I’ve come to believe, through my experience treating hundreds of patients, that many of us benefit from supplementation even if we’re eating a nutrient-dense, whole-foods diet. Some nutrients are challenging to get through food alone due to challenges like declining soil quality, a growing toxic burden, an increase in digestive issues and chronic diseases that interfere with nutrient absorption, and several other factors that are now common in the modern world. The latest statistics suggest that most Americans don’t get enough of several essential vitamins and minerals, and low nutrient intake is associated with a higher risk of chronic disease and a shorter lifespan.
That said, there are some nutrients that we need to be careful with when supplementing. More is not always better, and the specific form of the nutrient in the supplement can make a big difference in how it impacts us. This doesn’t mean that we should never take these nutrients as supplements, but it does mean that we have to be smart about how we supplement with them.
Calcium supplements are a prime example of this.
Do Calcium Supplements Work?
Calcium has become extremely popular as a supplement, especially among aging women, in the hope that it will prevent fractures and protect against 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. Osteoporosis is a serious concern in women’s health, and it affects at least 10 percent of American women. (1) Yet the evidence that calcium supplementation strengthens the bones and teeth was never strong to begin with, and it has grown weaker with new research published in the past few years.
Are you taking a common supplement that may increase the risk of heart disease, stroke, and death? Read this article to find out. #bonehealth #heartdisease #nutritionalsupplements
A 2012 analysis found that consuming a high amount of calcium beyond recommended dietary guidelines, typically from supplementation, provided no benefit for hip or lumbar vertebral bone mineral density in older adults. (2) A 2007 study published in The American Journal of Clinical Nutrition found that calcium supplements don’t reduce fracture rates in postmenopausal women and may even increase the rate of hip fractures. (3)
Are Calcium Supplements Safe?
Beyond being ineffective for bone health, standard calcium supplements are associated with some pretty serious health risks.
Heart Disease Risk
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 2012 study of 24,000 men and women aged 35 to 64 years published in the British Medical Journal (BMJ) found that those who used calcium supplements had a 139 percent greater risk of heart attack during the 11-year study period, while intake of food calcium did not increase the risk. (4) A meta-analysis of studies involving more than 12,000 people also published in the BMJ found that calcium supplementation increases the risk of:
- Heart attack by 31 percent
- Stroke by 20 percent
- Death from all causes by 9 percent (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 percent increase in the risk of death from CVD. (6) Researchers suspect that the increase 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 the bones, but is excreted in the urine, increasing the risk of calcium kidney stones. The excess calcium could also be circulated in the blood, where it might attach to atherosclerotic plaques in arteries or heart valves. (8)
Cancer, Kidney Stones, and Other Health Risks
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 1,000 mg is associated with increased prostate cancer risk and an increase in kidney stones. (10)
Additionally, a recent Swedish study reported a 40 percent higher risk of death among women with high calcium intakes (1,400 mg and above), and a 157 percent higher risk of death if those women were taking a 500-mg calcium supplement daily. Those rates were compared to women with moderate daily calcium intakes between 600 and 1,000 mg. (11) A Consumer Lab analysis found that many of the calcium supplements they analyzed failed quality testing for reasons including lead contamination and mislabeled contents. (12)
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Other Forms of Calcium Supplementation
Even if you’re not popping a calcium pill 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 milk
- Bread
- Instant oatmeal
- Graham crackers
- 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 varieties of non-dairy milk, are fortified with calcium. You may be consuming more supplemental calcium than you realize.
In addition, many multivitamins contain high doses of cheap or inferior forms of calcium that are not well absorbed. This can lead to an accumulation of calcium in the soft tissues (where we don’t want it), which in turn contributes to the adverse effects discussed in this article.
Not all multivitamins are created equal. When I formulated Adapt Naturals Bio-Avail Multi, I included a minimal dose (50 mg) of calcium, which is only 4 percent of the total daily requirement. I also used di-calcium malate, a highly bioavailable form of calcium that is much better absorbed than calcium carbonate and other forms of calcium.
