Updated 05 August 2010

Calcium supplements

There can be no doubt that calcium is an important bone mineral. Many people need to take calcium supplements to ingest enough calcium. But how much do you know about these?

Calcium supplementation

Although the recommended daily allowance (RDA) varies from country to country, the diets of most individuals in Western countries, including South Africa (500-600mg/d), most likely contain insufficient calcium.
The National Osteoporosis Foundation of South Africa (NOFSA) recommends the following:

National Osteoporosis Foundation South Africa RDA of Calcium
Infants 1000
Children and adolescents 1500
Young adults 1000
Pregnant and lactating females 1500
Post-menopausal women
• on hormone replacement
• not on hormone replacement


Calcium Carbonate 40
Calcium Phosphate 30-40
Calcium Citrate 24
Calcium Citrate Malate 24
Calcium Lactate 13
Calcium Gluconate 9

  • If you need to take an iron supplement as well, take your calcium supplement either two hours before or after the iron supplement to ensure proper absorption of both
  • Calcium may interfere with the body's ability to use certain antibiotics like tetracycline − use calcium two hours before or after taking the tetracycline
  • If you are using a bisphosphonate drug like Fosamax or Actonel for osteoporosis, do not take the calcium supplement in the morning, as it will interfere with the absorption of the medication
  • Excessive intake of protein, salt and caffeine may lead to an increased excretion of calcium in the urine
  • Calcium absorption is inhibited to a certain degree by fibre in the diet – try taking your calcium when you are having a low-fibre meal
  • Although the calcium content in green vegetables like spinach is high, little gets absorbed due to the phytate content of these foods
  • Vitamin D is necessary for calcium absorption and is consumed in the diet and produced in the skin by the UV rays in sunlight. The RDA for vitamin D is 400 IU per day in persons under 70 and 800 IU in persons over 70 years of age. Pharmacological doses of vitamin D supplementation should be done under medical supervision. The aged and home-bound persons who are not exposed to sunlight should be supplemented with vitamin D
  • Special care should be taken when considering supplements that contain oyster shells, dolomite or bone meal as these may contain high doses of lead which can in the long run be harmful

  • Much has been written about this subject and while it is true that magnesium is important in calcium metabolism (low magnesium levels stimulate calcium excretion in the urine), it is generally accepted that most healthy  individuals do not need additional supplementation of vitamins and minerals like magnesium, boron, vitamin K, vitamin C, sink, selenium etc. In fact, many of these nutrients will be present in a diet with five or more servings of fruit and vegetables a day. Certain individuals may however be at risk for magnesium deficiency, including those with gastrointestinal diseases, causing poor absorption or increased losses of magnesium. Frail elderly individuals with poor diets, alcoholics, diabetics, individuals receiving chemotherapy and those taking high doses of diuretics that deplete magnesium are also at risk. Magnesium deficiency is easy to detect by doing a simple blood test. Your medical professional will prescribe a magnesium supplement if it is necessary or if you have a disease or condition that causes magnesium deficiency.

  • Calcium supplements in reasonable doses (1000 mg /day) are generally a satisfactory option for many people. Certain preparations may however cause patients to feel bloated and have constipation. If simple measures such as an increased fluid and fibre intake as well as exercise do not solve the problem, another form of calcium should be tried.
  • Gastritis may be caused if calcium carbonate is taken between meals - this can stimulate rebound acid production in the stomach.
  • There is no scientific evidence that calcium causes kidney stones. If you do have kidney stones and have hypercalcuria (determined by a 24 H urinary calcium measurement), it is probably wise to limit your intake to about 1000mg. If you have normal urinary calcium levels in the presence of kidney stones, it is not necessary to limit your calcium intake, but care should be taken with vitamin D supplementation and should be used only after consultation with a doctor.  
  • A total daily intake of more than 2500mg of calcium is not recommended- it is not more beneficial for the bones and the kidneys just need to work harder to eliminate the excess calcium.

Company Product Compound  Elemental
Adcock Ingram Osteo- Matrix  Calcium citrate malate 500 mg
Arctic Health   Mena-Cal 7  Calcium Carbonate  520 mg 
Georen  B- Cal-D Calcium Carbonate 500 mg
  B-Cal-Plus  Calcium Citrate  300 mg
  Calcium Lacto Forte sachets Calcium Lactate Gluconate 500 mg
  Calcium Citrate D granules Calcium Citrate 500 mg 
Novartis  Calcium Sandoz Forte Calcium Carbonate/Lactate Gluconate 500 mg
Pharma Natura Vita Force Calcium Carbonate   333 mg
  Bettaway Fizzie Calcium Carbonate 280 mg
  Bettaway CalciumExtra Calcium Carbonate  333 mg
  Vitaforce Calcium Chews Calcium Carbonate 500 mg
Pinnacle   Calpin plus   Calcium Carbonate 600 mg
  Calpin D  Calcium Carbonate  300 mg
Vital   Natrodale Calcium  Calcium Carbonate 320 mg
  Vitalfarm  Calcium Carbonate  320 mg
Wyeth Caltrate Plus  Calcium Carbonate 600 mg


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Healthy Bones

Tereza is the CEO of the National Osteoporosis Foundation and worked as a Nursing Sister in the field of Osteoporosis for 18 years prior to her appointment with the Foundation. She used to be the Educational Officer for the Foundation and co-wrote the patient brochure on Osteoporosis. Read more

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