Calcium is an essential mineral taken as a supplement to help build strong bones and reduce the risk of fractures as we grow older. However, because calcium is available in different salt forms –carbonate, citrate, gluconate, acetate and lactate –making a decision on the right choice of calcium supplement could be difficult for many patients.
Normal range of calcium is usually between 8.5 and 10.5 mg/dL which can be determined through a lab test. Some of the causes of low calcium levels include excessive alcohol consumption and medications such as diuretics –furosemide –that work by eliminating excess water from the body. Antidepressants like sertraline, paroxetine and anti-seizure medications like phenytoin and phenobarbital could also cause calcium imbalance.
There are many signs that serum calcium level is low, but some of the most common symptoms include confusion, anxiety, muscle cramps, tingling in the fingers, irregular heartbeat, lack of energy and sometimes seizures at very low levels. If you have any of these symptoms, I would recommend you consult with your healthcare provider immediately, because long term inadequate calcium intake could lead to weak bones susceptible to fracture.
According to the Institute of Medicine, adult men between the ages of 51 and 70 require 1000 mg of calcium daily and women over 50 years old require 1200 mg daily from food and supplements. There are various foods that are rich in calcium including dairy products (milk), fish with edible bones, kale and yogurt.
The amount of elemental calcium supplied by supplements varies depending on the salt form that is consumed. Elemental calcium means the amount of calcium available for absorption by the body.
Calcium carbonate is the salt of choice because it contains the highest amount of elemental calcium of 400 mg –about 40%. It is also the least expensive, but it dissolves best only if consumed in an acidic environment. It is recommended that calcium carbonate be taken with meals to increase the absorption of the salt.
Calcium citrate contains about 211 mg of elemental calcium. Citrate could be taken without food because it is not acid dependent and better absorbed than the carbonate form. The advantage with the use of citrate is that it has fewer side effects like upset stomach compared to carbonate.
Other salt forms include calcium gluconate with approximately 93 mg of elemental calcium, calcium acetate with about 240 mg elemental calcium and calcium lactate with about 130 mg of elemental calcium. These other sources of calcium are rarely used due to low amounts of calcium provided.
Therefore, calcium carbonate or citrate is a good choice for anyone looking for a calcium supplement because the human body only needs about 500 mg of calcium to be absorbed at a time.
In conclusion, when you are not sure about what product to buy, it will be prudent to double check with a healthcare provider, especially a pharmacist who is properly trained to help you evaluate the product for appropriateness, potential side effects and any drug with drug interaction that may occur with the use of other medications you are taking.
AUTHOR:- Eddy Airiohuodion, PharmD, R.Ph