Skip navigation

Calcium


What is it?

Calcium is a mineral that is an essential part of bones and teeth. The heart, nerves, and blood-clotting systems also need calcium to work.

Calcium is used for treatment and prevention of low calcium levels and resulting bone conditions including osteoporosis (weak bones due to low bone density), rickets (a condition in children involving softening of the bones), and osteomalacia (a softening of bones involving pain). Calcium is also used for premenstrual syndrome (PMS), leg cramps in pregnancy, high blood pressure in pregnancy (pre-eclampsia), and reducing the risk of colon and rectal cancers.

Some people use calcium for complications after intestinal bypass surgery, high blood pressure, high cholesterol, Lyme disease, to reduce high fluoride levels in children, and to reduce high lead levels.

Calcium carbonate is used as an antacid for “heartburn.” Calcium carbonate and calcium acetate are also used for reducing phosphate levels in people with kidney disease.

Calcium-rich foods include milk and dairy products, kale and broccoli, as well as the calcium-enriched citrus juices, mineral water, canned fish with bones, and soy products processed with calcium.

Calcium can interact with many prescription medications, but sometimes the effects can be minimized by taking calcium at a different time. See the section titled “Are there any interactions with medications?"

How effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for CALCIUM are as follows:

Effective for...

  • Raising calcium levels in people who have low calcium.
  • Preventing low calcium levels.
  • Reversing high potassium levels, when given intravenously (by IV).
  • Use as an antacid as calcium carbonate.
  • Reducing phosphate levels in people with kidney disease.

Likely effective for...

  • Treating osteoporosis (weak bones). Taking calcium by mouth is effective for preventing and treating bone loss and osteoporosis. Most bone growth occurs in the teenage years, and then bone strength in women remains about the same until age 30-40. After age 40, bone loss typically occurs at rates of 0.5% to 1% per year. In men, this occurs several decades later. There is more bone loss if less than the recommended amount of calcium is obtained from the diet. This is very common among Americans. Bone loss in women over 40 can be reduced by taking calcium supplements. Some researchers estimate that taking calcium for 30 years after menopause might result in a 10% improvement in bone strength, and a 50% overall reduction in bone break rates.
  • Preventing bone loss caused by insufficient calcium in the diet. This can reduce the risk of breaking bones.
  • Reducing symptoms of premenstrual syndrome (PMS). There seems to be a link between low dietary calcium intake and symptoms of PMS. Consuming calcium daily seems to significantly reduce mood swings, bloating, food cravings, and pain. Also, increasing calcium intake from food seems to prevent PMS. Women consuming an average of 1283 mg/day of calcium from foods seem to have about a 30% lower risk of developing PMS than women who consume an average of 529 mg/day of calcium. Taking calcium supplements, however, doesn’t seem to prevent PMS.
  • Increasing fetal bone density in pregnant women with low calcium intake.
  • Reducing bone loss in people taking drugs called corticosteroids, when used in combination with vitamin D.
  • Reducing thyroid hormone levels in people with kidney failure.

Possibly effective for...

  • Reducing the risk of colorectal cancer. Research suggests that high intake of dietary or supplemental calcium seems to reduce the risk of colorectal cancer. Research also shows that taking calcium supplements might help to keep colorectal cancer from returning.
  • High blood pressure. Taking calcium supplements seems to reduce blood pressure slightly (usually around 1-2 mmHg) in people with or without high blood pressure. Calcium seems to be more effective in salt-sensitive people and people who normally get very little calcium. Taking calcium by mouth also seems to be helpful for reducing blood pressure in people with serious kidney disease.
  • High blood pressure in pregnancy (pre-eclampsia). Taking 1-2 grams of calcium by mouth each day seems to reduce pregnancy-related high blood pressure. Calcium appears to reduce the risk of high blood pressure in pregnancy by about 50%. Calcium appears to have the greatest effect in high-risk women and women with low calcium levels.
  • High cholesterol. Taking calcium supplements along with a low-fat or low-calorie diet might modestly reduce cholesterol. Taking calcium alone, without the restricted diet, doesn’t seem to lower cholesterol.
  • Reducing weight and body fat while dieting. Adults and children with low calcium intake are more likely to gain weight, have a higher body mass index (BMI), and be overweight or obese compared to people with high calcium intake. So researchers have studied whether increasing calcium intake might help with weight loss. Some clinical research shows that increasing calcium consumption from dairy products such as yogurt seems to increase weight loss, lean body mass, and body fat loss in people on a low-calorie diet as well as people on a regular unrestricted-calorie diet.
  • Preventing stroke in women.
  • Preventing fluoride poisoning in children when taken with vitamins C and D.
  • Reducing tooth loss in elderly people.

Possibly ineffective for...

  • Preventing breast cancer in older (postmenopausal) women.
  • Reducing lead levels in breast-feeding women.

