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Building and Keeping Strong Bones:
Calcium Supplements and Vitamin D

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Should I take calcium supplements?

If you have a hard time eating enough high-calcium foods, supplements are a great way to get the calcium you need. Calcium comes in a number of forms, such as calcium carbonate and calcium citrate. The elemental calcium content is what is important. Read the label to find the amount on elemental calcium in each pill. Here are just a few options:

CALCIUM TABLETS
  Drug Elemental Calcium / Tablet
(mg)
Cost*
Calcium carbonate
  Average generic price 600
$ 2.12
 

Calcium 600 (Lederle)

600
   6.03
 

Os-Cal 500 (SK Beecham)

500
   7.11
 

Tums 500 (SK Beecham)

500
   3.97

Calcium citrate

  Average generic price 200
   7.04
 

Citracal (Mission)

200
10.31
Calcium phosphate
  Posture-D (Whitehall) 600
   7.97
*Cost to the pharmacist for a 30-day supply, according to wholesale price (AWP) listings in Drug Topics Red Book 1996 and November Update.

How should I take my calcium?

  • Calcium is best absorbed if taken in small amounts throughout the day. Divide the daily dose into smaller amounts if the total daily dose is 500 mg or more per day.
  • Use of manufactured supplements is best. Calcium as bone meal or dolomite may contain lead or other heavy metals as contaminants.
  • Calcium supplements should not be taken with high fiber meals or with bulk-forming laxatives.
  • If using calcium carbonate supplement, take it with meals to assure high stomach acid for maximum absorption. Calcium citrate is the most well absorbed type of calcium.
  • Drink plenty of fluids while using supplements to reduce bloating and constipation.

How much Vitamin D should I get?

All vertebrates, including humans, obtain most of their vitamin D from sunlight (UVB). Latitude, season, time of day and pollution affect production. In Seattle, latitude 47 degrees N, exposure to sunlight between late October and early April will not produce any significant amounts of vitamin D in the skin. Dark skin pigmentation, skin aging and sunscreen reduce skin production of vitamin D. Vitamin D deficiency is most common among the elderly.

Recommended Daily Vitamin D Intake *
Population Group
Daily
Birth to age 50
200 IU
Age 51-70
400 IU
AGE 70 and over
600 IU
Homebound/Institutionalized Elderly
800 IU
*In the absence of adequate sunlight

There is usually plenty of vitamin D in a multivitamin and some calcium supplements also include vitamin D—just check the label.


Compiled by
Mary Laya, MD, MPH
Assistant Professor,
Department of Medicine / Division of General Internal Medicine
University of Washington Medical Center

 

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