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Calcium

Calcium is a mineral important for strong bones and teeth. It also helps your heart, nerves, muscles, and other body systems work properly. Milk and dairy products, such as cheese and yogurt, give you most of the calcium you get from food, but you can also get it from nuts, green leafy vegetables, and calcium-enhanced orange juice. Vitamins A, C, D, and E help you use the calcium you get from food. Stress and lack of exercise can harm your calcium balance. Most people in the United States, especially women, do not get enough calcium in their diet.

Uses

Getting enough calcium can help your body do the following.

 

bulletDevelop strong bones and teeth
bulletPrevent osteoporosis and broken bones
bulletReduce your blood pressure
bulletLower your cholesterol levels
bulletKeep your heart regular
bulletReduce cramps and moodiness from premenstrual syndrome
bulletReduce irritability, insomnia, depression, and headaches during menopause
bulletReduce risks of pregnancy, such as high blood pressure and preeclampsia
bulletPrevent gum disease
bulletPrevent cancer of the colon and rectum
bulletPrevent kidney stones

 

Dietary Sources

The richest sources of calcium include cheeses (Parmesan, Romano, Gruyère, Swiss, Provolone, Monterey Jack, Edam, Cheddar, Muenster, Gouda, Tilsit, Colby, Caraway, Brick, Roquefort, Port du Salut, Cheshire, Havarti, Fontina, Mozzarella, Feta); wheat-soy flour; blackstrap molasses; and rennin.

Other good sources of calcium include almonds, bok choy, brazil nuts, broccoli, cabbage, caviar, dried figs, greens (dandelion, turnip, collard, mustard, kale), hazelnuts, ice cream, milk, oysters, sardines, soybean flour, and yogurt.

You can also get calcium from many herbs, spices, and seaweeds (for example, basil, chervil, cinnamon, dill weed, fennel, fenugreek, ginseng, kava kava, kelp, marjoram, oregano, parsley, poppy seed, sage, and savory).

Other Forms

Calcium is available in many forms. Lead has been found in some types, so use caution when choosing a product. Lead is a toxic metal that can harm the brain and kidneys, and can reduce red blood cell production. Children are most at risk for lead poisoning. The following are some of the available forms of calcium.

 

bulletCalcium citrate. This is the most easily used form of calcium, and the most easily digested. Lead levels are safe. It is especially recommended for elderly persons, people taking ulcer medication, and people who want to lower their blood pressure.
bulletCalcium carbonate. This type is less expensive, and lead levels are safe if it is refined. Rolaids and Tums contain calcium carbonate. Other antacids contain aluminum and can harm your calcium balance.
bulletCalcium gluconate. This type is safe.
bulletCalcium lactate. This is another safe form.
bulletCalcium chloride. This is not recommended because it irritates the gastrointestinal tract.

 

You should be cautious with products that may contain harmful levels of lead. These include unrefined calcium carbonate from oyster shells or limestone, bone meal, and Dolomite.

How to Take It

You should take small doses throughout the day, and drink 6 to 8 cups of water throughout the day to avoid constipation.

 

bulletAdults ages 19 to 50 need 1,000 mg of calcium each day. After age 50, adults need 1,200 mg each day.
bulletAdolescents ages 9 to 18 need 1,300 mg each day.
bulletChildren ages 6 to 8 need 800 mg each day; children ages 1 to 5 need 500 mg each day.

 

Precautions

Do not take extremely large doses of calcium (5,000 mg per day, or 2,000 mg per day or more over a long period) without talking with your health care provider. High doses can cause kidney stones and other serious problems.

Avoid calcium products that contain harmful levels of lead (see above).

Talk with your provider about your calcium needs if you have any thyroid or kidney problems, or if you have hormone or vitamin deficiencies.

Possible Interactions

Calcium can interfere with the absorption of tetracycline.

Some corticosteroid medications such as glucocorticoids also inhibit the absorption of calcium, thereby increasing the risk for osteoporosis over time.

Two different classes of diuretics interact with calcium in opposite ways—thiazide diuretics such as hydrochlorothiazide can raise calcium levels in the blood, while loop diuretics such as furosemide and bumetanide can decrease calcium levels.

High levels of calcium may increase the likelihood of a toxic reaction to digoxin, including symptoms of arrhythmia (irregular heartbeat); however, low levels of calcium render digoxin ineffective. People who are taking digoxin should have calcium blood levels monitored closely.

Supporting Research

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Devine A, Dick IM, Heal SJ, et al. A 4-year follow-up study of the effects of calcium supplementation on bone density in elderly postmenopausal women. Osteoporosis Int. 1997;7:23–28.

Ensminger AH, Ensminger ME, Konlande JE, Robson JRK. Foods and Nutrition Encyclopedia. 2nd ed. Baton Rouge, Fla: CRC Press Inc; 1994;2:1338–1341.

Garrison Jr RH, Somer E. The Nutrition Desk Reference. 3rd ed. New Canaan, Conn: Keats Publishing Inc; 1995:158–165.

Hardman JG, Gilman AG, Limbird LE, eds. Goodman and Gilman's Pharmacological Basis of Therapeutics. 9th ed. New York, NY: McGraw-Hill; 1996:839–874.

Hathcock JN. Metabolic mechanisms of drug-nutrient interactions. Fed Proc. 1985;44(1):124-129.

Heinerman J. Heinerman's Encyclopedia of Nature's Vitamins and Minerals. Paramus, NJ: Prentice Hall Inc; 1998:296–302.

Lukert BP, Raisz LG. Glucocorticoid-induced osteoporosis: pathogenesis and management. Ann Intern Med. 1990;112(5):352-364.

Murray MT. Encyclopedia of Nutritional Supplements. Rocklin, Calif: Prima Publishing; 1996:159–175.

Nicar MJ, Pak CY. Calcium bioavailability from calcium carbonate and calcium citrate. J Clin Endocrinol Metab. 1985;61(2):391–393.

Physicians’ Desk Reference. 54th ed. Montvale, NJ: Medical Economics Co., Inc; 2000:1215-1218.

Reid IR, Veale AG, France JT. Glucocorticoid osteoporosis. J Asthma. 1994;31(1):7-18.

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Rodrâiguez JA, Novik V. Calcium intake and bone density in menopause. Data of a sample of Chilean women followed-up for 5 years with calcium supplementation. Rev Med Chil. 1998;126:145–150.

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Thys-Jacobs S, Starkey P, Bernstein D, Tian J. Calcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. Premenstrual Syndrome Study Group. Am J Obstet Gynecol. 1998;179:444–452.

Van de Vijver LP; Kardinaal AF; Charzewska J, et al. Calcium intake is weakly but consistently negatively associated with iron status in girls and women in six European countries. J Nutr. 1999; 129(5):963-968.

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