Insufficient evidence to rate effectiveness for...

  • Preventing falls. Evidence suggests that calcium plus vitamin D might help prevent falls by decreasing body sway and helping to keep blood pressure normal. Calcium alone doesn’t seem to have the same benefit. Interestingly, calcium plus vitamin D seems to prevent falls in women, but not in men.
  • Metabolic syndrome. Some evidence suggests that getting more calcium from diet and supplements, either alone or in combination with vitamin D, might lower the risk of developing metabolic syndrome.
  • Cancer. Research shows that healthy older women who take 1400-1500 mg/day of calcium plus 1100 IU/day of vitamin D3 (cholecalciferol) have a 60% lower risk for developing cancer of any type.
  • Pregnancy-related leg cramps. Limited evidence shows that calcium can help prevent leg cramps in the second half of pregnancy.
  • Diabetes. Some evidence suggests that getting more calcium from diet and supplements, either alone or in combination with vitamin D, might lower the risk of developing type 2 diabetes.
  • Lyme disease.
  • Seizures.
  • Other conditions.
More evidence is needed to rate the effectiveness of calcium for these uses.

How does it work?

Return to top
The bones and teeth contain over 99% of the calcium in the human body. Calcium is also found in the blood, muscles, and other tissue. Calcium in the bones can be used as a reserve that can be released into the body as needed. The concentration of calcium in the body tends to decline as we age because it is released from the body through sweat, skin cells, and waste. In addition, as women age, absorption of calcium tends to decline due to reduced estrogen levels. Calcium absorption can vary depending on race, gender, and age.

Bones are always breaking down and rebuilding, and calcium is needed for this process. Taking extra calcium helps the bones rebuild properly and stay strong.

Are there safety concerns?

Return to top
Calcium is LIKELY SAFE for most people when taken appropriately in recommended doses. Calcium can cause some minor side effects such as belching or gas.

Avoid taking too much calcium. The Institute of Medicine sets the daily tolerable upper intake level (UL) for calcium based on age as follows: Age 0-6 months, 1000 mg; 6-12 months, 1500 mg; 1-3 years, 2500 mg; 9-18 years, 3000 mg; 19-50 years, 2500 mg; 51+ years, 2000 mg. Higher doses increase the chance of having serious side effects. Some recent research also suggests that doses over the recommended daily requirement of 1000-1300 mg daily for most adults might increase the chance of heart attack. This research is concerning, but it is still too soon to say for certain that calcium is truly the cause of heart attack. Until more is known, continue consuming adequate amounts of calcium to meet daily requirements, but not excessive amounts of calcium. Be sure to consider total calcium intake from both dietary and supplemental sources and try not to exceed 1000-1300 mg of calcium per day. To figure out dietary calcium, count 300 mg/day from non-dairy foods plus 300 mg/cup of milk or fortified orange juice.

Special precautions & warnings:

Pregnancy and breast-feeding: Calcium is LIKELY SAFE when used in recommended amounts during pregnancy and breast-feeding.

High levels of phosphate in the blood (hyperphosphatemia) or low levels of phosphate in the blood (hypophosphatemia): Calcium and phosphate have to be in balance in the body. Taking too much calcium can throw this balance off and cause harm. Don’t take extra calcium without your health provider’s supervision.

Under-active thyroid (hypothyroidism): Calcium can interfere with thyroid hormone replacement treatment. Separate calcium and thyroid medications by at least 4 hours.

Too much calcium in the blood (as in parathyroid gland disorders and sarcoidosis): Calcium should be avoided if you have one of these conditions.

Are there interactions with medications?

Return to top

Major

Do not take this combination.

Ceftriaxone (Rocephin)
Administering intravenous ceftriaxone (Rocephin) and calcium can result in life-threatening damage to the lungs and kidneys. Calcium should not be administered intravenously within 48 hours of intravenous ceftriaxone (Rocephin).

Moderate

Be cautious with this combination.

Antibiotics (Quinolone antibiotics)
Calcium might decrease how much antibiotic your body absorbs. Taking calcium along with some antibiotics known as "quinolones" might decrease their effectiveness. To avoid this interaction, take these drugs at least 2 hours before, or 4 to 6 hours after calcium supplements.

Some quinolone antibiotics that might interact with calcium include ciprofloxacin (Cipro), levofloxacin (Levaquin), ofloxacin (Floxin), moxifloxacin (Avelox), gatifloxacin (Tequin), gemifloxacin (Factive), and others.

Antibiotics (Tetracycline antibiotics)
Calcium can attach to some antibiotics called tetracyclines in the stomach. This decreases the amount of tetracyclines that can be absorbed. Taking calcium with tetracyclines might decrease the effectiveness of tetracyclines. To avoid this interaction, take calcium at least 2 hours before or 4 to 6 hours after taking tetracyclines.

