Need Calcium Supplements? What You Should Know

Your doctor will likely advise you to take calcium supplements if you have osteopenia or osteoporosis. That sounds easy until you find an overwhelming number of choices: pills, powders, liquids, gummies and chocolates; carbonate and citrate; factory-made or derived from seashells or coral. Then there are rogue-sounding mix-ins like malate and vitamin K. The doses differ, too.

You’ll quickly wonder which is best.

Here’s a quick answer: You can’t really go wrong with any calcium supplement made by a major manufacturer or vetted by a licensed agency. Buy a bottle and take the supplement as directed. All will help your bone strength, and none will hurt your heart. However, some choices are better than others.

Calcium and Your Bones

Women need plenty of calcium. Most adult females require 1,000 to 1,200 milligrams a day. That’s because calcium, a mineral, is involved in your body’s circulation, fluids, tissue, blood vessels, muscles, nerve function and hormones.

We store calcium in our bones, where it keeps our bones and feet shaped as nature planned. If we run low, the calcium seeps out of our bones and into the other parts of our bodies that need it — meaning our bones get less dense and therefore more brittle. They can break more easily and our spines might hunch over.

As we age, our bones lose calcium even if we’re eating a balanced diet. That’s why your doctor might advise you to take calcium supplements and Vitamin D, either separately or packaged into one supplement. Vitamin D helps us absorb calcium.

Shopping for the Right Calcium Supplement

There is no set answer about what calcium supplement to choose. No government agency regulates supplements, yet certain rules mandate that bottles spell out all ingredients. Here are tips for finding a good calcium supplement.

• Estimate how much you need. Keep a food diary to see how much calcium and vitamin D you get without supplements, then work with a doctor or dietitian to see how much more to add via supplements.
• Choose calcium citrate. Calcium carbonate costs less but it must be taken with food, and your body won’t absorb it as well as it will calcium citrate. Citrate is also less likely to upset your stomach.
• Identify the source of the calcium. The calcium in your supplement might be made from oyster shells, limestone, citrus fruits, coral, or ingredients in a factory. All should work. This will matter if you prefer a more natural source, or a manmade source that has no risk of lead or other contaminants.
• Look at what’s mixed in. All forms except powder likely have additional ingredients needed to form pill shapes, capsule exteriors, etc. Those elements might involve lubricants that keep supplements from sticking to each other, binders to hold each one together, fillers to create shapes, disintegrants to help your body break them down, and color and flavor add-ins.   You might avoid those if you seek only natural ingredients.
• Question the format. The calcium in capsules tends to be absorbed better, but pills are more flexible; for example, they can be halved or crushed.
• Watch out for other additives. Calcium is frequently bundled with Vitamin D, but you might see versions including magnesium, vitamin K or other elements. Ask your doctor or dietitian before taking any of these. 
• Dosing matters. Your body will not use more than 500 milligrams maximum of calcium at a time, so take one 500mg calcium supplement in the morning and another in the evening. Any more will be wasted and can even lead to kidney stones.
• Look for an emblem. Some supplement manufacturers pay third-party testers to vet their products to see if they meet high criteria. Look for an emblem, then go online to see if the third party identified is legitimate.

Get All the Calcium You Can from Food

Try to get calcium from foods and beverages. These are loaded with calcium naturally:

• Dairy products such as milk, cheese, yogurt and kefir
• ‘Alternative’ dairy including nut milks, seed milks and soy milk
• Dark green vegetables including broccoli, curly kale, collard greens and bok choy. To keep the nutrients intact, cook the vegetables with dry heat, like an oven, rather than wet heat such as boiling.
• Canned fish with soft bones like sardines
• Almonds and other nuts
• Apricots, dried figs and oranges, among other fruits
• Tofu

Don’t be scared off of natural foods that contain oxalates and phytates, which decrease calcium absorption. Spinach, rhubarb, beans and seeds, for example, are great for you in many ways, and the oxalate/phytate issues are negligible.

If you’re post-menopausal, a small eater or have any other reason to think you might not be getting enough calcium, take action. Keep a food diary, meet with a healthcare professional, determine how much more calcium you need daily, then eat calcium-rich foods and take a supplement.