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Calcium

What is calcium and what are its functions?

Calcium is an essential mineral. It gives strength to the bones and teeth and enables proper functioning of the nerves, muscles, gut, heart and blood vessels. It also participates in blood coagulation and production of energy from carbohydrates [1].

The chemical symbol for calcium is Ca.

How much calcium do you need?

The Recommended Dietary Allowance (RDA) for calcium for adults has been set at 1,000 mg (1 g) per day [1]. The average calcium intake in Americans (data from 2003-2006) is about 700-1,200 mg/day and is lower in women than in men [6].

Chart 1. Recommended Dietary Allowance (RDA) for calcium

AGE RDA (mg/day)
Infants 0-6 months 200 (Adequate Intake)*
Infants 7-12 months 260 (Adequate Intake)
Children 1-3 years 700
Children 4-8 years 1,000
9-18 years, including pregnant and breastfeeding women 1,300
Adults 19-70 years, including pregnant and breastfeeding women 1,000
Adults 71+ years 1,200

Chart 1. source: The Food and Nutrition Board of the U.S. Institute of Medicine (IOM) [1] *Breast milk of healthy mothers should provide enough calcium for exclusively breastfed infants 0-6 months of age [1,3].

Foods Rich in Calcium

Common foods rich in calcium include dairy products, calcium-fortified foods, fish with edible bones, almond milk, radishes and certain mineral waters.

Non-Dairy High-Calcium Foods Picture


Picture 1. Non-dairy foods high in calcium

Chart 2. List of foods high in calcium

DAIRY

CALCIUM (mg)
Cheese, American pasteurized 700-1,000
Cheese, Gruyere, romano, Swiss  (2.5 oz, 70 g) 700-750
Cheese, blue, brick, caraway, cheddar, colby, edam, gouda, gout, Mexican blend, monterey, muenster, provolone, Roquefort, Swiss-processed, tilsit (2.5 oz, 70 g) 400-600
Milk, sheep (1 cup, 237 mL) 470
Yogurt, plain (6 oz, 170 g) 350
Mozzarella (2.5 oz, 70 g) 350-670
Cheese, feta (2.5 oz, 70 g) 350
Milk cow/goat, nonfat, skim, whole (1 cup, 237 mL) 300
Cheese, brie, camembert, Ricotta (2.5 oz, 70 g) 150-300
Whey, sweet, powder (1 oz, 28 g) 220
Cheese, cottage, cream, neufchatel (2.5 oz, 70 g) 60

NON-DAIRY

CALCIUM (mg)

Meat, Fish

Sardines, Atlantic, with bones (1 can, 92 g) 350
Canned mackerel and salmon (pink, chum, sockeye) with bones (1 can, 92 g) 200-250
Crabs, cuttlefish, shrimps, canned (3 oz, 85 g) 100-150
Carp, burbot, herring, trout (3 oz, 85 g) 50-80

Cereals

Granola bar (60 g) 200
Bread, wheat, white or whole-grain (2 small slices, 60 g) 40-80

Vegetables, Beans

Radishes, oriental, dried (1/2 cup, 60 g) 360
Lambsquarters (1/2 cup, 90 g) 230
Taro (1 cup, 137 g) 200
Blackstrap molasses (1 tbsp, 20 g) [42] 170
Amaranth leaves, collards, turnip greens (1/2 cup, ~80 g) 120-135
Soybeans, green, boiled (1/2 cup, 90 g) 130
Cowpeas (1/2 cup, 100 g) 100
Tempeh (1/2 cup, 80 g) 90
Chinese cabbage, bok choi; kale, Scotch; okra (1/2 cup, ~80 g) 70-85
Carrots, boiled (1/2 cup, 75 g) 50

Nuts, Seeds

Almond milk (1 cup, 237 mL) 450
Chia seeds (1 oz, 28 g) 180
Chestnuts, Japanese, dried (1 cup, 150 g) 110
Sesame seeds (1 tbsp, 9 g) 90
Almonds (1 oz, 28 g) 80
Coconut water (1 cup, 237 mL) 60

Fruits

Figs, dried (1/2 cup, 75 g) 120
Kiwi fruit, orange, prickly pear (1 fruit or 1 cup) 70
Prunes (1/2 cup, 60 g) 50