Some tetracyclines include demeclocycline (Declomycin), minocycline (Minocin), and tetracycline (Achromycin, and others).

Bisphosphonates
Calcium can decrease how much bisphosphate your body absorbs. Taking calcium along with bisphosphates can decrease the effectiveness of bisphosphate. To avoid this interaction, take bisphosphonate at least 30 minutes before calcium or, preferably, at a different time of day.

Some bisphosphonates include alendronate (Fosamax), etidronate (Didronel), ibandronate (Boniva), risedronate (Actonel), tiludronate (Skelid), and others.

Calcipotriene (Dovonex)
Calcipotriene (Dovonex) is a drug that is similar to vitamin D. Vitamin D helps your body absorb calcium. Taking calcium supplements along with calcipotriene (Dovonex) might cause the body to have too much calcium.

Digoxin (Lanoxin)
Calcium can affect your heart. Digoxin (Lanoxin) is used to help your heart beat stronger. Taking calcium along with digoxin (Lanoxin) might increase the effects of digoxin (Lanoxin) and lead to an irregular heartbeat. If you are taking digoxin (Lanoxin), talk to your doctor before taking calcium supplements.

Diltiazem (Cardizem, Dilacor, Tiazac)
Calcium can affect your heart. Diltiazem (Cardizem, Dilacor, Tiazac) can also affect your heart. Taking large amounts of calcium along with diltiazem (Cardizem, Dilacor, Tiazac) might decrease the effectiveness of diltiazem (Cardizem, Dilacor, Tiazac).

Levothyroxine
Levothyroxine is used for low thyroid function. Calcium can decrease how much levothyroxine your body absorbs. Taking calcium along with levothyroxine might decrease the effectiveness of levothyroxine. Levothyroxine and calcium should be taken at least 4 hours apart.

Some brands that contain levothyroxine include Armour Thyroid, Eltroxin, Estre, Euthyrox, Levo-T, Levothroid, Levoxyl, Synthroid, Unithroid, and others.

Sotalol (Betapace)
Taking calcium with sotalol (Betapace) can decrease how much sotalol (Betapace) your body absorbs. Taking calcium along with sotalol (Betapace) might decrease the effectiveness of sotalol (Betapace). To avoid this interaction, take calcium at least 2 hours before or 4 hours after taking sotalol (Betapace).

Verapamil (Calan, Covera, Isoptin, Verelan)
Calcium can affect your heart. Verapamil (Calan, Covera, Isoptin, Verelan) can also affect your heart. Do not take large amounts of calcium if you are taking verapamil (Calan, Covera, Isoptin, Verelan).

Water pills (Thiazide diuretics)
Some "water pills" increase the amount of calcium in your body. Taking large amounts of calcium with some "water pills" might cause there to be too much calcium in the body. This could cause serious side effects, including kidney problems.

Some of these "water pills" include chlorothiazide (Diuril), hydrochlorothiazide (HydroDIURIL, Esidrix), indapamide (Lozol), metolazone (Zaroxolyn), and chlorthalidone (Hygroton).

Minor

Be watchful with this combination.

Estrogens
Estrogen helps your body absorb calcium. Taking estrogen pills along with large amounts of calcium might increase calcium in the body too much.

Estrogen pills include conjugated equine estrogens (Premarin), ethinyl estradiol, estradiol, and others.

Medications for high blood pressure (Calcium channel blockers)
Some medications for high blood pressure can affect calcium in your body. These medications are called calcium channel blockers. Getting calcium injections might decrease the effectiveness of these medications for high blood pressure.

Some medications for high blood pressure include nifedipine (Adalat, Procardia), verapamil (Calan, Isoptin, Verelan), diltiazem (Cardizem), isradipine (DynaCirc), felodipine (Plendil), amlodipine (Norvasc), and others.

Are there interactions with herbs and supplements?

Return to top
Magnesium
Calcium supplements can decrease the absorption of dietary magnesium, but only at very high doses (2600 mg per day). However, in people who have enough magnesium stored in their bodies, taking calcium doesn't cause a problem over the long term. People at high risk for magnesium deficiency, however, should take calcium supplements at bedtime, instead of with meals, to avoid reducing dietary magnesium absorption.

Vitamin D
Taking vitamin D along with calcium increases absorption of calcium.

Are there interactions with foods?

Return to top
Caffeine
High caffeine intake from foods and beverages causes the body to remove calcium. Taking more than 300 mg of caffeine per day (three to four cups of coffee, or six 12-oz. cola drinks) is linked to increased bone loss and breaks in elderly women, especially when calcium intake is low. Be sure to get the amount of calcium from food and supplements that is recommended for your age and gender.

Fiber
Dietary fiber from certain sources can interfere with calcium absorption. These sources include wheat bran, spinach, rhubarb, and others. It's best not to eat fibrous foods within two hours of taking calcium supplements.

