JOHNS HOPKINS



CALCIUM SUPPLEMENTS

In general, we recommend calcium supplements in individuals who do not meet their daily requirements through diet alone. We suggest a name brand to ensure that dissolution and absorption is optimal. Avoid bone meal or dolomite as they may contain toxic ingredients.

DAILY REQUIREMENTS

|AGE GROUP |ELEMENTAL CALCIUM (MG) |

| Teens and young adults |1,200 |

|Adults 25-50 years |1,000 |

|Pregnant/nursing women |1,200 |

|Post-menopausal women |1,500 |

There are three major choices for calcium supplements

Calcium carbonate contains the highest amount of elemental calcium, 40%. Therefore a product which is 1250 mg of calcium carbonate yields about 500 mg elemental calcium. It is well absorbed when taken on a full stomach, since hydrochloric acid enhances absorption. In some individuals, it may cause gas or constipation, therefore increased fluid intake is advised.

Calcium citrate is the most easily absorbed supplement and is 50% bioavailable. The only disadvantages are the higher cost and the lower percent of elemental. Calcium citrate is the salt which is used to fortify breakfast cereals and orange juice.

Calcium phosphate is a well absorbed supplement that dose not cause gas and constipation. It can be taken without regard to food. Calcium phosphate tends to be more expensive than calcium carbonate but less expensive than calcium calcitrate.

How to take calcium supplements:

Calcium is best absorbed if consumed throughout the day. However, taking it all at once is better than not taking it at all. We recommend that you choose a particular hour, or meal to take the supplement regularly.

Certain substances in food such as spinach, rhubarb and whole grains may reduce the amount of calcium your body can absorb. However, these foods are important sources of other vitamins and minerals. They should be included in a balanced diet, but NOT at the same time as when a calcium supplement is taken.

Certain antacids and prescription medication medication may also interfere with absorption and retention. Consult your doctor about the possibility of such an interaction.

COMMONLY USED CALCIUM PRODUCTS

CALCIUM CARBONATE: PROVIDES 40 % ELEMENTAL CALCIUM

|NAME |TYPE |STRENGTH |ELEMENTAL CALCIUM |

|Alka-Mints |Calcium carbonate |850 mg |340 mg |

|Caltrate |Calcium carbonate |1500 mg |600 mg |

|Oyster shell (OsCal) |Calcium carbonate |615 or 1250 mg |250 or 500 mg |

|Titralac Tablets |Calcium carbonate |420 mg |168 mg |

|Titralac Liquid (1 tsp) |Calcium carbonate |1000 mg |400 mg |

|Tums and Tums Extra |Calcium carbonate |500 or 750 mg |200 or 300 mg |

CALCIUM CITRATE : PROVIDES 21 % ELEMENTAL CALCIUM:

|NAME |TYPE |STRENGTH |ELEMENTAL CALCIUM |

|Citracal Liquitabs |Calcium citrate |3276 mg |500 mg |

|Citracal 950 |Calcium citrate |950 mg |200 mg |

|Citracal 1500 |Calcium citrate |1500 mg |315 mg |

|Citracal 1500-D |Calcium citrate |1500 mg |315 mg + 200 IU Vit D3 |

CALCIUM PHOSPHATE: PROVIDES 21 % ELEMENTAL CALCIUM

|NAME |TYPE |STRENGTH |ELEMENTAL CALCIUM |

|Posture |Calcium phosphate |1500 mg |600 mg |

|Posture-D |Calcium phosphate |1500 mg |600 mg + 125 IU Vit D3 |

CALCIUM CONTENT IN FOODS:

|FOOD ITEM |SERVING SIZE |CALCIUM CONTENT |

|Milk (whole & skim) |8 oz |300 mg |

|Yogurt (plain) |8 oz |415 mg |

|Cheese |1 oz |200 mg |

|Cottage Cheese |4 oz |78 mg |

|Ice Cream/ice milk |1 cup |176 mg |

|Sardines |3 oz |372 mg |

|Oysters |1 cup |226 mg |

|Salmon |3 oz |167 mg |

|Shrimp |3 oz |98 mg |

|Bok Choy |1 cup |74 mg |

|Broccoli |1 cup |136 mg |

|Soybeans |1 cup |131 mg |

|Collards |1 cup |357 mg |

|Tofu |1 cup |108 |

|Turnips |1 cup |252 mg |

VITAMIN D PREPARATIONS

| |Potency* |How Supplied |Daily dose (range) |

|Ergocalciferol |40,000USP units/mg |Capsules 25,000 & 50,000|25,000-200,000 units |

|(Vitamin D2) | |units/ml | |

|Dihydrotachysterol |120,000 USP units/mg |Tablets 0.125,0.2, 0.4 mg|0.2-1 mg |

|Calcifediol | |Capsules of |20-200 mcg |

| | |20 and 50 mcg | |

|Calcitriol | |Capsules of |0.25-5 mcg |

|(Rocaltrol) | |0.25 & 0.5 mcg | |

• Number of units of Vitamin D provides by 1 mg of the preparation

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