Calcium is an essential mineral for our body as it aids in achieving healthy and strong bones, and boosts the functioning of our heart, muscles and nerves. As such, calcium deficiency may lead to osteoporosis and other complications. In India, the average calcium intake is only 429 mg per day against the requirement of 800-1000 mg per day, according to the map launched by the International Osteoporosis Foundation (IOF), a non-governmental organisation.
To compensate for this deficiency, many opt for calcium supplements. However, “we don’t recommend calcium supplements since they are associated with dangerous side effects including heart attacks, strokes and kidney stones, and are very commonly contaminated with lead, which is toxic,” Functional Nutritionist Mugdha Pradhan, CEO and Founder, iThrive said.
Agreeing, Dr Gaurav Jain, Senior Consultant, Internal Medicine, Dharamshila Narayana Superspeciality Hospital said that while calcium supplementation may increase bone density, it may cause some health problems such as an increased risk of heart disease, prostate cancer, kidney stones, etc. “Oral calcium supplementation can temporarily boost calcium concentrations in the body. People who have a hereditary tendency to have greater blood calcium levels are at a higher risk of heart disease and heart attack,” he explained.
But, not all forms of calcium are the same, he highlighted. “Calcium carbonate – the most common formulation – is associated with most of these problems. Calcium citrates, maleates and other liquified ionic calciums are much less likely to cause the same issues,” Dr Jain said.
Agreeing that calcium supplements are not for everyone, Dr Priyanka Rohatgi, Chief Clinical Dietitian, Apollo Hospitals said, “If you have a health condition that causes excess calcium in your bloodstream known as hypercalcemia, you should avoid calcium supplements. Other side effects can sometimes occur, including gas, constipation and bloating. In general, calcium carbonate is the most constipating.”
But, why does it happen? Experts explained that higher calcium levels may increase the likelihood of calcifications forming on blood vessels. “These calcifications cause your blood arteries to perform less efficiently because blood cannot flow as freely. Excess calcium may impair blood clotting in the body,” Dr Jain said.
Dr Gaurav Gupta, Associate Director – Orthopedics, Max Super Speciality Hospital, Dehradun, however, disagrees! “No, calcium supplements are not harmful. Especially for post-menopausal women and elderly males, these supplements are necessary to prevent osteoporosis and other bone degenerating diseases,” he said.
Explaining the same, he added that dietary calcium supplements cannot alter the calcium levels in the blood as excess calcium is not absorbed and is passed through the stools. “In fact, contrary to popular belief that excess calcium chelates with oxalate crystals in your food making calcium oxalate and passes through the stool, thus preventing excess oxalate crystals deposition in the kidneys, which is the precursor for most of the kidneys stones,” he said.
However, he advised patients with a history of excess calcium deposition in their heart valves and blood vessels to avoid taking excess calcium.
How much should you consume?
According to experts, the recommended daily intake for most individuals is 1,000 mg, which rises to 1,200 mg for women over 50 and men over 70. “As a result, if you generally only get 500 mg per day from diet and require 1,000 mg per day, you can take one 500-mg supplement every day,” Dr Jain said.
Agreeing, Dr Gupta said that one calcium supplement tablet gives us around 500 mg of elemental calcium, which is absorbed in still less quantity, depending upon your gut conditions. “Therefore, it is safe to consume one calcium tablet per day as a supplement.”
Things you must keep in mind
Increase your calcium supplement intake to deal with bloating, constipation, and gastrointestinal issues gradually, Dr Jain said. “Keep track of how much calcium you absorb each day. To begin, take 500 mg per day and gradually increase your intake.”
It’s also crucial to note that patients should not have a history of hypercalcemia and heart valve or blood vessel calcification. “These supplements are taken after food for optimum absorption and to prevent flatulence and gastritis. Physical activity is also very important for the optimum absorption and utilisation of calcium in the body. Therefore, bedridden patients should avoid taking them without the hormonal supplements,” Dr Gupta said.
Experts suggested consuming a diet rich in calcium such as milk and milk products, and certain fruits and vegetables as alternatives for calcium supplements.