Iron
Calcium supplements may decrease the absorption of dietary iron. However, in people who have enough iron stored in their body, taking calcium doesn't cause a problem over the long term. People who are at high risk for iron deficiency should take calcium supplements at bedtime, instead of with meals, to avoid reducing the absorption of iron.

Magnesium
Calcium supplements may decrease the absorption of dietary magnesium. However, in people who have enough magnesium stored in their body, taking calcium doesn't cause a problem over the long term. People who are at high risk for magnesium deficiency should take calcium supplements at bedtime, instead of with meals, to avoid reducing the absorption of magnesium.

Sodium
Eating foods that contain a lot of sodium causes the body to remove calcium. A calcium intake of 1000 mg/day is needed to prevent bone loss in postmenopausal women ingesting 2000 mg sodium chloride daily. About 1500 mg/day calcium is needed if sodium chloride intake is 3000 mg/day.

Zinc
Calcium supplements may decrease the absorption of dietary zinc. However, in people who have enough zinc stored in their body, taking calcium doesn't cause a problem over the long term. People who are at high risk for zinc deficiency should take calcium supplements at bedtime, instead of with meals, to avoid reducing the absorption of zinc.

What dose is used?

Return to top
The following doses have been studied in scientific research:

BY MOUTH:
  • For preventing low calcium levels: 1 gram elemental calcium daily is typically used.
  • For heartburn: Calcium carbonate as an antacid is usually 0.5-1.5 grams as needed.
  • To reduce phosphates in adults with chronic renal failure: The initial dose of calcium acetate is 1.334 grams (338 mg elemental calcium) with each meal, increasing to 2-2.67 grams (500-680 mg elemental calcium) with each meal if necessary.
  • For prevention of weak bones (osteoporosis): Doses of 1-1.6 grams elemental calcium daily from foods and supplements. Osteoporosis treatment guidelines in North America currently recommend 1200 mg daily of calcium.
  • For prevention of bone loss in premenopausal women over 40: A dose of 1 gram.
  • For pregnant women with low dietary calcium intake: The dose for increasing fetal bone density ranges from 300-1300 mg/day beginning at gestation week 20-22.
  • For premenstrual syndrome (PMS): 1-1.2 grams calcium per day as calcium carbonate.
  • For reducing thyroid hormone levels in people with chronic renal failure: 2-21 grams calcium carbonate.
  • To prevent bone loss in people taking corticosteroid drugs: Divided daily doses of 1 gram of elemental calcium daily.
  • For high blood pressure: 1-1.5 grams calcium daily.
  • For preventing high blood pressure during pregnancy (pre-eclampsia): 1-2 grams elemental calcium daily as calcium carbonate.
  • For preventing colorectal cancer and recurrent colorectal benign tumors (adenomas): Calcium 1200-1600 mg/day.
  • For high cholesterol: 1200 mg daily with or without vitamin D 400 IU daily has been used in conjunction with a low-fat or calorie-restricted diet.
  • For preventing fluoride poisoning in children: Calcium 125 mg twice daily, in combination with ascorbic acid and vitamin D.
  • For weight loss, increasing calcium consumption from dairy products to total intake of 500-2400 mg/day in combination with a calorie-restricted diet has been used.
Calcium carbonate and calcium citrate are the two most commonly used forms of calcium.

Calcium supplements are usually divided into two doses daily in order to increase absorption. It’s best to take calcium with food in doses of 500 mg or less.

The Institute of Medicine publishes a recommended daily allowance (RDA) for calcium which is an estimate of the intake level necessary to meet the requirements of nearly all healthy individuals in the population. The current RDA was set in 2010. The RDA varies based on age as follows: Age 1-3 years, 700 mg; 4-8 years, 1000 mg; 9-18 years, 1300 mg; 19-50 years, 1000 mg; Men 51-70 years, 1000 mg; Women 51-70 years, 1200 mg; 70+ years, 1200 mg; Pregnant or Lactating (under 19 years), 1300 mg; Pregnant or Lactating (19-50 years), 1000 mg.

The Institute of Medicine also sets the daily tolerable upper intake level (UL) for calcium based on age as follows: Age 0-6 months, 1000 mg; 6-12 months, 1500 mg; 1-3 years, 2500 mg; 9-18 years, 3000 mg; 19-50 years, 2500 mg; 51+ years, 2000 mg. Doses above these levels should be avoided.

Doses over the recommended daily intake level of 1000-1300 mg/day for most adults have been associated with an increased risk of heart attack. Until more is known, continue consuming adequate amounts of calcium to meet daily requirements, but not excessive amounts of calcium. Be sure to consider total calcium intake from both dietary and supplemental sources and try not to exceed 1000-1300 mg of calcium per day. To figure out dietary calcium, count 300 mg/day from non-dairy foods plus 300 mg/cup of milk or fortified orange juice.

