Andrew M. Sklar, DDS, PC
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Calcium 101- Part II Supplementation
In Part 1 of this article, we discussed the importance of calcium, the daily requirements and the best dietary sources. To briefly review, calcium is important in the development and maintenance of strong bones, controlling blood pressure, maintaining ones heart beat, helping muscles work properly and maintaining weight loss.
The best source, surprisingly, is not dairy, but greens, almonds, salmon and sardines. Many common antacids and acid blockers (like Maalox and Prilosec), aspirin, steroids and thyroid meds can deplete your body of calcium and increase the need for supplementation.
The amount of calcium one needs per day can range from 300-1,500mg, depending on ones age, hormonal state (for women) and any medications they are on. Most individuals can get at least half the calcium they need from food, with a good supplement providing the rest. Here are a few things you should know about supplementation.
1. Only elemental calcium is available for absorption with any supplement. Calcium carbonate contains the most (40%), but it is harder to digest, not easily absorbed and seems to create more stomach acid after it leaves. This form is not recommended for people with heartburn, reflux, GERD or ulcers. Tums and Viactiv contain this form.
Calcium citrate (24%) is a better form. Though it does not contain as much elemental calcium, it does not cause stomach upset and is better absorbed- primarily because it doesn't require the acid environment usually required for calcium absorption, and can be taken with or without food. This is the preferred form for people with kidney stones, on acid blockers, or with gastrointestinal conditions.
Calcium gluconate is a form that is also easier on the stomach and is better absorbed, but it contains only 9% elemental calcium.
A supplement offering a combination of the three can be a good choice, unless you have one of the conditions previously mentioned.
2. Calcium should always be taken in divided doses of no more than 450mg per dose. The body cannot utilize more than that amount at one time. It should be taken at least 2 hours before or after taking an iron supplement and avoided at bedtime if you experience nighttime heartburn.
3. It is important not to consume more than 2500mg of calcium per day.
4. Calcium can be involved in drug interactions with medication and can interfere with the body's ability to use certain antibiotics tetracycline, for example. So you should always touch base with your doctor before starting calcium supplements.
5. Since calcium must dissolve in your stomach before it can be absorbed in your intestines and used by your body, choose a supplement with an isotonic delivery system and/or a USP symbol.
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