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Bones-Part 2: What type of calcium should I take?

Updated: Jan 20

Calcium deficiency and bones

Low calcium levels can lead to osteopenia (slight bone loss) and osteoporosis (severe bone loss).

How to treat calcium deficiency

Only about 30% of women in the US get enough calcium from their diet alone. For women over 51 years of age and men age 70+, the RDA (Recommended Daily Allowance) increases from 1000mg per day to 1200 mg daily. One must make a conscious effort to consume enough calcium-rich foods to meet the required amount. For example, an 8-ounce cup of low-fat plain yogurt contains 415mg of calcium. Fortified orange juice, cheeses, sardines (with bones), kale, and chia seeds are among other dietary sources of calcium. It is a good idea to calculate how much calcium you get from your foods and make up the deficit by taking the right calcium supplement.

The two most popular and widely available forms are calcium carbonate and calcium citrate. Calcium carbonate contains 40% elemental calcium and requires stomach acid to be absorbed by the body, therefore it should be taken with food. Calcium citrate, on the other hand, can be taken with or without food. Calcium citrate has 21% elemental calcium but is more readily absorbed. Calcium gluconate, lactate, or phosphate are also available, but they generally contain less absorbable calcium. Dicalcium Malate is one of the best forms of calcium (e.g. Osteoforce by Designs for Health).

Another important factor in taking calcium is the amount of calcium your body can absorb. Studies show that the body can only absorb 500 mg of calcium at a time. Therefore, it is best to divide the dose of your calcium supplement. For example, if you’re taking 1,000 mg of supplemental calcium, it is better to take 500 mg two times a day to optimize absorption.

Other ingredients that are recommended to be present in a calcium supplement:

  • Vitamin D - The sunshine nutrient, vitamin D, is necessary for calcium absorption and helps with bone turnover

  • Magnesium - Based on clinical data, magnesium(Mg) can contribute to bone formation. It is best to keep a 2:1 calcium to magnesium ratio since too much Mg seems to have negative effects on the bone

  • Vitamin K - Vitamin K is important for calcium to work better. Low vitamin K levels are associated with low bone mineral density and increased fractures

  • Zinc - Zinc helps to increase bone formation and mineralization

  • Copper - Copper helps keep bones flexible and strong

  • Manganese - Manganese is essential in forming the bone matrix. Calcium and other minerals are then deposited into the matrix

  • Potassium- Studies have shown that in older women, potassium intake has a positive correlation with bone health

  • Boron - Boron and calcium work together to strengthen bones

  • Vitamin C - Critical in maintaining the balance necessary for healthy bone mass and is also required for the synthesis of healthy collagen, the primary structural protein in bones

Side effects

While taking calcium supplements, side effects including gas, constipation, and bloating may occur. In general, calcium carbonate is the most constipating. You may need to try a few different brands or types of calcium supplements to find one that you tolerate the best.


Calcium supplements can interact with many prescription medications, such as thyroid hormones, some blood pressure medications, antibiotics, and calcium channel blockers. Ask your doctor or pharmacist about possible interactions and which type of calcium supplement would work for you.

Supplement form

Calcium supplements come in a variety of forms, including tablets, capsules, chews, liquids, and powders. If you have trouble swallowing pills, you may want a chewable or liquid calcium supplement. Click here to see Dr. Green's recommendation for great supplements.

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