Other names

Return to top
Acétate de Calcium, Aspartate de Calcium, Bone Meal, Calcio, Calcium Acetate, Calcium Aspartate, Calcium Carbonate, Calcium Chelate, Calcium Chloride, Calcium Citrate, Calcium Citrate Malate, Calcium D-Gluconate, Calcium Disuccinate, Calcium Gluconate, Calcium Glycerophosphate, Calcium Hydrogen Phosphate, Calcium Hydroxyapatite, Calcium Lactate, Calcium Lactogluconate, Calcium Orotate, Calcium Phosphate, Calcium Sulfate, Carbonate de Calcium, Chélate de Calcium, Chlorure de Calcium, Citrate de Calcium, Citrate Malate de Calcium, Coquilles d’Huîtres Moulues, Coquilles d’œuf, Dicalcium Phosphate, Di-Calcium Phosphate, Dolomite, Egg Shell Calcium, Gluconate de Calcium, Glycérophosphate de Calcium, Heated Oyster Shell-Seaweed Calcium, Hydroxyapatite, Lactate de Calcium, Lactogluconate de Calcium, MCHA, MCHC, Microcrystalline Hydroxyapatite, Orotate de Calcium, Ossein Hydroxyapatite, Oyster Shell, Oyster Shell Calcium, Phosphate de Calcium, Phosphate de Calcium Hydrogène, Phosphate de di-Calcium, Phosphate Tricalcium, Poudre d’os, Sulfate de Calcium, Tricalcium Phosphate.

Methodology

Return to top
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).

References

Return to top
To see all references for the Calcium page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/781.html.