Water

Mineral water (1 cup, 237 mL) [4] 0-130
Tap water (1 cup, 137 mL) [5] 0-35

EXAMPLES OF CALCIUM-FORTIFIED FOODS AND JUICES

CALCIUM (mg)
Cereals, ready-to-eat (1 cup, prepared with water) 100-1,000
Tofu with calcium sulfate (1 block, 80 g) 550
Formulated bar (55 g) 530
Milk (1 cup, 237 mL) 500
Cornmeal, self-rising (1 cup, 237 mL) 500
Bread, wheat, white, fortified (2 small slices, 60 g) 400
Orange juice (1 cup, 237 mL) 350
Fruit or vegetable juice, soy milk, rice drink (1 cup, 237 mL) 200-350
Cocoa powder (1 packet, 15 g) 200
English muffin with calcium propionate (57 g) 100

Chart 2. source: US Department of Agriculture (USDA.gov) [3] 

What is calcium from foods good for?

Osteoporosis

Adequate calcium intake along with physical activity throughout life may reduce the risk of osteoporosis at old age [6]. The bone mineral density (BMD) increases until about 30 years of age and then starts to decline slowly. The higher the calcium intake until 30, the higher the peak bone density after 30 [6].

Kidney Stones

In 2 systematic reviews (2009, 2013), researchers have found only a weak association between high calcium intake and reduced risk of kidney stones [67,68].

Some studies suggest calcium supplements in doses greater than 1,000 mg/day, especially when taken with vitamin D, but not calcium from food, can increase the risk of kidney stones [6,30]. In two systematic reviews from y. 2008 and 2012, researchers have found no association between calcium supplements and kidney stones, though [47,48].

High Blood Pressure

In the 1996 DASH feeding study, high calcium diet including fruits and dairy (~1,200 mg Ca/day) for 8 weeks resulted in a decrease of the upper (systolic) blood pressure in individuals with high blood pressure by up to 11.5 mm Hg more than a control diet low in fruits and dairy (~400 mg Ca/day) [1].

In one 2012 systematic review of studies, high intake of low-fat dairy was associated with 16% decrease, and high intake of cheese (high-fat dairy) with no significant decrease of high blood pressure [14].

From these studies, it is still not clear, was it calcium or some other food ingredient that was associated with decreased blood pressure.

Tooth Decay

In one 1994 study in 65-87 years old women, higher calcium intake was associated with less dental caries [36].

Health Effects of Hard Water

Hard water contains high amounts of calcium and/or magnesium. For some individuals, especially vegans, who may get little calcium from food, hard water can be a convenient source of calcium. Bottled mineral waters are usually harder than tap water and this is usually harder than most bottled “plain” waters.

According to World Health Organization (WHO), water hardness has neither beneficial or harmful effects on health [62].

Can consuming too much calcium be bad for you?

The Institute of Medicine in the U.S. has set the Tolerable Upper Intake Level (UL) for calcium–the intake (from foods and supplements) unlikely to cause adverse effects in most healthy individuals 1 year or more of age–at 2,000-3,000 mg/day [1].

Men: Prostate Cancer

In several, but not all studies, high calcium intake (>1,000 mg/day) from either foods or supplements, and high dairy intake were associated with increased risk of prostate cancer [1,50]. Until more is known, Linus Pauling Institute in the U.S. recommends men to limit calcium intake to 1,000-1,2000 mg/day [1].

In one 2013 systematic review, researchers have found no convincing association between high calcium intake and other types of cancer (breast, lung, colorectal, endometrial) [15].

Coronary Heart Disease and Heart Attack

Results of studies of calcium intake on heart disease are controversial. In one study in women, high calcium intake (>1,400 mg/day) was associated with increased and in another study with decreased mortality due to heart disease [6], but one 2012 review of studies has found no association between calcium intake and coronary heart disease [59].

A Low-Calcium Diet

If you have a chronic kidney disease and tend to have elevated blood calcium levels, your doctor may recommend you to decrease calcium intake by eating more low-calcium foods and limit, but not necessary completely avoid, calcium-rich foods.

Low-calcium diet is NOT recommended to individuals with increased risk of calcium kidney stones [44,47].

