Calcium

Last Updated: May 21, 2025

Calcium is a macromineral that can be obtained through the diet, particularly in dairy products and, to a lesser extent, vegetables. It’s primarily used to support bone health, and there is some evidence that it supports cardiovascular health and women’s health.

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Calcium is most often used for

What is calcium?

Calcium is an essential macromineral, meaning that it's needed in large amounts relative to other minerals. It is arguably the most notable nutrient for bone health.[27][28] Among its various functions in the body, calcium is typically associated with the formation and metabolism of bone.

Over 99% of total body calcium is found in the bones and teeth, predominantly as calcium hydroxyapatite, which is critical for bone structure and strength.[27][28][29] The remaining 1% of bodily calcium resides in extracellular fluids (plasma) or soft tissue, where it aids in cellular signaling.[30][27][28][31]

What are calcium’s main benefits?

Supplementing calcium with vitamin D can reduce the risk of fractures in older adults.[32][33][34] For people under the age of 35, calcium supplementation may still be beneficial in increasing bone mineral density, especially if they have inadequate dietary calcium intake.[7][1]

Calcium supplementation may also be beneficial for cardiovascular health, particularly with regards to reducing blood pressure in all ages.[10][11] The positive effects of calcium supplementation for both blood pressure and bone health can also be seen in individuals who are pregnant or looking to conceive, with added effects that could potentially reduce the risks associated with or prevent gestational diabetes.[18][19][20][21]

Some meta-analyses have also indicated that calcium supplementation could aid in endocrine or metabolic related health as well. In individuals with or at risk of metabolic disorders, calcium appears to modestly reduce BMI, waist circumference, body fat, triglycerides, and total cholesterol.[13][14][15][16] Calcium supplementation in conjunction with vitamin D and metformin, may also improve some signs and symptoms in people who have PCOS.[17]

Does calcium affect bone health?

Does calcium affect cardiometabolic health?

Does calcium affect women’s health?

How does calcium work?

Bone integrity depends on cycles of bone formation by cells called osteoblasts and resorption by osteoclasts. If the cycle falls out of balance toward excessive resorption, conditions like osteoporosis or rickets may occur.[35] During bone formation, osteoblasts lay a foundation for hydroxyapatite crystals to be deposited into, thus hardening the bone structure. In this sense, stored calcium contributes to skeletal integrity, but it may also act as a reserve for release into the bloodstream when needed elsewhere.[2]

Calcium-sensing receptors in the kidneys, thyroid, and parathyroid respond to fluctuating calcium concentrations in an effort to maintain balance.[36] Interestingly, inflammation, particularly interleukin 6 and interleukin 1-beta, is thought to increase the number of calcium-sensing receptors available.[37][38][36] When blood calcium levels get too high, the hormone calcitonin is released by the thyroid, which inhibits calcium uptake and resorption and lowers serum calcium through increased urinary excretion.[2]

Symptoms and severity scores of hypercalcemia

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When blood calcium levels fall too low, parathyroid hormone is released, which signals osteoclasts to release stored calcium from the bone into the system. Parathyroid hormone also influences the kidneys to increase calcium resorption and secrete vitamin D3. Vitamin D3 then enhances intestinal absorption of supplemental or dietary calcium.[2][36] Once free in the system, calcium serves as a cofactor for activities like blood clotting, a trigger for responses like muscle contraction or nerve signals, and a stabilizer of the phospholipids in cellular membranes.[2]

What are other names for Calcium?
Note that Calcium is also known as:
  • Elemental calcium
  • Ca2+
  • Ca
  • Calcium carbonate
  • Calcium citrate
  • Coral calcium
  • Calcium phosphate
  • Calcium gluconate
  • Calcium lactate
Dosage information

Formulation:

Supplemental calcium is usually recommended when dietary calcium is insufficient, and it is most frequently found as calcium carbonate and calcium citrate.[1][2] Forms of calcium supplements that may also be available include calcium phosphate, calcium lactate, calcium gluconate, and coral calcium.[1] Different forms of oral calcium supplements have their own benefits and drawbacks. Coral calcium and calcium citrate, for example, may be better absorbed than calcium carbonate. Calcium carbonate is, on the other hand, less expensive than other forms, making it more accessible.[3][4] Standalone calcium citrate supplements may be more readily used by the body than calcium carbonate. The exception to this seems to be in calcium-fortified foods, where calcium carbonate is absorbed better.[5]

Range of dosages studied:

Current meta-analyses have reported on studies that cover a wide range of calcium supplementation dosages, from a low dose of 162 mg per day all the way up to 7,700 mg per day. In many of these studies, calcium was taken with vitamin D3 ranging from 400 to 1,000 IU per day. Ranges studied for skeletal health, pregnancy-related concerns, digestion, metabolism, and body mass are similar (about 200 to 2,000 mg per day), but cardiovascular health uses a higher range (500 to 7,700 mg per day).

Effective Dosages:

Bone health

Adults under 50 years: Meta-analyses suggest calcium supplementation has mixed results in adults under the age of 50 over a variety of formulations, doses, and administration routes. Formulations include calcium carbonate, citrate, and lactate in powders, tablets, and capsules. Dosages ranging from 200 to 2,000 mg per day over 6 months to 7 years. Divided doses, singular administrations, combination therapies (usually plus vitamin D), and as a dietary fortification have been examined. Total body bone strength does not appear to benefit from dosages over 1,000mg per day, though both dietary and supplemental calcium have some beneficial effect.[6][7]

Special considerations: The effectiveness of calcium on skeletal strength may vary by structural location. For example, the neck of the femur appears to be more susceptible to calcium-related bone strength improvements, but the rates of improvement on the total hip and lumbar spine have been negligible unless also supplemented with vitamin D.[6][7]

Adults 50 years or older: In meta-analyses in older adults without known health conditions, calcium (500 to 1,200 mg per day) combined with vitamin D (400 to 800 IU per day) for periods of one to seven years may be effective for increasing bone mineral density and reducing fracture risk. The formulations that were studied include calcium carbonate, citrate, and lactate in powders, tablets, and capsules. The supplements were taken in once-daily, divided doses and fortified foods/beverages.[8][9]

Special considerations: Some improvements in bone mineral density were only seen when vitamin D intake was less than 400 IU/day, and fortified foods appear to be more effective than supplementation alone.[8][9]

Cardiovascular health

Adults with hypertension (age 18–82): In a meta-analysis of studies that involved participants primarily with mild to moderate hypertension, calcium supplementation (1,000 to 7,700 mg per day, over durations of 1 to 48 weeks) was associated with reductions in diastolic blood pressure, but not systolic blood pressure or heart rate. The formulations and administration routes were not specified clearly in this meta-analysis, but the referenced studies make note of oral and dietary calcium supplementation, and one study used calcium carbonate.[10]

Adults and children with normal blood pressure (11 years to older adults): For individuals without prior hypertension, calcium supplementation (500 to 2,000 mg per day over a median duration of 3.5 months, and up to 4 years) was associated with mild reductions in blood pressure. A variety of formulations (calcium carbonate, citrate, gluconate, and a combination of calcium salts) and administration routes (tablets and fortified food or beverages) were included. Calcium carbonate was used most frequently. Younger adults (under 35 years) had more pronounced reductions in blood pressure than older adults.[11]

Special considerations: There may be a dose-response relationship where higher doses (greater than 1,000 mg per day) could lead to larger reductions in blood pressure, with moderate to high certainty of evidence.

