Calcium is a mineral in your body that is also found in many foods. Most of the calcium in your body is in your bones and teeth. There is also calcium in your blood, muscles, other body tissues, and the fluid between your cells.

Path to improved health

You need calcium to keep your bones and teeth healthy and strong throughout your life. Your body also uses calcium to:

• Help blood vessels and muscles work properly
• Help release hormones and enzymes that keep your body working properly
• Help your nerves carry messages throughout your body
• Help control important nutrients, such as magnesium, phosphorus, and potassium

Your body can’t make more calcium. So, it’s important for you to provide it with the calcium it needs. The amount of calcium you need each day depends on your age, your sex, and other factors. For example, vitamin D improves calcium absorption. Alcohol reduces calcium absorption.

Doctors recommend:

• Children ages 0-6 months: 200 milligrams (mg) per day
• Children ages 7-12 months: 260 mg per day
• Children ages 1-3: 700 mg per day
• Children ages 4-8: 1,000 mg per day
• Children ages 9-13: 1,300 mg per day
• Teens ages 14-18: 1,300 mg per day
• Adults ages 19-50: 1,000 mg per day
• Adult men ages 51-70: 1,000 mg per day
• Adult women ages 51-70: 1,200 mg per day
• Adults ages 71 and older: 1,200 mg per day
• Pregnant and breastfeeding teens: 1,300 mg per day
• Pregnant and breastfeeding adults: 1,000 mg per day

Dietary sources of calcium

It’s best to spread your calcium throughout the day. Eat calcium-rich foods at every meal rather than all at once. Be sure to get enough vitamin D each day to help your body absorb the calcium.

Nonfat and low-fat dairy products (yogurt, cheese, and milk) are good sources of calcium. Vegetable sources of calcium include dried beans, kale, spinach, and collard greens. Animal sources of calcium include fish with soft bones, such as sardines and salmon. For example, 2 ounces of nonfat American cheese has 447 mg of calcium. One cup of skim milk has 299 mg of calcium. And 3 ounces of pink salmon has 183 mg of calcium. Some foods may be fortified with calcium (orange juice, bread, pasta, dry breakfast cereal, and dairy substitutes).

Calcium supplements

If you’re not getting enough calcium from dietary sources, talk to your doctor about a calcium supplement. Depending on your age, sex, overall health, and other factors, your doctor might recommend that you take a calcium supplement. Also, your doctor can tell you if a calcium supplement will affect any medical conditions you have. They will need to know about any prescription or over-the-counter (OTC) medicines, or other dietary supplements you are taking.

It’s important to know that calcium supplements can affect the way certain other medicines you are taking work. For example, calcium supplements can interfere with blood pressure and synthetic thyroid medicines, bisphosphonates, and antibiotics as well as certain medicines prescribed to treat bipolar disorder and HIV. Other supplements, such as iron, can affect how the body absorbs, uses, or gets rid of medicines or supplements.

There are 2 main types of calcium supplements: calcium carbonate and calcium citrate. Both types are available without a prescription. Over-the-counter calcium supplements are available in tablet, chewable, liquid, and powder form. Other types of calcium include calcium gluconate and calcium lactate. These contain less elemental calcium than calcium carbonate and calcium citrate.

If a supplement is right for you, your doctor will help you decide which one to take. They will also explain what amount of calcium to take each day and how to take the supplement. For example, calcium carbonate should be taken with meals to avoid possible unpleasant health effects (also called adverse effects). Taking it with meals helps your body to better absorb it. Calcium citrate can be taken on an empty stomach.

Things to consider

If your body doesn’t get enough calcium and vitamin D to support important functions, it takes calcium from your bones. This is called losing bone mass. Losing bone mass makes the inside of your bones become weak and porous. This puts you at risk for the bone disease osteoporosis.

Certain populations are at higher risk for low calcium levels, including:

• Postmenopausal women
• People who have lactose intolerance and avoid dairy products
• Women who have an eating disorder (for example, anorexia)
• People who do not eat animal, fish, or dairy products (vegans)
• People who take certain medicines for osteoporosis
• People who have parathyroid disorders, inflammatory bowel disease, or liver or kidney disease

Unfortunately, getting more calcium than your body needs can cause adverse (negative) effects. This includes kidney stones, frequent urination, belly pain, nausea/vomiting, and fatigue. It is rare to get too much calcium from food alone. There is an amount of calcium that most people can take each day without developing problems. This is called the tolerable upper intake level. Doctors recommend the following tolerable upper intake levels by age:

• Ages 0-6 months: 1,000 mg per day
• Ages 7-12 months: 1,500 mg per day
• Ages 1-8: 2,500 mg per day
• Ages 9-18: 3,000 mg per day
• Ages 19-50: 2,500 mg per day
• Ages 51 and older: 2,000 mg per day
• Pregnant and breastfeeding teens: 3,000 mg per day
• Pregnant and breastfeeding adults: 2,500 mg per day

In addition, research shows that high intakes of calcium may provide health benefits in lowering the risk of colon cancer, preeclampsia (pregnancy related complication), and metabolic syndrome (such as diabetes). Other research shows that high calcium intake may raise the risk of prostate cancer. Conflicting research suggests that a high intake of calcium may or may not provide a protection against heart disease.

