Q: Should I be taking calcium pills for my bones?
Last fall, my 75-year-old next-door neighbor fell down 3 steps, shattering her left ankle into tiny pieces that were painstakingly put back together during a 5-hour surgery. She has osteoporosis, or “thin bones” due to years of taking daily prednisone for an inflammatory condition called lupus. Her doctor has her taking a bone-building medicine, and she was told to take a calcium supplement every day.
Calcium helps keep our bones healthy, but it has other critical jobs as well: your muscles, nerves, and blood vessels depend on calcium to work properly. Every time your heart beats and you take a breath, the muscles of your heart and chest work to keep you alive and well. However, if you don’t have enough calcium available, your body will take some out of your bones, like an ATM (automated teller machine) for calcium instead of $20 bills.
If your body gets low on calcium occasionally, it’s no big deal. But if your body has to pull calcium out of your bones regularly, those withdrawals will eventually weaken your bones, increasing your risk of a fracture from a fall or causing the vertebrae in your spine to collapse.
How much calcium do you need?
The Institute of Medicine recommends 1000mg daily of calcium for men and women up to age 50, and 1200mg for adults older than 50. Most postmenopausal women get 600-900mg of calcium daily through their food, falling short of that goal unless they make up the difference with a calcium supplement.
Calcium supplements were widely recommended to ensure women and men at risk for osteoporosis get their recommended daily dose of calcium consistently. That’s changing because recent studies show that TOO MUCH calcium increases your risk of heart attack or stroke. It’s suspected that the spike in blood levels of calcium you get by taking a calcium supplement may damage blood vessels.
Taking calcium supplements also encourages the formation of painful kidney stones. For bone health, doctors no longer recommend getting ALL of your recommended daily calcium from taking a calcium supplement.
Calcium carbonate is the most concentrated form of calcium supplement available but can cause constipation. Calcium citrate is absorbed better and a better choice if you also take an acid-blocking medicine like Prilosec® (also known as omeprazole) for heartburn.
Weight-bearing exercises like walking and eating prunes have also been shown to improve bone strength.
Here are 5 Tips on Getting Enough Calcium:
- Get as much calcium from your diet as you can.
Most people get 300mg of calcium daily from non-dairy sources. You can also get 300mg per serving of dairy products like milk, yogurt, and cheese. Green vegetables, oranges, and figs also contain calcium. You can also use the Calcium Calculator available as a phone app for iPhone and Android phones and online at The International Osteoporosis Foundation website www.iofbonehealth.org at their website under Quick Links.
- When taking a bone-building medicine like Fosamax® (alendronate), Actonel® (risedronate), or Boniva®, make sure you get enough calcium.
These medicines work by encouraging calcium to move back into your bones, but if you don’t have enough extra calcium available in your diet or by taking a supplement, they can’t help you.
- Avoid taking more than 500mg of a calcium supplement at one time.
Your body absorbs calcium better when you take less of it, and keeping your blood levels of calcium from “spiking” after taking a tablet will help to avoid increasing your risk of heart attack and stroke.
- Get 400 IU of Vitamin D every day.
Vitamin D is necessary to help your body absorb calcium and can help prevent falls in the elderly. You can get vitamin D from the sun, but salmon (800 IU per 3 ounces), canned tuna (150 IU per 3 ounces), fortified milk (about 120 IU per 4 ounces), and fortified orange juice (80 IU per 4 ounces) are also good sources.
- Eat dried plums or prunes to build bone.
In one study, women who ate 100 grams of dried plums daily for a year had measurably stronger bones. Despite the extra calories, none of the women in the year-long study gained weight, possibly because of the plums’ very high fiber content. 100 grams of dried plums are about 9 of those plump plums sold in big bags at Costco®. Watch out, though; plums (also known as prunes) have a natural laxative effect, so go slowly to avoid side effects like intestinal gas and diarrhea.