Bio-Avail Multi also contains meaningful doses of vitamins A, D, and K2, as well as magnesium. Each of these nutrients plays critical roles in calcium metabolism and bone health and may be even more important for improving bone health than increasing calcium intake—at least for some people.
Vitamin E is another important nutrient for bone health—but here, I’m referring to delta- and gamma-tocotrienols, a newly discovered form of vitamin E, rather than alpha-tocopherol, the more common form that is in most supplements. Tocotrienols have several positive effects on bone health: they decrease bone resorption, increase bone turnover rate, and improve osteoblast number, bone formation, mineral deposition, and bone microarchitecture. Adapt Naturals Bio-Avail E+ contains 300 mg of delta- and gamma-tocotrienols (with no tocopherols), sourced from the annatto plant. Taken together with Bio-Avail Multi, you can have confidence that you’re getting the nutrients you need for optimal bone health.
The Safest Ways to Get Enough Calcium
If you’re concerned about keeping your bones healthy, you’re better off getting your calcium from food sources like:
- Dairy products
- Canned, bone-in fish (e.g., sardines, salmon, etc.)
- Dark, leafy greens
- Seeds (especially poppy and sesame)
- Almonds
The Recommended Dietary Allowance (RDA) for calcium for adult men and women is 1,000 mg—or approximately three servings of dairy products or bone-in fish per day. Pregnant and lactating women, and adults 70 and older, need 1,200 mg per day.
It’s critical to understand that healthy bone formation also depends on other nutrients like vitamins A, D, and K2, and minerals like magnesium and silica, each of which plays a role in regulating calcium metabolism. Some research suggests that consuming optimal levels of these nutrients may reduce the amount of calcium you need each day, due to their synergistic effects. Regular weight-bearing exercise can also make a big difference for maintaining healthy bones. (13)
Does calcium carbonate count as a calcium supplement that should be avoided?
Hey Chris,
I’m not a friend of mail subscriptions, but I must say I like your mail updates. They’re always short, to the point, helpful and interesting. So big THANKS to you and for what you’re doing. Keep it up!
Bets Regards,
Seb
Wow, i’m just amazed how much new comments have been created since Februar, I just wanna tell you guys, that it is worth do go this hard healty way. In the end you feel creater.
Don’t overdue it feel yourself, takes patient and time.
See the whole thing there are so many factors.
A little step a day, and the middel way for your styl of wonderful life. Dont forget Love its the most important thing overall.
the middle way i mean its like going on the peak path of the montain right you are falling down left too
Chris
Thanks for your informative article, i have a concern regarding dairy product to my daughter , 18 yr old Hashi, who lives in dormitory. it is highly difficult for her to eat healthy which she was managing OK with the help, that I was sending her home made Raw milk Kefir and yoghurt and Dr Mercola’s whey powder, every week, but last wk i read your article that dairy is not good for Hashis we are so confused, except for little bone broth, what more I can give her for calcium and protein. please advice whether a cup of kefer or yoghrt/day will be ok or she needs to go cold turkey for dairy.
Hi Chris,
Very informative article. I wanted to share something here as well. At the end of the day, its all about consuming a mostly plant based diet. The more greens you consume, the better off you are going to be in so many ways. One of my dear friends, Jacob is touching 41 and he looks like he is in his early 30s. I highly encourage people to use the same kind of mindset when looking for supplements. Our product http://www.boneblast.com is actually a plant based (Icelandic Algae Derived) calcium source (Love to send it to you to try it out). Infused with Vitamin D3, Magnesium and more for proper absorption. If you live in a cold environment or where sunshine is low anyways, you must supplement. Just being realistic here. At the end of the day, just try to add more plants and more vegetables to your diet. The sooner the better.
I encourage everyone to request the personalisation of medicine rather than one size fits all. This would eventually root out sales people who try to promote supplementing without any real knowledge of how the individual health picture /metabolism works.
If you are tempted to buy a supplement, write and ask the company for a written assurance that your health will not be damaged by taking their supplement. I promise you none will provide it.
