Calcium

USAGE AND EFFECTIVENESS

Usage	Effectiveness
High Blood Pressure	Mild effectiveness (Lower risk of high blood pressure) Several clinical and observational studies showed that calcium may decrease in risk of high blood pressure and reduce blood pressure levels; however, the magnitude of blood pressure drop may be small (1 to 2 mm mercury). More evidence is needed to support the above.
High Blood Pressure during Pregnancy	Effective (Reduce high blood pressure and pregnancy complications) Shown in several strong clinical studies to reduce pregnancy-related high blood pressure, and pre-eclampsia (a type of pregnancy complication) with superior effect to pills without active ingredient; beneficial effect is more certain if calcium intake is low. WHO recommends intake of 1 to 2 grammes of calcium daily for women with high chance of pre-eclampsia and have low calcium consumption.
Fetal Bone Mineralization	Effective (Strengthen baby's bone) Shown in a clinical study to increase fetal bone mineralization and density when daily calcium intake of pregnant mother is low.
High Potassium Levels	Effective (Reverse electrocardiogram changes and abnormal heartbeat) Shown in one strong clinical study to reverse electrocardiogram changes and abnormal heartbeat due to high potassium levels One strong clinical study to support the point above.
Indigestion	Effective (Help treat indigestion) Shown in one strong clinical study to treat indigestion using calcium carbonate Calcium carbonate is a standard ingredient for over-the-counter antacid sold in many pharmacies and clinics.
Low Calcium Levels	Effective (Treat and prevent low calcium levels) Shown in one strong clinical study to treat and prevent low calcium levels One strong clinical study to support the point above
Kidney Failure	Effective (Control electrolyte disorder and reduce blood pressure in patients with end stage kidney disease) Shown in several strong clinical studies to control electrolyte disorder (bind phosphorous and prevent muscle and joint problem) and reduce blood pressure in patients with end stage kidney disease One strong clinical study to support the point above.
Osteoporosis	Effective (Prevent and treat osteoporosis) Taking calcium prior to peak bone mass (30 to 40 years old in ladies, few decades later for men) will help to increase bone mass further; thereafter, taking calcium may help to arrest decline in bone mass For those who are diagnosed with osteoporosis, taking enough calcium would be needed for optimum response to prescription medicines. Calcium would also be useful for potential osteoporosis due to use of steriod. Many studies to support and has been recommended by clinical guidelines.
Overactive Thyroid	Effective (Reduces parathyroid hormone levels) Shown in several strong clinical studies to reduce parathyroid hormone levels in patients with chronic renal failure and secondary hyperparathyroidism and reduce risk of hip fracture and primary high parathyroid hormone levels Several strong clinical studies to support the point above
Premenstrual Syndrome (PMS)	Effective (Improve symptoms of premenstrual syndrome) Shown in several strong clinical studies to reduce depressed mood, water retention and pain due to premenstrual syndrome (especially in women with low calcium intake); symptoms may decrease by as much as 18% as compared to women who take pills without active ingredient. From studies, taking calcium rich food seems to work better than calcium supplement. Several strong clinical studies to support the point above
Tooth Decay	Effective (Promote tooth retention in elderly population) Shown in one strong clinical study to affect tooth retention in elderly population Several strong clinical studies to support the point above
Autism	Mild effectiveness (Reduce odds of autism spectrum disorders) One clinical study showed reduced risk of baby having autism spectrum disorders (by 52%) when pregnant mother takes calcium; more evidence is needed to support wider use of the above.
Colorectal Cancer	Mild effectiveness (Reduce risk of colorectal cancer and adenoma) Several clinical studies showing reduction in risk of colorectal cancer and adenoma, but does not decrease rectal mucosal tissue proliferation; but clinical study is not robust enough; more evidence is needed to support the above.
Diabetes	Mild effectiveness (Lower risk of developing type 2 diabetes) Population studies showed taking calcium may lower risk of developing type 2 diabetes, though the study design of these research may not be good enough to warrant widespread recommendation of calcium to prevent diabetes. More evidence is needed to support the above.
Dizziness	Mild effectiveness (Reduce symptoms) One large clinical study showed that calcium may reduce dizziness due to sudden movement (e.g. standing up from squatting or lying down) by much as 27%; more evidence is needed to support the above.
Dysmenorrhea	Mild effectiveness (Reduce pain) One clinical study showing reduction in pain when calcium carbonate is used as compared to pills without active ingredient; more evidence is needed to support the above. Dysmenorrhea is a condition of extremely or severe cramps during menstruation.
Endometrial Cancer	Mild effectiveness (Reduce risk of endometrial cancer) Analysis of population studies showed that calcium supplement may reduce risk of endometrial cancer, though there don’t seem to be any effect from dietary calcium more evidence is needed to support the above.
