SUPPLEMENT - MINERALS

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What is calcium and what does it do?


Calcium is a mineral found in many foods. The body needs calcium to maintain strong bones and to carry out many important functions. Almost all calcium is stored in bones and teeth, where it supports their structure and hardness.

The body also needs calcium for muscles to move and for nerves to carry messages between the brain and every body part. In addition, calcium is used to help blood vessels move blood throughout the body and to help release hormones and enzymes that affect almost every function in the human body.

Calcium, the most abundant mineral in the body, is found in some foods, added to others, present in some medicines (such as antacids), and available as a dietary supplement.

Calcium makes up much of the structure of bones and teeth and allows normal bodily movement by keeping tissue rigid, strong, and flexible [1]. The small ionized pool of calcium in the circulatory system, extracellular fluid, and various tissues mediates blood vessel contraction and dilation, muscle function, blood clotting, nerve transmission, and hormonal secretion [1,2].

Calcium from foods and dietary supplements is absorbed by both active transport and by passive diffusion across the intestinal mucosa [1,3]. Active transport is responsible for most absorption when calcium intakes are lower, and passive diffusion accounts for an increasing proportion of calcium absorption as intakes rise [1,3].

Almost all (98%) calcium in the body is stored in the bones, and the body uses the bones as a reservoir for, and source of, calcium to maintain calcium homeostasis [1]. More than 99% of calcium in the body is in the form of calcium hydroxyapatite, an inorganic matrix of calcium and phosphate that is stored in the bones and teeth [1,4,5]. Unlike teeth, bone undergoes continuous remodeling, with constant resorption and deposition of calcium into new bone [4]. Bone remodeling is required to change bone size during growth, repair damage, maintain serum calcium levels, and provide a source of other minerals [4].

At birth, the body contains about 26 to 30 g calcium. This amount rises quickly after birth, reaching about 1,200 g in women and 1,400 g in men by adulthood [1]. These levels remain constant in men, but they start to drop in women as a result of increases in bone remodeling due to decreased estrogen production at the start of menopause [1].

An inverse relationship exists between calcium intake and absorption. Absorption of calcium from food is about 45% at intakes of 200 mg/day but only 15% when intakes are higher than 2,000 mg/day [6]. Age can also affect absorption of dietary calcium [1,4]. Net absorption of dietary calcium is as high as 60% in infants and young children, who need substantial amounts to build bone, but it decreases to about 25% in adulthood and continues to decline with age [1].


How much calcium do I need?


The amount of calcium you need each day depends on your age. Average daily recommended amounts are listed below in milligrams (mg):

  LifeStage

  RecommendedAmount

  Birth to 6 months

200 mg  

  Infants 7–12 months

260 mg  

  Children 1–3 years

700 mg  

  Children 4–8 years

1,000 mg  

  Children 9–13 years

1,300 mg  

  Teens 14–18 years

1,300 mg  

  Adults 19–50 years

1,000 mg  

  Adult men 51–70 years

1,000 mg  

  Adult women 51–70 years

1,200 mg  

  Adults 71 years and older

1,200 mg  

  Pregnant and breastfeeding teens

1,300 mg  

  Pregnant and breastfeeding adults

1,000 mg  


What happens if I don’t get enough calcium?


Insufficient intakes of calcium do not produce obvious symptoms in the short term because the body maintains calcium levels in the blood by taking it from bone. Over the long term, intakes of calcium below recommended levels have health consequences, such as causing low bone mass (osteopenia) and increasing the risks of osteoporosis and bone fractures.

Symptoms of serious calcium deficiency include numbness and tingling in the fingers, convulsions, and abnormal heart rhythms that can lead to death if not corrected. These symptoms occur almost always in people with serious health problems or who are undergoing certain medical treatments.


What are some effects of calcium on health?


Scientists are studying calcium to understand how it affects health. Here are several examples of what this research has shown:

Bone health and osteoporosis

Bones need plenty of calcium and vitamin D throughout childhood and adolescence to reach their peak strength and calcium content by about age 30. After that, bones slowly lose calcium, but people can help reduce these losses by getting recommended amounts of calcium throughout adulthood and by having a healthy, active lifestyle that includes weight-bearing physical activity (such as walking and running).


