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Clinician’s Corner: Calcium

Let’s discuss one of the most common supplements in our vitamin section, calcium. Calcium is most abundant mineral in our body. Calcium is found in some foods, added to others, available as a dietary supplement in out vitamin section, and present in some medicines, we recommend as an antacid (Tums).

Our bodies use calcium for a lot of functions, however less than 1% of total body calcium is needed to support these critical metabolic functions. The other 99% is stored in bones and teeth. Here are the recommendations for calcium supplements:

14-18 years 1,300mg 1,300mg
19-50 years 1,000mg 1,000mg
51-70 years 1,000mg 1,200mg
71+ years 1,200mg 1,200mg

Calcium carbonate: (Os-Cal-500 and generics)

  • Contains 40% Calcium (500mg active calcium per tablet)
  • Should be taken with a meal. Take with food, because this form of calcium needs stomach acid to dissolve.
  • Must divide doses. Approximately 500mg can be absorbed at a single time.

Calcium Citrate (Citracal® and generics)

  • Contains 21% calcium by weight. May be taken with or without meals. Does not require stomach acid for absorption. Best choice for elderly with reduced gastric acid.
  • Best choice for patients on drugs that suppress stomach acid, like Prilosec and Zantac.
  • Works best for patient’s complaining of GI upset.
  • Must divide doses.

Your Thompson Pharmacist wants you to know this about calcium supplements:

  • Tetracyclines, fluoroquinolones–decreased efficacy of the antibiotic. Separate doses by at least 2-3 hours.
  • L-thyroxine & Bisphosphonates–decreased efficacy by decreasing absorption. Separate dose from calcium by 4 hours.
  • Corticosteroids, like prednisone decrease absorption of calcium, and over time can weaken bones.

Who should supplement:

  • Women who have gone through menopause.
  • Pregnant women
  • Patients with lactose intolerance
  • Vegetarians because they eat more plant-based diet, the consume more oxalic and phytic acids which block absorption of calcium.
  • Prednisone can cause calcium depletion and eventually osteoporosis if used chronically
  • Patients using acid suppressing therapy- proton pump inhibitors (Omeprazole etc.) and histamine-2 receptor blockers (Ranitidine, etc.) Be sure to choose citrate!
  • Bariatric surgery weight loss patients should use calcium citrate, preferably a chewable dosage form.

Your Thompson Pharmacist is a great resource for choosing a calcium supplement that is just right for you.  Your Thompson Pharmacist is the drug expert, so have them review your prescription profile and choose a supplement based on medications you are taking.   At Thompson Pharmacy… it’s all for You!