Something I found interesting about my personal training and weight lifting years: I knew the protein and calorie amounts of most foods. When I was at the peak of my body-building, I intentionally trained without any supplementation, only real ingredients.
No protein powders or creatine. Just food.
So, I got to know the nutritional profile of a lot of ingredients. It made meal-planning a breeze. And I knew which foods I could turn to on-the-go.
To this day, I still remember that a small carton of milk contains 9 grams of protein.
If I was in between meetings and hadn’t packed a snack, any convenience store could supply a nice protein boost in the way of milk.
We know food is best when it comes to getting your daily calcium count, but an osteoporosis diagnosis can feel as though someone upped the ante.
Here’s the big question:
Should I be taking a calcium supplement… and if so, which one?
Calcium Supplements & Osteoporosis
Most health care professionals will suggest you assess your daily calcium intake before deciding to supplement.
That seems like a lot of math, doesn’t it?
Check out this cool calcium calculator from Osteoporosis Canada:
https://osteoporosis.ca/calcium-calculator
Remember the RDA (in Canada, women over 50: 1200mg per day, men over 70: 1200mg per day.
Write down maybe 2 or 3 or 7 days’-worth of meals, snacks and beverages. Use the calculator to assess how much dietary calcium you’ve been consuming day-to-day. Consider if there are snacks or ingredients you can add to your day to help you meet that daily calcium target.
Keep in mind, calcium is best spread across the day.
What if I can’t meet my calcium needs through food?
There are a variety of reasons why this may happen:
- Allergies or sensitivities
- Digestive issues
- Lack of access to the foods you need
- Existing health conditions
- Medication
- Age affecting absorption
This is when supplementation may become a useful tool.
Are all calcium supplements the same?
No.
Here are the common forms:
Calcium carbonate
Pros:
- inexpensive
- high percentage of elemental calcium
Cons:
- absorbed best with food
- may be harder for some people to tolerate
- may not be ideal for people with reduced stomach acid
Calcium citrate
Pros:
- absorbed well even with lower stomach acid
- can usually be taken with or without food
- often recommended for older adults
Cons:
- contains less elemental calcium, so more tablets may be needed
Other forms
You may also encounter:
- calcium lactate
- calcium gluconate
- calcium phosphate
- calcium citrate-malate
The research doesn’t suggest they’re dramatically superior for everyone.
Often, the “best” form is simply the one that suits your digestive system and medical history.
When I first thought about calcium supplements, my immediate question was:
What about kidney stones?
And then I read in the osteoporosis online groups that calcium buildup in the arteries was a thing. What?
I already have osteoporosis on my mind, I don’t need to worry about more issues while working to alleviate my current one!
First, the kidney stone question. I’m not a doctor and as I read through information and studies online, it’s often a mixed bag of answers.
Dietary calcium actually appears to help reduce the absorption of oxalates in the intestine and may lower the risk of certain kidney stones.
Large supplemental doses taken without food may be a different story.
Again…
Food behaves differently than isolated nutrients. And each person has a unique constitution with a specific health history and dietary needs.
On to the calcium buildup in the arteries:
From the Mayo Clinic Staff, 2024:
“Calcium supplements are usually taken to treat or prevent bone disease, such as osteoporosis. There is some evidence that calcium supplements can increase the risk of heart attack. Some research suggests that the risk is significantly higher in people with diabetes.
One review of studies found that calcium supplements increased the risk of heart disease, particularly in healthy postmenopausal women. But other studies have said calcium supplements don’t increase the risk.
More research is needed to know how calcium supplements affect a person’s overall risk of heart attack. What is known is that calcium from food sources isn’t a concern. Food sources of calcium include dairy products and leafy green vegetables.
Taking calcium with vitamin D does provide a benefit for people who have bone loss or too little calcium. Ask your healthcare professional if a calcium supplement is right for you.” 1
Remember, the great thing about food is that it provides much more than calcium. You receive the benefits of additional nutrients.
There’s one other form of calcium I’d like to discuss, since it’s one I happen to have on hand.
Calcium from red algae
In reading a 2010 study from the National Library of Medicine, I discovered something interesting: 2
Researchers wanted to know whether a special form of calcium called Active Absorbable Algal Calcium (AAACa) was absorbed better than the more common calcium carbonate.
To find out, they recruited 10 postmenopausal women between the ages of 59 and 77.
