Calcium citrate & elemental calcium

Posted by bdhop @bdhop, Jul 14, 2023

Hi, I was newly diagnosed with osteoporosis. My doctor told me to start taking 1200 mg of calcium. I started with calcium citrate 600 mg, w/ 2 pills, so that I could divide the pills throughout the day for better absorption. I am also taking vitamin D and vitamin K2. I take both of those separately. It is very difficult to find calcium carbonate without vitamin D already in it. I am taking 1000 vitamin D and 100 of vit K2. This is my dilemma and I have spent countless hours and up way too late at night doing research on nutrition, vitamins, minerals, absorption, interactions, etc!!!! Back to the point, I was under the misconception that I was getting 600 mg of calcium citrate out of my two pills. However my new understanding after speaking with two pharmacist and reading a lot of articles states that I’m actually only getting 21% of that 600 mg which means out of two pills I’m only getting 126 mg of calcium. So how can I reach 1200 mg or even 900 mg without taking 16 pills or more???!!! Am I way off? I thought the supplemental label fact sheet stated the actual amount of elemental calcium in the pill. But the pharmacist told me that is not correct. Calcium citrate is 21% elemental calcium which means the rest of it is just filler. Can anyone give me insight into this?

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@bdhop Welcome to Mayo Connect, where you can talk directly to people with questions just like yours. A few years ago, I asked this very same question of my friends' daughter, a nutritionist who did research on supplements.
What she explained was enlightening - no matter what you take in, through food or supplement, only a portion is used by your body, and the rest is excreted. Even when you take 500 mg of amoxycillin, for example, not all 500 mg stays in your body to fight infection, a portion is lost. When dosages are calculated, or RDA's are established, the amount accounts for that which the body absorbs as well as that which is lost.
I hope this sets your mind at ease - the doctor was talking about what he wants you to ingest, not what will stay in your body. And just like anything else, more calcium isn't necessarily better. Here is what Cleveland Clinic has to say about too much:
https://health.clevelandclinic.org/too-much-calcium-supplements/

I hope this reassures you that you don't need to walk around all day eating calcium supplements like they were peppermints!
Sue

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@sueinmn

@bdhop Welcome to Mayo Connect, where you can talk directly to people with questions just like yours. A few years ago, I asked this very same question of my friends' daughter, a nutritionist who did research on supplements.
What she explained was enlightening - no matter what you take in, through food or supplement, only a portion is used by your body, and the rest is excreted. Even when you take 500 mg of amoxycillin, for example, not all 500 mg stays in your body to fight infection, a portion is lost. When dosages are calculated, or RDA's are established, the amount accounts for that which the body absorbs as well as that which is lost.
I hope this sets your mind at ease - the doctor was talking about what he wants you to ingest, not what will stay in your body. And just like anything else, more calcium isn't necessarily better. Here is what Cleveland Clinic has to say about too much:
https://health.clevelandclinic.org/too-much-calcium-supplements/

I hope this reassures you that you don't need to walk around all day eating calcium supplements like they were peppermints!
Sue

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Sue, thank you for the info! My mind has not been at ease for 4 months.., but I’m adjusting. It’s confusing because if I take calcium carbonate it has 40% elemental calcium, so I would be getting 480mg out of the 1200mg pills??? Would I benefit more from the carbonate?

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@bdhop

Sue, thank you for the info! My mind has not been at ease for 4 months.., but I’m adjusting. It’s confusing because if I take calcium carbonate it has 40% elemental calcium, so I would be getting 480mg out of the 1200mg pills??? Would I benefit more from the carbonate?

Jump to this post

It has been a while since I studied this issue, but my PCP told me Calcium Citrate is absorbed better than Calcium Carbonate, so the effect would be similar.
Sue

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Aside from calcium, we also need minerals. Our bones are not just calcium. It’s more complex. But doctors only focus on calcium and don’t talk about minerals needed or the foods we should consume. I recently learned this and my doctor recommended Trace Mineral Drops, no prescription needed.

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I take Citracal. I take 2 pills in the morning but will now try spreading them out. I wanted to take Algae cal but it is too expensive. I’m wondering if it’s worth it to continue Citracal.
Thank you

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Citracal and Algaecal are completely different forms of calcium. Citracal is made from rock, Algaecal from seaweed which is a food source. Take a look at how each is made and how absorbable they are. Algaecal is expensive but the benefits outweighed the cost for me as I do not want to go on any biophosphates.

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You may want to read this long but informative article on myths re calcium dissolution and absorbability. Calcium is calcium. How it works is a function of trace minerals. Of course Algaecal is pushing their product but not on the calcium basis.

https://www.algaecal.com/calcium-supplement/absorption/?ph=gads-bbp&campaignid=20327604380&adgroupid=150361077586&adid=664259579203&gad=1&gclid=Cj0KCQjwzdOlBhCNARIsAPMwjbx9m1Hn3HQDZDjSOz9YuiJnSmP7f_eUYBNM4OOp9oggmh8Lznhb7ZAaAq21EALw_wcB
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@patjack2

I take Citracal. I take 2 pills in the morning but will now try spreading them out. I wanted to take Algae cal but it is too expensive. I’m wondering if it’s worth it to continue Citracal.
Thank you

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AlgaeCal is a form of calcium carbonate, promoted by its producer as superior because it comes from seaweed and thus is more absorbable, and contains trace minerals. AlgaeCal also includes Strontium in some of its formulas, which is controversial in the treatment of osteoporosis.

There have been no published independent studies yet that compare AlgaeCal, CitraCal, and other calcium supplements in matched populations over a period of years.

I use a generic Calcium Citrate supplement from a reliable source with magnesium, zinc & D3 as was recommended by my primary over 30 years ago. At age 72, with familial risk, my DEXA scans have remained stable for over 10 years.

I think you should talk to your provider if you are confused, but continue to take an affordable Calcium supplement as well as maintaining a healthy diet, and doing weight-bearing exercises to keep your bones as strong as possible.
Sue

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According to AlgaeCal, their calcium is not more absorbable per se. It is the other ingredients that allow the body to use it more efficiently.

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@sueinmn

@bdhop Welcome to Mayo Connect, where you can talk directly to people with questions just like yours. A few years ago, I asked this very same question of my friends' daughter, a nutritionist who did research on supplements.
What she explained was enlightening - no matter what you take in, through food or supplement, only a portion is used by your body, and the rest is excreted. Even when you take 500 mg of amoxycillin, for example, not all 500 mg stays in your body to fight infection, a portion is lost. When dosages are calculated, or RDA's are established, the amount accounts for that which the body absorbs as well as that which is lost.
I hope this sets your mind at ease - the doctor was talking about what he wants you to ingest, not what will stay in your body. And just like anything else, more calcium isn't necessarily better. Here is what Cleveland Clinic has to say about too much:
https://health.clevelandclinic.org/too-much-calcium-supplements/

I hope this reassures you that you don't need to walk around all day eating calcium supplements like they were peppermints!
Sue

Jump to this post

I have the same concerns. My Doctor suggested that I should take 1,000 mg. of Calcium as a supplement each day. I know that mg. is a measurement of mass, and that a pure mg. of Calcium Citrate vs a pure mg. of Calcium Carbonate contains different amounts of Elemental Calcium (which is what my doctor is prescribing).
Is the amount of calcium that is printed on the supplement's label, the amount of Elemental Calcium or the amount (mass) of Calcium Citrate or Calcium Carbonate?

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