Fall Prevention	Mild effectiveness (reduce unintentional body movement and normalise blood pressure) Few clinical studies showed that calcium may improve muscle strength (thus reduce body sway) and normalise blood pressure (which both reduce chance of falling down); more evidence is needed to support the above.
Fluorosis	Mild effective (Reduce excess fluoride levels in children and improving symptoms of fluorosis in children) Shown in one strong clinical study to reduce excess fluoride levels in children and improve symptoms of fluorosis in children As the study was carried out with Vitamin C and D, question arose on whether calcium alone would be effective.
Heart Failure	Mild effectiveness (Reduce risk in selected population) One clinical study showed that calcium supplement (1000mg, together with 400 IU of vitamin D) may reduce the risk of developing heart failure in women without risk factor of heart after menopause, by as much as 37%; the same effect has not been seen in other population More evidence is needed to support the above.
Lead Toxicity	Unclear effectiveness (Increase serum concentrations of lead and reduce blood lead levels) One clinical study showing increase in serum concentrations of lead and reduce blood lead levels, while another showed that calcium supplementation has no effect; more evidence is needed to support the above.
Metabolic Syndrome	Mild effectiveness (Lower risk) One population study showed that high intake of calcium may lower risk of developing metabolic syndrome; more evidence is needed to support the above
Oral Mucositis	Mild effectiveness (Reduce days of symptoms, duration and use of pain reliever) One clinical study showed that mouth rinse containing calcium may reduce the number of days with mucositis & pain, and number of days of use and amount of morphine, for patients with oral mucositis due to bone marrow transplant; more evidence is needed to support the above.
Postpartum Depression	Mild effectiveness (Reduce depression) One clinical study showed that calcium may reduce depression if taken 12 weeks after child birth. Earlier intake of calcium (at 6 weeks after child birth) seems to have no effect; more evidence is needed to support the above.
Pregnancy-related Leg Cramps	Mild effectiveness (Reduce pregnancy-related leg cramps) One small clinical study showed that calcium may decrease pregnancy-related leg cramps as compared to no treatment; more evidence is needed to support the above.
Rickets	Mild effectiveness (Improve radiographically measured rickets) Several clinical studies showed that calcium may improve rickets in children when observed using x ray; response increase with increase of calcium dose, up to 1000mg. Rickets is a condition where bones are weakened due to severe long-term vitamin D deficiency or sometimes inherited disorders; symptoms include bone deformities, slow growth, poor motor skill development, muscle weakness and leg, pelvic & back pain.
Bone Fractures	Unclear effectiveness Some studies showed reduction in fracture risk, while some showed no reduction. Not enough clinical studies to support the point above; more evidence is needed.
Breast Cancer	Unclear effectiveness Some clinicals study shows reduction in risk of developing breast cancer while others show no reduction in risk. Not enough clinical studies to support the point above; more evidence is needed.
Cancer	Unclear effectiveness Some studies showed reduction in risk of cancer (all causes) while some shows no reduction. Not enough clinical studies to support the point above; more evidence is needed.
High Cholesterol	Unclear effectiveness (Reduce cholesterol levels) One clinical study showed that calcium may reduce bad cholesterol level and increase good cholesterol level when used together with low fat diet; but clinical study is not robust enough; however, there is another study that contradict this finding; more evidence is needed to support the above
Ovarian Cancer	Unclear effectiveness (Lower risk of ovarian cancer) Analysis of population studies showed that calcium may not lower the risk of ovarian cancer while another analysis showed that low intake of calcium may increase risk of cancer by 20%; more evidence is needed to support the above.
Prostate Cancer	Unclear effectiveness Some clinicals studies show decrease in risk of developing prostate cancer while some shows increased risk Not enough clinical studies to support the point above; more evidence is needed.
Stroke	Unclear effectiveness (Decrease risk of stroke) Many clinical studies showed that calcium may not reduce risk of stroke; these studies were done primarily on women after menopause and effect on other population is unknown; more evidence is needed to support or disprove its use.
Depression	Unknown effectiveness No clinical study to support the above point; More evidence needed to support the point above.
Heart & Blood Vessel Diseases	Unknown effectiveness (Atherosclerosis – hardening of blood vessels) No clinical study to support the above point; More evidence needed to support the point above.
Kidney Diseases	Unknown effectiveness No clinical study to support the above point; More evidence needed to support the point above.
Lyme Disease	Unknown effectiveness No clinical study to support the above point; More evidence needed to support the point above.
Overall Mortality	Unknown effectiveness No clinical study to support the above point; More evidence needed to support the point above.
Heart Attack	Ineffective Proven by clinical studies for its ineffectiveness Supplementation may increase the risk of heart if the daily intake of calcium is already above 805mg. Best to acquire calcium via diet instead of using supplement if you are at risk of heart attack or already had a previous episode.