Adults at risk of calcium-related conditions: Meta-analyses studying calcium supplementation particularly in older individuals found it was not associated with increased risks of stroke, heart attack, heart failure, or cardiovascular-related death. Calcium in this study was taken in ranges from 500 to 2,000 mg per day, over durations of 1.5 to 11.9 years and in a variety of formulations (calcium carbonate, citrate, and gluconate and tricalcium phosphate).[12]

Weight management, digestion, and metabolism

Adults with a BMI over 24.9 (ages 18 to 80): Calcium supplementation ranging from 162 to 1,500 mg per day (via tablet supplements and fortified foods and beverages for durations less than 6 months) resulted in small reductions in BMI, waist circumference, and body fat mass.[13] When combined with exercise and a high protein intake, 480 to 2,000 mg per day of calcium supplementation (over 3 to 24 months’ duration) saw larger improvements in fat-free mass and bone mineral density when compared to the control group.[14]

Adults with or at risk of metabolic syndrome (ages 20 to 75): Meta-analyses of observational data suggest that increases of 300 mg per day in dietary calcium intake is associated with a 7% lower risk of developing metabolic syndrome.[15]

Adults (ages 20 to over 50): In a diverse group of participants that included individuals with and without known health conditions (pregnancy, PCOS, colorectal cancer, type 2 diabetes, or with a BMI over 24.9), taking 500 to 2,000mg of calcium per day with 125 to 7,142 IU of vitamin D3 per day was associated with some blood lipid improvements. Though total cholesterol and triglycerides were reduced, and HDL was increased, no change was seen for LDL or VLDL levels.[16]

Adult heartburn relief (over 18): Supplementing with calcium carbonate (500 to 1,000 mg, as needed, in tablet, oral suspension, powder, or chewable form) reduces heartburn caused by GERD. However, the current recommendation is to avoid supplementation over 7,000 grams per day.[5]

Adult women with PCOS (over 18): Calcium citrate or carbonate in tablet form (500 to 1,000 mg per day over 8 to 16 weeks’ duration) combined with metformin and 400 to 1,000 IU of vitamin D3 may improve clinical signs of PCOS, including irregular periods, increased serum insulin levels, HOMA-IR, and hair growth.[17]

Pregnancy and infant health

Pregnant/conceiving women (age 15 to 42): Calcium supplementation or dietary fortification (300 to 2,000 mg per day over durations ranging from 6 to 22 months) before and/or during pregnancy may reduce the risk of preeclampsia, mitigate losses in bone mineral density, and lead to infants with higher birth weights than control groups. When combined with vitamin D3 (400 to 1,000 IU per day over 6 weeks’ duration), calcium supplementation may also help reduce fasting blood sugar and serum insulin levels, potentially preventing gestational diabetes. When these meta-analyses provided specific formulations and routes, calcium carbonate was most popular. Capsules and tablets were a typical administration route when supplementation was not otherwise done through fortified foods and beverages.[18][19][20][21]

Other considerations:

Calcium supplementation frequently includes concurrent use of vitamin D, and the evidence suggests increased efficacy when they are used together. Vitamin D increases the intestinal absorption of calcium, and when there is insufficient vitamin D, the body may be unable to absorb enough calcium to meet its needs.[22] On the other hand, taking calcium at the same time as iron, magnesium, strontium and zinc should be avoided, because these nutrients will compete with calcium for absorption. Spacing strontium and calcium supplements by at least 2–4 hours and taking calcium supplements between meals may avoid competitive absorption.[23] This makes sense, because our ability to absorb strontium decreases when taken in conjunction with calcium.[24][25][22]

For many, sufficient calcium may be obtained through a balanced diet (1,000 mg calcium per day) including dairy, vegetables, and/or calcium-fortified grains. Of the 1,000 mg daily calcium intake, the intestine may only absorb 200 to 400 mg, excreting the excess. Proportional absorption of calcium decreases as supplemental intake exceeds 500 mg per dose.[1][2]

Calcium should be supplemented with consideration for the overall dietary calcium intake and guided by the known recommended daily intake (RDI) amounts. RDIs are determined by age and sex.

Age/sexRDI
1 to 3 years old700 mg per day
4 to 8 years old1,000 mg per day
9 to 18 years old1,300 mg per day
19 to 50 years old1,000 mg per day
Men 50 to 70 years old1,000 mg per day
Women 50 to 70 years old1,200 mg per day
Adults 71 years and older1,200 mg per day

Calcium supplementation does not depend on timing, and it can be taken any time of the day, preferably with a meal to aid absorption.[26][1]

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