  1. National Osteoporosis Foundation. 2010 Clinician's Guide to Prevention and Treatment of Osteoporosis. www.nof.org/sites/default/files/pdfs/NOF_ClinicianGuide2009_v7.pdf.
  2. Warensjo E, Byberg L, Melhus H, et al. Dietary calcium intake and risk of fracture and osteoporosis: prospective longitudinal cohort study. BMJ 2011;342:d1473.
  3. Dietary reference intakes for calcium and vitamin D. Institute of Medicine, November 30, 2010. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/Vitamin%20D%20and%20Calcium%202010%20Report%20Brief.pdf.
  4. Manson JE, Allison MA, Carr JJ, et al. Calcium/vitamin D supplementation and coronary artery calcification. Menopause 2010;17:683-91.
  5. Calcium supplementation and vascular events. Pharmacist's Letter / Prescriber's Letter 2008;24:240306.
  6. Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010;341:c3691.
  7. Chlebowski RT, Johnson KC, Kooperberg C, et al. Calcium plus vitamin D supplementation and the risk of breast cancer. J Natl Cancer Inst 2007;100:1581-91.
  8. Margolis KL, Ray RM, Van Horn L, et al. Effect of calcium and vitamin D supplementation on blood pressure: the Women's Health Initiative Randomized Trial. Hypertension 2008;52:847-55.
  9. Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin d and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab 2007;92:2017-29.
  10. Bolland MJ, Barber PA, Doughty RN, et al. Vascular events in healthy older women receiving calcium supplementation: randomised control trial. BMJ 2008;336:262-6.
  1. Rocephin (ceftriaxone) and calcium interaction. Pharmacist's Letter / Prescriber's Letter 2007;23:231005.
  2. Lin J, Manson JE, Lee IM, et al. Intakes of calcium and vitamin D and breast cancer risk in women. Arch Intern Med 2007;167:1050-9.
  3. Lappe JM, Travers-Gustafson D, Davies KM, et al. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr 2007;85:1586-91.
  4. Trowman R, Dumville JC, Hahn S, Torgerson DJ. A systematic review of the effects of calcium supplementation on body weight. Br J Nutr. 2006;95:1033-8.
  5. Caan B, Neuhouser M, Aragaki A, et al. Calcium plus vitamin d supplementation and the risk of postmenopausal weight gain. Arch Intern Med 2007;167:893-902.
  6. Rajpathak SN, Rimm EB, Rosner B, et al. Calcium and dairy intakes in relation to long-term weight gain in US men. Am J Clin Nutr 2006;83:559-66.
  7. Gonzalez AJ, White E, Kristal A, Littman AJ. Calcium intake and 10-year weight change in middle-aged adults. J Am Diet Assoc. 2006l;106:1066-73.
  8. Major GC, Alarie F, Dore J, et al. Supplementation with calcium + vitamin D enhances the beneficial effect of weight loss on plasma lipid and lipoprotein concentrations. Am J Clin Nutr 2007;85:54-9.
  9. Thompson WG, Rostad Holdman N, Janzow DJ, et al. Effect of energy-reduced diets high in dairy products and fiber on weight loss in obese adults. Obes Res 2005;13:1344-53.
  10. Gunther CW, Legowski PA, Lyle RM, et al. Dairy products do not lead to alterations in body weight or fat mass in young women in a 1-y intervention. Am J Clin Nutr 2005;81:751-6.
  11. Zemel MB, Richards J, Mathis S, et al. Dairy augmentation of total and central fat loss in obese subjects. Int J Obes Relat Metab Disord 2005;29:391-7.
  12. Bowen J, Noakes M, Clifton PM. Effect of calcium and dairy foods in high protein, energy-restricted diets on weight loss and metabolic parameters in overweight adults. Int J Obes Relat Metab Disord 2005;29:957-65.
  13. Heaney RP, Dowell MS, Bierman J, et al. Absorbability and cost effectiveness in calcium supplementation. J Am Coll Nutr 2001;20:239-46.
  14. Bo-Linn GW, Davis GR, Buddrus DJ, et al. An evaluation of the importance of gastric acid secretion in the absorption of dietary calcium. J Clin Invest 1984;73:640-7.
  15. Recker RR. Calcium absorption and achlorhydria. N Engl J Med 1985;313:70-3.
  16. Grau MV, Baron JA, Sandler RS, et al. Prolonged effect of calcium supplementation on risk of colorectal adenomas in a randomized trial. J Natl Cancer Inst 2007;99:129-36.
  17. Hofmeyr GJ, Atallah AN, Duley L. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev 2006;3:CD001059.
  18. Zemel MB, Richards J, Milstead A, Campbell P. Effects of calcium and dairy on body composition and weight loss in African-American adults. Obes Res 2005;13:1218-25.
  19. van Mierlo LA, Arends LR, Streppel MT, et al. Blood pressure response to calcium supplementation: a meta-analysis of randomized controlled trials. J Hum Hypertens 2006;20:571-80.
  20. Bischoff-Ferrari HA, Orav EJ, Dawson-Hughes B. Effect of Cholecalciferol plus calcium on falling in ambulatory older men and women: a 3-year randomized controlled trial. Arch Intern Med 2006;166:424-30.
  21. Wactawski-Wende J, Kotchen JM, Anderson GL. Calcium plus vitamin D supplementation and the risk of colorectal cancer. N Engl J Med 2006;354:684-96.
  22. Lorenzen JK, Molgaard C, Michaelsen KF, Astrup A. Calcium supplementation for 1 y does not reduce body weight or fat mass in young girls. Am J Clin Nutr 2006;83:18-23.
  23. Jackson RD, LaCroix AZ, Gass M. Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med 2006;354:669-83.
