Calcium Supplements for Osteoporosis

You’ve heard it all your life: Calcium builds strong bones. It’s why your parents served you milk when you were growing up. It’s why low-fat dairy and leafy greens are an important part of your adult diet. But are calcium supplements right for you?

As you age, you may assume taking a daily calcium supplement for osteoporosis, if you have or are at risk for the condition, is a good way to boost your bone health. But it turns out there are pros and cons to taking the supplement, and it may not be helpful for you. Worse, there could be dangerous side effects.

What Is Osteoporosis? Who’s at Risk?

As you age, your bones get more fragile. Osteoporosis makes bones very weak and more likely to break during a fall. Women are more likely to develop this condition. Other risk factors include:

  • Aging
  • Being thin or having a small body frame
  • Being white or Asian
  • Excessive alcohol intake
  • Family history of osteoporosis
  • Smoking
  • Taking certain medications

Discuss your risk factors with your primary care provider to determine if you need a bone mineral density test to assess bone strength. Often, osteoporosis does not cause any symptoms until you break a bone.

How Much Calcium Do I Need?

The best way to get the recommended daily amount of calcium is by eating foods high in the mineral. Your body is more likely to absorb the calcium that way, and you are less likely to experience side effects. 

For prevention of osteoporosis:

  • Pre-menopausal women and men over the age of 18: 1000 mg of calcium (total from diet and supplements)
  • Post-menopausal women: 1200 mg elemental calcium (total from diet and supplements)
  • Calcium supplementation is often recommended to be paired with vitamin D supplementation because vitamin D helps the body absorb calcium.

Many foods like cereals, orange juice and non-dairy milk varieties are fortified with calcium, so it might be easier for you to get calcium without realizing it. Adding nonfat powdered milk to recipes or sprinkled on foods is another way to boost your calcium — each tablespoon has 50 milligrams of the mineral.

Do Calcium Supplements Really Help Osteoporosis?

Multiple studies show that calcium supplements prevent some postmenopausal bone loss by about 20%. If you are a woman and have trouble getting enough calcium in your diet, your primary care provider may recommend a supplement, especially if you are at high risk for osteoporosis. However, the added calcium will not increase bone density, and supplements do not seem to prevent fractures. 

What Is the Best Form of Calcium to Take for Osteoporosis?

If your doctor recommends calcium supplements, you may be overwhelmed with the number of choices out there. Here are a few things to keep in mind:

  • Calcium carbonate, found in over-the-counter antacids, is a cheap and effective calcium source. However, antacids may also contain aluminum, sodium or sugar, which could be an issue for some patients.
  • Calcium citrate is slightly more expensive, but it is more easily absorbed by the body, especially in older people. Calcium citrate is absorbed more readily when taken fasting compared to calcium carbonate.  When taken with food, they are similar.  Also, a common class of medications called proton pump inhibitors reduce the absorption of calcium carbonate.
  • Calcium gluconate, calcium lactate and calcium phosphate do not contain enough calcium to be effective supplements.
  • Make sure the supplement’s label says “purified” or has the United States Pharmacopeia (USP) symbol. Other products could be made from bone meal, dolomite or oyster shell and contain high levels of toxic metals.
  • Take your supplement with food. Never take more than 500 milligrams at a time.
  • Drink plenty of water.

Why You Might Want to Avoid Calcium Supplements

Calcium supplements can cause side effects like bloating, constipation and gas. Studies have also shown more serious drawbacks.

  • One study found a 17% increased relative risk of kidney stones in women on calcium and vitamin D supplements.
  • Another study found an increased relative risk of hospitalization from acute gastrointestinal symptoms, most commonly indigestion and/or constipation.
  • More than one study has found increased relative risks of hip fractures — something supplements are supposed to help prevent.
  • Multiple studies found calcium supplements may increase the risk of heart attack and stroke.

If you’re at high risk for heart disease in addition to osteoporosis, weigh the risks of calcium supplements carefully.

Talk to Your Doctor

Navigating nutrition requirements and dietary supplements can get confusing quickly. That’s why you should always discuss starting calcium — or any other nutritional supplement — with your University of Maryland Medical System provider beforehand. Calcium supplements can interfere with certain medications. If you’re on supplements but finding the side effects challenging, your doctor may be able to suggest a different option or recommend nutritional counseling to help you learn how to get more calcium in your daily diet.

Listen to a Podcast about Osteoporosis

Osteoporosis is a disease where the bones become brittle and weak, which makes them easier to break. Did you know there are ways to prevent weakening and increase bone strength? In this podcast, Dr. Natalie Chilaka, an osteoporosis expert who heads up the UM BWMC Osteoporosis Clinic, talks about who is most at risk for this disease, ways to prevent it and how you can improve your bone health. Listen here or find us on your favorite podcast streaming app at Live Greater Podcasts.

More to Read

Do you have questions about osteoporosis or calcium?

Talk to a University of Maryland Medical System provider.

Posted by Eric Jackson