Questions? We're here to help. Health advisors on staff. Call us toll-free at (866) 947-6789.

Calcium Choices: How to Choose Calcium and Mineral Supplements

Calcium Foods

Neil Levin

When people come into our health food stores and ask for calcium, what can we tell them? How do we match up the people with the variety of products that we carry? We first need to try to determine both their calcium status and what they're thinking that they need. So a short conversation to determine their dietary intake and goals is essential to our meeting one's mineral needs.

Some key areas to consider when discussing this are:

- Are you presently taking dietary supplements? Which ones? What exactly do they provide to you?

- What are you asking for? Does it make sense to us, and does it provide what we think you need?

- What are you willing to take in terms of dosage form; such as diet, pills, capsules, softgels, powders, and liquids? How much per day and per serving is reasonable to you? How large of a pill or capsule will you willingly take? Are you open to liquids or other forms?

After we determine your basic diet, we can recommend dietary supplements. If you eat a lot of meat and dairy products but not whole grains, you may not need calcium as much as magnesium. If you tend to get muscle cramps, that may again indicate a need for more magnesium to balance excess calcium in your diet. If you don't get much sunlight, Vitamin D might be your best supplement. But as you see, calcium is not normally a problem in most people's diets. Some research indicates that as little as 400 mg total daily dietary calcium intake did not lead to osteoporosis, if the people ate a wholesome (mostly plant food) diet and got some sunlight and exercise. So why do our health experts recommend large doses of calcium?

Bone is made up of a variety of minerals and tissues, and is a living body organ. If mostly calcium is available and not enough of other minerals and essential bone-forming co- factors, that bone will become brittle, muscles will become stiff and crampy, and people will tend to get calcium deposits and kidney stone formation. Bones should be flexible, dense and strong. Muscles should be able to relax. That's why we tend to recommend multi-mineral formulas instead of just calcium alone. Piling in large doses of calcium carbonate is the medical model, but nutritional biochemists believe that the scientific evidence favors a balanced vitamin and mineral intake of a variety of bone nutrients, from a variety of sources. These include calcium, magnesium, zinc, boron, silica, Vitamin D, and plant sources of estrogens (phytoestrogens).

The most popular calcium supplement in our stores is a mixture of calcium with magnesium (Cal-Mag). Although the traditional two to one ratio of Cal-Mag is the best seller, there are also formulas with equal ratio of calcium to magnesium; or even reverse-ratio, yielding twice as much magnesium as calcium. I take the reverse-ratio, high magnesium formula. These formulas tend to correct diets high in calcium but lacking the other essential minerals.

Vitamin D is almost always needed with calcium. However, many (if not most) calcium formulas tend not to include D. In fact, most of the calcium formulas with D are the inorganic calcium carbonate forms, from rock powder or shells. These have the advantage of being rich in calcium and relatively low cost. The disadvantage is their poorer absorption, especially if there is low stomach acid present (this is common in seniors). The amount of Vitamin D in multiple vitamins is not likely to be enough to help absorb large doses of minerals.

Calcium Citrate is a pre-acidified form that is also well-absorbed and utilized by the body. This form is becoming well-known to doctors because of successful studies. Sometimes it is combined with malic acid (another fruit acid) as calcium citrate-malate (CCM). One advantage of these forms is that you also won't interfere with digestion by using up stomach acid to digest them. Research suggests that calcium absorbs better with meals; which provide vitamins, carbohydrates, proteins and other minerals with the calcium.

A big problem with calcium supplementation is with the dose recommended by most experts. The 1200-1500 mg. per day should include both food and supplement sources. The form should be easily digested and assimilated. If taken as pills, this typically requires at least 3 a day. If capsules, you could be taking 6-9 a day to get this dose. Adding magnesium and other factors to the pills makes them that much bigger or increases the number required to swallow to receive the target dose. Of course, this big dose is not normally needed by all people as a dietary supplement. Powders are sometimes used, and there is growing popularity of liquid forms of calcium formulas.

Other popular types of calcium include chelated minerals. Chelated means "clawed" in Greek and suggests a bonding of two or more substances. These forms include amino acid chelates and Kreb's cycle (citric acid cycle) chelates, which have some research behind them as pre-digested, absorbable forms. These chelates have the advantage of being transported to specific tissues rather than into the general bloodstream. These delivery areas can include the exterior/interior surfaces of cell walls, the interior fluids of cells or even into mitochondrial structures (organelles) living within the cells.

There is some evidence about another form of calcium called microcrystalline hydroxyapatite complex (MCHC [or MCHA]), which is made from bone matrix. Unlike the traditional bone meal, this form theoretically includes whole bone tissue providing all of the substances needed to make healthy bones. The processing of this form may resemble the processing of raw glandular tissues, rather than the simple ground up sterilized bones of old. Glandulars are cold-processed to retain delicate structures. For MCHC that may enhance bone tissue formation even more than supplying simple calcium.

The latest form of calcium is from Coral Calcium. This type is harvested from beds of ancient (dead) coral deposits in Okinawa. There are two main sources: from under the beach sands or vacuumed from the ocean floor. Both methods are approved by environmental authorities in Japan, but American consumers prefer the above water harvesting method because it doesn't temporarily cloud up the water and risk harming the aquatic life. The predominant mineral in coral is Calcium (along with Carbon, a non-mineral element), plus substantial amounts of Magnesium, Sulfur, Silicon, Hydrogen (another non-mineral element) and Iron. These are typically beneficial metals that you would find in food or dietary supplements.

There are up to 70 minerals present in Coral Calcium. The hydrogen present in coral is partly in the form of deuterium, which helps regulate body balance of acid- alkaline pH, affects nutrient transport and enzyme systems while inhibiting tumors, microbial growth, yeasts and molds. Other minerals present also have various affects on body chemistry. As you see, the Calcium content of Coral Calcium is only a part of its effect on the body. Practitioners have especially used it for an alkalinizing effect; to remedy weak, acidic metabolisms that are more prone to infections and disease.

The key is to deliver the right form to you for your unique biochemistry. You should be satisfied with all aspects of the product: value, dosage, and customization to your own particular needs.

Health Disclaimer. Copyright ©2003-2021. First version published in April 2003, last reviewed and updated in June 2021. Content provided by NOW Foods. Published with permission.

Neil E. Levin CCCN, DANLA is a certified clinical nutritionist and is a professional member of the International & American Associations of Clinical Nutritionists. Neil is the Nutrition Educator Manager for NOW Foods. He also serves as a Product Formulator and Truth Advocate.