Should We Take Calcium Supplements?

Written by Dr. Steve Chaney on . Posted in Calcium Supplements, Exercise, Food and Health, Healthy Lifestyle

Clearing Up The Calcium Confusion

Author: Dr. Stephen Chaney

should we take calcium supplementsShould we take calcium supplements?  You have every right to be confused about calcium supplementation. There have been a lot of conflicting headlines in recent months.

It has seemed like a no-brainer for years that calcium supplementation could help post-menopausal women and men over 50 avoid the debilitating effects of osteoporosis.

After all:

  • >99% of adults fail to get the USDA recommended 2.5-3 servings/day of dairy products.
  • 67% of women ages 19-50 and 90% of women over 50 fail to meet the RDA recommendations for calcium intake from diet alone.
  • Men do a little better (but only because we consume more food). 40% of men ages 19-50 and 80% of men over 50 fail to meet the RDA recommendations for calcium intake from diet alone.
  • Inadequate calcium intake over a lifetime is considered a major risk factor for osteoporosis.
  • Osteoporosis is serious business. It doesn’t just cause bone fractures. It can result in chronic pain, disability, long term nursing home care, and even death.

It’s no wonder that some experts have predicted that supplementation with calcium and vitamin D could save over $1 billion per year in health care cost savings. It is also why health professionals have recommended calcium supplementation for years, especially for postmenopausal women and men over 50.

However, recent headlines have claimed that calcium supplementation doesn’t really increase bone density or prevent osteoporosis (more about that later). Other headlines have suggested that calcium supplementation is actually bad for you. It may increase your risk of heart disease.

That’s why the general public, and even many doctors, are confused.  Should we take calcium supplements?  Everyone wants to know the answer to two questions:

  • Do calcium supplements work?
  • Are calcium supplements safe?

I will start with the second question first.

Are Calcium Supplements Safe?

are calcium supplements safeI have discussed the issue of calcium supplements and heart disease risk in a previous issue of Health Tips From the Professor. Briefly, the initial studies suggesting that calcium supplementation might increase the risk of heart attacks and cardiovascular disease were good studies, but they were small, short-term studies.

The initial studies raised an important question, so the scientific community stepped up to the plate and conducted larger, longer term studies to test the hypothesis. Both of those studies concluded that calcium supplementation posed no heart health risks.

Now a third major study on the subject has just been published (Raffield et al, Nutrition, Metabolism & Cardiovascular Disease, doi: 10.1016/j.numecd.2016.07.007). The study followed 6236 men and women ages 45-84 for an average of 10.3 years. The subjects were from four different race/ethnicity groups and came from 6 different locations in the United States. More importantly, there were 208 heart attacks and 641 diagnoses of cardiovascular disease during the study, so the sample size was large enough to accurately determine the relationship between calcium supplementation and heart disease.

The results were pretty straight forward:

  • The authors concluded: “[This study] does not support a substantial association of calcium supplement use with negative cardiovascular outcomes.” If you would like the plain-speak version of their conclusion, they were saying that they saw no increase in either heart attacks or overall cardiovascular disease in people taking calcium supplements.
  • If anything, they saw a slight decrease in heart attack risk in those taking calcium supplements, but this was not statistically significant.

In summary, the weight of evidence is pretty clear. Three major studies have now come to the same conclusion: Calcium supplementation does not increase the risk of either heart attacks or cardiovascular disease.

Of course, once information has been placed on the internet, it tends to stay there for a very long time – even if subsequent studies have proven it to be wrong. So the myth that calcium supplementation increases heart attack risk will probably be with us for a while.

So, should we take calcium supplements?  Let’s first investigate a little further.

 

Do Calcium Supplements Work?

do calcium supplements workAs I mention above, recent headlines have also suggested that calcium supplementation does not increase bone density, so it is unlikely to protect against osteoporosis. I analyzed the study behind those headlines in great detail in two previous issues of Health Tips From the Professor.

In Part 1 Calcium Supplements Prevent Bone Fractures  I pointed out the multiple weaknesses in the study that make it impossible to draw a meaningful conclusion from the data.

 

In Part 2 Preventing Osteoporosis  I discussed the conclusion that the study should have come to, namely: Adequate calcium intake is absolutely essential for strong bones, but calcium intake is only one component of a bone healthy lifestyle.

The bottom line is that calcium supplementation will be of little use if:

  • You aren’t getting adequate amounts of vitamin D and all of the other nutrients needed for bone formation from diet and supplementation.
  • You aren’t getting enough exercise to stimulate bone formation.
  • You are consuming bone dissolving foods or taking bone dissolving drugs.

Conversely, none of the other aspects of a bone healthy lifestyle matter if you aren’t getting enough calcium from diet and supplementation.

