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)
I just saw this information about calcium supplements. I have been taking calcium plus D and Biotin for about 5 months… id miss some days along because I work 2 jobs. I already have horrible triglycerides. Now Im scared. Im going to my doctor and get updated labs and then maybe see a nutritionist to get a real diet plan. I had never heard of this before but that little voice told me to google calcium supplements and there it was in the hits. I threw them away tonight. What to do if Ive made a bad situation worse? Is it like once it’s there it wont leave my arteries?
I seem to be intolerant of diary products.
And for dark leaky greens, you would have to eat about 10 servings a day to get the RDA of calcium.
Salmon’s too expensive.
What form of calcium supplement is best?
Is calcium orotate any better then the other forms?
Wow this article was very interesting and I am so glad I read it
I always felt that popping cal tabs is not really gonna do anything that great. If it were that easy nobody would have osteoprorosis right? I eat my calcium in foods like greens salads yogurt and the most important thing is weight bearing exercise along with a good diet , I wear a weight vest to get my weight workout its the easy fast way to do it and my doctor uses it also. She recommends the one by NYKNYC
This is the best way to keep bones strong there is no magic bullet .. being healthy strong beautiful takes work.
I’ve been told that calcium that is derived from algae and organic sources is ok – even for heart. That it’s the calcium from rock/shell like inorganic things that is bad. Please comment
According to many doctors, calcium deficiency measured in bones is more often a result of a failure to absorb calcium properly as a result of other deficiencies. Calcium is one of the most abundant elements on earth so it is difficult to avoid ingesting a sufficient quantity through diet. But just because its in the food doesn’t necessarily mean it will go to the places where it is needed. Human metabolism is extremely complex and not always obvious in the way it works and so treating a bone deficiency with calcium supplementation can have the opposite effect upon mortality. If you cannot absorb calcium properly and you taker a supplement then as Chris indicated you could end up with the calcium deposited in your arteries or on the outside of bones creating bone spurs. Magnesium and vitamin D3 are essential for calcium absorption and it turns out many people are deficient due to food content deficiency due to crop production methods and lack of sunshine. Medical advice following an indication of osteopenia should be to first take a calcium-potassium supplement plus vitamin D3 and then determine if osteopenia diminishes. If you wish to learn more about this aspect of human metabolism take a look at chapter 9 of the excellent book by the Drs. Eades: “The Protein Power Lifeplan” . I bought my last copy for 1 cent through Amazon!
Dr. Kesser is brilliant I would say. But, Dairy products? Really? Do you mean milk products? Homogenized, pasteurized, highly processed cow milk products? This is such a problem food for so many people. and the bioavailability of calcium from processed milk, even organic milk, is questionable at best I think. Raw milk maybe, – for some people who are not sensitive to/have problems digesting the casein or lactose, but raw milk is very hard to come by, and most people have what I believe is an unjustified fear of it. I get what you are saying about supplements, but I tend to disagree with milk being a good source of calcium.
Hi Chris!
What I find interesting is my mom has osteoporoses and when I was in my early forties I asked my then ob/Gyn if I was at risk b/c of my mom. At the time she seemed to think I was fine and probably got enough calcium from my diet without even knowing what I ate. At the time excoriated 4 to 5 times a week doing weights.
My sister told me a few year after that she was told women start losing bone density in there forties. I need to mention I was and still am taking bio identical hormones. Long story short I convinced my dr to give me a bone scan and the results shocked me. I have osteopenia in my left hip. I have since starting taking 4000 iu of vit D3, mag and 600 mg cal x 2. Changes my workout to crossfit and my bone density has gone up. I also eat low carbs and try to eat paleo tho I’m not a 100% . I’m not saying there isn’t anything to this study however I am a strong believer that no two people are a like. I come from a family of longevity. The women live well into their nineties. My grandmother live to be 97. She took vitamins her whole life. She use to pour them in my mouth when I was a kid. She chewed bone mill pills and died with all of her teeth. I just think more needs to be look at b/f we can come to he conclusion that calcium is bad for you.
Being lactose intolerant, my GP insisted that I take calcium supplements (“any kind”) which I reluctantly did — for years — only to end up needing a triple bypass. As I have eaten very healthy since I was quite young, this came as a major shock. Now I wouldn’t touch calcium supplements with a ten foot pole! I do take magnesium though as I think we are all deficient.
I take a liquid angstrom calcium mineral @ night. The recommendation came after a hair-analysis. The Calcium is 146ppm in 1 TBSP. The other ingredients are Chloride, Magnesium, Zinc, Potassium, Boron, Gold, Manganese, and Cobalt.
Do you have any experience with this type of product?
