What you need to know about the different types of calcium supplements

As your patients age, they may be considering adding calcium into their regular regimen of vitamins and supplements.

However, they can find themselves facing a bewildering array of different types of calcium supplements at their local health food store, with no clear idea of which one is best for their needs.

Given that there are a number of reasons why your patients may want to start taking calcium supplements, it’s important that they are taking the right kind of supplement for the right purpose. What are some of the common reasons your patients might want to start taking calcium, and what are the various types of supplements from which they can choose?

Common reasons for taking calcium supplements

Bone loss among menopausal and postmenopausal women: This will likely be the largest group of patients who will be seeking your help in deciding which kind of calcium supplement to take. As a woman ages, her body begins to stop producing estrogen, which can also lead to bone loss.¹

This condition can lead to osteoporosis, making the bones particularly susceptible to fractures due to brittleness, as well as deformities of the spine. Various health organizations recommend daily calcium supplementation, ranging between 800 and 1,200 IU.¹

Osteoarthritis: This is a degenerative disease, in which the cartilage between the joints gradually wears away, until the bones that form the joint are rubbing directly against one another. Symptoms usually include pain, soreness and stiffness around the affected joints. The Arthritis Foundation recommends a daily calcium supplement intake of 1,000 IU for your patients ages 50 and under, and 1,200 for those ages 50 and older.²

Types of calcium supplements

First, it’s important to consider the amount of elemental calcium (the amount that the body can actually absorb) that the type of supplement contains. Some types of supplements contain more elemental calcium than others. The body’s ability to absorb calcium can be another issue. As a general rule, calcium supplements can be absorbed more easily if they are taken with meals.

Calcium citrate: This is probably the most easily absorbed and tolerated type of calcium supplement, and is often taken to help promote bone density. This is because it requires less stomach acid production, which makes it an excellent choice for your senior patients, particularly those prone to digestive issues. Its main drawbacks are that it has relatively low levels of calcium (21 percent) and it is more expensive than other types of calcium supplements.

Calcium carbonate: This type of calcium supplement is the most common, as it often found in over-the-counter antacid products such as Tums and Rolaids. It is also the least expensive type of supplement. It also has the highest amount of elemental calcium, in the range of 35 to 40 percent. Unfortunately, this does not mean it has high bioavailabity, as its form requires the body to produce extra stomach acid. This means that it should be taken with food (preferably a low-iron meal) to be properly absorbed. It may also not be the best choice for your patients with stomach issues.

Calcium phosphate: This is the type of calcium that is found human bones and teeth. It is used in prescription medications to treat osteoporosis and posture issues in menopausal women. It has approximately the same amount of elemental calcium as calcium carbonate, yet it is easier to absorb. However, it is more expensive than calcium carbonate and may require higher doses.

Overall, in terms of cost and amount of elemental calcium, the best overall choice looks to be calcium carbonate. Additionally, its safety in terms of digestion makes it even better for your older patients, particularly your female patients who have gone through menopause.

References

Spangler M, Phillips BB, Ross MB, Moores KB. Calcium supplementation in postmenopausal women to reduce the risk of osteoporotic fractures. American Journal of Health-System Pharmacy. 2011;68(4):309-318.

“What you need to know about calcium supplements.” Arthritis Foundation. Published May 2015. Accessed July 2018.