The bottom line is that you need to get adequate calcium and have a bone healthy lifestyle to build strong bones and prevent osteoporosis, and calcium supplementation is often essential to make sure you are getting adequate calcium.

 

Should We Take Calcium Supplements?

should we take calcium supplements nowShould we take calcium supplements?  If you are one of the millions of Americans who aren’t meeting the RDA guidelines for calcium from diet alone, the answer is an unqualified yes.  Calcium supplementation is safe, and it is cheap.  Osteoporosis is preventable, and it is not a disease to be trifled with.

However, you also need to be aware that calcium supplementation alone is unlikely to be effective unless you follow a bone healthy lifestyle of diet, exercise and appropriate supplementation to make sure you are getting all of the nutrients needed for bone formation.

Of course, it is always possible to get too much of a good thing. The RDA for calcium is 1,000 – 1,200 mg/day. The suggested upper limit (UL) for calcium is 2,000 – 3,000 mg/day.  I would aim closer to the RDA than the UL unless higher intakes are recommended by your health care professional.

 

The Bottom Line

 

  • 80% of men and 90% percent of women over 50 do not get enough calcium from their diet.
  • Consequently, doctors have consistently recommended calcium supplementation to prevent osteoporosis, and 50% of men and 60% of women over 60 currently consume calcium supplements on a regular basis.
  • Some small, short term studies suggested that calcium supplementation might increase the risk of heart disease, and warnings about calcium supplementation have been widely circulated on the internet. This hypothesis has been evaluated by three larger, longer term studies that have all concluded that calcium supplementation does not increase heart disease risk.
  • A recent study claimed that calcium supplementation was ineffective at increasing bone density, and that report has also been widely circulated. However, there are multiple weaknesses in the study that make it impossible to draw a meaningful conclusion from the data.
  • If you are one of the millions of Americans who aren’t meeting the RDA guidelines for calcium from diet alone, you should consider calcium supplementation.  It is safe.  It is effective when combined with a bone healthy lifestyle of diet, exercise, and appropriate supplementation.  Finally, it is cheap. Osteoporosis is preventable, and it is not a disease to be trifled with.
  • Of course, it is always possible to get too much of a good thing. The RDA for calcium is 1,000 – 1,200 mg/day. The suggested upper limit (UL) for calcium is 2,000 – 3,000 mg/day. I would aim closer to the RDA than the UL unless higher intakes are recommended by your health care professional.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Comments (6)

  • Jennifer

    |

    Calcium supplements were the wrong thing for me, I recently learned. I am hyperparathyroid, due to a tumor on one or more parathyroid glands. The calcium level in my blood had risen to 12.5 due to the malfunction of the parathyroid gland that regulates calcium in the bones, and more. I had osteoporosis—so all the more reason to take calcium? Wrong. For years, I faithfully took calcium, until this year. For years, doctors mused over my high blood calcium levels, above 10. However, due to thinning bones, every one recommended calcium supplements. Now that the tumor and malfunction is discovered, I halted all calcium and I’m preparing for surgery to remove the tumor(s) on my parathyroid gland(s), the only cure. One should not assume that thin bones are the only marker to take calcium.

    Reply

    • Dr. Steve Chaney

      |

      Dear Jennifer,
      You are correct in saying that calcium supplements won’t help if you are hyperparathyroid. However, I must wonder how your doctor’s missed that diagnosis. With thinning bones and high blood calcium levels, they should have tested you for hyperparathyroidism – not muse about it.
      Dr. Chaney

      Reply

  • Jeanie Porter

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    Dr. Chaney, I would like additional information on where magnesium fits into the calcium/osteoporosis equation and in what ratio it should be included. Also, the same for strontium – how important is it for bone health and in what ratio?
    Thank you. Jeanie Porter

    Reply

    • Dr. Steve Chaney

      |

      Dear Jeanie,
      You should certainly aim for RDA intake of magnesium (300-310 mg/day for women and 400-420 mg/day for men. I have seen recommendations for a 2:1 ratio of calcium to magnesium. What many people neglect to say is that holds only up to RDA levels of calcium (which would correspond to 400-500 mg/day of magnesium. It is also important to know that excess magnesium can cause diarrhea. If you are taking a magnesium supplement, you get one that is sustained release.
      Strontium is more complicated. There is a form, strontium ranelate, that is prescribed to help increase bone density in women with osteoporosis in Europe. However, it has not been approved for use in this country, and the strontium supplements used in this country are unrelated to strontium ranelate. Unfortunately, there has been very little research on strontium supplements in this country. In short, strontium supplements may help increase bone density, but we have no idea what kind or how much would be beneficial.
      Dr. Chaney

      Reply

  • Ruth wood

    |

    Hello Dr. Chaney.
    I’m interested in information regarding the effect of calcium supplementation on development of kidney stones.

