important menopause information
The Journal of the American Heart Association published an article in October, 2016, that indicated that use of calcium supplements may increase the incidence of coronary artery calcifications. This wasn't the first study that questioned whether use of calcium supplements actually helped your bones, which was the purpose, or ended up in unwanted places like the vessels of the heart or in the kidney as stones. The article received significant press coverage, and many patients stopped their calcium supplements.
After studying many articles, I realize the controversy has been going on for a decade or more. Some studies actually found that those who took the highest dose of calcium in both food and supplements had the lowest risk of cardiovascular disease.
My search led me to a presentation by Dr. Andrea Singer from Georgetown who looked at the studies and put them in perspective. She evaluated the literature since 2008 and noted some problems with trying to get data. Studies on dietary supplements are difficult when looking at diseases that take a very long time to develop, such as heart disease and osteoporosis. The studies showed conflicting data, with some studies demonstrating a benefit, and others, an increased risk of cardiac disease. Interesting, is that women noted to have a lower bone density also had an increased risk of cardiovascular disease. So maybe the calcium supplement matters not at all.
Finally, the National Osteoporosis Foundation and the American Society for Preventive Cardiology came together to produce this policy statement:
“There is moderate-quality evidence (B level) that calcium with or without vitamin D intake from food or supplements has no relationship (beneficial or harmful) to the risk for cardiovascular and cerebrovascular disease, mortality, or all-cause mortality in generally healthy adults.” • “In light of the evidence available to date, calcium intake from food and supplements that does not exceed the tolerable upper level of intake (defined by the National Academy of Medicine as 2000 to 2500 mg/d) should be considered safe from the cardiovascular standpoint."
Obtaining calcium from food sources is preferred. • Supplemental calcium can be safely used to make up any shortfall in dietary intake. • Discontinuation of supplemental calcium for safety reasons is not necessary and may be detrimental to bone health in situations where intake from food is suboptimal • Aim to reach, but not exceed, recommended intakes.
The recommended dose for women <50 is 1000 mg per day, >50 is 1200 mg/day.
For a more complete discussion of the effects of calcium in the body, and a list of foods that contain calcium, look for the tab "Calcium" in the MORE section of this site.
M. Jerome, MD