General Safety

• Generally safe when used in appropriate doses; generally unsafe when used in excessive doses.

Pregnant/Breastfeeding Women

• Generally safe when used in appropriate doses for pregnancy; Unsafe when used in excessive amounts.

Children

• Generally safe when used in appropriate doses; generally unsafe when used in excessive doses.

Elderly

• Generally safe when used in appropriate doses; generally unsafe when used in excessive doses.

Special to Note

• None to note.

Contraindications

• Details:
  • May cause lower calcium absorption in fasting state in individuals with absence of stomach acid secretion
  • May increase calcium adsorption in individuals with hyperparathyroid activity
  • May cause high serum phosphate levels in individuals with electrolyte disorder with increased levels of phosphate in blood
  • May decrease thyroid enzyme levels and treatment for low thyroid function
  • May increase risk of calcium and alkalosis in individuals with kidney insufficiency
  • May increase risk of calcium absorption and high calcium levels in individuals with sarcoidosis
  • May decrease calcium absorption in the intestine for individuals who smoke
  • May cause increased risk of developing dementia in elderly woman with history of stroke

Side Effects

• Generally safe; side effects may include:
  • Heart:May increase risk of heart attack
  • Digestive System:May cause burping, gas, nausea, digestive discomfort, and diarrhoea
  • Cancer:May increase risk of prostate cancer
  • Brain/CNS:One case of high blood sugar-induced seizures was reported in a premature baby
  • Hormone System:One case of nausea, vomiting, and stomach pain, with increased levels of enzyme levels and acute pancreas infection was reported
  • Kidney:May increase risk of kidney stones

• Medicines
  Low to High severity interactions with medicines such as aluminum, medicines to prevent loss of bone density, vitamin D medicines, calcium channel blockers, antibiotics, treat heart conditions, antiretroviral medicines for HIV/AIDS, integrase inhibitors for HIV/AIDS, estrogens, medicines for thyroid hormone deficiency, lithium, treat and prevent abnormal heart rhythms, diuretics, and medicines for high blood pressure; Certain medicines can also affect calcium levels which include aluminium, anticonvulsants, medicines for bile acid secretion, corticosteroids, loop diuretics, antibiotics, H2-Blockers, medicines for thyroid hormone deficiency, magnesium, mineral oil, proton pump inhibitors, stimulant laxatives, and antibiotics
• Supplements
  Medium to High severity interactions with iron, lycopene, lysine, magnesium, prebiotics, probiotics, and vitamin D
• Food
  Interactions with food such as caffeine-containing food, fiber-containing food, iron-containing food, magnesium-containing food, prebiotics, probiotics, protein-containing food, salt-containing food, and zinc-containing food
• Lab Tests
  Interactions with lab test for 11-Hydroxycorticosteroids, 17- Hydroxycorticosteroids, gastrin, I-131 uptake, lipase, magnesium

