Calcium supplements… Do you need them?
I think this is a very important question to ask since it seems everyone I encounter these days — primarily women — are on some sort of Calcium supplement. Whether it was their doctor, last nutritionist, trainer, or the latest magazine article that told them to take it, most believe their Calcium supplements are necessary. And yes, for some this may be true. Especially since so many people these days are scared of dairy (the best source of Calcium) for one reason or another.
Still the question stands, “do you really need it?” And if you do, is the supplement you are taking really working?
Most of us know we need Calcium for bone health. Many of us know we need it for proper cell and nerve function. Yet, few of us really understand how Calcium works in the body and what other cofactors are needed for proper absorption and utilization.
To really understand if we need to supplement our diets with Calcium and to understand if it is working in our body, we need understand so much more… only then can we make an educated decision on if we actually need a supplement.
First, what is the role of Calcium in the body?
*Bone and teeth structure
*Nerve and cell function
*Regulates the heart beat
*Lowers blood pressure by down-regulating parathyroid hormone (PTH)
99% of Calcium is stored in the skeletal system (the bones are referred to as Calcium banks). The other 1% is located in the soft tissue and blood. Every day there is a transfer of Calcium among the bones, cells, and blood. Thus, since we do not make our own Calcium within the body, a constant intake of dietary Calcium is needed. Without proper intake, the body will pull Calcium from our Calcium banks (bones) and use it for cellular function. This is one big reason why we need to be ingesting an adequate level of Calcium every day. Ok, so it does make sense for doctors to prescribe Calcium supplements, right? Well, maybe…
The Calcium paradox
Although there are many paradox’s surrounding Calcium, a big one is this. Why do some nations like the US, who supplement with more Calcium than most other nations, have a higher level of osteoporosis (bone breakdown)? In a 1992 study between the US and Japan, the US showed almost 3 times as many hip fractures than the Japanese, even though on average the Japanese ingested far less Calcium on a daily basis. In fact, in a nation where people are trying to consume the recommended daily allowance of Calcium, some 10 million Americans have osteoporosis, while another 34 million have low bone mass. Why is this happening? If Americans are consuming more Calcium, shouldn’t we have less osteoporosis?
Another factor to consider is a 2010 study published by the British Medical Journal concerning Calcium supplementation and cardiovascular risks. In a meta-analysis (compiled results of several studies that address a related research hypotheses) of 12,000 individuals, it was concluded that taking Calcium supplements increased the chance of a heart attack by 30%.
Kate! Are you saying increased Calcium supplementing may NOT prevent osteoporosis AND it may also increase my chance of a heart attack? In some respects, yes… in others, no. Huh? Have I confused you yet?
You see, for Calcium to work properly, there are so many other factors to consider. Calcium needs many helpers and a certain gut environment for proper absorption and utilization. If these helpers or conditions are unavailable, Calcium may be excreted through the urine… or worse — calcified in tissues and arteries. Obviously, over time, this could lead to bone breakdown and stiff, blocked arteries.
So, before popping your next Calcium supplement, let’s look at what really needs to be occurring in your diet and body for proper Calcium absorption and utilization.
1. Adequate levels of Vitamin D (specifically D3). Vitamin D helps Calcium to be absorbed through the small intestine by increasing the number of Calcium-binding proteins. Without enough Vitamin D, the absorption of Calcium decreases significantly. Know anyone with a Vitamin D deficiency? It seems just about everyone these days. Best source of Vitamin D — the sun. Other sources are milk, butter, eggs, shellfish, and white fish.
*In the British 2010 meta-analysis, it was shown that those supplementing with Calcium plus Vitamin D did not show an increase in heart attacks ONLY those taking Calcium alone.
2. Adequate levels of Vitamin A. Vitamin A is a fat-soluble vitamin required in proper Calcium metabolism. Good sources are liver, milk, cheese, and eggs.
3. Adequate levels of Vitamin E. Vitamin E is a fat-soluble vitamin needed for proper Calcium metabolism. Good sources are milk, blueberries, blackberries, butternut squash, olive oil, crab, nectarines, and papaya.
4. Adequate levels of Vitamin K (more specifically K2). Vitamin K is a fat-soluble vitamin. Increased levels of vitamin K are showing a decrease in calcification of tissue and arteries and increase in bone development. In a clinical study from Rotterdam, Holland: “When Vitamin K2 is lacking, the Calcium remains in the blood and ends up getting deposited in the walls of arteries and other sites, which is very undesirable.” Good sources of vitamin K2 are foie gras, Gouda, and Edam cheese. Good sources of K1 are green leafy vegetables. Bacteria in the small intestine can convert K1 to K2.
