Calcium supplements have become the therapeutic staple in the fight against osteoporosis. There is a clear relationship between calcium intake, bone mineral density, and the risk of fractures. Although recommendations exist for appropriate amounts of intake of elemental calcium, there is not a clear consensus as to what type of calcium supplement or salt form offers the most benefit There are several types of calcium (known as salts) available on the market and determining which formulation is best can be difficult.
Calcium carbonate is usually the most inexpensive form of calcium and it provides the most elemental calcium per tablet. However, it is less soluble than most of the other calcium salts...and therefore, requires gastric acid for absorption.
Calcium citrate is more soluble than calcium carbonate, and its absorption is NOT affected by gastric acidity.
Calcium gluconate and lactate are also soluble salts...but they provide less elemental calcium per tablet.
Calcium glubionate/lactobionate comes in a syrup and therefore may be a good option for kids or adults who cannot swallow large tablets.
Calcium acetate is used to bind phosphates in renal failure patients. It is NOT used for supplemental calcium.
For most people, calcium carbonate is the calcium of choice ...it's inexpensive and convenient to take. However, calcium citrate is preferred for patients who are likely to have LOW gastric acidity, such as the elderly or patients taking acid-blocking drugs, such as rantidine, rabeprazole, etc. Either way, aim for 1000 to 1500 mg/day of ELEMENTAL calcium and at least 400 to 600 IU/day of vitamin D...from both diet and supplements to meet daily requirements for osteoporosis protection. Vitamin D is essential to aid in calcium absorption so aim to take a combo tablet or supplement separately if desired. It is also advised to take calcium supplements WITH meals to improve absorption and no more than 500 mg of elemental calcium at a time. For higher amounts, it is suggested to split the dose.
If you would like to discuss which type of calcium is best for you, please drop in to Columbia Street Pharmacy to speak to one of our pharmacists.