Diets in the modern world and lifestyle requirements have impacted health of present generations. Imbalanced diets and insufficient intake of required nutrients have contributed to the need for fortified food products and supplements. Bone health is of utmost importance to overall health of individuals. The need for calcium supplements is primarily due to the need to ensure that the recommended daily requirements are met, to prevent complications from poor bone health. Supplements, buy virtue of being unregulated, depend entirely on manufacturing practices and quality of ingredients for the overall quality of the products. It is therefore necessary to choose the right product and also follow proper measures to avoid Calcium citrate side effects as outlined below.

Why is calcium necessary and what are the benefits of calcium?

The general perception is to link calcium with bone health alone; however, calcium has many vital roles in the overall health of the human body.  For instance, calcium is essential for supporting heart health, muscles and also has a role in the nervous system. Imbalanced diets may have an impact on health, and it also affords protection from cancer, controlling blood glucose levels and beneficial for patients diagnosed with hypertension.  Bone mass in adults is an important factor in overall heath, and calcium has a pivotal role in ensuring proper bone mass, thereby preventing onset of osteoporosis.  Possible height of children as per genetic makeup is also determined in part by the amount of calcium intake during formative years.

How much of calcium should one take daily, ideally?

Studies have determined the amount of calcium that can be safely consumed daily without any possibility of unwanted effects. Individuals tend to overuse supplement use in an attempt to either make up or ensure that the recommended dietary requirements are met. However, excessive consumption is reportedly one of the leading causes for calcium citrate side effects. The actual safe thresholds or requirements are determined by age and gender of the individual. For instance, males between the ages of eighteen and seventy are recommended a daily intake of 1000 mg daily. Males above 70 years are advised to intake a marginally higher dose of 1200 mg daily. This is mainly because of the increased needs and the lesser dietary intake of calcium from diets of elderly males.

The recommended intake for women slightly differs with females between the ages of eighteen and fifty recommended intake of 1000 mg daily. The recommended intake marginally increases to 1200 mg daily for women above 50 years. This is primarily for the purpose of ensuring adequate supply of calcium during the post-menopausal stage.  The above values are only for the purpose of reference and are the ideal/average recommended intake. However, this may differ for certain individuals who may be advised to intake higher levels. Regardless of the need, there is an upper limit to the intake that can be safely consumed.  At no point of time should the intake exceed 2500 mg daily for adults between the ages of 18 and 50, while the safe threshold limits for adults above 50 is 2000 mg daily.

What are the dietary sources of calcium?

The human body receives calcium in the form of dietary intake through various food products that are part of normal cuisines globally. Certain products are rich sources of calcium, and it is necessary to include the right mix of products for balanced nutrition. Dairy products are regarded as the best sources of calcium; and this is precisely one of the reasons for the inclusion of yoghurt, cheese and milk in traditional diets. Additionally, there are aquatic sources of calcium, such as fish with soft chewable bones, such as salmon and sardines. Among vegetables, kale, broccoli and other leafy vegetables that are dark and leafy are considered as rich and abundant sources of calcium.

What kind of fortified food products deliver the required amount of calcium?

As outlined above, certain food products are rich in calcium; however, individuals who receive inadequate calcium through dietary intake may choose calcium fortified food products. Various products are available in shelves of markets, offering consumers the required amount of calcium. This includes milk, soy, cereal and fruit juices. These products also contain vitamin D as it is essential for absorption of calcium. Adequate exposure to sunlight will deliver the required vitamin D to the human body, and will also help in absorption of calcium. However, when fortified food products are consumed, it is necessary to also ensure that additional vitamin D is supplied. Consumers of fortified calcium food products need to ensure that the RDA of vitamin D, i.e., 600 IU per day is delivered to the body, which will help in proper absorption.

Who actually needs additional calcium?

Most individuals are likely to receive the required amount of calcium through dietary intake. However, certain categories of individuals may not receive the necessary intake or may be in need of additional calcium due to one of many reasons. Lactose intolerance is a condition wherein dairy food products are either not consumed or consumed in lesser quantities. Strictly vegan diets may also contribute to lesser than desired calcium intake, if the right amount of calcium rich vegetables is not part of routine diet. Imbalanced diets are a reason for insufficient calcium intake, making it necessary for fortified calcium supplementary intake.