Chart 4. Low-Calcium and Calcium-Free Foods

FOOD CALCIUM (mg)
Kale, squash, winter (1/2 cup, 65 g) 45
Legumes: beans, lentils, peas (1/2 cup) 20-35
Broccoli (1/2 cup, 40 g) 30
Nuts: hazelnuts, macadamia, peanuts, pistachios, walnuts (1 oz, 28 g) 20-30
Meats: beef, chicken, lamb, pork, turkey, veal (3 oz, 85 g) 10-30
Fruits: apple, apricot, banana, blackberries, currants, cherries, elderberries, grapes, mango, peach, pear, pineapple, raspberries, strawberries (1 serving = berries: 1/2 cup, other: 1 cup or 1 fruit) 10-30
Potato, sweet potato, yam (1 cup, 160 g) 10-30
Sunflower seeds (1 oz, 28 g) 25
Egg (50 g) 25
Rice, white or brown, regular or parboiled; pasta: macaroni, spaghetti (1 cup, 150 g) 20
Tilefish, mackerel without bones (3 oz, 85 g), oyster, tuna (1 can, 92 g) 5-20
Bulgur, buckwheat, couscous, millet (1 cup, 170 g) 5-20
Tomato  (150 g), lettuce (1 cup), lemon (60 g), raisins (1 oz, 28 g) 15
Butter, coconut meat, honey, jam, margarine, oils, table sugar, vinegar (1 tbsp, 15-20 g), cornmeal, cornflakes, popcorn, distilled alcohol beverages, sausages, tea (ice, green, herbal, black) (1 serving) 0-5

Chart 4. source: US Department of Agriculture (USDA.gov) [3] 

Calcium Absorption and Excretion

Most of calcium is absorbed in the small intestine [6,65]. Oxalic acid (oxalate) found in spinach and rhubarb, and phytic acid (phytate) in dried beans and wheat bran inhibit calcium absorption, so these foods are not good sources of calcium [1]. Calcium from kale [60] and soybeans [63] is absorbed well. Most of calcium absorbed in excess of body needs is excreted with the urine [65]. Only small amounts of calcium are lost with sweat [64].

Normal Blood Calcium Levels Range

Normal blood calcium level range for adults is 8.6-10.2 mg/dL or 2.15-2.55 mmol/L [7].


Calcium Deficiency and Low Blood Calcium Levels (Hypocalcemia)

Calcium deficiency refers to low calcium stores in the body and may or may not lead to low blood calcium levels (hypocalcemia). About 1,000 grams (1 kg) of calcium is stored in the adult body, mainly in bones [52]. When you consume little or no calcium, calcium is resorbed from the bones into the blood, so the blood calcium levels do not fall, but in long-term calcium deficiency, the bones can become porous (osteoporosis).

Who is at risk to develop calcium deficiency?

  • Women after menopause who have low estrogen levels are at increased risk of osteoporosis.
  • Female athletes with anorexia nervosa and absent menstruation (amenorrhea) who have low estrogen levels are at increased risk of osteoporosis.
  • Vegans
  • Young alcoholics. Alcohol abuse in adolescence and young adulthood can affect calcium metabolism and increase the risk of osteoporosis later in life [6,23].

Hypocalcemia means blood calcium levels lower than 8.6 mg/dL. A short-term low dietary calcium intake (days/weeks) does not likely result in low blood calcium levels in healthy people.

What can cause calcium deficiency or low blood calcium levels?

  • Hyperventilation, for example, due to anxiety or strenuous exercise, can result in transient hypocalcemia that is not detected by a blood test when you are not hyperventilating [56].
  • A disorder of the parathyroid glands resulting in parathormone deficiency (hypoparathyroidism)
  • Vitamin D deficiency
  • Acute pancreatitis, acute kidney failure
  • Celiac and Crohn’s disease, surgical removal of the stomach (gastric bypass, bariatric surgery) [8], small intestinal bacterial overgrowth (SIBO)
  • Chronic alcoholism and anorexia nervosa
  • Spread of the cancer to the bones
  • Very low blood magnesium level (hypomagnesemia)
  • Thyroid disease
  • Surgical removal of overactive parathyroid glands
  • Medications: amphotericin B, cinacalcet, cisplatin, enemas (sodium phosphate), estrogens, fluoride, foscarnet, gentamicin, phenobarbital, steroids, zoledronic acid, laxatives abuse (mineral oil, senna), long-term use of gastric acid-lowering drugs (cimetidine, omeprazole, aluminium and magnesium antacids) reduce calcium absorption [1,6].