5. Adequate levels of Magnesium. Magnesium is needed for Calcium absorption and retention. According to Dr Ray Peat, “Magnesium deficiency and Calcium deficiency have some similar symptoms (such as cramping). But Magnesium is antagonistic to Calcium in many systems. It is the basic protective Calcium-blocker. G. Jasmin, showed that Magnesium deficiency causes inflammation. A deficiency of either Calcium or Magnesium can stimulate the parathyroid glands to produce more hormone (parathyroid hormone, PTH), which increases Calcium absorption, but also removes Calcium from the bones. This hormone, responding to a dietary Calcium or Magnesium deficiency, is an important factor in causing cells to take up too much Calcium. And its excess is associated with many inflammatory and degenerative diseases.”
Good sources of Magnesium are Epson salt baths, tropical fruits, coffee, dark chocolate, bone broth, squash, spinach, some nuts.
6. Stomach health. Calcium is an alkaline mineral. However, it needs an acidic environment to break down to allow for proper absorption. If your stomach does not produce enough hydrochloric acid (HCl), Calcium will not be able to break down and be absorbed in the small intestine. HCl naturally decreases with age.
7. Adequate levels of protein. Too much or not enough protein can interfere with Calcium metabolism. According to Dr Ray Peat, “Traditional meat-eating cultures efficiently use the whole animal, including blood, skin, bones, and the various organs, rather than just the muscles. That diet is favorable for Calcium regulation, because it provides more vitamin A, D, E, and K, Calcium, and gelatin, and less of the pro-inflammatory amino acids — tryptophan and cysteine.”
8. Adequate levels of fat. Fats contain all the fat-soluble vitamins (A, D, E, and K) that are needed for proper Calcium metabolism.
9. Adequate levels of sugar (carbohydrates). As I told you in my Milk blog, lactose or other sugars are necessary to help increase Calcium absorption.
10. Small intestine health. Calcium is absorbed into your body through your small intestine. If you have intestinal inflammation (due to stress, processed foods, PUFA’s, alcohol, drugs, food additives, etc.) all your minerals, including Calcium, have a hard time entering your system. The unabsorbed Calcium ends up being excreted through the urine.
11. Stress. Parathyroid hormone (PTH) increases under stress. PTH is a hormone produced by the pituitary gland and acts to increase levels of Calcium in the blood. Under stress, PTH pulls Calcium from the bones and kidneys to increase blood Calcium levels. This is needed to keep blood Calcium levels within the normal range. However, like all stress hormones, chronic high levels will cause damage. Chronic elevated levels of PTH will lead to bone breakdown and calcification of soft tissues.
12. The quality of the supplement. Most supplements these days are filled with additives, fillers, and binders. Due to the binders, these supplements can be hard for your system to break down and absorb. And the additives and fillers can cause an allergic reaction. The end result may be an expensive pill that creates intestinal inflammation or is just excreted in your urine or feces.
13. Other influences. Smoking, caffeine, corticosteroids, drugs, oxalates, insoluble fiber, and Phosphorus all inhibit the absorption of Calcium.
Holy cow! Can you see why taking a Calcium supplement might not be doing you any good?
So then what is the answer to, “Do I really need to take Calcium supplement?”
Well, here is my take… Are you ready?
My theory is really complex….
Eat REAL food and remove the CRAP!
You should always try to get your Calcium from food first. Why? Because the right Calcium-enriched foods usually will contain a lot of the other nutrients to help with proper Calcium absorption and utilization. This is why food should be your supplement…
Best sources of Calcium.
1. Milk. An 8oz (1 cup) serving of milk contains about 300mg of Calcium. In addition, milk contains proteins, sugars, fats, Vitamins A, D, and E, plus Magnesium. Do you see why I like real milk so much? *Remember there is a BIG difference between conventionally farmed milk and grass-fed organic milk. So choose wisely!
2. Cheese. One ounce of cheese contains about 200mg of Calcium. Cheese, in addition to milk, contains Vitamins A, D, E, and Magnesium. Most cheese contains only fat and protein (no sugar or carbs). Once again, where the cheese comes from makes a difference. Grass-fed organic is always best. Try to find cheese that is void of fillers and additives.
