The Calcium Conversation: Should I be taking a calcium supplement or not?

taking-a-calcium-supplement/osteoporosis/bone-densityBy Romy Block M.D. and Arielle Levitan M.D.

Until recently, we were doling out calcium supplements for women as if they were candy. The intention was good: calcium builds bones. Bone density declines with age, so as women are living longer, osteoporosis has reached epidemic proportions. Therefore, it makes sense that we should do anything we can to prevent or minimize this troublesome condition. But, is there such a thing as too much calcium? How much calcium should you take for strong bones. First question:

What exactly is osteoporosis?

Osteoporosis is a thinning of the bones that causes a predisposition to fragility fractures such as hip fractures or vertebral fractures (painful compression of the spine that can ultimately lead to a loss of height or a hump backed appearance). These fractures can be painful, debilitating and especially in the case of broken hips, even deadly. Hip fractures are associated with a high short term and longer term mortality and are often fraught with complications such as pneumonia and blood clots. In fact, some studies show that women with a hip fracture have twice as high a death rate in the year following the break.

So it only makes sense to try to prevent all of this. Getting enough calcium is useful in building bone density. So taking more is probably better, right? Take more calcium to prevent osteoporosis. Well that was the thought…If calcium prevents Osteoporosis, should I be taking a calcium supplement?

Previous recommendations included calcium supplements of 1200-1500mg per day. These supplements usually came in the form of large, difficult to swallow tablets that were supposed to be taken multiple times daily with food. Beyond the hassle factor, other downsides to taking calcium supplements include unwanted side effects such as upset stomach, kidney stones, constipation and, less commonly, serious overdoses with high blood levels of calcium. All of that aside, more than half of older women in the US are taking these supplements in the name of bone density. So it sounds like lots of people are taking calcium for osteoporosis prevention and treatment.  But wait… there’s more.

Taking Calcium supplements may cause harm.

Turns out, there could be more unintended problems with ingesting large amounts of calcium supplements. The calcium may not just make its way to your bones – it may deposit other places in your body. The most concerning deposits may occur in important blood vessels that supply your heart and your brain. That’s right, all this circulating calcium may actually clog your arteries and contribute to heart disease and stroke. Hold the presses!!

We’re not sounding the alarm bells here. The data still is not definitive and continues to be tested. There is a lot more to be learned. In fact a recent large study disputed this, showing that a large group of women taking supplements did not have a greater risk of these problems. However, a sensible approach to preserving your bones would say that mega doses of calcium supplements may not be the best idea – but dietary calcium still is important.  So most of us can actually cut down on the calcium supplements and take less. In fact  you can get enough calcium via a supplement (in addition to your diet) in a well crafted all in one vitamin based on your needs. A custom vitamin will give you the right about of calcium with your other vitamins and not too much. Take our vitamin quiz here to find out what you need.

There are many great sources from which you can get your daily calcium in addition to the commonly thought of milk, cheese and yogurt (see table below). Green leafy vegetables such as kale, spinach and broccoli or even nuts and seeds such as sesame seeds, almonds and chick peas are all good sources. Most of us can cobble together 1000 mg or so daily via all of these food sources.

We may still need to take a small amount of Calcium supplement.

But, gone are the days of the big calcium pills. Each person should find the right supplement for their individual needs (the big milk drinker may need less than the lactose intolerant person). A thoughtful custom vitamin regimen or all in one vitamin likely includes other things important for bone density (Vitamin D and magnesium in varied amounts – again depending on your needs). This is true for women (and some men) of any age since our bone density peaks at about age 35. Prior to this, getting as much dietary calcium as possible is good to build up peak strength. Then, as our bone strength declines, appropriate levels of calcium and Vitamin D are equally important.

To get just the right amount of vitamins that you need get a personalized all in one vitamin. Take our vitamin survey about your diet and health history. Find your Vous®!

Selected Food Sources of Calcium
FoodMilligrams (mg)
per serving
Percent DV*
Yogurt, plain, low fat, 8 ounces41542
Mozzarella, part skim, 1.5 ounces33333
Sardines, canned in oil, with bones, 3 ounces32533
Yogurt, fruit, low fat, 8 ounces313–38431–38
Cheddar cheese, 1.5 ounces30731
Milk, nonfat, 8 ounces**29930
Soymilk, calcium-fortified, 8 ounces29930
Milk, reduced-fat (2% milk fat), 8 ounces29329
Milk, buttermilk, lowfat, 8 ounces28428
Milk, whole (3.25% milk fat), 8 ounces27628
Orange juice, calcium-fortified, 6 ounces26126
Tofu, firm, made with calcium sulfate, ½ cup***25325
Salmon, pink, canned, solids with bone, 3 ounces18118
Cottage cheese, 1% milk fat, 1 cup13814
Tofu, soft, made with calcium sulfate, ½ cup***13814
Ready-to-eat cereal, calcium-fortified, 1 cup100–1,00010–100
Frozen yogurt, vanilla, soft serve, ½ cup10310
Turnip greens, fresh, boiled, ½ cup9910
Kale, raw, chopped, 1 cup10010
Kale, fresh, cooked, 1 cup949
Ice cream, vanilla, ½ cup848
Chinese cabbage, bok choi, raw, shredded, 1 cup747
Bread, white, 1 slice737
Pudding, chocolate, ready to eat, refrigerated, 4 ounces556
Tortilla, corn, ready-to-bake/fry, one 6″ diameter465
Tortilla, flour, ready-to-bake/fry, one 6″ diameter323
Sour cream, reduced fat, cultured, 2 tablespoons313
Bread, whole-wheat, 1 slice303
Broccoli, raw, ½ cup212
Cheese, cream, regular, 1 tablespoon141

* DV = Daily Value. DVs were developed by the U.S. Food and Drug Administration to help consumers compare the nutrient contents among products within the context of a total daily diet. The DV for calcium is 1,000 mg for adults and children aged 4 years and older. Foods providing 20% of more of the DV are considered to be high sources of a nutrient, but foods providing lower percentages of the DV also contribute to a healthful diet. The U.S. Department of Agriculture’s (USDA’s) Nutrient Databaseexternal link icon Web site lists the nutrient content of many foods and provides comprehensive list of foods containing calcium arranged by nutrient content and by food name.
** Calcium content varies slightly by fat content; the more fat, the less calcium the food contains.
*** Calcium content is for tofu processed with a calcium salt. Tofu processed with other salts does not provide significant amounts of calcium.


Romy Block specializes in Endocrinology and Metabolism and is mother to three active adolescent boys. Arielle Levitan is a Doctor of Internal Medicine with a special interest in Preventive Medicine and Women’s Health.  She is a mother of three teen agers. As professional women with active family lives, they recognize that people often neglect their own health needs and are uncertain about what vitamins to take. Each person is different in her diet, exercise and health history, and will benefit from different nutrients.  After years of advising their patients about the proper vitamins to take,  Drs. Block and Levitan created Vous Vitamin® to provide people everywhere with quality vitamins that are suited to their individual needs. They are authors of the award winning The Vitamin Solution: Two Doctors Clear Confusion About Vitamins and Your Health (She Writes Press, 2015). Take your vitamin survey now to get exactly the right vitamins for your needs.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Nothing contained herein is intended to be a diagnosis or constitute medical advice. The symptoms described in this Blog may be a result of a serious medical condition which requires medical treatment. You should consult with your doctor if you are experiencing any of the symptoms mentioned in this Blog and before beginning any vitamin or supplement regimen.

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