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Supplements are taken along with foods to offer essential nutrients to your system. These dietary add-ons are either sourced through artificial processes or by natural means (i.e., from food-based sources). Dietary supplements are taken as a stand-alone item or at times, consumed with a few drugs or foods. Of the many forms of supplements, vitamins-enriched foods or supplements are widely taken all over the world. Other popular supplements are – minerals such as iron, calcium, etc., fatty acids and amino acids. There are also some supplements that perform the tasks of microbial organisms; for example, probiotic bacteria. Most of these nourishments are of great use to support those living with deficiencies of key nutrients. In this milieu, calcium supplements also have a fairly wide level of usage. If you have calcium deficiencies, it is important to know more about calcium citrate.

United States (US) has a directive named as “Dietary Supplement Health and Education Act”. This was implemented in 1994; in short, this is called DSHEA. This directive’s definition of a dietary supplement is a product having one or more ingredients such as vitamins, minerals, botanical herbs or amino acids – in the form of an extract, concentrate or as a metabolite. These products are generally taken through the oral route. Among essential minerals, calcium assumes additional significance. It is common knowledge that a steady supply of calcium can help decrease risks of bone conditions such as osteoporosis. Also, without needful supply of calcium, your body may witness sub-optimal functioning of cells, muscles as well as nerves. It is an important mineral for healthy construction of bones. Calcium supplements are often combined with vitamin D. However, these dietary aids are also available without being enriched by such vitamins.

Calcium citrate and its uses

Provision of needful amount of calcium – either as part of your daily diet or as an added supplement – can help prevent loss of bones as well as minimize fractures. Calcium citrate is a medication used for the treatment of low concentration of calcium in your blood. This hypo condition arises when you are not adding ample quantities of calcium to your diet. Apart from correcting mineral imbalances, calcium citrate is also used in the case management of bone related problems (such as osteoporosis, fractures due to falls or bone loss), sub-optimal functioning of the parathyroid gland (a medical condition known as hypoparathyroidism), weakening of bones (clinically known as rickets or as osteo-malacia), etc. In this light, your parathyroid hormone has a direct connection to your calcium level. When you are not taking needful amounts of calcium, the parathyroid gland supplies calcium to your system; however, once your system gets needful quantity of this mineral, the gland stops secreting parathyroid hormone.

As an extended use, the citrate form of calcium can help treat a few muscular disorders / diseases such as tetany (especially, the latent form of this condition). Not stopping with these uses, calcium citrate can also be used to enhance mineral balance in women who are pregnant, those who are nursing an infant, etc. People who are consuming anticonvulsants, anti-seizure meds or muscle relaxing drugs such as phenobarbital, phenytoin, etc., often require calcium supplements; calcium citrate is taken along with such meds.

How to safely use calcium citrate?

This drug is consumed orally; your doctor may advise its intake either before or after a meal. It is also a safe practice to divide the daily dose into two or three equally distributed dosages. The standard dosage level hovers at 600 mg (milligrams) in a 24-hour timeline. A regular use of this drug is recommended for better results. In order to have the best outcomes, always have it at the same timeslot every day. As an added precaution – in some cases – your doctor may suggest a special diet that goes well with this medication plan. You are advised to strictly follow the dietary changes; if you need any additional clarifications, it is highly recommended to consult with a qualified dietitian. In general, you may be advised not to take other nutrient supplements while taking daily doses of calcium citrate.

The drug is sold in multiple forms – the range includes an effervescent version, chewable form, as a powder, in a liquid format and also as a pill. The effervescent pill is neither swallowed nor chewed. Always disintegrate it in a glassful of water and then drink the mixture directly. If you are taking the powdered form of this supplement, you need to take the right quantum of its powder – i.e., the measurement needs to be proper. For getting the measurements right, always use the ladle or the spoon provided along with the drug. Never use a spoon from your household or from the kitchen. The liquid variant of calcium citrate needs to be shaken well before measuring the needful dose. On the other hand, the chewable form of this calcium supplement needs to be chewed first, and then swallowed.

Likely discomforts and side effects of calcium citrate

This supplement is unlikely to cause any major side effects. A few minor discomforts may occur; these may include abdominal problems, difficulties to discharge stools (or constipation), loss of appetite as well as migraines / headaches.  Some of the acute side effects – witnessed rarely though – may include a severe bout of nausea coupled with vomiting, inexplicable loss of body weight, persistent spells of feeling thirsty, frequent discharge of urine, etc. In elderly people, the drug may cause excessive levels of weariness, fatigue, mental conditions such as mood shifts, depression or hallucinations.