Each woman took both forms of calcium about a month apart. Using special, harmless calcium “markers” (stable isotopes), the researchers were able to measure how much of each form was actually absorbed into the body, rather than simply passing through the digestive system.
What did they find?
The women absorbed:
- 23.1% of the Active Absorbable Algal Calcium (AAACa)
- 14.7% of the calcium carbonate
In other words:
The algal calcium was absorbed about 1.6 times better than calcium carbonate.
That difference was statistically significant, meaning it was unlikely to be due to chance.
An interesting observation
The women in the study had low vitamin D levels, which is common in older adults. Even so, the algal calcium was still absorbed more efficiently than calcium carbonate.
What the researchers concluded
The researchers concluded that this particular algal calcium preparation appeared to be more bioavailable than calcium carbonate.
Bioavailability simply means: How much of a nutrient your body is actually able to absorb and use.
Again, each person is unique and this was a rather small study group.
This 2016 article in The National Library of Medicine looks at AlgaeCal, another algal calcium supplement:
“…gains in BMD were consistent and linear over the 7-year study period, averaging 1.04% per year over the 7-year study. The results are also consistent with earlier short-term studies suggesting that this supplement can facilitate significant increases in total body BMD in contrast to studies suggesting that calcium supplements can only slow down age-related declines in BMD.” 3
So, bone mineral density (BMD) not only ceased to decline with AlgaeCal, but actually increased.
After some Googling around, I decided on New Chapter’s Plant-based Bone Strength. While I work to get all of my calcium from food, if I fail to plan well (I’m also a Seniors Real Estate Specialist® and this past week saw me driving all over the place, shuttling clients to showings and writing up contracts… rather than writing my daily blog posts… I thank you for your patience), I have the supplement on hand as a tool in my osteoporosis management and bone health toolbox.
Keep in mind: The amount of a nutrient in a supplement isn’t the same as the amount your body can actually use.
Calcium is but one piece of this bone health puzzle. Don’t lean too heavily upon it. It might break. (A little osteoporosis humour… too soon?)
Bone is living, complex tissue. We can’t just slap a calcium band aid on it. And, frankly, the jury is still out on calcium as a supplement for osteoporosis.
A 2014 article in The National Library of Medicine says:
“Advocacy for the use of calcium supplements arose at a time when there were no other effective interventions for the prevention of osteoporosis. Their promotion was based on the belief that increasing calcium intake would increase bone formation. Our current understandings of the biology of bone suggest that this does not occur, though calcium does act as a weak antiresorptive. Thus, it slows postmenopausal bone loss but, despite this, recent meta-analyses suggest no significant prevention of fractures. In sum, there is little substantive evidence of benefit to bone health from the use of calcium supplements.” 4
The article continues to explain how dietary sources of calcium do not share the kidney stone, cardiovascular or gastric issues that may accompany supplement use.
Again, this is only one piece of the bone health puzzle. We haven’t even found all of the edge pieces yet! And I’ll have to check the floor to make sure I haven’t dropped any.
The goal isn’t to get more calcium into your body. The goal is to create the conditions in which your body can wisely use the calcium it receives.
Instead of asking:
“How much calcium should I take?”
Perhaps we ask:
- Am I eating calcium-rich foods?
- Is my gut healthy enough to absorb nutrients?
- Are my vitamin D levels adequate?
- Am I getting enough protein?
- Am I building muscle?
- Am I loading my bones through movement?
- How are my hormones?
- Am I sleeping well?
- Am I managing stress?
- Am I nourishing my body as a whole?
Calcium Isn’t a Lone Ranger
We’ve been taught to think of calcium as the hero.
But perhaps calcium is better understood as a member of an extraordinary team.
Without:
- vitamin D
- magnesium
- hormones
- movement
- protein
- digestion
calcium cannot do its job as effectively.
Is more calcium better?
No.
This is such an important message.
Our culture loves:
More.
The body often prefers:
Enough.
Osteoporosis Canada weighs in:
“Take no more than 500-600 mg of elemental calcium at one time. In fact, it is best to take smaller doses more frequently rather than large doses once a day.”
Supplement if you must.
If you take the time to get to know which foods contain what amount of calcium, that’s knowledge you’ll have for the rest of your life. And all of those foods will come with a host of nutrients to contribute to the whole body.
Just like my little milk carton protein snack.
Much love,
Stephanie
2 https://pubmed.ncbi.nlm.nih.gov/22254052/
Stephanie Hrehirchuk - Author 