  24. Liu S, Song Y, Ford ES, et al. Dietary calcium, vitamin D, and the prevalence of metabolic syndrome in middle-aged and older US women. Diabetes Care 2005;28:2926-32.
  25. Dagnelie PC, Schuurman AG, Goldbohm RA, Van den Brandt PA. Diet, anthropometric measures and prostate cancer risk: a review of prospective cohort and intervention studies. BJU Int 2004;93:1139-50.
  26. Baron JA, Beach M, Wallace K, et al. Risk of prostate cancer in a randomized clinical trial of calcium supplementation. Cancer Epidemiol Biomarkers Prev 2005;14:586-9.
  27. Giovannucci E, Liu Y, Stampfer MJ, Willett WC. A prospective study of calcium intake and incident and fatal prostate cancer. Cancer Epidemiol Biomarkers Prev 2006;15:203-10.
  28. Tavani A, Bertuccio P, Bosetti C, et al. Dietary intake of calcium, vitamin D, phosphorus and the risk of prostate cancer. Eur Urol 2005;48:27-33.
  29. Reid IR, Horne A, Mason B, Ames R, Bava U, Gamble GD. Effects of calcium supplementation on body weight and blood pressure in normal older women: A Randomized Controlled Trial. J Clin Endocrinol Metab 2005;90:3824-9.
  30. Bertone-Johnson ER, Hankinson SE, Bendich A, et al. Calcium and vitamin D intake and risk of incident premenstrual syndrome. Arch Intern Med 2005;165:1246-52.
  31. The RECORD Trial Group. Oral vitamin D3 and calcium for secondary prevention of low-trauma fractures in elderly people (Randomised Evaluation of Calcium Or vitamin D, RECORD): a randomised placebo-controlled trial. Lancet 2005;365:1621-8.
  32. Papadimitropoulos E, Wells G, Shea B, et al. Meta-analyses of therapies for postmenopausal osteoporosis. VIII: Meta-analysis of the efficacy of vitamin D treatment in preventing osteoporosis in postmenopausal women. Endocr Rev 2002;23:560-9.
  33. Rizzato G. Clinical impact of bone and calcium metabolism changes in sarcoidosis. Thorax 1998;53:425-9.
  34. Weingarten MA, Zalmanovici A, Yaphe J. Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps. Cochrane Database Syst Rev 2004;:CD003548.
  35. Tseng M, Breslow RA, Graubard BI, Ziegler RG. Dairy, calcium, and vitamin D intakes and prostate cancer risk in the National Health and Nutrition Examination Epidemiologic Follow-up Study cohort. Am J Clin Nutr 2005;81:1147-54.
  36. Akerstrom G, Hellman P, Hessman O, et al. Parathyroid glands in calcium regulation and human disease. Ann N Y Acad Sci 2005;1040:53-8.
  37. Bania TC, Blaufeux B, Hughes S, et al. Calcium and digoxin vs. calcium alone for severe verapamil toxicity. Acad Emerg Med 2000;7:1089-96.
  38. Ahee P, Crowe AV. The management of hyperkalaemia in the emergency department. J Accid Emerg Med 2000;17:188-91.
  39. Homik J, Suarez-Almazor ME, Shea B, et al. Calcium and vitamin D for corticosteroid-induced osteoporosis. Cochrane Database Syst Rev 2000;:CD000952.
  40. Emmett M. A comparison of clinically useful phosphorus binders for patients with chronic kidney failure. Kidney Int Suppl 2004;90:S25-32.
  41. Qunibi WY, Hootkins RE, McDowell LL, et al. Treatment of hyperphosphatemia in hemodialysis patients: The Calcium Acetate Renagel Evaluation (CARE Study). Kidney Int 2004;65:1914-26.
  42. James WP, Branch WJ, Southgate DA. Calcium binding by dietary fibre. Lancet 1978;1:638-9.
  43. Vella A, Gerber TC, Hayes DL, Reeder GS. Digoxin, hypercalcaemia, and cardiac conduction. Postgrad Med J 1999;75:554-6.
  44. Gueguen L, Pointillart A. The bioavailability of dietary calcium. J Am Coll Nutr 2000;19:119s-136s.
  45. Bourke JF, Mumford R, Whittaker P, et al. The effects of topical calcipotriol on systemic calcium homeostasis in patients with chronic plaque psoriasis. J Am Acad Dermatol 1997;37:929-34.
  46. Peters ML, Leonard M, Licata AA. Role of alendronate and risedronate in preventing and treating osteoporosis. Cleve Clin J Med 2001;68:945-51.
  47. Simoneau G. Absence of rebound effect with calcium carbonate. Eur J Drug Metab Pharmacokinet 1996;21:351-7.
  48. Decktor DL, Robinson M, Maton PN, et al. Effects of aluminum/magnesium hydroxide and calcium carbonate on esophageal and gastric pH in subjects with heartburn. Am J Ther 1995;2:546-52.
  49. Boonen S, Body JJ, Boutsen Y, et al. Evidence-based guidelines for the treatment of postmenopausal osteoporosis: a consensus document of the Belgian Bone Club. Osteoporos Int 2005;16:239-54.
  50. Bischoff-Ferrari HA, Willett WC, Wong JB, et al. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA 2005;293:2257-64.
  51. Shea B, Wells G, Cranney A, et al. Calcium supplementation on bone loss in postmenopausal women. Cochrane Database Syst Rev 2004;:CD004526.
  52. Sambrook P. Vitamin D and fractures: quo vadis? Lancet 2005;365:1599-600.
  53. Larsen ER, Mosekilde L, Foldspang A. Vitamin D and calcium supplementation prevents osteoporotic fractures in elderly community dwelling residents: a pragmatic population-based 3-year intervention study. J Bone Miner Res 2004;19:370-8.
  54. Porthouse J, Cockayne S, King C, et al. Randomised controlled trial of calcium and supplementation with cholecalciferol (vitamin D3) for prevention of fractures in primary care. BMJ 2005;330:1003.