Symptoms

  • ACUTE: numbness and tingling in the fingers, toes and around the mouth (paresthesia), lightheadedness, excessive bleeding, stiffness and cramps in the legs (calves), spasms in the feet changed voice, muscle twitching [69], constipation, seizures, abnormal heart rhythm (arrhythmia) or even death
  • CHRONIC: dry and itchy skin

Signs

  • In chronic hypocalcemia: dry skin and hair, psoriasis, brittle nails, cataracts, memory loss (dementia)

Treatment of hypocalcemia includes calcium supplements and treatment of the underlying disorders.

Rickets and Osteoporosis

  • In children, long-term calcium deficiency with or without vitamin D deficiency can result in poor calcium mineralization of bones ─ soft bones or rickets.
  • In adults, calcium deficiency can result in low bone density ─ osteoporosis.
  • References: [33]

Dental Fluorosis

Low dietary calcium and high fluoride intake, mainly by drinking water high in fluoride, can result in teeth discoloration (dental fluorosis).

Sources: Emedicine [9,10]

Calcium Supplements

Types of Oral Calcium Supplements Without Prescription (Over-The-Counter)

  • Calcium carbonate can be used as a calcium supplement or antacid.
    • “Coral calcium” or “marine calcium” supplements are derived from coral reefs and contain calcium carbonate and magnesium. In one small study in Japan, coral calcium carbonate was better absorbed than regular calcium carbonate [39], but there is no scientific evidence about its superiority over other calcium supplements.
    • “Bio-calcium” obtained from pearl shells contains calcium carbonate, which is, according to few studies, no more effective than calcium carbonate from other sources [41].
    • “Rock calcium” is a general term for inorganic calcium derived from limestone. Calcium carbonate and citrate are examples of rock calcium.
  • Calcium citrate and citrate malate are appropriate for individuals with low gastric acid and increased risk of kidney stones.
  • Calcium magnesium citrate is a calcium and magnesium supplement.
  • Calcium lactate and gluconate are highly soluble but bulky, so they are mostly used as powders for solutions.
  • Calcium phosphate is usually available in combination with vitamin D3.
  • Calcium oxide (“lime”) and hydroxide (“slaked lime”) are sometimes used in multivitamin/mineral supplements and rarely, for example in Japan, as individual supplements, which are produced from oyster shells. They are more alkaline than other calcium supplements.
  • In calcium orotate, calcium is combined with orothic acid, in calcium D-glucarate with glucaric acid, in calcium osporotate with aspartic, orothic and citric acid, in calcium amino acid chelates with hydrolyzed vegetable protein and in calcium AEP with amino ethanol phosphate. These supplements are often advertised to have greater bioavailability, but they have not been proven to be more effective than other calcium supplements.
  • Calcium hydroxiapatite is derived from bovine bones.
  • References: [6]

Available oral forms: tablets, capsules, chews, powder and liquids.

Chart 5. Calcium carbonate vs calcium citrate

PROPERTIES CALCIUM CARBONATE CALCIUM CITRATE
Uses Calcium supplement, antacid (tums) Calcium supplement
Amount of elemental calcium 40% (500 mg calcium carbonate contains 200 mg Ca) 21% (500 mg calcium citrate contains 105 mg Ca)
Recommended intake With foods With or without foods
Absorption in low gastric acid (achlorhydria, hypochlorhydria) Poor Good
Short-term side effects Constipation, bloating Less side effects than calcium carbonate
Risk of kidney stones with long-term use Possibly No

Chart 5. sources: [6,34,35]

Calcium Injections

In severe hypocalcemia, your doctor can give you an injection of calcium gluconate or chloride into a vein. These two supplements can be also used as antidotes to prevent adverse effects of hyperkalemia on the heart muscle but not to treat hyperkalemia itself [40].