Countries with lower levels of sunlight do not report all of the populace to be unfit to go about their daily routine, only a small percentage. Why is that ? Research the issue before you begin supplementing with vitamin D3 or any other mineral.
If your doctor recommended you take calcium supplements hopefully there was a medical reason rather than just a ‘general recommendation’. Usually those supplements combine with steroid vitamin D3 which is where problems creep in. If you were deficient, a review should be in place rather than to continue supplements indefinately. Metabolic bloods inc thyroid, full blood count, iron level, your doc will know if calcium toxicity is present. The whole blood study is relevant and your history will direct concerns as well as any concerns you may have.
Vitamin D2 (ergocalciferol) and D3 (cholecalciferol) are not fully understood by the medical world in regard to ‘mechanism of action’. This is why there is such a plethora of confusion about this in the medical world.
Testing only for vitamin D2 markers creates a ‘blindside’ to the cause of many metabolic disturbances caused by inflammation. Vitamin D3 if raised, will indicate that the patient is suffering from more than, for example, osteoporosis or osteopenia. Many peer reviews on the subject always caution against Vit D supplementing in metabolic disorders, which often begin as undetected inflammatory illnesses. They usually end by saying..’but more research is needed’.
Sufficiency in mineral levels and electrolytes is where to aim, avoiding supplementation where no medical reason indicates. Overdoing things in the gym can be a step backward. Know your skeletal issues, good posture and have a qualified medical physiotherapist look at any instabilities in your gait. Avoid shoes with heels that invite opportunity for a nasty fall especially if you suffer from backache issues. Go for surface security rather than fashion passion! Treat yourself to the luxury of a good sole !
Susan.
Sunlight is vital for life so of course we need it.
If we supplement with any mineral or vitamin for long enough, we risk toxicity and possible calcification of organ systems if we overdo for example, calcium. Thats why a regular blood panel is a great idea.
Long term stress and grief can disturb our immune system. Thats why it’s so important to make sure we surround ourselves with people who are good hearted and trustworthy. As we age, our body slows down, so everything we have done to it over the decades, decides whether we will handle illness successfully and feel well again.
So yes steroid hormone D3 and D2 work together to keep us ‘on top of things’ for health, but when they are challenged by inflammatory issues, the body needs to rebalance and not expose to excessive sunlight or sources of active D3 which is the same as sunlight. An experienced endocrinologist or rheumatologist can explain it.
Very few of us want to take steroids unless we are seriously ill. Vitamin D3 is a steroid hormone, destructive when it rises to toxic levels.
If it isn’t broken, don’t fix it!
Not getting a cold does not mean your body is free from disease.
I am going in for labs next month. Thanks Emily,
What would I look for on my lab report to show that I needed to stop taking calcium supplements?
I would prefer to get my nutrition thru food but our soils are so depleted of the good stuff so supplementating sure makes it easier but not certain of long term effects.
“HIGH-DOSE VITAMIN D PREVENTS FRACTURES IN ELDERLY
A new analysis of nearly a dozen studies testing vitamin D in older individuals has concluded that it takes a daily dose of at least 800 international units (IU) to consistently prevent broken bones.
A dose that high was found to reduce the risk of hip fracture by 30 percent and other breaks by 14 percent. Lower doses didn’t have any effect.
The report, published in the New England Journal of Medicine, also suggests that too much calcium — perhaps more than 1,000 milligrams (mg) per day — can weaken the benefit.
The Institute of Medicine recommends that most adults get 1,000 to 1,200 mg of calcium per day and 600 to 800 IU of vitamin D. It sets a recommended upper limit at 2,000 mg of calcium and 4,000 IU of vitamin D.
Dr. Richard Bockman, a hormone expert at Hospital for Special Surgery in New York, said the findings are an important counterbalance to last month’s widely-reported recommendation by the U.S. Preventive Services Task Force.
The government-backed task force advised against taking doses of less than 400 IU of vitamin D with 1,000 mg of calcium and concluded the evidence was unclear for higher doses.
