Made famous by the “got milk” campaign, with celebrities donning trendy mustaches, calcium for strong bones is fairly common knowledge. The truth is, good bone health is a life-long goal. The skeleton contains 99 percent of the calcium in our bodies. A growing awareness of osteoporosis in recent years has led to greater efforts in maintaining and treating bone density, with calcium boasting significant benefits [Source: Prince, Devine].

For many, dairy sources like milk, cheese and yogurt provide an adequate amount of calcium. For those allergic or intolerant, work on increasing your dark leafy green vegetable and almond intake. Turnip greens, bok choy, broccoli, almonds, Brazil nuts, sardines and salmon (canned with the bones) are all sources of calcium. Patients unable to meet the suggested daily calcium intake through diet should consider supplementation.

The recommendations for supplemental calcium are based on age, gender, dietary habits and medical history. The need for supplementing is higher in postmenopausal women, patients on chronic steroids like prednisone, and the elderly, as they have an increasing risk of bone fractures without appropriate intake.

Soft drinks contain significant amounts of sugar and chemicals called phosphates that can leach calcium out of the body. In fact, more than 70 years ago, Dr. Weston Price observed the health of teeth and bones of those in undeveloped areas around the world when refined sugar wasn’t part of the diet. He found that once refined sugar became a regular food staple, the teeth, jaw and dental arches suffered dramatically. As our sugar consumption has continued to increase, so has our need for minerals like calcium.

A common mistake is attempting to treat poor bone density with calcium alone. Vitamin D must be present in the body to aid in the absorption of calcium. Magnesium is also needed for bone structure, along with other functions, and is commonly deficient in the American diet. Boron and vitamin K are other nutrients that help with bone strength.

The recommended daily calcium intake (diet plus supplementation if needed) for adolescents is approximately 1,200 mg, while adults should get 1,000 mg and the high risk groups mentioned above should get 1,500 mg [Source: Simon]. The preferred forms of calcium are calcium citrate or calcium citrate malate. Commonly available in stores, calcium carbonate often won’t dissolve in the digestive tract and therefore is poorly absorbed, especially in those with a history of digestive issues or the elderly.

Calcium supplements can have interactions with antibiotics. The absorption and blood levels of tetracyclines and fluoroquinolones appear to be decreased when these drugs are taken at the same time as calcium [Source: Pai]. Patients should check with their doctor or pharmacist to see if calcium should be taken a special way in coordination with a new prescription.

Patients taking the drug digoxin need to have calcium levels monitored, as too little calcium might limit the drug, or too much can increase the chances of toxicity. Certain blood pressure medications can affect calcium excretion. Some, like furosemide (Lasix) increase how quickly the body gets rid of calcium. Others, like hydrochlorothiazide, may raise the level of calcium in the bloodstream. If you are taking supplements containing calcium, let your doctor and pharmacist know so that any possible interactions can be noted.

Sources of calcium: [Source: McGee]

  • 8-ounce glass of milk = 300 mg of calcium
  • 2 ounces of Swiss cheese = 530 mg of calcium
  • 6 ounces of yogurt = 300 mg of calcium
  • 2 ounces of sardines with bones = 240 mg of calcium
  • 6 ounces of cooked turnip greens = 220 mg of calcium
  • 3 ounces of almonds = 210 mg of calcium