    Reply

    • Dr. Steve Chaney

      |

      Dear Ruth,
      Some forms of kidney stones do contain calcium, but if your calcium intake is less than 4,000 mg/day, the kidney stones are probably not caused by excess calcium. Kidney stones are more likely caused by inadequate water intake, too little magnesium, too little B6, too much vitamin D, or hormone imbalances. If you are getting adequate water, magnesium, and B vitamins and still suffer from recurrent kidney stones, you should probably get a full workup by your physician.
      Dr. Chaney

      Reply

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Latest Article

How to Choose the Right Pillow

Posted April 17, 2018 by Dr. Steve Chaney

Wake Up Each Morning Pain Free

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

 

how to choose the right pillow without headachesThe way you sleep is often a key to discovering the cause of headaches and more. If you wake up with neck pain, a headache, or you suffer from ringing in your ears, dizziness, or ear pain, there is a good possibility that it may be caused by the way you are sleeping. Your pillow may be the culprit.  But if you need to know how to choose the right pillow for you, it’s easy.   It just takes a little “investigation.”

 

How to Choose the Right Pillow if You Sleep On Your Side

Your head, neck, and spine need to always stay in a nice straight line, just as it is when you are standing up, but that takes a little thought and understanding of the way you sleep.  So, get comfy in your bed and then notice how your head is resting.

how to choose the right pillow to sleep painfreeIf you sleep on your side, your pillow needs to be just the right size, so your head doesn’t point down toward the mattress (your pillow is too soft) or up to the ceiling (your pillow is too thick). Either of these positions will make the muscles on the side of your neck stay in the contracted position for hours and pull your vertebrae in that direction, especially when you try to turn over to your other side.

Your SCM Muscle May Cause Serious Problems

You also need to notice if you turn your head a bit, especially if you are turning into your pillow or turning your head up toward away from your pillow. In either of these two cases you will be causing your sternocleidomastoid (SCM for short) to be held shortened for hours.

Your SCM originates on your collarbone and inserts into the bone behind your ear.  When it contracts you turn your head to the opposite side. However, if the muscle is tight (for example, when you’ve held your head turned toward one side for an extended period of time) and then you bring your head back so you are facing forward, the tight muscle will pull on the bone behind your ear and cause havoc.

The symptoms for a tight SCM are tinnitus (ringing in the ear), dizziness, loss of equilibrium, ear pain, headaches, pain in the eye and around the skull, pain at the top of the head, and even pain in the throat. Amazing! What’s even more amazing is that it’s rare that this muscle is considered when a medical professional is searching for the cause of your symptoms.

These are the things to know when considering how to choose the right pillow if you sleep on your side.

How To Choose The Right Pillow If You Sleep On Your Back

how to choose the right pillow for sleeping on your backIf you sleep on your back, your head should be on the mattress (not propped up with a pillow) and you should have a tiny support (like a folded washcloth) under your neck.  Or, you can have a wedge pillow that starts at your mid-back and gently raises your entire trunk and head up while still allowing your head and back to be in a straight line.

It’s always a challenge for people who toss and turn during the night, sometimes on their side and sometimes on their back.  The best thing I’ve found for this situation is to have the pillow below shoulder level so when you turn on your side your shoulder will automatically slide to the edge of the pillow while still supporting your head properly, and when you turn onto your back, the pillow will start at shoulder level so your head and neck are supported, but your head is being pushed in a way that causes your chin to move down to your chest.

hip pain causes and treatment pain freeIt’s tricky, but I can personally attest to the fact that it will work.  I can always tell when I’ve had my head tilted (I toss and turn during the night) because I will wake with a headache. When that happens I’m grateful that I know how to self-treat the muscles of my neck and shoulders so the headache is eliminated quickly.  If you already have Treat Yourself to Pain Free Living,  you can self-treat all your neck and shoulder muscles to release the tension.

How To Choose The Right Pillow If You Sleep On Your Stomach

If you sleep on your stomach, this is the one position that is so bad that it behooves you to force yourself to change your position. Your head is turned to the side and held still for hours, putting a severe strain on all your cervical and upper thoracic vertebrae. Not only will this cause headaches, tinnitus, and a list of other pains, but it can cause problems down your entire spine. It can also impinge on the nerves that pass through the vertebrae on their way to your organs.

If you do sleep that way, let me know and I’ll give you some suggestions that work to change your habit of sleeping. It takes time and energy, but the results are worth the effort.

In every case, the way you sleep may cause neck pain that won’t go away until the pillow situation is resolved.

Now you should know how to choose the right pillow for the way you sleep.

Wishing you well,

Julie Donnelly

About The Author

julie donnelly

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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