Forms of supplemental calcium
The two most common forms of supplemental calcium include calcium carbonate and calcium citrate, followed by calcium hydroxyapatite.. Regardless of the form chosen, absorption is best when taken with food, in divided doses of 500mg or less at a time and when given concurrently with vitamin D.
Calcium carbonate
Generally well
absorbed and tolerated when taken with food, though best avoided by those taking H2 blockers or proton pump
inhibitors (PPIs), or individuals with hypochlorhydria as it requires an acidic
environment for optimal absorption.
Provides a higher amount of elemental calcium per tablet, so
is best for cost and compliance considerations,however, is also the form most
associated with GI disturbance.
Calcium citrate
Best absorbed and
most bioavailable form of calcium when taken with food. It can also be taken
without food if needed with little to no GI disturbance.
Calcium phosphate /Calcium hydroxyapatite
Aids bone and mineral regeneration, helps maintain strong bones and can also lessen the risk of osteoporosis.
Several studies have shown this form aids improvement in blood lipid profile, GI hormone secretion, microbial composition of the gut, and increases bile acid secretion.
Calcium lactate and Calcium gluconate
Much less concentrated forms of calcium requiring high dosing, which is expensive and impractical for patients.
Calcium supplementation recommended dosage
General dietary or total calcium needs for women: 1,000
mg/day
GI diseases such as coeliac disease: 1,200 - 1,500 mg/day
plus 1000 IU vitamin D per day
Menopausal and post-menopausal women over 50 years, for the
reduction of osteoporosis and osteoporotic fractures: 1,000 – 1,200 mg/day plus
400 IU – 800 IU vitamin D per
day
Pregnancy and lactation: 1,500 – 2,000 mg/day
Women with amenorrhoea: 1,200-1,500 mg/day plus 400-1000 IU
vitamin D per day
If taking certain medications (e.g. Corticosteroids): 1200
mg/day plus 800 – 2000 IU vitamin D per day
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