I DISAGREE by recent personal experience. I am 67. I loved and consumed lots of dairy foods but greatly reduced them 20 years ago when I was diagnosed with lactose intolerance. I am regularly outside gardening and walking and have always done heavy work in the garden and bushwalking long distances while on holiday. I have suffered for 20 years from muscle spasms and restless legs syndrome at night, and lately it got so bad waking me up at night, that I went to the doctor. It was then I was stunned to be diagnosed with osteoporosis and very little Vitamin D in my system, despite plenty of sunlight. I am wheat intolerant, so it is my belief that I have not been absorbing the calcium and Vitamin D through my gut. I immediately bought a good calcium and mineral supplement, but the night one upset my stomach. So then I fixed that by crushing up the tablet into calcium enriched rice milk. I do that morning and night. I am having the rice milk other times during the day – about a litre per day. This, is believe, is ensuring that there is readily available calcium in liquid form circulating in my body. I am taking extra Vitamin D as well. I am also taking a very good probiotic. The RESULTS were immediate. I am no longer awakened at night by my legs twitching and refusing to be still; I no longer have to go for a walk several times in the middle of the night to bring up gas, after which the muscle spasms would settle down. This improvement showed immediately. I believe it is because I am crushing the calcium and having it in the rice milk that is the key. My ribs were sore, as was T7 and my sternum. Most of the soreness has gone – still a little in my right hip. The improvement was immediate, and now after only 1 month, I am healthy again. I believe my system just got too low in Calcium and because it couldn’t take it out of my bones any more, it was taking it out of my muscles as well – hence the cramps at night. The fibromyalgia has settled down; my digestion has settled down; I no longer have to go to bed early because my legs are twitching; I can stay up later and sleep through the night. The difference is extremely marked.
Older people need calcium and Vitamin D, but we do have to find a way to absorb it properly.
which calcium supplement do you take?
How about an organic calcium? Such as one derived from algae?
definitely i have done a mistake, sorry for iam humanoid and not a hard built system
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Before I forget, one question, an important one for me. I have had a lifelong below normal blood sodium level for whatever reason(s). Could that be easily remedied in your opinion, without consuming salt in moderate amounts in my diet. The problem I have with the low sodium level is faintness/dizziness from loss of needed electrolyte levels. I try to balance drinking adequate amounts fluids with drinking too little fluids when for example I have a cold or flu. Thanks.
Chris, you say in general you discourage the taking of common multivitamin/mineral supplements. Except for your recommendations of supplementation for specific issues, I plan to stop taking all vitamin and mineral supplements, but for the sake of avoiding worry I will continue to take my relatively low dose multi (Kirkland Mature Multi – very inexpensive and highest rated by Consumer Reports Magazine). I may end up discarding it too, except I live with two other people dear to me and they don’t like a number of the healthy foods, and do like some of the less healthy ones, some in substantial numbers of servings, e.g. high carbohydrate foods such as breads, cereals, baked goods, potatoes, rice, etc., whereas I don’t consume, especially added sugars save for an rare occasional drib of organic honey because I love it so much and I figure the amount I have would be considered negligible by any standard.
On a purely practical lifestyle note, I’m always happy to discover ways to eliminate costs of things which are of little or no use to me, as I am one among the millions of older Americans who’s sole monthly/annual income is well below adequate to provide what most people might consider a minimum level lifestyle. I’m not complaining about it, just need to be practical and watch expenses closely. This especially applies where vitamin and mineral supplements are concerned: if I might be better off not supplementing than supplementing it’s very important to look for sources of information such as this website. I’m smart and educated enough to benefit from most of the discussion here, for which I am most most grateful! Thank y’all for your contributions. Taken altogether I have a great learning tool here, which is fantastic in a day of so much not-information and disinformation, both intended and not intended to be non- or dis- informational. Without expert guidance and common sense, I regard surfing the internet a severe form of mental and behavioral disorder in our present day consumeristic society here in the USA.
I’m really surprised that your research has not discovered that calcium supplements are NOT real calcium, but calcium carbonate. The important point is that carbon as a food additive is extremely harmful to the human body. It creates an acidic environment which requires even more calcium to correct this, which causes osteoporosis and plaques in the brain, Alzheimer’s disease among a host of other problems .
Calcium carbonate is the “limescale” that you get in hard water supplies and is best avoided. The reason that calcium from food doesn’t cause health problems is because the calcium is bonded in a natural state. NOT because its in small amounts. The body only needs small amounts in its natural form. Here is a comprehensive explanation about dietary calcium. http://www.uswellnessmeats.com/Calcium_Myth_and_Facts.pdf
Who is the author of that article?
Ch. Potthast
Are calcium carbonate (and calcium citrate) powders neutralized/broken down promptly in the stomach by its hydrochloric acid content into calcium ions and carbon dioxide (and citrate ions)?
I’ve never liked taking calcium supplements for some reason, so really appreciated this article. I’m not a big milk drinker, but starting making/drinking milk kefir this summer because of some GI problems I was having. I make it from local raw milk, which I think has vitamin K along with a long list of beneficial bacterias, vitamins and minerals. I’m 58 and have no signs of osteoporosis despite not taking calcium supplements and having been on a drug a few years ago (Fermara) that is known to cause it. Doctors keep insisting I take calcium supplements, now I have some information to arm myself with!