Do you know how to supplement calcium correctly?

This is the 3867th article of Da Yi Xiao Hu

As we all know, calcium is an important mineral for the human body, especially in bone tissue. Calcium ions and phosphorus form hydroxyapatite crystals that are deposited on the matrix composed of collagen to maintain the firmness of bones. As a neurotransmitter, it also has the function of stabilizing muscle excitability. "Calcium supplementation" can be said to be deeply rooted in people's minds. Children need "calcium supplementation" for growth, pregnant women need "calcium supplementation", leg cramps need "calcium supplementation", and middle-aged and elderly people need "calcium supplementation" to prevent osteoporosis. It seems that "calcium" has become a "universal" medicine. But are you "calcium supplementation" correct?

Which calcium supplement is more reasonable?

There are many kinds of calcium supplements, which can be divided into inorganic calcium and organic acid calcium according to their ingredients. Inorganic calcium contains a high amount of calcium, but most of them have low solubility and have certain gastrointestinal irritation; organic acid calcium has better solubility, but the calcium content is low. Therefore, it is necessary to choose different calcium supplements according to the physique of different people. People with gastric acid deficiency basically do not absorb inorganic calcium, so it is more appropriate to take organic acid calcium such as calcium citrate. For calcium supplementation of the general population, inorganic calcium with high calcium content such as calcium carbonate can be selected. Patients with hypoparathyroidism and chronic renal failure often have hyperphosphatemia and cannot use calcium supplements containing phosphorus. For patients with urinary stones, calcium citrate is recommended for calcium supplementation.

How much is appropriate to supplement every day?

The recommended daily calcium intake of 800 mg for adults formulated by the Chinese Nutrition Society is an appropriate dose for achieving ideal bone peak and maintaining bone health. For postmenopausal women and the elderly, the recommended daily calcium intake is 1000 mg. The average daily calcium intake of the elderly in my country is about 400 mg from their diet, so the average daily calcium intake that postmenopausal women and the elderly should supplement is 500-600 mg (e.g., each tablet of calcium carbonate contains 600 mg of elemental calcium).

Can calcium supplements be taken for a long time?

For patients who take calcium tablets orally, the patient's blood calcium and urine calcium levels should be measured, combined with the patient's dietary calcium intake to prevent the occurrence of hypercalcemia. The maximum daily calcium intake allowed for adults in my country is 2000 mg. After calcium supplementation, it is recommended to test blood calcium and urine calcium concentrations every 3 months. If hypercalcemia occurs, the drug should be discontinued, and the calcium dosage should be reduced if urine calcium increases.

When is the best time to take it?

Is it okay to just take calcium tablets?

Osteoporosis patients often have decreased calcium absorption and conversion ability. Therefore, while supplementing calcium, vitamin D is indispensable as a "golden partner" and is also a basic treatment. Therefore, many doctors emphasize the timely supplementation of vitamin D. The ordinary vitamin D dose can be 800~1200 IU/d in the prevention and treatment of osteoporosis. Because ordinary vitamin D needs to be converted into active vitamin D to work, more doctors will recommend the use of active vitamin D, including α-calcitriol (0.25~1.0 μg per day) or calcitriol (0.25~0.5 μg per day). Renal osteoporosis can only be supplemented with calcitriol. It is best to regularly test the patient's serum 25-hydroxyvitamin D concentration. A value equal to or higher than 30ng/mL (75nmol/L) can reduce the risk of falls and fractures.

Author: Department of Orthopedics, Tianjin Third Central Hospital

Guo ShuzhangChief Physician