Do you need a calcium supplement?

Do I need calcium supplements?

Probably not. Adults need 700mg of calcium a day, and the NHS says you should be able to get it all from food.

Milk, cheese, sardines eaten with the bones and bread made with fortified flour all count. Can’t get enough from food? The ROS (Royal Osteoporosis Society) says a supplement can top up what you miss.

Women need the same 700mg as men. But the menopause raises the risk of osteoporosis, when bones get weak and break easily. After the menopause, ask your GP if you need more.

Vegan? The NHS lists calcium-set tofu, fortified soya or oat drinks, tahini and pulses as good sources.

Your next step: find your row. A blood test won’t settle it, as it doesn’t show if you get enough from food. See calcium blood test results.

Calcium carbonate or calcium citrate: which is best?

Both work. The ROS says calcium carbonate and calcium citrate are both good for your bones.

The one to take with a meal is calcium carbonate.

In a small study, people with no stomach acid absorbed very little calcium carbonate on an empty stomach. Taken with breakfast, they absorbed it normally. The author notes this is common in older people.

A review of 15 small studies found citrate was absorbed about 22 to 27% better, with or without food. But better absorbed doesn’t mean stronger bones. For bones, the ROS rates both as good.

Your next step: on carbonate, take it with a meal. Often take tablets on an empty stomach? Ask a pharmacist if citrate suits you better.

Is coral calcium or liquid calcium better?

There’s no good evidence it is. Coral calcium is made from coral, which has magnesium in it too.

One study in just 12 adults found it was absorbed a bit better than carbonate. It didn’t look at bones.

Liquids, chews and powders are a format, not a type. The label still says which calcium is inside, such as carbonate or citrate.

Coral and cal-mag tablets add magnesium. Count it too: see calcium, magnesium and zinc and which magnesium to take.

How much calcium can I take a day?

Keep supplements to 1,500mg a day or less. The NHS says that is unlikely to cause any harm. More can cause stomach pain, diarrhoea and kidney stones.

More isn’t better. Extra calcium is unlikely to make your bones stronger.

Taking several tablets a day? A review found splitting them across the day (with meals and at bedtime) was absorbed much better than one big dose.

Constipation, diarrhoea or feeling sick? Ask a pharmacist or doctor about trying a different type.

Prescribed calcium? The box may show more calcium than you expect. Your leaflet lists the “available” calcium, the part your body should use.

Worried about your heart? The ROS says there’s not enough evidence to prove calcium tablets raise your risk of a heart attack.

Your next step: not sure how much you need? Ask your doctor.

Can I take calcium tablets with my medicines?

Often, but some medicines don’t mix well with calcium. Ask your pharmacist before you start if you take one of these.

Taking calcium with vitamin D? See calcium and vitamin D tablets for the medicines that matter there.

Never stop or change a prescribed medicine without your prescriber.

When to speak to a GP

Get advice if:

• You have kidney stones, kidney disease, high blood calcium or a gut condition, or you’re at risk of heart disease. Cochrane says get medical advice first.
• You think you may be at risk of osteoporosis and you’re worried. See a GP.
• You have back pain that isn’t getting better after a few weeks, or your spine becomes curved or hunched. See a GP.
• You’ve had a fall or injury and the pain isn’t getting better. Ask for an urgent GP appointment or call 111.
• You have severe pain after a fall or injury. Call 999 or go to A&E.

Your GP can check your risk and may refer you for a bone density scan.