Calcium Supplements

Building strong and healthy bones requires an adequate dietary intake of calcium and exercise beginning in childhood and adolescence for both sexes. Most importantly, however, a high dietary calcium intake or taking calcium supplements alone is not sufficient in treating osteoporosis, and should not be viewed as an alternative to or substituted for more potent prescription osteoporosis medications. In the first several years after menopause, rapid bone loss can occur even if calcium supplements are taken.

The following calcium intake has been recommended by The National Institutes of Health Consensus Conference on Osteoporosis for all people, with or without osteoporosis:

800 mg/day for children ages 1 to 10
1,000 mg/day for men, premenopausal women, and postmenopausal women also taking estrogen
1,200 mg/day for teenagers and young adults ages 11 to 24
1,500 mg/day for post menopausal women not taking estrogen
1,200mg to 1500 mg/day for pregnant and nursing mothers
The total daily intake of calcium should not exceed 2,000 mg
Daily calcium intake can be calculated by the following method:

Excluding dairy products, the average American diet contains about 250 mg of calcium.
There are about 90 mg of calcium in 1/2 cup of vanilla ice cream.
There are about 200 mg of calcium in 1 ounce of cheddar cheese.
There are about 300 mg of calcium in an 8-ounce glass of milk or calcium-fortified orange juice.
There are about 450 mg of calcium in 8 ounces of plain yogurt.
There are about 1,300 mg of calcium in 1 cup of cottage cheese.
Unfortunately, surveys have shown that average women in the United States are consuming less than 500 milligrams of calcium per day in their diet, less than the recommended amounts. Additional calcium can be obtained by drinking more milk and eating more yogurt or cottage cheese, or by taking calcium supplement tablets as well from calcium-fortified foods, such as orange juice.

The calcium carbonate supplements are best taken in small divided doses with meals. The intestines may not be able to reliably absorb more than 500 mg of calcium all at once. Therefore, the best way to take 1,000 mg of a calcium supplement is to divide it in two doses. Likewise, a dosage of 1,500 mg should be divided into three doses.

Calcium supplements are safe and generally well tolerated. Side effects are indigestion and constipation. If constipation and indigestion occur with calcium carbonate supplements, calcium citrate (Citracal) can be used. Certain medications can interfere with the absorption of calcium carbonate. Examples of such medications include proton-pump inhibitors [omeprazole (Prilosec), lansoprazole (Prevacid), lansoprazole (Protonix), and rabeprazole (Aciphex)], which are used in treating GERD (acid reflux) or peptic ulcers. In these cases, calcium citrate is preferred.

Many "natural" calcium carbonate preparations, such as oyster shells or bone meal, may contain high levels of lead or other harmful elements and should be avoided. (Information from WebMD)

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