Bockman said the best trial is a 2003 study, known as the Trivedi trial, in which volunteers received an average of 800 IU per day as a single 100,000 IU dose every four months.
“It clearly showed a reduction in fracture risk in people who were getting vitamin D,” he said.
Read the full story at reuters.com.
I thought vitamin D3 was good for us?? I’m getting tired of all of the conflicting info that’s out there!
I take 5,000 iu during the cold and flu season and I never catch a cold or the flu and I drop down to 2,000 iu in the spring thru the fall season.
Hi Beth,
I hope Chris responds to you as well. I have had similar health issues and would like to comment on two things I picked up on reading your post. Please consider iodine supplementation and reconsider millet. I am not able to tell you all the reasons for iodine supplementation, but I believe it will help with your gut and thyroid issues, and good to take selenium with it, so you’ve got that covered. Millet is goitragenic and there is no way to prepare it which makes it safe for the thyroid, according to research I read from WAPF. D is tricky, and must be impacted by gut health or something. Hope we learn more about how D works.
You may want to also check out borax conspiracy and borax cures on the net, dmso and baking soda. Do your own research, and make up your own mind, but they have helped me in moderation.
Best, Vicki
Vitamin D3, cholecalciferol (active form) is a steroid hormone. All inflammatory diseases will send its metabolism out of kilter and it isn’t easy to reverse it. If d2 and d3 are not transcribing normally, sunbathing will drive it higher and inflammation will increase.
I hope vitamin D3 will soon be renamed steroid hormone D.
Don’t believe what I write here, do the research on Vitamin D3
My big question relates to Calcium but bare with me…
I have had lots of different problems since a amoebic gut infection 8 years ago and possible other infection but unknown. I became lactose and gluten intolerant and my dietician thinks I may actually be celiacs because my son is having similar problems. I can’t be tested because I’ve been gluten free for 10 months and I don’t want to go backwards. I have had ongoing underactive thryroid with thryroid antibodies since my trip to india but wonder if it’s always been a problem as my mum has also had a thryoid goiter which was removed and is now on medication. I have also had ongoing skin, nasal problems and urinary issues which affect my kidneys which I can map with changes in eostrogen and progesterone and possible infection at times where the eostrogen levels are increasing and the immune system is low. I know infection is still an issue and I am still working on biofilm in urinary tract and sinuses. Generally I am a lot better when I go hard on detoxing and antimicrobrials.
I have been self-treating because dr’s haven’t helped and take supplements that help keep toxins down. I am strict with my diet, have for 8 months been eating meat having been brought up vegetarian with some fish. I am almost Paleo but still have some grains in the week, millet or rice. Meat has helped tremendously and I notice a big change in my energy levels.
I also take vitamin D, selenium and now zinc. Zinc has greatly improved my eye problems. However, I realised I wasn’t getting enough calcium due to my intolerence and despite your advice tried calcium supplementation with magesium. It immediately calms my skin and my numbness and tingling in my hands is vastly improved. These things also improved whilst I was in South Africa for 2 months.
I know sun is often the common dinominator. Do some people only absorb Vitamin D from the sun and struggle through the supplemtation form and can this have the knock on effect of affecting my calcium levels? What would my alternatives be to calcium supplementation. I am eating tonnes of greens and sardines with bones, but I can’t seem to get my levels up.
Hope you can give some direction. Many thanks, Beth
I don’t see much convincing evidence that Chris is well informed on this issue and many of the questions here are important. Very few of us actually get a reply. I recommend we find a reliable source rather than wasting our time here. Being too busy isn’t a good enough plea.
Wishing everyone good health.
Hey Emily,
I’m seeing months and months of comments w/o reply…point well taken.
I have 2 cups of Kefir a day and a slice or two of cheddar. I also have a lot of veges etc, so hopefully am in the ballpark without needing to supplement…
Dr. Tent has Veal Bone concentrate. Only from grass fed cows from New Zealand.
Dee, if you would, please, reply and inform: who is Dr. Tent? Google search doesn’t appear to avail in this.
