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Choosing the Right Calcium Supplement

According to a 2009 Statistics Canada study, 3% of men and 19% of women aged 50 or older reported having been diagnosed with osteoporosis.1 We now know that several factors are important for bone health such as a healthy diet and lifestyle which includes the avoidance of smoking and excess caffeine, sodium and alcohol. Proper intake of several bone building nutrients, one of which is calcium, is also important. But don’t forget, in order for calcium to be efficiently used by the body, many nutrient cofactors are necessary such as vitamin D, vitamin K, magnesium, boron and others.

Ensuring that you are taking the best form of calcium for your body will not only benefit your bones, but will also save you from spending money on a type of calcium supplement that

is not going to work well for you or which may provide little value to your body. With so many forms of calcium on the market, choosing one can be complicated indeed. Certain types of calcium supplements may be better for some types of people than others. Some of the most common forms of calcium supplements that are available include: calcium carbonate, oyster shell calcium, calcium gluconate, calcium citrate, calcium citrate-malate, calcium hydroxyapatite, and the more recently discovered calcium lactobionate. Be sure to keep the following factors in mind when choosing a calcium supplement that’s right for you.

Give Your Body Calcium It Can Use

Elemental calcium refers to the actual amount of calcium in the supplement. This is what your body can absorb and use for: growing bones and teeth, supporting muscle function, maintaining the heartbeat, nerve impulse transmission, wound healing and blood clotting among other important functions. The Supplement facts panel on a calcium supplement is useful for determining how much calcium a serving actually contains although the bioavailability of the particular calcium type must be taken into consideration. Also pay attention to the serving size when calculating the amount of calcium that is in one serving. For example, a label may or may not provide the total amount of available elemental calcium on a label. See examples of a supplement facts panel in Figure 1. Your body must be able to absorb and use the type of calcium in your supplement in order for it to be of benefit to you. The best way to take your calcium supplement is to divide your daily doses and take 500mg or less at the same time as your meals, when your stomach is actively producing acid to aid digestion.

Choosing the Right Form of Calcium for YouCalcium Carbonate: This is a commonform of calcium supplement which is an alkaline-based compound found in rocks, limestone, marine animal shells, pearls, eggshells and snails.

This form of calcium provides one of the highest concentrations of elemental calcium (35-40%). For example, a calcium carbonate supplement contains 40 percent elemental calcium; this means that 1,250 milligrams (mg) of calcium carbonate will provide 500 mg of elemental calcium. Yet it has poor bioavailability and requires extra stomach acid production to be absorbed. This type of calcium is found in coral calcium, a form of calcium that has received much attention for exaggerated health claims. There is no research to confirm that coral calcium is in fact a better form of calcium than other forms.

Calcium Citrate: Unlike the alkalinequalities that calcium carbonate offers, calcium citrate has a base that is acidic in terms of pH value. Due to its acidity, it priorit requires less natural stomach acids to be produced in order for it to be absorbed.

This type of calcium is absorbed to a greater extent than calcium carbonate.2 An analysis of 15 randomized trials concluded  that   calcium  citrate  was absorbed  22%  to   27%  better  than calcium carbonate, whether taken on an empty stomach or with food.5

Oyster   Shell    Calcium:   Although it may seem to be a natural form
of calcium, and therefore higher in absorbable calcium, the calcium in the oyster shell as well as bone meal and dolomite, are more susceptible to have toxic levels of lead due to difficulty in maintaining quality control. It is better to avoid these natural forms of calcium.

Calcium Gluconate, Lactate and Phosphate: All three of these forms ofcalcium offer lower elemental calcium concentrations or bioavailability. It would be necessary to take large amounts of calcium gluconate to obtain calcium requirements as it is only 13% elemental calcium, and it is not certain how bioavailable this form of calcium really is.3 Calcium lactate is present in foods such as aged cheese and baking powder. It is common for this form of calcium to be used as an antacid and is added to fruits to maintain their firmness and to extend their shelf life. The bioavailability of this form of calcium is acceptable because it can be absorbed at various pH’s in the body; however, it has a relatively low amount of elemental calcium available, 9%.3 Calcium phosphate also has an absorption level similar to that of calcium carbonate and has an elemental calcium amount of 31%.3

