What is calcium and why do we need it?
Calcium is a mineral necessary to bone formation and maintenance. Calcium absorption normally decreases as we age. Aging is also associated with decreasing serum vitamin D levels and reduced ability for the skin to produce vitamin D.
Supplementation with calcium and vitamin D is the only way to ensure adequate intake of Calcium and Vitamin D especially as patients get older.
 

Osteoporosis
BMD - bone mineral density measures bone mass. Calcium may prevent bone loss and may slightly increase BMD. This helps slow osteoporosis. The biggest risk of ostoporosis is fractures which can be life threatening in the elderly.
The National Institutes of Health guidelines suggest that women should take 1,000 mg before menopause and 1,500 mg after menopause. Men should take 1,000 mg until age 65, 1,500 mg after 65.
 

Bone density test. This is a painless test using special Xrays which detect the mineral content of bone. Osteoporosis is the thinning of bone which occurs with age.
 

Calcium blood test.
There is a blood test for calcium. It is used to measure serum calcium levels in people who have diseases such as parathyroid gland tumours. Low body calcium is not reflected in the blood. Low blood levels of calcium can cause heart rhythm abnormalities and sudden death so the body keeps blood calcium normal, even if it has to steal the calcium from the bones. So there is no blood calcium level test for people at risk for osteoporosis.
 

Not all calcium supplements are equal.
The most commonly used calcium supplements are calcium carbonate and calcium citrate.  Calcium carbonate needs stomach acid for absorption. It should be taken with food. Food stimulates stomach acid production. Calcium citrate does not require stomach acid for absorption so it can be taken any time, not just with meals.

Calcium citrate is preferred patients who have little or no stomach acid (low - hypochlorhydric, absent - achlorhydric). As we get older we produce less stomach acid. Antacid medications taken for indigestion or heartburn, acid reflux disease, lower stomach acid.
Calcium citrate is more bio-available. The body absorbs and uses it better than calcium carbonate. More of the calcium in calcium carbonate is passed out in the urine. Calcium citrate is better for patients with kidney stones.
 

Interactions between calcium and other drugs
Calcium interferes with the absorption of some drugs. Patients should take calcium separate from when they take prescribed medications. This includes levothyroxine (thyroid hormone supplement), fluoroquinolones, ACE-I drugs (angiotensin-converting enzyme inhibitors).
 

Vitamin D assists in the absorption and use of calcium, and decreases osteoporosis, prevents fractures and helps even with cancer prevention. Click here for our Vitamin D page.
 

The National Institutes of Health guidelines suggest that women should take 1,000 mg before until menopause and 1,500 mg after menopause. Men should take 1,000 mg until age 65, 1,500 mg after 65. Calcium is best absorbed in doses of 500mg at a time, so a post menopausal woman with low stomach acid would take 500mg calcium citrate three times a day.