When it comes to building strong bones, which calcium is best?

July 5, 2017

Calcium and vitamin D work together! Calcium Citrate is best!

Welcome to Be Healthy! Be Happy! College of Bone Health – Bone Health 101.

Strong bones and teeth depend upon abundant dietary calcium and vitamin D. In fact, calcium is the major constituent of bones and teeth and vitamin D is essential for intestinal absorption of calcium and its metabolic maintenance throughout our bodies. Absent these two important constituents, bones can become weak and brittle leading to conditions like osteoporosis and what we call fragility or frailty fractures.

Apart from salmon, mackerel and fortified foods like milk and cereals, the primary source of vitamin D is ultraviolet light or sunshine. Since most of us don’t get enough of that, fortification with vitamin D supplements is essential to avoid deficiency. Experts estimate that as many as 1 billion people are deficient in vitamin D worldwide!

The recommended dietary allowance for vitamin D is 600 international units. The Linus Pauling Institute at Oregon State University recommends supplementing with at least 400 international units of vitamin D3 daily.

Dietary sources of calcium include tofu, yogurt, cheddar cheese, white beans and kale. The recommended dietary allowance for calcium is 1000 mg daily in adults aged 18 to 70 and 1200 milligrams daily for pregnant women and adults aged 70 years or older.

Patients often ask me which calcium supplement is best – calcium carbonate, calcium gluconate or calcium citrate? Calcium carbonate is generally the most economical, but must be taken with food, which can complicate things. Calcium citrate may be taken without regard to meals and is preferred in people who lack stomach acids or those who take medications like Zantac and Nexium or Prilosec.

Here’s another fun fact! Supplements containing more than 500 mg of calcium should be avoided in order to maximize absorption of this essential mineral.

So, you ask again, what’s my recommendation: calcium citrate combined with vitamin D taken at least two, but preferably three times daily.

This is Dr. Jim for Be Healthy! Be Happy! hoping this message powers your path to happiness!


Oregon State University Linus Pauling Institute Micronutrient Information Center. Online [available at]: http://lpi.oregonstate.edu/mic

Holick MF: Vitamin D deficiency. N Engl J Med 2007; 357(3): 266-81.