Calcium Lactobionate: This form ofcalcium is also referred to as lactobionic acid and it is not considered to be a useful source of calcium as much as it is known for its unique ability to help the body absorb more calcium from the diet and from supplements, therefore preventing calcium from accumulating in the arteries. It does this by binding to calcium ions from the diet that are in the stomach, intestines and the blood and helping to take them to the site where they are needed most, in the bone.4 The solubility of this form of calcium is sixty-five times higher than other forms of calcium like the citrate which is considered one of the most bioavailable forms. Originally found in the yogurt from Bulgaria and regions nearby, the Japanese were able to identify this unique form of calcium and its ability to help absorb additional calcium and increase bone mineral density. In addition, lactobionic acid also increases the production of equol by the gut microbes. Equol is a unique isoflavone similar to the soy isoflavanoid daidzein but more powerful in its bone health effects. Lactobionic acid is unique in that it helps the body to absorb more calcium from the diet and therefore helps to maintain optimal bone health without necessarily increasing intake of calcium above 1000mg per day. Calcium Citrate-Malate: Calciumcitrate-malate is formed from the calcium salt of citric acid and malic acid consisting of variable composition. It’s particularly valuable since it has been demonstrated to be highly bioavailable. Calcium citrate-malate’s bioavailability is possible due to its water-solubility and its method of dissolution. Upon being dissolved, it releases calcium ions and a calcium-citrate complex. Calcium ions are directly absorbed into intestinal cells. Although calcium citrate-malate contains only about 26% elemental calcium, it is one of the most well absorbed forms of calcium. The special structure of calcium citrate- malate makes it 6 to 9 times more easily dissolved in the stomach than plain calcium citrate, with an absorption rate of 36 -37% in tablets and capsules, or higher if dissolved in orange juice.

If you are a vegetarian and looking for a highly bioavailable calcium supplement, this is the form you will want to consider taking. AOR offers calcium citrate-malate in several supplements including: Ortho•Bone Vegan, Multi Basics 3, Essential Mix, Ortho•Core and Ortho•Minerals. Calcium citrate-malate is well-absorbed even when taken alone, and is recommended for individuals who have low levels of stomach acid, for those who are older, who are taking stomach acid blockers, or who have absorption or inflammatory bowel disorders.

Calcium        Hydroxyapatite       and Microcrystalline Hydroxyapatite Complex: Although many foods provide various calcium salts, human and animal bones are the only natural source of calcium hydroxyapatite. Be aware that there is a synthetic form of calcium hydroxyapatite called calcium orthophosphate; this is not the same as microcrystalline hydroxyapatite complex known as MCHC. MCHC is the most efficacious calcium hydroxyapatite when processed at low temperatures, and it is derived from natural sources. It is derived from the raw bones of free-range cattle from New Zealand where the cows are raised with no exposure to antibiotics, pesticides, hormones or other toxic chemicals. To preserve its full spectrum of nutrients and minerals, the bone extract needs to be processed at very low temperatures. This kind of calcium is significantly bioavailable to the body compared to other forms of calcium and as a result is easier to absorb. MCHC has been shown to stop and reverse bone loss in controlled human clinical trials.6 The benefits of MCHC are due to not only its calcium content, but also the growth factors, peptides, mucopolysaccharides and other micro nutrients that work together to target bone maintaining and building processes. One study demonstrated that ossein-hydroxyapatite compound is an effective and safe agent for the prevention of bone loss in postmenopausal osteopenic women. After they took the ossein-hydroxyapatite compound, there were significant increases in BMD observed in this group of patients.7 Therefore, MCHC is not just a calcium source but a quality bone building nutrient in itself. However, it is not suitable for vegetarians or vegans as it is sourced from animal bones. The body requires several nutrients and micro nutrients in order for calcium to be effectively used in the body; the calcium it receives must also be in a usable form. According to research, calcium citrate-malate has demonstrated impressive results for bone maintenance and is suitable for vegetarians. However, MCHC has proven to be the best all-around bone protection ingredient as it offers more than calcium to the bones. Its abilities to stimulate bone growth and prevent bone resorption makes it a superior bone building complex. Although other forms of calcium supplements may also offer some moderately beneficial results, it is important to get the best bone protective ingredients to ensure that your body has the nutrients it needs to stay healthy.

What You Need to Know

Calcium comes in a variety of forms, but it is important to realize that not all calcium supplements are created equal. Choosing a form of calcium that will work well for you will depend on your digestive system and what your calcium needs are. According to research, one of the most well absorbed vegetarian forms of calcium is calcium citrate-malate. Microcrystalline hydroxyapatite complex (MCHC) is known as the most beneficial form of calcium since it offers more than just calcium; it provides several bone enhancing factors including growth factors, peptides, mucopolysaccharides and other micronutrients.


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