Calcium Supplements

- See Vit D Discussion:

- Discussion:
    - calcium requirements:
         - age  1 - 10:  800-1000 mg per day;
         - age 11 - 35: 1200 mg per day;
         - premenopausal:  1000 mg per day;
         - postmenopausal: 1500 mg per day;
         - fracture healing: 1500 mg per day;
         - pregnancy: 1500 mg per day:
         - lactation: 2000 mg per day;
    - absorption characteristics:
         - approximately 20% of oral calcium is absorbed by the gut under normal conditions;
         - requires physiologic gastric acidity and normal bowel and pancreatic funciton;
         - in order to optimize absorption, give divided doses of calcium supplements throughout the day (doses less than 500 mg per dose);
         - excessive phosphorous (as in soft drinks) binds Ca and prevents absorption;
         - gastro-intestinal causes of osteomalacia:
                - excessive fatty acids bind calcium and prevent absorption;
                - phytic acids (found in wheat and tea);
    - calcium content of various supplements:
         - 8 oz of milk: 250-300 mg (and also contains 100 international units of vitamin D);
         - 1 gm of calcium is present in  2.5 gm of calcium carbonate;
         - 1 gm of calcium is present in  5.0 gm of calcium citrate;
         - 1 gm of calcium is present in  8.0 gm of calcium lactate;
         - 1 gm of calcium is present in 10.0 gm of calcium gluconate;
         - calcium citrate:
                 - preferred form of supplementation;
                 - will reduce kidney stones (citrate binds to oxalate which reduces its intestinal absorption)
         - phoslo
                - calcium acetate: 667 MG
                - calcium acetate anhydrous 667 MG = Calcium 169 M
         - calcium carbonate:
                - Os-Cal 250 = 625mg calcium carbonate (each tab contains 250mg of elemental calcium and 125 USP units of Vit D);
                - Os-Cal 500 = 1250 mg calcium carbonate (each tab contains 500mg of elemental calcium);
                - Os-Cal Forte = 250mg elemental calcium plus vitamins and minerals;
                - CaCO3 650mg PO tid/qid is good for slowing diarrhea induced by tube feeding;
                - for calcium replacment: Adults: 500mg PO qd or 1 tab tid;
                - note that there is reduced calcium absorption from medications that reduce stomach acid (prilosec);
                       - calcium carbonate requires a low pH for salt dissociation;
         - cal-bid: calcium supplement w/ Vit C and D added
                - 625 mmg (= 250 mmg elemental calcium);

- Phosporous Requirements:
    - daily requirement of phosphorous is 1000 mg;
    - 75% is absorbed in the gut

Effect of calcium infusion on heart function.

The beneficial role of calcium supplementation during resuscitation from shock.

Original Article: Effect of the Time of Administration of Calcium Acetate on Phosphorus Binding.

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, December 14, 2011 3:55 pm