Incidentally, one of my most favorite dishes is a risotto w. a broth made from oven-baked beef, or oxtail, bones, and white wine for added flavor. A recipe I use is from a coffee-table type Italian food cookbook, authored &/or edited at least in part by Lorenza de Medici (yes, that *is* the historically magnificent and notorious Medici family), but there are other, probably many, similar recipes of Italian cooks to be found.
On a related note, very old societies and cultures have prominent recipes and dishes which, over much time, have developed so to provide hidden nutritional benefits. Hence, I believe one reason for the highly regarded Mediterranean diet, among many other societies/cultures indigenous diets. Not only do they provide essential vitamins and minerals, often they also integrate many vitamin/mineral fats etc. synergies, both from the ingredients themselves but additionally due to techniques and methods of preparation. Tradition, tradition, tradition, in particular where foods and diet is concerned!
Correction “…are concerned.”
I have been taking 1,200 mgs of calcium citrate and 600 mgs of magnesium citrate on the recommendation from my dr for over five years now.
I have a hard calcium deposit on the top of my right foot at the base of my big toe. Is this caused by the high amount of calcium?
I was wondering if it can be dissolved without surgery?
Thanks for any and all replies to my problem.
So, about calcium toxicity. What blood markers most likely indicate it. For example would eGFR kidney filtration show up as high ?
Low 25d (d2) does not always mean osteoporosis. How many medics will check 1,25d levels to see if inflammation is present ?
Chriss,
Thank you for the article. There is an e-book called “Hair Like a Fox” that promotes Paleo friendly solutions to hair loss. In addition to bone broth, it recommends making calcium powder from egg shells. My integrative body doctor (Paleo) recommended I do this (she has already been taking homemade egg shell calcium herself). I am a post-menopausal woman with a lot of hair loss since my early 30’s. I am 52. I really want to take the eggshell calcium, but I’m afraid of potential problem with my arteries. I had a grandfather who died at my age from a heart attack and a grandmother who died at the same age of a stroke. I had one doctor tell me it doesn’t matter if it’s a grandparent, only if it’s a parent. I don’t necessarily believe that… I was raised with this fear.
Since I’m still overweight (I’ve lost 40 of the 110 lbs. I need to lose, so I’m still 70 lbs. overweight), I have a real fear of heart disease and don’t want to do something stupid. On the other hand, I’ve been told I have “soft bones”… so I may need the calcium. What do you think of homemade calcium powder from boiled/dried/ground eggshells? (They are pasture raised and certified organic.) Please respond! Thank you!
This article never distinguishes between calcium carbonate and calcium citrate with magnesium, and so the information is misleading and a disservice to readers. I take calcium citrate to prevent nocturnal leg cramps. It works! And calcium citrate is bioavailable, insurance for those whose calcium from food intake is haphazard.
Thanks, I get bad abdominal cramps during training. I will try magnesium citrate. Your advice and others in the comment section, especially regarding carbonate, has been helpful
I know this conversation is more about calcium but does anyone know why magnesium would cause muscle cramping? I used magnesium oil as a lotion according to directions, don’t remember now how much, that resulted in leg cramps. On other occasions through out the years taking magnesium supplements would result in my heart skipping beats.
Although, if I soak in bath water with epsom salts I feel very relaxed and no muscle cramping.
Any insights would be appreciated, I would like to supplement with magnesium.
I know this article is a bit old – but i’m very curious on what your opinions are on supplementing small amounts of calcium, say 100 mg, with a meal or two to help get up to the 600 mg minimum. Of course getting calcium from diet is better, but if that’s difficult for someone, would the small-dose supplementation be beneficial or harmful?
You may want to actually look at the studies…here is a biochemist who has taught medical students and ran a Cancer Research center …lots of credentials. He reviews studies and gave us this information…the meta-analysis reported in the British Study excluded many valid studies…AND excluded supplements that also contained vitamin D…which we know has a lot to do with calcium utilization. You have to really examine the studies to see the flaws.