Calcium Supplements: Should You Take Them?
Explore the health effects, risks, and benefits of calcium supplements and whether dietary sources may be the safer choice.
Calcium is vital for many aspects of health, particularly for strong bones and proper muscle, nerve, and heart function. While millions of adults take calcium supplements to ward off osteoporosis and ensure adequate intake, emerging research suggests that the answer to whether you should take them is not straightforward. This guide unpacks the science behind calcium supplementation, potential heart risks, safe intake, and how to prioritize sources for optimal health.
Why Is Calcium Important?
Calcium plays a fundamental role in:
- Building and maintaining strong bones and teeth
- Facilitating muscle contraction and relaxation
- Transmitting nerve impulses
- Helping blood to clot properly
- Supporting normal heart rhythm and function
Most of your body’s calcium (about 99%) is stored in bones and teeth, with the remainder enabling many crucial cellular activities.
Why Do People Take Calcium Supplements?
Many adults—especially women over 50 and men over 70—are encouraged to take calcium supplements. The primary reasons include:
- Preventing osteoporosis, a condition causing bones to become weak and brittle
- Ensuring daily calcium needs are met when diet falls short
- Addressing a medical condition that reduces calcium absorption (such as certain gastrointestinal disorders or dietary restrictions)
In the United States, around 43% of adults take a supplement that includes calcium, with more than half of women over 60 using them, often without physician oversight.
How Much Calcium Do You Need?
| Age/Sex Group | Recommended Dietary Allowance (RDA) |
|---|---|
| Adults 19-50 years | 1000 mg/day |
| Women 51+ years | 1200 mg/day |
| Men 71+ years | 1200 mg/day |
| Teenagers (14-18 years) | 1300 mg/day |
These recommendations are set to ensure bone health and the overall bodily functions relying on calcium. It’s important to remember that “more” is not always better, and excessive calcium can cause harm.
Dietary Calcium vs. Supplements
Calcium comes from two main sources:
- Foods: Dairy products (milk, yogurt, cheese), leafy greens (kale, broccoli), almonds, fortified plant milks and juices, tofu, and beans are naturally rich sources.
- Supplements: Pills (with forms like calcium carbonate or calcium citrate) meant to provide calcium isolated from food.
Experts widely agree that the body handles calcium from food very differently than from supplements. When calcium comes from whole food, it is absorbed gradually and accompanied by other nutrients, minimizing potential risks.
Comparing Food vs. Supplement Calcium
| Source | Benefit | Potential Risk |
|---|---|---|
| Food | Better absorption, contributes nutrients, helps heart health | Rarely causes harm; excessive intake is uncommon |
| Supplements | Convenient, easy to measure, may be necessary if deficient | May increase risk of kidney stones, constipation, and potentially heart disease |
What Does the Research Say About Calcium Supplements?
Calcium supplements have long been recommended for bone health, especially in those at risk of osteoporosis. However, recent research, including large-scale studies by Johns Hopkins Medicine and others, has raised concerns:
- Heart Disease: Taking calcium supplements has been linked to an increased risk of atherosclerosis—plaque buildup in arteries—which can lead to heart attack and stroke.
- No added bone benefit: In individuals already meeting their calcium needs via diet, extra supplements do not further improve bone strength or fracture rates.
- Other risks: Supplements carry a risk of digestive side effects, including bloating and constipation, and may contribute to kidney stones and, in some studies, dementia in older women.
What others are reading
Importantly, these negative effects are NOT seen with calcium that comes naturally from foods.
Expert Takeaways on the Research
- Association, not causation: While risk increases with supplement use, these studies show a strong association, not definitive proof of cause and effect.
- Calcium-rich foods may actually help protect against heart disease, rather than harm.
- Discuss any supplement plan with your physician, especially if you have risk factors for heart disease, kidney stones, or impaired calcium metabolism.
Potential Risks of Taking Calcium Supplements
Calcium supplements are not risk-free. Key issues include:
- Heart Disease: Supplementation may promote arterial plaque and increase heart attack risk in some individuals, especially with excessive intake.
- Kidney Stones: High doses increase the risk of stone formation, particularly when taken without adequate hydration.
- Digestive Issues: Constipation, gas, and bloating can occur with certain calcium compounds such as calcium carbonate.
- Dementia Risk: Some studies suggest an elevated risk of dementia in older women who take calcium supplements, though the evidence is less robust.
Who Needs Calcium Supplements?
