Is there any safe way to use calcium supplements?

Calcium supplements are a huge part of the natural products market. But that doesn’t mean they’re actually good for you.

You know I generally recommend against taking calcium supplements, because they can lead to serious health issues. Instead, I advise that you get your daily calcium from a balanced diet that includes dairy and meat.

But there are some instances when it’s necessary to take a calcium supplement. For instance, you may have dietary restrictions that make it difficult to get calcium from food.

Or your doctor may inexplicably insist you take a calcium supplement. Some doctors prescribe calcium supplements to postmenopausal women who are on hormone therapy after undergoing a hysterectomy — even though there’s usually no reason to do so.

If you have one of those doctors, I think it’s better to pick your battles. Draw the line at taking a toxic statin drug, rather than discouraging your doctor from actually prescribing a dietary supplement. That said, there are some important precautions you should follow.

Not all calcium supplements stack up

If you find that you must take a calcium supplement, it’s important to remember that not all supplements are created equal. Some will give you more benefits for your health and your pocketbook — and cause the least harm.

But how do you find these calcium supplements? An independent health and nutritional products testing lab may have the answer.

Recently, ConsumerLab performed an independent evaluation of 27 calcium supplements, analyzing them for quality, price, dosage, and formulation.1

The good news is that all 27 products actually contained the raw amounts of calcium listed on the labels. But for a 500 mg dose of calcium, prices varied wildly — from 4 cents to 80 cents per dose.

ConsumerLab’s top pick was GNC Calcium Citrate, which provides 500 mg of calcium per two-capsule serving, at a cost of 9 cents per dose. Note the “citrate” designation, which is an organic form of calcium that is actually digestible. (Taking calcium in mineral form is like literally trying to eat rock.)

For combination calcium and vitamin D supplements, which is what you really should look for if you are going to take calcium in supplement form at all, ConsumerLab recommends Bayer’s Citracal Petites. It has 400 mg of calcium and 500 IU of vitamin D per two-capsule serving, at a cost of 11 cents per dose.

Of course, this is a much lower dosage of D than the 10,000 IU a day I recommend from diet, sun exposure, and/or supplements. And it’s not enough calcium either. Most adults need 1,000 mg of calcium per day, from all sources.

(Some studies have suggested that 1,000-2,000 mg of calcium citrate together with 400-800 IU of vitamin D daily may help slow bone loss in postmenopausal women, but these claims are controversial).

Why food is better than pills 

Rich dietary sources of calcium include beans, dairy, dark leafy greens (like spinach, kale, collards, and bok choy), oranges, meat, seafood, and sesame and chia seeds.

And you don’t need to eat much. Just one cup of milk or yogurt provides 300-400 mg of calcium, or about a third of your daily requirement.

But it’s important to note that calcium from food does not have the same effect in the body as calcium from supplements.

It is impossible to get too much calcium from food. In fact, higher levels of calcium from the diet are associated with many health benefits. But too much calcium in the form of supplements is associated with cardiovascular disease.

How? Well, supplements can create excess calcium in the blood, which contributes to calcification of the arteries. Otherwise known as arteriosclerosis, this “hardening of the arteries” is an underlying cause of heart disease, stroke, and peripheral vascular disease of the legs.

High calcium intake from supplements (but not from diet) also increases the risk of dementia, kidney stones, and prostate cancer. In addition, calcium supplements may affect thyroid hormone production and interfere with certain antibiotics (although I generally advise against taking these drugs in most instances).

And if that weren’t enough, calcium can interfere with absorption of other minerals taken at the same time.  That’s another nail in the coffin for ridiculous multivitamin pills. Even if they possibly could contain the right doses and combinations of vitamins and minerals, these nutrients often can’t be taken together!

So, the bottom line of the Great Calcium Supplement Debate?

If you already get enough calcium from your diet, you don’t need supplements. But if you do have to take a calcium supplement, never exceed 1,000 mg per day. Always take it along with vitamin D. And since your body has a hard time absorbing calcium from supplements (but not from food), take only a few hundred milligrams at a time, preferably with meals.