Osteoporosis is a disease of the bones in older adults (especially women) in which the bones become porous, fragile, and more prone to fracture. Osteoporosis is a serious public health problem for more than 10 million adults over the age of 50 in the United States. Adequate calcium and vitamin D intakes as well as regular exercise are essential to keep bones healthy throughout life.


Taking calcium and vitamin D supplements reduce the risk of breaking a bone and the risk of falling in frail, elderly adults who live in nursing homes and similar facilities. But it’s not clear if the supplements help prevent bone fractures and falls in older people who live at home.

Cancer


Studies have examined whether calcium supplements or diets high in calcium might lower the risks of developing cancer of the colon or rectum or increase the risk of prostate cancer. The research to date provides no clear answers. Given that cancer develops over many years, longer term studies are needed.


Cardiovascular

disease

Some studies show that getting enough calcium might decrease the risk of cardiovascular disease and stroke. Other studies find that high amounts of calcium, particularly from supplements, might increase the risk of heart disease. But when all the studies are considered together, scientists have concluded that as long as intakes are not above the upper limit, calcium from food or supplements will not increase or decrease the risk of having a heart attack or stroke.

High blood

pressure

Some studies have found that getting recommended intakes of calcium can reduce the risk of developing high blood pressure (hypertension). One large study in particular found that eating a diet high in fat-free and low-fat dairy products, vegetables, and fruits lowered blood pressure.

Preeclampsia

Preeclampsia is a serious medical condition in which a pregnant woman develops high blood pressure and kidney problems that cause protein to spill into the urine. It is a leading cause of sickness and death in pregnant women and their newborn babies. For women who get less than about 900 mg of calcium a day, taking calcium supplements during pregnancy (1,000 mg a day or more) reduces the risk of preeclampsia. But most women in the United States who become pregnant get enough calcium from their diets.

Kidney stones

Most kidney stones are rich in calcium oxalate. Some studies have found that higher intakes of calcium from dietary supplements are linked to a greater risk of kidney stones, especially among older adults. But calcium from foods does not appear to cause kidney stones. For most people, other factors (such as not drinking enough fluids) probably have a larger effect on the risk of kidney stones than calcium intake.

Weight loss

Although several studies have shown that getting more calcium helps lower body weight or reduce weight gain over time, most studies have found that calcium—from foods or dietary supplements—has little if any effect on body weight and amount of body fat.


For more information on calcium and weight loss, see our consumer fact sheet on Weight Loss.



Can calcium be harmful?


Getting too much calcium can cause constipation. It might also interfere with the body’s ability to absorb iron and zinc, but this effect is not well established. In adults, too much calcium (from dietary supplements but not food and beverages) might increase the risk of kidney stones. Some studies show that people who consume high amounts of calcium might have increased risks of prostate cancer and heart disease, but more research is needed to understand these possible links.

Most people do not get amounts above the upper limits from food and beverages; excess intakes usually come from the use of calcium supplements. Surveys show that some older women in the United States probably get amounts somewhat above the upper limit since the use of calcium supplements is common among these women.


Where can I find out more about calcium?


• For general information on calcium:
o Office of Dietary Supplements Health Professional Fact Sheet on Calcium
o Calcium and Calcium in diet, MedlinePlus®
• For more information on food sources of calcium:
o U.S. Department of Agriculture’s (USDA) FoodData Central 
o Nutrient List for calcium (listed by food or by calcium content), USDA
• For more advice on choosing dietary supplements:
• For information about building a healthy dietary pattern:


References


1. Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press; 2011.

2. Heaney RP. Calcium. In: Coates PM, Betz JM, Blackman MR, et al., eds. Encyclopedia of Dietary Supplements. 2nd ed. London and New York: Informa Healthcare; 2010:101-6.

3. Weaver CM, Heaney RP. Calcium. In: Ross AC, Caballero B, Cousins RJ, Tucker KL, Ziegler TR, eds. Modern Nutrition in Health and Disease. 11th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2014:133-49.

4. Weaver CM. Calcium. In: Marriott BP, Birt DF, Stallings VA, Yates AA, eds. Present Knowledge in Nutrition. 11th ed. Cambridge, Massachusetts: Wiley-Blackwell; 2020:321-48.

5. Wawrzyniak N, Suliburska J. Nutritional and health factors affecting the bioavailability of calcium: a narrative review. Nutr Rev 2021. [PubMed abstract]

6. Health information data from U.S. National Institutes of Health

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