While dietary sources are best, there are people who may require supplementation, including:
- People with diagnosed osteoporosis or at high fracture risk (verify with a physician)
- Individuals who cannot get enough calcium from food (due to allergies, intolerances, or dietary preferences such as veganism)
- Patients with certain medical conditions affecting calcium absorption (like celiac or inflammatory bowel disease, or after certain bariatric surgeries)
If you fall into these groups, consult a healthcare professional to determine the right dosage and monitor for side effects.
Best Dietary Sources of Calcium
Meeting calcium needs through your diet is not only effective—it may also confer cardiovascular and overall health benefits. Top sources include:
- Dairy: milk, yogurt, cheese
- Plant-based options: fortified soy, almond or oat milks, tofu processed with calcium
- Leafy greens: kale, bok choy, broccoli (note that spinach, while high in calcium, also contains oxalates which reduce absorption)
- Nuts and seeds: almonds, chia seeds
- Fish with edible bones: canned sardines or salmon
Check food labels, as many processed foods are now fortified with calcium. Diverse food choices make it possible for most adults to reach daily targets without supplementation.
Guidelines for Calcium Supplementation
- Consult your doctor: Before starting any supplement regimen, especially if you have cardiovascular risk factors or chronic conditions.
- Prioritize food first: Seek dietary sources as your primary means of calcium intake.
- Take only what you need: Calculate your daily intake from foods before adding supplements, so you do not exceed recommended levels.
- Choose your supplement carefully: If required, divided doses (not over 500-600 mg at a time), and take with meals to improve absorption.
Special Considerations
- Some medications and supplements (like vitamin D) may interact with calcium. Always inform your healthcare provider of everything you are taking.
- Older adults, postmenopausal women, and individuals on steroid medications may have different calcium needs. Tailor supplementation to individual risk profile and lab findings.
Frequently Asked Questions (FAQs)
Q: Can you get too much calcium?
A: Yes. Excessive calcium from supplements can cause kidney stones, interfere with absorption of other essential minerals, and increase the risk of heart disease and other complications. Stay within recommended guidelines and count both dietary and supplemental sources toward your total.
Q: How can I know if I need calcium supplements?
A: If you have a medical condition impacting absorption, dietary limitations, or a physician-diagnosed deficiency, supplements may be justified. Otherwise, most people meet their needs with a balanced diet. Consult your healthcare provider before starting any supplement.
Q: Are certain forms of calcium supplements better than others?
A: Calcium carbonate and calcium citrate are the most common forms. Calcium carbonate requires stomach acid to dissolve, so take with food. Calcium citrate can be absorbed with or without food and may be better for individuals with lower stomach acid.
Q: Is vitamin D required with calcium?
A: Vitamin D helps the body absorb calcium. If your vitamin D levels are low, your body cannot utilize calcium effectively. Some supplements pair calcium with vitamin D for this reason, but the combination should be tailored to individual needs and lab results.
Q: What if I am lactose intolerant or vegan?
A: Many non-dairy and plant-based foods are rich in calcium, such as fortified plant milks, leafy greens, almonds, and tofu. Read food labels to check calcium content.
Takeaway: Should You Take Calcium Supplements?
If you eat a balanced diet rich in calcium-containing foods, supplements are rarely needed and may pose risks—particularly for heart health. If you do need to supplement, keep the dose modest and work with a healthcare professional to meet, but not exceed, total daily requirements. For most people, food is the safest, most beneficial source of calcium, supporting bone and heart health alike.
References
- Johns Hopkins Medicine, “Calcium Supplements: Should You Take Them?”
- ABC7, “Scientists urge caution on taking calcium supplements”
- The Journal of the American Heart Association, “Calcium-rich diet could be beneficial for the heart, but supplements seem to increase risk”
- PubMed, “Vitamin D, Calcium Supplements, and Implications for Cardiovascular Health”
References
- https://abc7.com/post/calcium-supplements-research-study/13443273/
- https://hub.jhu.edu/2016/10/13/calcium-supplements-heart-damage/
- https://www.natap.org/2019/HIV/070919_06.htm
- https://pubmed.ncbi.nlm.nih.gov/33509400/
- https://pure.johnshopkins.edu/en/publications/vitamin-d-calcium-supplements-and-implications-for-cardiovascular
- https://www.hopkinsarthritis.org/arthritis-info/osteoporosis-info/osteoporosis-prevention-and-treatment/
- https://pure.johnshopkins.edu/en/publications/vitamin-d-and-calcium-supplements-helpful-harmful-or-neutral-for-
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