As mentioned, incidence of very serious allergic reactions or discomforts is rare. In truly one-off instances, a very small segment of users have noticed allergies like inflammation of throat or tongue, rashes on the skin, respiratory problems such as wheezing, gasping or shorter breathing cycles, etc. Among old people, a regular intake of this supplement can cause drowsiness or an acute spell of dizziness. It is always a good practice to talk to your treating doctor upon sensing one or more of these side effects as well as allergic reactions.

It is important to remember that the discomforts listed above do not constitute a complete list of all the likely side effects. Hence, it is possible to encounter a few discomforts which are not listed above or known to any. Upon sensing any such unknown as well as unlisted side effects, you are advised to take medical help on an emergency mode. People living in the US may consider calling 911 for help on an urgent basis. You may also try calling the helplines of the food and drug administration (FDA); you need to note that FDA runs its own helpline to offer quicker clinical help as well as to track the likelihood of side effects of drugs it has approved. But, if you are living in any of the Canadian provinces, you can establish contact with Health Canada or report about your discomforts to a poison control center in the province where you reside.

Precautions associated with the intake of calcium citrate

It becomes essential to tell your doctor about any prior allergies or medical conditions. At times, some of the passive or not-so-active ingredients may pose some risks of allergies. Hence, it becomes necessary to talk to your caregiver about all known allergies to drugs, foods or treatment plans. Foremost precaution among all is – this med must never be taken when you are living with excessive levels of calcium in your system. This condition is clinically called as hypercalcemia. Upon taking this calcium supplements, those with hypercalcemia may soon witness excessive build-up or accumulation of this mineral. This may lead to toxicity of calcium; you may also experience bone health conditions, blood circulation problems as well as impairment of the wellbeing of your nerves. In some instances, excessive calcium can also cause formation of stones in your kidneys.

You also need to be wary of a few pre-existing medical conditions. If you are living with conditions such as renal disorders or a marked drop in the filtering efficiency of your kidneys, presence of crystals in your urinary tract or bladder, reduced secretion of gastric juices or acids, etc., your caregiving team must be made aware of these ailments. Also, those who live with pancreatic disorders – such as pancreatitis, and those facing problems with absorption of nutrients from foods – must tell their treating physician about all such malabsorption problems. Those living with conditions like phenylketonuria (PKU) – may need to be watchful while taking the sugarless version of calcium citrate. This is because – this version may contain aspartame; this substance can cause more harm to people who live with PKU. Always talk to your doctor prior to starting your medication plan that involves a regular intake of calcium citrate.

Safety of this drug on women who are pregnant and those who are nursing

There are no clinical evidences on the likely risks pregnant women face upon taking this drug. In general, if you are pregnant – it is a safe practice to stay away from using this calcium supplement. It is safe to talk to your obstetrician or gynecologist on how safe it is to take this drug. Those who are planning to become pregnant are advised to use contraceptives – especially, birth control techniques such as vaginal rings, skin patches, etc. Consult with your doctor if you not sure of the type of contraceptive.

As an extended caution, women who are breastfeeding or nursing a newly born baby must also keep away from this drug. Your medical team may prescribe this supplement only when there is an acute need for it. In general, the active ingredients of this drug may pass through mother’s milk. Hence, it is a safe practice to avoid consuming this drug while you are nursing an infant.

Both pregnant women as well as breastfeeding women must know that this supplement may reduce the absorption efficiencies of your system. In general, it is a safe practice to tell your doctor about all the other drugs you are currently consuming. You may need to make a list of the drugs; as you are making such a list, make sure to add herbal meds, vitamins, OTC drugs as well as any other forms of dietary supplements. Above all, if you are taking any antibiotics, (either quinolone based drugs – such as levofloxacin, ciprofloxacin, etc. or other tetracycline antibiotic drugs like minocycline); you need to tell your treating doctor of your intake of calcium citrate.

In sum, calcium citrate is widely used for treating low levels of calcium. Inadequate supply of calcium tends to cause osteoporosis, fractures or bone loss; also, your parathyroid gland may not work to its fullest potential. Calcium citrate is also taken for the case management of a few muscular or nerve-related conditions. Standard dose is maintained at 600 milligrams per day. If you need any clarifications about the dosage levels of calcium citrate and its uses, it is highly recommended to talk to a qualified medical practitioner, your pharmacist as well as a dietitian.