Talk to your doctor about whether supplements are right for you.

Questions to ask your doctor

• Can too much calcium upset your stomach?
• Can illness cause low calcium?
• Can you develop osteoporosis at an early age?

Resources

National Institutes of Health: Calcium and Vitamin D: Important at Every Age

National Institutes of Health, Office of Dietary Supplements: Calcium

U.S. National Library of Medicine, MedlinePlus: Calcium

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Vitamin D is an important nutrient. It helps your body build strong bones and teeth. Maintaining an adequate level of vitamin D is important for all stages of life. It is especially important for children while their bones and teeth are developing. Vitamin D has other health benefits, as well. Vitamin D may protect against various health conditions, such as some cancers, muscle weakness, mood disorders, diabetes, kidney disease, heart disease, and high blood pressure.

Path to improved health

You can get Vitamin D from certain foods, sunlight, and dietary supplements.

Vitamin D is sometimes called the “sunshine vitamin.” That’s because your body creates its own vitamin D when you are exposed to sunlight. Depending on where you live, you might only need 10 minutes of sunshine 3 to 4 times a week to help your body create the vitamin D it needs. This can happen while you’re taking your dog for a walk or your children to the park. During certain times of the year, especially in northern states, there may not be enough of the right sunlight to make vitamin D. This is true even if you are outside all day.

Most people get very little vitamin D from the foods they eat. That’s because there are very few foods that contain vitamin D. Foods that naturally contain vitamin D include fatty fish, fish oil, eggs, cheese, and butter. There are also foods and drinks that have been fortified with vitamin D. These include milk, milk alternatives, some brands of orange juice, and some vitamin-fortified breakfast cereals. Read the food nutrition labels to learn if the products you choose are sources of vitamin D.

Vitamin D is available over the counter and by prescription. If you are concerned that you are not getting enough vitamin D, talk to your doctor. They will ask you about your diet and your exposure to sunlight. Your doctor also will consider other risk factors you may have.

Your doctor may want to test your level of vitamin D. This can be done through a blood test (inserting a small needle into your vein and taking a sample of blood to send to a lab). This will help determine if you need a supplement and, if so, how much. If you are a senior, a vegetarian or vegan, a nursing mother, or a pregnant woman, talk to your doctor about whether you should take a vitamin D supplement.

Things to consider

A low level of vitamin D in the body is called a vitamin D deficiency. Children who don’t get enough vitamin D are at risk for rickets. Rickets is a disorder that affects the bones. It causes bones to soften and break easily. Vitamin D deficiency can delay a child’s growth. And it can lead to cavities and problems with teeth structure. Adults who do not get enough vitamin D are at risk for osteomalacia (weak bones), osteoporosis (thin bones), and muscle weakness. This can increase the risk of bone fractures and falls.

The amount of vitamin D your body needs can vary depending on several factors, including:

• Weight
• Genetics
• Skin color
• Chronic conditions
• Where you live
• Sun exposure

Adults 70 years old and younger need 600 international units (IU) of vitamin D a day. Adults over the age of 70 need 800 IUs of vitamin D a day. For children between the ages of 1 and 18, the recommended daily dose is 600 IU. For children from birth to 12 months of age, the recommended daily dose is 400 IU.

If you breastfeed your baby, your doctor may prescribe a vitamin D supplement. Breast milk only has a small amount of vitamin D. Talk to your family doctor before giving older children vitamin supplements.

Vitamin D deficiency risk factors:

Some people are at higher risk for vitamin D deficiency than others, including:

• Infants who are only breastfed
• Babies and toddlers who are given non-milk food products or foods that are not fortified with vitamin D
• Seniors or older adults
• Darker-skinned people
• Those with limited exposure to sunlight (this includes people who are homebound)
• People who have difficulty absorbing dietary fat (because of conditions such as colitis, inflammatory bowel disease, and cystic fibrosis)
• Vegans, ovo-vegetarians, and those with other dietary restrictions such as milk-allergies and lactose-intolerance
• Obese people with a body mass index (BMI) greater than 30
• People with kidney disease, including kidney transplant recipients
• Those on medicines called glucocorticoids

People who live in northern states can also be at high risk. This is especially true during winter months. The farther south you live, the easier it is to get your vitamin D from sun exposure all year round.

Questions to ask your doctor

• Can a vitamin D deficiency make you feel overly tired?
• Can too much vitamin D be bad for your health?
• Are there any side effects to vitamin D dietary supplements?
• Can you get adequate sunlight by sitting near a window?

Resources

National Cancer Institute: Vitamin D and Cancer Prevention

National Institutes of Health, Office of Dietary Supplements: Vitamin D

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