• General (Adults)
  Consume 1000mg for age 19-50 years old; 1000mg for men aged 51-70 years; 1200mg for women aged 1200mg; 1200mg for age 70+ years and above; 1300mg for pregnant/lactating below aged 19 years old; 1000mg for pregnant/lactating aged 19-50 years old
• Cancer (Adults)
  Consume 1400-1500mg calcium combined with 1100IU daily for 4 years
• Colorectal Cancer (Adults)
  Consume calcium up to 2 grams/day for up to 4 years; Consume up to 2 grams/day calcium for 4 years, Consume 1000mg calcium daily combined with 400IU vitamin D3 daily for 4 years
• Corticosteroid-induced osteoporosis (Adults)
  Consume 500-1000mg calcium daily in separate doses for up to 2 years combined with vitamin D
• Dysmenorrhea (Adults)
  Consume 1000mg calcium carbonate daily for three menstrual cycles
• Indigestion (Adults)
  Consume 0.5-1.5 grams calcium carbonate
• Fall Prevention (Adults)
  Consume 400-1200mg/day calcium combined with vitamin D for up to 1200 IU/day for up to 3 years
• Fetal Bone Mineralization (Adults)
  Consume 300-2000mg/day calcium during second and third trimesters of pregnancy
• High Cholesterol (Adults)
  Consume 800mg calcium daily for 2 years; Consume 400mg calcium three times daily for 6 weeks or 600mg twice daily combined with 200IU vitamin D twice daily for 15 weeks
• Lead Toxicity (Adults)
  Consume 1200 mg/day calcium beginning during the first trimester of pregnancy
• Metformin-related Vitamin B12 deficiency (Adults)
  Consume 1.2 grams/day calcium for one month
• Osteoporosis (Adults)
  Consume 500-2500 mg calcium daily from supplements and food sources for up to 7 years combined with vitamin D; Consume 1000mg daily for men aged 50-70 years and 1200mg daily for women 51 and older or men 71 and older; Consume daily recommendation of 1000-1200mg daily
• Postpartum Depression (Adults)
  Consume 2 grams calcium daily beginning 11-21 weeks gestation
• High Blood Pressure during Pregnancy (Adults)
  Consume 1-2 grams daily from second trimester
• Pregnancy-related leg cramps (Adults)
  Consume 1 gram calcium twice daily as a mixture of salts for 2 weeks
• Premenstrual Syndrome (Adults)
  Consume 1000-1336 mg/day calcium for up to three menstrual cycles; Consume specific supplement containing 400mg calcium and 400IU vitamin D daily for 3 months
• Prostate Cancer (Adults)
  Consume 1200mg calcium daily for 4 years
• Kidney Failure (Adults)
  Consume 1-6.5 grams/ day calcium acetate or calcium carbonate in separate doses usually for 2-52 weeks
• Seizures (Adults)
  Consume 600mg calcium single dose from algal source
• Tooth Retention (Adults)
  Consume 700IU/day Cholecalciferol together with 500mg calcium citrate malate per day for 3 years
• Vertigo (Adults)
  Consume 400IU Vitamin D and 500mg calcium twice daily for one year
• Oral Mucositis (Adults)
  Use 30mL of specific mouth rinse containing 4.74 mmol/L calcium, 2.96 mmol/L phosphate, 97.67mmol/L sodium, and 116.6mmol/L chloride four to ten times daily after fluoride treatments during hospital recovery from hematopoietic stem cell transplantation
• High Potassium Levels (Adults)
  Administer 20mL or 10% calcium gluconate over 5-10 minutes in adults as slow infusion over 20-30 minutes for patients taking digoxin
• Low Calcium Levels (Adults)
  Administer 100-200mg calcium intravenously as a bolus in the central vein; One milimeter of calcium chloride provides 27mg elemental calcium and 1mL of calcium gluconate providing 9mg
• General (Children)
  Consume 700mg for children aged 1-3 years old; 1000mg for children aged 4-8 years old; 1300mg for aged 9-18 years old; 1300mg for pregnant/lactating less than 19 years old
• Fluorosis (Children)
  Consume 125mg calcium twice daily combining with ascorbic acid (Vitamin C), and vitamin D in children aged 6-12 years old
• High Blood Pressure (Children)
  Consume 1.5 grams/day calcium for 8 weeks
• Rickets (Children)
  Consume 500-2000mg calcium daily for 24 weeks
• High Potassium Levels (Children)
  Administer 0.5mL/kg of 10% calcium gluconate over 5-10 in children

• General Information
  • Calcium is commonly used by consumers for bone health.
• How does it work?
  • Contains chemicals that relieve pain, have anticancer effects, lower risk of diabetes, lowers blood pressure levels, cholesterol levels, alleviate premenstrual symptoms, help with weight loss and kidney disease.