DEDHAM, MASS. — All calcium supplements are not created equal. The stomach absorbs some better than others, Michael F. Holick, M.D., told a gathering of clinicians at a symposium on bone health sponsored by Boston University School of Medicine.
Dr. Holick said patients can use a simple test to gauge the ability of the GI system to absorb these pills. Toss one in white vinegar and see if the pill dissolves, said the Boston University professor and director of the Bone Healthcare Clinic at Boston Medical Center.
Though there is some controversy about the need for calcium supplements in teenagers and many adults, most experts agree there is one group of individuals who are likely to benefit from them—and also likely to suffer from an indigestible concoction. They are the frail elderly—frequently women, often institutionalized, and occasionally malnourished. The scientific literature and clinical experience generally agree that these individuals are at particular risk for hip fracture.
Healthy people generally get their calcium from their diet, Dr. Holick said. “There's 300 mg in an 8-ounce glass of milk, guaranteed.” Other good sources of calcium include sardines, Tums, and calcium-fortified orange juice, he said.
As with calcium supplements, all sources of dietary calcium are not equal, he noted. At 100 mg calcium per cup, for example, “you'd have to be a cow in order to get enough calcium from broccoli.”
For those individuals who don't get enough calcium in their diet, there are supplements. A huge industry has grown up around them, producing variable results.
A recent ER visit by a 17-year-old woman prompted Dr. Holick to share his calcium pills acid test with his colleagues. The patient arrived with serious abdominal pain. After some investigating, Dr. Holick discovered her calcium supplements were leaving her body in the same state they entered. They were not “bioavailable,” he said.
“Take white vinegar and mix in the calcium preparation,” Dr. Holick said. “In 20 minutes, if it doesn't dissolve in white vinegar, guess what? It's not going to dissolve in your stomach.” In addition, when you find a good calcium supplement, “always take it with your meal,” he advised.
Teenagers need 1,300 mg calcium/day, young and middle-aged adults need 1,000 mg/day, and adults over age 50 require 1,200 mg/day, according to the Institute of Medicine.