Other categories of individuals are also in need of supplements. For instance, excessive protein and sodium has the effect of eliminating calcium from the body, which will leave lesser calcium in the body. Such situations arise when there is excessive protein intake or sodium intake through supplements. Similarly, certain medications also have an impact on calcium levels. Corticosteroids will reduce the amount of calcium in the body.

Intestinal malabsorption and low calcium levels

Patients with certain bowel and digestive diseases such as celiac disease and inflammatory bowel disease will have lesser calcium in the body. These ailments compromise the ability of the system to absorb calcium from food sources and this in turn has an effect on the amount of calcium in the body.

Impact of medical procedures on calcium

Medical procedures such as geriatric bypass and other weight loss surgeries will have an impact on the body’s ability to absorb calcium.

Impact of smoking and over indulgence in alcohol on calcium

Unknown to many, smoking and over indulgence in alcohol will also have an impact on the calcium levels in the body.

Eating disorders and low calcium levels

An aversion to certain food products or an eating disorder may also contribute to low calcium levels as the right food products may not be consumed, resulting in lesser calcium intake.

All the above category of individuals may require some form of supplements with fortified calcium to make up for the relatively low levels of calcium in the body.

Adverse or unwanted effects of calcium supplements and fortified food products

As mentioned above, medications and all supplements come with the possibility of undesirable effects. Some are mild, moderate, while others are intense, warranting the need for some kind o medical attention. Depending on the severity or the persistent nature, some side effects may require emergency treatment at healthcare facilities. A common misconception is that all users of medications or supplements will experience undesirable outcomes. However, this is far from the truth, as undesirable effects may manifest only in a small percentage of users, with a predominantly higher percentage of users reportedly free from all undesirable outcomes.

The most common effects reported about calcium citrate include possible allergic reactions, and swelling in the face. Some have reportedly experienced difficulty while breathing. Hives is a possible reaction, but the actual incidence of hives is minimal and extremely rare. Digestive complications and an upset stomach are a possible outcome, apart from constipation when additional calcium intake is provided. Certain outcomes are serious in nature; for instance, bone pain requires medical attention as this could have a bearing on bone health.

Too much of calcium in the body can have long term health effects such as hardening of arteries or the formation of colon polyps. The intake needs to be within the recommended limits with a careful monitoring of symptoms that indicate any possible adverse outcomes.

Impact on routine activities

There could be an impact on routine activities, as more calcium may result in increased frequency of urination or quantity. This may sometimes have an impact on routines. Increased thirst is another possible outcome, and depending on the nature of the job, or the location, users may need access to sufficient drinking water or multiple breaks. Confusion is another outcome reportedly experienced by a section of users, and this may have a bearing on behavior either in social settings or at home.

Who should not take calcium supplements?

Specific categories of individuals are advised to stay off calcium supplements as this could be detrimental to health and could, in some cases, pose a grave danger to overall health.  Kidney ailments, stones in the kidney and patients who have recovered from kidney stones are to seek explicit advice regarding use of supplements. Parathyroid gland disorder may also make the patient unsuitable for intake of extra calcium.

What needs to be checked when picking supplements?

Since supplements are not within the purview of regulatory authorities, there is a possibility of choosing products that are of inferior quality. Unscrupulous manufacturers are known to rely on fillers which effectively means that the amount of calcium may be lesser than claimed. It is necessary to check the label for ingredients for an understanding. Similarly, supplements may often contain ingredients such as bone, dolomite, oyster shells, coral or lead that may either be contaminating in nature or toxic to the human body at specific levels.

How to avoid interactions with other products and medications?

Interactions with other supplements and medications is a possibility, and simple methods can help to effectively deal with or prevent interactions. Iron and zinc supplements may have an impact on calcium supplements, and it is necessary to avoid taking these supplements at the same time. Similarly, thyroid medications and antibiotics are also known to cause some kind of interactions. Consult the specialist and change timings of intake to prevent and lessen the possibility of interactions.

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