanks so much.
As an add on, here in the UK, I was prescribed calc/vit D supplement following a bone density scan – I threw the prescription in the bin knowing that the best method to improve bone density if the scans were of concern (which too may be in question) was to supplement magnesium for the first 6months minimum, to see if any problem resolved. And in addition ensure optimum vit D levels.
I was prescribe Calcium 500mg D200unit tab by my Doctor along with other medication for my prostrate cancer treatment and my PSI are being monitored.
Are you telling me this stuff is no good? And can kill me. So much for modern medicine.
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