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Use caution with calcium supplements

Created date

April 23rd, 2013
Milk and calcium

Recently, the U.S. Preventive Services Task Force (USPTF) recommended against using daily supplemental calcium pills for the prevention of fractures in post-menopausal women, and the AARP Diet and Health Study showed an increase in mortality among men who take these supplements. This news surprised many because it is widely believed that calcium helps keep your bones strong and prevents fractures. In fact, 50% of older men and almost 70% of older women use calcium supplements.

So how do we make sense of it all and should you keep taking those horse pills? For people with a diagnosis of osteoporosis who are thus at a higher risk of fracture, calcium has been shown to be an effective treatment and you should continue to strive for a daily adequate intake of 1,000–1,200 mg of calcium through your diet and with supplements as needed. If you are not sure whether or not you have osteoporosis or if you are at high risk, see your doctor for a screening. You can then make an informed decision about your daily calcium needs.

If you do not have osteoporosis and you are simply taking calcium supplements for prevention of future fractures, carefully consider the recent study findings and USPTF recommendations. Although the AARP study showed an increased risk of cardiovascular deaths among men associated with taking calcium supplements (particularly among smokers), the association between calcium supplements and heart disease remains controversial for women. Nevertheless, the task force recommended against using supplements because they were not generally found to prevent fractures, but they were associated with a mild increase in the risk of kidney stones.

The USPTF is very conservative so they don’t recommend a treatment if there is evidence of a health risk along with minimal benefit. Not all experts agree, however, as there have been some studies on calcium use in post-menopausal women that show fracture risk reduction.

Making sense of the information

This is all very confusing, but there is a silver lining in this cloud of information. All the studies reviewed show that the calcium found in the food we eat is safe. It is only calcium supplements that raise cause for concern. Increased dietary calcium intake in men is not associated with heart disease risk and increased dietary calcium in women is not associated with kidney stones. It turns out that low-fat dairy products, some cereals, and green leafy vegetables are the best ways to get your calcium, build your bones, and avoid side effects. A favorite recommendation of mine is figs. They are tasty, very rich in calcium, and unlike calcium supplements, they help with bowel regularity.

It is important to remember that if you have osteoporosis or are at high risk, you may still need supplements to achieve an intake of 1,200 mg of calcium a day. Before making any changes to your current regime, please discuss bone health and calcium with your doctor.

This is certainly more complicated than we would like, but knowledge is empowering and gives you the opportunity to have an informed conversation with your health care provider, weigh your options, and choose the path that is right for you. Next month, we’ll discuss vitamin D’s important role in fracture prevention.

In good health,

Dr. Narrett