There has been a great deal of confusion regarding calcium requirements. Patients have voiced concern to me regarding calcium deposits in their breast found at their mammogram which required closer follow up or biopsy. These calcium deposits are not related to ones dietary calcium input, but instead to tissue changes in the breast. Calcium deposits have been shown to line the cardiac vessels which can be an ominous sign for heart disease. This occurs with heart disease, however is not exaccerbated by the normal intake of caclium.
As a gynecologist, we are concerned with your heart as well as your bones. Calcium is very important. Getting adequate calcium in your diet is ideal. If you do not get enough calcium in your diet, the body will take what it needs form the bones for normal function, thus leading to a thinning and weakening of the bones over time ( a condition called osteopenia or osteoporosis).
A premenopausal woman should get 1000 mg of elemental calcium per day, a post menopausal woman needs a bit more – 1200 – 1500 mg per day. Most calcium tablets contain 250-500 mg of calcium per tablet. If taking a tablet, one should not take more that 500 mg at at time as the GI Tract has trouble absorbing any more. Ideally, the calcium tablet should be taken with a meal, which improves absorption.
It is important to understand that one can take too much calcium which may lead to other problems. One report that I am familiar with estimated that one should not take more that 4000 mg of calcium per day. We firmly recommend between 1000 mg and 1500 mg of calcium daily (tablet + diet).
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Calcium tablets come in two main forms – calcium carbonate and calcium citrate. If you are someone who has suffered with a kidney stone, you should take calcium citrate (not carbonate). Calcium citrate will not incease your risk for future stones, calcium carbonate might. Most formulations of calcium supplements are with calcium carbonate, which is an excellent choice for people who have not had a kidney stone. It is also very important to be sure that your 25-OH Vitamin D level is normal (above 30), as a low value will hinder calcium absorption in your GI Tract.
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In the US we are blessed with many choices in regards to calcium. It is important to choose the calcium you feel best with, either diet or supplement, and make sure you stay within the guidelines. Taking enough is important, taking too much is not helpful and might even be harmful.
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