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Calcium is the most abundant, essential mineral in the human body. Of the two to three pounds of calcium contained in the average body, 99% is located in the bones and teeth. Calcium is needed to form bones and teeth and is also required for blood clotting, transmission of signals in nerve cells, and muscle contraction. The importance of calcium for preventing osteoporosis is probably its most well-known role.

Osteoporosis is a condition in which the normal amount of bone mass has decreased. Although insufficient when used as the only intervention, calcium supplements help prevent osteoporosis. Though some of the research remains controversial, the protective effect of calcium on bone mass is one of very few health claims permitted on supplement labels by the U.S. Food and Drug Administration.

Where is it found?
Most dietary calcium comes from dairy products. The myth that calcium from dairy products is not absorbed is not supported by scientific research. Other good sources include sardines, canned salmon, green leafy vegetables, and tofu.

Who is likely to be deficient?
Severe deficiency of either calcium or vitamin D leads to a condition called rickets in children and osteomalacia in adults. Since vitamin D is required for calcium absorption, people with conditions causing vitamin D deficiency (e.g., pancreatic insufficiency) may develop a deficiency of calcium as well. Vegans (pure vegetarians), people with dark skin, those who live in northern climates, and people who stay indoors almost all the time are more likely to be vitamin D deficient than are other people. Vegans often eat less calcium and vitamin D than do other people. Most people eat well below the recommended amount of calcium. This lack of dietary calcium is thought to contribute to the risk of osteoporosis, particularly in white and Asian women.

Calcium deficiency has been implicated as a possible cause of gestational hypertension. Gestational hypertension (GH) is high blood pressure that develops after the twentieth week of pregnancy and returns to normal after delivery, in women with previously normal blood pressure. In two preliminary studies, women who developed GH were found to have significantly lower dietary calcium intake than did pregnant women with normal blood pressure. Calcium supplementation has significantly reduced the incidence of GH in preliminary studies and in many, though not all, double-blind trials. Calcium supplements may be most effective in preventing GH in women who have low dietary intake of calcium. The National Institutes of Health (NIH) recommends an intake of 1,200 to 1,500 mg of calcium daily during normal pregnancy. In women at risk of GH, studies showing reduced incidence have typically used 2,000 mg of supplemental calcium per day, without any reported maternal or fetal side effects. Nonetheless, many doctors continue to suggest amounts no higher than 1,500 mg per day.

How much is usually taken?
The National Academy of Sciences has established guidelines for calcium that are 25 to 50% higher than previous recommendations. For ages 19 to 50, calcium intake is recommended to be 1,000 mg daily; for adults over age 51, the recommendation is 1,200 mg daily. The most common supplemental amount for adults is 800 to 1,000 mg per day. General recommendations for higher daily intakes (1,200 to 1,500 mg) usually include the calcium most people consume from their diets. Studies indicate the average daily amount of calcium consumed by Americans is about 500 to 1,000 mg.

Are there any side effects or interactions?
Constipation, bloating, and gas are sometimes reported with the use of calcium supplements.

People with hyperparathyroidism, chronic kidney disease, or kidney stones should not supplement with calcium without consulting a physician. For other adults, the highest amount typically suggested by doctors (1,200 mg per day) is considered quite safe. People with prostate cancer should avoid supplementing with calcium.

Vitamin D's most important role is maintaining blood levels of calcium. Therefore, many doctors recommend that those supplementing with calcium also supplement with 400 IU of vitamin D per day.

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