Dosage

To treat calcium deficiency, a typical dose is 1 gram (1,000 mg) of elemental calcium per day [6]. It is your doctor who can prescribe the dose appropriate for you.

To know how much calcium you get from supplements you should check milligrams of elemental calcium, not milligrams of the the whole calcium compound.

Chart 6. Elemental Calcium

CALCIUM SUPPLEMENT ELEMENTAL CALCIUM (mg of calcium in a 500 mg pill)
Ca oxide 71% (355 mg)
Ca hydroxide 54% (270 mg)
Ca carbonate 40% (200 mg)
Ca phosphate, tribasic 38% (190 mg)
Ca chloride 27.2% (136 mg)
Ca acetate 25.3% (126.5 mg)
Ca phosphate, dibasic 23% (115 mg)
Ca citrate 21% (105 mg)
Microcrystalline hydroxyapatite  (MH) 20% (100 mg)
Calcium chelates: orotate, aspartate (about 100 mg)
Ca lactate 13% (65 mg)
Ca gluconate 9.3% (46.5 mg)
Ca gluceptate 8.2% (41 mg)
Ca glubionate 6.5% (32.5 mg)

Chart 6. source: Globalrph.com (54), producers

Absorption and Bioavailability of Supplemental Calcium

Calcium is optimally absorbed when taken in doses up to 500 mg elemental calcium at once [6]. You can divide larger doses in half for better absorption.

Different calcium supplements are probably absorbed equally well and have about the same bioavailability. Unlike other supplements, calcium citrate and calcium citrate malate are absorbed well on an empty stomach and in low gastric acid (achlorhydria, hypochlorhydria) [6]. Calcium phosphate is less well absorbed, because phosphate binds to calcium in the gut and inhibits its absorption [26].

Possible Calcium Supplements Benefits

Calcium supplements are EFFECTIVE for:

  • Prevention and treatment of calcium deficiency
  • Preventing irregular heart rhythm in hyperkalemia (intravenous injection) [40]
  • Lowering high phosphate levels in kidney failure
  • Reducing gastroesophageal reflux and heartburn (calcium carbonate)

Calcium supplements are LIKELY EFFECTIVE for reducing thyroid hormone levels in people with a kidney failure

Calcium supplements MAY BE EFFECTIVE (low evidence or only slight effect):

  • When taking along with vitamin D:
    • For prevention of bone fractures in men after 65 and women after menopause with osteoporosis [18,43], and for prevention of bone loss in individuals who take steroids [31].
    • For prevention of fluoride poisoning in children.
  • When taking along with a low-fat or low-calorie diet: for reducing blood cholesterol levels.

Other sources: Linus Pauling Institute [1], Natural Medicines Comprehensive Database [16]

There is INSUFFICIENT EVIDENCE about calcium supplements effectiveness for preventing colorectal, prostate or other cancer, dental caries (tooth decay) [37,38], heart disease, high blood pressure [49], high blood pressure in pregnancy (pre-eclampsia), Lyme disease, metabolic syndrome, osteoporosis (in individuals who do not already have osteoporosis) [25], pregnancy-related leg cramps, diabetes, premenstrual syndrome (PMS), seizures, stroke or for promoting weight loss. Other references: [16,45,46].

Calcium supplements are POSSIBLY INEFFECTIVE for preventing breast cancer in postmenopausal women [16].

Calcium Supplements Safety: Side Effects, Toxicity

The Upper Tolerable Intake Limit (UL) for calcium–the intake unlikely to cause side effects in most healthy people–is: for 0-6 months: 1,000 mg/day; for 7-12 months: 1,500 mg/day; for 1-8 years: 2,500 mg/day; for 9-18 years: 3,000 mg/day; for 19-50 years: 2,500 mg/day and for 51 years and older: 2,000 mg/day [1].

Side effects of calcium supplements include constipation and bloating [6]. Injection of calcium chloride can irritate the veins or muscles [55].

Certain calcium supplements derived from bone meal, dolomite or oyster shells contain small amounts of lead, but calcium inhibits lead absorption in the gut, so the actual harm of lead is probably lower than the benefit from calcium supplements [1,29].

