Calcium Citrate vs Calcium Carbonate
Most of us have probably heard about calcium. Some of us may associate calcium with milk. Some of us grew up being told that drinking milk helps us be healthy and tall. So why is it important to take enough calcium, and how can I get enough calcium? This article will go over why calcium is essential and compare the differences between two of the most popular versions of calcium supplements: calcium citrate vs. calcium carbonate.
What is Calcium?
Calcium is one of the essential minerals. It is not something that our body can make and must be ingested in our diet. One of the most well-known roles of calcium is maintaining strong bones and teeth. But calcium’s role is not limited to just that. Calcium also has essential roles in heart function, muscle contraction, and nerve transmission. These later functions are must-have functions of the body. Our heart needs to beat properly. Our muscles need to move correctly. Our nerve is essential to our body’s sensory and cognitive functions. So whatever calcium we take goes straight toward being used to maintain these important functions.
So, what do you think happens when the body doesn’t get enough from the diet?
Well, calcium still has to come from somewhere. But from where? Well, over 99% of the calcium in our body is in our bones and teeth, and when the body doesn’t get enough from diet, it will draw the needed calcium from the bones. Without calcium, bones can become weak and brittle, making them more susceptible to breakage. This is one of the reasons older adults are more vulnerable to bone breakage when they fall.
In modern-day diets, it can be difficult to ingest recommended amount of calcium. To supplement their diet, people often turn to calcium supplements. Calcium supplements come in various forms: tablets, chewable, and gummies. Today, we will focus on two of the most popular calcium supplement tablets: calcium citrate and calcium carbonate. These two products are available widely, but what are their differences? The answer is absorption, dosage, price, and lactose content.
Absorption
One of the main differences between calcium citrate and calcium carbonate is how our bodies absorb them.
Calcium citrate is absorbed more easily by our bodies. This is due to its chemical property of being able to dissolve easily in water and not have to rely on our stomach acid. This is why calcium citrate does not need to be taken with foods, making it a good option for those who don’t like taking supplements with foods or people with low levels of stomach acid. People with reduced amounts of stomach acid are generally older adults and people with a history of acid reflux or stomach ulcers.
Calcium carbonate is absorbed less easily by our bodies. It requires
acidity to properly be absorbed, which means that it relies on stomach acid to break it down before the body can absorb it. This formulation must be taken with foods. Because of all these, calcium carbonate may not be an ideal candidate for those with low stomach acid levels. However, this is not mean that these people cannot take calcium carbonate because the presence of foods may generate enough stomach acid for this formulation.
I also want to mention that calcium absorption relies on vitamin D. This is why many calcium supplements are already supplemented with vitamin D.
Dosage
From the absorption section, you may think that calcium citrate seems to be a clear winner. But hold your decision just yet. There is a difference between calcium citrate and calcium carbonate when it comes to the amount of total calcium or elemental calcium.
The Institute of Medicine (IOM) recommends a daily intake of 1,000 mg per day for those between 19-50 years, 1,000 mg per day for males between 51-70 years, and 1,200 mg per day for females between 51-70 years.
Calcium citrate supplement tablets generally come in smaller doses compared to calcium carbonate. A couple of factors are a result of this smaller dosage. The first is that multiple tablets are typically in a serving size. The second is the tablet size of calcium citrate tends to be smaller. When talking about elemental calcium, there is 211 mg of elemental
calcium in 1,000 mg of calcium citrate.
Calcium carbonate, in contrast, generally comes in bigger doses. The tablet size of calcium carbonate is usually larger. Usually, only one tablet is needed in each serving size. When talking about elemental calcium, there is 400 mg of elemental calcium in 1,000 mg of calcium carbonate.
Price
Another factor to consider when choosing between calcium citrate and calcium carbonate is cost. Calcium carbonate is often a less expensive option. Calcium citrate supplements are often more costly, but considering they do not require foods or rely on stomach acid, they may be worth the extra cost for some people.
Lactose Intolerance
One of the reasons why people may not get enough calcium is because they are lactose intolerant. Foods with high calcium content, such as milk, yogurt, and cheese, are a big no-no for these people. The good news is that most calcium supplements are dairy. Of course, you should still check the label and make sure that it’s actually lactose-free. Calcium carbonate supplements are likelier to contain lactose or dairy.
How to Take Calcium Supplements
Just remember that if you take calcium carbonate, you should take the tablet with food. Calcium needs to be absorbed slowly. If you are taking more than 500 mg, it is recommended that you divide the dose if possible. The body tends just to eliminate any excess calcium beyond 500 mg so you would not get the full benefit from the supplement.
You should not take more than the daily recommended amount. One of the ways that calcium is eliminated from the body is through the kidney. Excess amounts of calcium may precipitate kidney stones. Always consult your health provider if you have any questions.
Side effects and Medication Interactions
Most people do just fine on calcium supplements. The two most common side effects are constipation and indigestion.
Medications can interfere with calcium absorption. Antibiotics are among the most common medications that may interfere with calcium supplements. Not all of them, but there are definitely some out there.
I want to say again that if you are considering calcium supplementation, you should consult with your healthcare provider, especially if you have any health conditions.
Conclusion
In conclusion, calcium is essential to our health. Calcium must be ingested through our diet, and most of our calcium should hopefully come from there. If you cannot get the recommended daily calcium in, you may consider calcium supplements. Two of the most common are calcium citrate and calcium carbonate. There are some differences between the two, so be mindful of those. Calcium supplements are very well tolerated but may interact with some medications. Consult healthcare professionals if you are considering starting calcium supplements.
As usual, feel free to comment about your experience with calcium supplements or any questions you have. Thank you for your support!
Reference:
1. Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011 Jan;96(1):53-8. doi: 10.1210/jc.2010-2704. Epub 2010 Nov 29. PMID: 21118827; PMCID: PMC3046611.
2. Lexicomp Online, Lexi-Drugs Online. Waltham, MA: UpToDate, Inc.; November 11, 2022. https://online.lexi.com. Accessed February 4, 2023.
