Calcium and Calcium Salts
Trailokya, A.; Srivastava, A.; Bhole, M.; Zalte, N.
Journal of the Association of Physicians of India 65(2): 100-103
2017
ISSN/ISBN: 0004-5772 PMID: 28457049 Document Number: 17082
Calcium is the most abundant mineral in the body. Bones and teeth contain approx. 99% of calcium. Calcium exists in both plant and animal foods. The best source of calcium is milk. Indian Council of Medical Research (ICMR) recommends 600-800 mg/day of calcium which increases to 1200 mg/day in pregnant and lactating mothers. Inadequate calcium intake for longer duration is responsible for osteopenia and osteoporosis. Prevention and treatment of osteoporosis is frequently done with calcium supplementation. Calcium deficiency can be treated with various calcium preparations, organic salts like tricalcium citrate, calcium lactate, calcium lactate gluconate, calcium gluconate and inorganic salts like calcium chloride, calcium carbonate and calcium phosphate. Appropriate calcium salt selection depends on calcium content, solubility, taste and bioavailability as well as cost of available preparations. The most commonly available salt forms are calcium carbonate and calcium citrate. Calcium Carbonate provides with 40% elemental calcium, better absorbed and well tolerated especially when taken with a meal. It is the most commonly used and least expensive calcium salt as cost is a consideration for many patients. Calcium Citrate provides 21% of elemental calcium and better absorbed than calcium carbonate in patients with higher gastric pH. Calcium lactate and calcium gluconate do not contain adequate amount of calcium hence not a choice for practical use. Data available on hydroxyapatite as a calcium source is limited. Calcium supplements are also derived from natural sources such as coral, dolomite and oyster shell. Calcium from a coral has not been proven to be better than other calcium sources. Coral calcium products and Dolomite supplements may also contain unsafe amounts of lead along with other heavy metals. In clinical practice, to obtain optimal clinical outcomes, the dose of elemental calcium should not exceed 500 mg at one time. An adequate calcium intake through proper selection of calcium salt is one of the measures to ensure a healthy skeleton.
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