During Pregnancy

According to the U.S. Food and Drug Administration (FDA), pregnancy categories for calcium supplements are:

  • “Not classified” for calcium carbonate, glubionate, phosphate
  • Category C, which means harmful effects for the babies have been not proven but can not be excluded due to lack of human trials: calcium acetate, citrate, chloride, gluconate, lactate
  • Source: Drugs.com: 17

High Blood Calcium Levels (Hypercalcemia)

Hypercalcemia means blood calcium higher than 10.5 mg/dL. High calcium intake from foods, water or supplements does not likely cause hypercalcemia in healthy individuals.

What can cause high blood calcium levels?

  • Increased blood parathormone (PTH) level (hyperparathyroidism) due to a parathyroid tumor (adenoma) or other parathyroid gland disorder
  • Cancer, especially bone metastases, and rare tumors called VIPomas
  • Conditions that increase bone resorption or intestinal calcium absorption: prolonged immobilization, Paget’s disease, multiple myeloma, sarcoidosis, tuberculosis, systemic fungal infection, AIDS, advanced liver disease
  • Kidney failure combined with high doses of calcium supplements (>2 g elemental Ca/day) or consumption of large amounts of milk, which can result in milk-alkali syndrome. If not recognized, milk-alkali syndrome may lead to kidney calcification and failure or even death.
  • Vitamin D in doses exceeding 50,000 IU/day, calcium exceeding 2 g calcium/day, high doses of vitamin A, lithium, theophylline, thiazide diuretics (chlorothiazide), calcipotriene (calcipotriol), parathormone (PTH), calcium-based phosphate binders, estrogens

Symptoms: nausea, constipation, depression, weakness, muscle or joint aches, frequent urination, headache and, in severe cases, coma or death.

Treatment may include rehydration, diuretics and treatment of the cause.

Calcium Deposits

Calcium deposits, calcification or calcinosis means buildup of calcium or calcium-phosphate crystals in the body organs and their damage. Diet high in calcium does not likely cause calcium deposits [53]. Main causes include cancer, chronic hypercalcemia and hyperphosphatemia, especially in chronic kidney failure, high doses of calcium supplements (>2 g elemental Ca/day), sarcoidosis, tuberculosis, scleroderma and genetic or autoimmune processes.

Sources: Emedicine: [11,12,13] 

Calcium-Nutrients Interactions

  • Oxalate in spinach, rhubarb, beet greens, Swiss chard and beans can decrease calcium absorption from these foods, but not likely from other foods [6,19]. On the other hand, calcium reduces absorption of oxalate thus possibly reducing the risk of calcium-oxalate kidney stones.
  • Phytates in seeds, nuts and wheat bran can decrease calcium absorption from these and other foods [20].

Frequently Asked Questions

1. Do vegans need to take calcium supplements?

Not necessary. Bread and calcium-enriched foods are good sources of calcium.

2. Which calcium supplements are vegan?

Most calcium supplements are vegan. Calcium lactate (E327) is usually derived from non-animal sources and only occasionally from whey, so it is “typically vegan.” Non-vegan supplements are calcium caseinate, stearate and hydroxyapatite, and supplements derived from bone meal, bone flour and shellfish shells [32].

3. Does caffeine causes calcium deficiency?

Caffeine slightly decreases calcium absorption but it is not clear if this has any importance for health [6,16,22,24].

