Many women must rely on a supplement to meet their calcium needs. To help you decide if you need a calcium supplement, use my 300 Milligram Rule. One milk serving gives you 300 milligrams of calcium. For every serving you’re missing and not replacing with other calcium-rich foods, you need to get 300 milligrams of elemental calcium through a supplement. Here’s how to choose a high-quality supplement:
1. Look at the source of calcium. There are many types of calcium supplements on the shelf. Some of the more common types include the following:
• Calcium carbonate is only about 10 to 30 percent absorbed by the body. The amount you absorb depends on the how much stomach acid is present. As people age, their stomachs produce less hydrochloric acid. Because of this calcium carbonate is not the best choice for older adults or for people on medications that block acid production. If you do take this form of calcium, take it with meals to increase its absorption. Do not take calcium carbonate at bedtime, unless you take it with a snack. On the plus side, this is the most inexpensive type of calcium supplement.
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• Calcium citrate is about 30 percent absorbed by the body, so it is a better choice for anyone over the age of 50. Calcium citrate malate is one of the most highly absorbable (and expensive) forms of calcium. Calcium citrate supplements are well absorbed either with meals or on an empty stomach.
• Calcium chelates (HVP chelate) are supplements that contain calcium that’s bound to an amino acid. In the case of HVP chelate, the amino acid is from vegetable protein. Some manufacturers claim that up to 75 percent of calcium in the chelate form is absorbed by the body.
• Effervescent calcium supplements contain calcium carbonate and often other forms of more absorbable calcium. Because they get a head start on disintegrating they may be absorbed in the intestinal tract more quickly. Dissolve these in water or orange juice.
• Bone meal or dolomite or oyster shell are not recommended because some products have been found to contain trace amounts of contaminants such as lead and mercury.
2. Know how much “elemental calcium” each pill gives you. Look on the list of ingredients for this information. The amount of elemental calcium is what you use to calculate your daily intake. Calcium carbonate or calcium chelates may not be 100 percent elemental calcium. The front label may state 500 milligrams, but when you look carefully at the ingredient list you may find the product contains only 350 milligrams of elemental calcium. This will determine how many tablets you need to take to get your recommended dose.
3. Choose a formula with vitamin D and magnesium. These nutrients work in tandem with calcium to promote optimal bone health. For instance, vitamin D increases calcium absorption in your intestine by as much as 30 to 80 percent.
4. Spread larger doses throughout the day. Since all calcium sources (including food sources) are not 100 percent absorbed, it makes sense to split a higher dose over two or three meals. If you’ve been advised to take 600 milligrams of calcium a day, take a 300 milligram tablet with breakfast and another one at dinner.
5. Take your calcium supplements with a large glass of water.
The daily upper limit for calcium intake is 2500 milligrams from food and supplements. In most healthy people, this amount will not cause any side effects. The major risks from getting too much calcium include kidney stones (in people with a history of stones), constipation and gas.