3. Yogurt. One cup of plain Greek yogurt contains about 230 mg of Calcium. It contains, fat, protein, and sugars, plus Vitamin A, D, and E. Fage Greek yogurt is a good option.
4. Ice cream. ½ cup of vanilla ice cream contains about 100mg of Calcium. Ice cream also contains fats, sugars, and proteins, plus Vitamin A, D, and E. I only use Hagan Daz (no fillers or additives — just milk, sugar, eggs, and cream).
Other good sources of Calcium are sardines, salmon, almonds, and *egg shells.
Although many other sources (spinach, chard, berries, and nuts) contain adequate levels of Calcium, these sources also contain oxalates. Oxalates bind with Calcium and increase Calcium excretion from the body. This just means less Calcium absorption.
*Ground up, boiled eggshells are a great way to get your Calcium if you have a hard time getting Calcium via food. One eggshell equals about 800mg of Calcium without added fillers and binders.
How much do you need?
The RDA recommends anywhere from 1200-1500mg a day. The exact amount for you may depend on your activity, your gut health, stress, age, sex, and the source from where you are getting it. Each of these may increase your need for Calcium while also increasing your need for other minerals and nutrients.
It is also recommended to take Calcium throughout the day. But no more than 500mg is recommended at one serving/meal. Too much at once will not be absorbed and will be excreted from the body.
We must remember that there is a reason real food is designed the way it is…it is a perfectly designed energy source. Real, unaltered food provides all the nutrients we need without having to become a nutritional scientist and concocting a supplemental cocktail.
In a world of genetically modified foods, environmental toxins, pesticides, processed foods, fast-food, herbicides, fertilizers, additives, preservatives, fillers, emulsifiers, hormones, and antibiotics, it does seem to make sense that we would need to supplement our food. However, doesn’t it make more sense to just eat well? Yes, it may cost more NOW, but in the long run, it will cost far less.
Pay NOW or pay LATER… The choice is yours.
Your Optimal Health Coach,
“Disclaimer: I am an exercise physiologist, personal trainer, nutritional and lifestyle coach, not a medical doctor. I do not diagnose, prescribe for, treat or claim to prevent, mitigate or cure any human disease or physical problem. I do not provide diagnosis, care treatment or rehabilitation of individuals, nor apply medical, mental health or human development principles. I do not prescribe prescription drugs nor do I tell you to discontinue them. I provide physical and dietary suggestions to improve health and wellness and to nourish and support normal function and structure of the body. If you suspect any disease please consult your physician.”References:
2. Cees Vermeer, Laviena Braam et al. Vitamin K supplementation: A simple way to bone and cardiovascular health, AgroFOOD industry hi-tech, Nov/Dec 2003 17-20
3. Cranney, A; Horsley, T, O’Donnell, S, Weiler, H, Puil, L, Ooi, D, Atkinson, S, Ward, L, Moher, D, Hanley, D, Fang, M, Yazdi, F, Garritty, C, Sampson, M, Barrowman, N, Tsertsvadze, A, Mamaladze, V (2007 Aug). “Effectiveness and safety of vitamin D in relation to bone health”. Evidence report/technology assessment (158): 1–235. PMID 18088161
4. Feskanich D, Weber P, Willett WC, Rockett H, Booth SL, Colditz GA. Vitamin K intake and hip fractures in women: a prospective study. Am J Clin Nutr. 1999; 69:74–79.
5. R. Bowen. Endocrine control of Calcium and Phosphate Homeostasis. 2003
6. Dr Ray Peat. “Calcium and Disease: Hypertension, organ calcification, & shock, vs. respiratory energy”
7. Effect of Calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010; 341 doi: 10.1136/bmj.c3691 (Published 29 July 2010) Cite this as: BMJ 2010;341:c3691
8. Iwamoto J, Takeda T, Sato Y. “Effects of vitamin K2 on the development of osteopenia in rats as the models of osteoporosis.” Department of Sports Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. firstname.lastname@example.org
9. Wallin R, Schurgers L, Wajih N. “Effects of the blood coagulation vitamin K as an inhibitor of arterial calcification.” Department of Internal Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina 27157, USA. email@example.com. Thromb Res. 2008;122(3):411-7. Epub 2008 Jan 30
10. Heaney RP (2000) “Calcium, dairy products and osteoporosis.” Journal Am Coll Nutr 19 (2 Suppl) : 835-995 PMID 1075913