  1. Calcium facts: functions, supplements effects  Linus Pauling Institute
  2. Dietary Reference Intakes  Institute Of Medicine
  3. List of foods containing calcium  US Department of Agriculture
  4. Mineral waters calcium and magnesium content  PubMed Central
  5. Tap water calcium content PubMed Central
  6. Calcium function, sources, hypocalcemia, hypercalcemia, supplements  Office of Dietary Supplements
  7. Calcium blood test  Labtestsonline
  8. Nutrient deficiencies after bariatric surgery  Endojournals
  9. Small intestinal bacterial overgrowth and hypocalcemia  Emedicine
  10. Hypocalcemia  Emedicine
  11. Hypercalcemia  Emedicine
  12. Milk-alkali syndrome definition  Emedicine
  13. WDHA syndrome  Emedicine
  14. A systemic review of elevated blood pressure and consumption of dairy foods  Journal of Human Hypertension
  15. Calcium intake and health maintenance  Foodandnutritionresearch.net
  16. Calcium supplements benefits, side effects  Natural Medicines Comprehensive Database
  17. Calcium supplements pregnancy categories  Drugs.com
  18. Calcium and vitamin D in treatment of osteoporosis  PubMed Central
  19. Oxalate and calcium absorption  The American Journal of Clinical Nutrition
  20. Phytates and calcium absorption  Arizona Cooperative Extension
  21. Calcium decreases the absorption of heme ad nonheme iron  The American Journal of Clinical Nutrition
  22. Caffeine and osteoporosis  Drugs.com
  23. Alcohol and osteoporosis  National Institute of Alcohol Abuse and Alcoholism
  24. The effects of caffeine on bone  PubMed
  25. Vitamin D and calcium supplementation to prevent fractures  The U.S. Preventive Services Task Force
  26. Effects of calcium phosphate supplements on blood phosphate and calcium levels  Nutrition Journal
  27. Calcium and vitamin D3 supplements in elderly Annals of Internal Medicine
  28. Diuretics and calcium homeostasis  UpToDate
  29. Calcium supplements benefits and risks  Medscape
  30. Effect of a combination of calcium and vitamin D supplements on kidney stones  PubMed
  31. Calcium and vitamin D supplements to prevent osteoporosis during corticosteroid therapy  PubMed
  32. Vegan supplements  The Vegetarian Resource Group
  33. Calcium and vitamin D deficiency and risk of rickets  The American Journal of Clinical Nutrition
  34. The health benefits of calcium citrate malate  PubMed
  35. Strategies for prevention of calcium oxalate stones  PubMed Central
  36. Lifestyle and sociodemographic factors as determinants of blood lead levels in elderly women  PubMed
  37. Dietary factors [calcium phosphate or dicalcium phosphate dihydrate] in the prevention of dental caries  PubMed
  38. Long-term remineralizing effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on early caries lesions in vivo  PubMed
  39. Coral calcium carbonate absorption  PubMed
  40. Calcium gluconate and chloride in hyperkalemia  PubMed Central
  41. Bio-calcium from pearl shells  PubMed
  42. Blackstrap molasses  Indobase.com
  43. Vitamin D and fractures due to osteoporosis in elderly  Cochrane
  44. Dietary intervention in idiopathic hypercalciuria  Cochrane
  45. Calcium, magnesium and potassium supplements effect on primary hypertension  Cochrane
  46. Calcium and stroke  Cochrane
  47. Calcium supplementation and incident kidney stone risk  PubMed
  48. Calcium supplements and risk of kidney stones in treatment of osteoporosis  PubMed
  49. Calcium supplements and high blood pressure  PubMed
  50. Calcium Intakes and Prostate Cancer Risk  Journal of The National Cancer Institute
  51. EU approved food additives with E-numbers  Food Standards Agency
  52. Calcium metabolism in health and disease  Clinical Journal of the American Society of Nephrology
  53. Calcium deposits in soft tissues  Harvard.edu
  54. Elemental calcium GlobalRPh
  55. Calcium chloride vs gluconate for injection  Institute for Safe Medication Practices
  56. Moon HS et al, Hypocalcemia and hypokalemia due to hyperventilation syndrome in spinal anesthesia -A case report  PubMed Central
  57. Treatment of hypomagnesemia with hypocalcemia  Emedicine
  58. Calcium/magnesium intake ratio  PubMed Central
  59. Calcium intake and risk of cardiovascular disease  PubMed
  60. Calcium absorption from kale  The American Journal of Clinical Nutrition
  61. Health effects of hard water  PubMed Central
  62. Hardness in drinking water  World Health Organization
  63. Soybean phytate content: the effect on calcium absorption  The American Journal of Clinical Nutrition
  64. Calcium loss in sweat  PubMed
  65. Calcium  US Department of Agriculture
  66. Protein intake, calcium balance and health consequences  European Journal of Clinical Nutrition
  67. Diet, fluid and supplements for prevention of nephrolithiasis  PubMed Central
  68. Recurrent nephrolithiasis in adults: comparative effectiveness of preventive medical strategies  Agency for Health Research and Quality
  69. Hypocalcemia – infants  MedlinePlus

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