  55. Ariyan CE, Sosa JA. Assessment and management of patients with abnormal calcium. Crit Care Med 2004;32:S146-54.
  56. National Osteoporosis Foundation. Physician's Guide to Prevention and Treatment of Osteoporosis. Universal Recommendations for All Patients. Available at: http://www.nof.org/physguide/univeral_recommendations.htm#adequate. (Accessed 14 May 2005).
  57. Zemel MB, Thompson W, Milstead A, et al. Calcium and dairy acceleration of weight and fat loss during energy restriction in obese adults. Obes Res 2004;12:582–90.
  58. Davies KM, Heaney RP, Recker RR, et al. Calcium intake and body weight. J Clin Endocrinol Metab 2000;85:4635-8.
  59. Jacqmain M, Doucet E, Després JP, et al. Calcium intake, body composition, and lipoprotein-lipid concentrations in adults. Am J Clin Nutr 2003;77:1448–52.
  60. Tanasescu M, Ferris AM, Himmelgreen DA, et al. Biobehavioral factors are associated with obesity in Puerto Rican children. J Nutr 2000;130:1734–42.
  61. Buchowski MS, Semenya J, Johnson AO. Dietary calcium intake in lactose maldigesting intolerant and tolerant African-American women. J Am Coll Nutr 2002;21:47-54.
  62. McCarron DA. Calcium and magnesium nutrition in human hypertension. Ann Intern Med 1983;98:800-5.
  63. Zemel MB, Shi H, Greer B, et al. Regulation of adiposity by dietary calcium. FASEB J 2000;14:1132-8.
  64. Cho E, Smith-Warner SA, Spiegelman D, et al. Dairy foods, calcium, and colorectal cancer: a pooled analysis of 10 cohort studies. J Natl Cancer Inst 2004;96:1015-22.
  65. Zemel MB, Miller SL. Dietary calcium and dairy modulation of adiposity and obesity risk. Nutr Rev 2004;62:125-31.
  66. Grau MV, Baron JA, Sandler RS, et al. Vitamin D, calcium supplementation, and colorectal adenomas: results of a randomized trial. J Natl Cancer Inst 2003;95:1765-71.
  67. Cifuentes M, Riedt CS, Brolin RE, et al. Weight loss and calcium intake influence calcium absorption in overweight postmenopausal women. Am J Clin Nutr 2004;80:123–30.
  68. Shapses SA, Heshka S, Heymsfield SB. Effect of calcium supplementation on weight and fat loss in women. J Clin Endocrinol Metab 2004;89:632-7.
  69. Zemel MB. Role of calcium and dairy products in energy partitioning and weight management. Am J Clin Nutr 2004;79:907S-12S.
  70. L'Abbe MR, Whiting SJ, Hanley DA. The Canadian health claim for calcium, vitamin D and osteoporosis. J Am Coll Nutr 2004;23:303-8.
  71. Bischoff HA, Stahelin HB, Dick W, et al. Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res 2003;18:343-51.
  72. Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, et al. Effect of Vitamin D on falls: a meta-analysis. JAMA 2004;291:1999-2006.
  73. Frier BM, Scott RD. Osteomalacia and arthropathy associated with prolonged abuse of purgatives. Br J Clin Pract 1977;31:17-9.
  74. Sojka J, Wastney M, Abrams S, et al. Magnesium kinetics in adolescent girls determined using stable isotopes: effects of high and low calcium intake. Am J Physiol 1997;273:R710-5.
  75. NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA 2001;285:785-95.
  76. Bar-Or D, Yoel G. Calcium and calciferol antagonize effect of verapamil in atrial fibrillation. Br Med J 1981;282:1585-6.
  77. Pletz MW, Petzold P, Allen A, et al. Effect of calcium carbonate on bioavailability of orally administered gemifloxacin. Antimicrob Agents Chemother 2003;47:2158-60.
  78. Eastwood GL. Pharmacologic prevention of colonic neoplasms. Effects of calcium, vitamins, omega fatty acids, and nonsteroidal anti-inflammatory drugs. Dig Dis 1996;14:119-28.
  79. Kahela P, Anttila M, Tikkanen R, Sundquist H. Effect of food, food constituents and fluid volume on the bioavailability of sotalol. Acta Pharmacol Toxicol (Copenh) 1979;44:7-12.
  80. Heaney RP, Weaver CM. Effect of psyllium on absorption of co-ingested calcium. J Am Geriatr Soc 1995;43:261-3.
  81. Ebeling PR, Wark JD, Yeung S, et al. Effects of calcium and calcitriol on bone mass over three years in men with primary osteoporosis- A prospective cross-over study. Bone 2000;27:54S.
  82. Scopacasa F, Wishart JM, Need AG, et al. The effects of divided dose calcium on bone resorption in early postmenopausal women. Bone 2000;27:45S.
  83. Miller GD, Jarvis JK, McBean LD. The importance of meeting calcium needs with foods. J Am Coll Nutr 2001;20:168S-85S.
  84. Anderson JJ. Calcium requirements during adolescence to maximize bone health. J Am Coll Nutr 2001;20:186S-91S.
  85. Heaney RP. Calcium needs of the elderly to reduce fracture risk. J Am Coll Nutr 2001;20:192S-197S.
  86. Jackson KA, Savaiano DA. Lactose maldigestion, calcium intake and osteoporosis in African-, Asian-, and Hispanic-Americans. J Am Coll Nutr 2001;20:198S-207S.
  87. Bohmer H, Muller H, Resch KL. Calcium supplementation with calcium-rich mineral waters: a systematic review and meta-analysis of its bioavailability. Osteoporos Int 2000;11:938-43.
  88. Fujita T, Ohgitani S, Nomura M. Fall of blood ionized calcium on watching a provocative TV program and its prevention by active absorbable algal calcium (AAA Ca). J Bone Miner Metab 1999;17:131-6.
  89. Bauman WA, Shaw S, Jayatilleke E, et al. Increased intake of calcium reverses vitamin B12 malabsorption induced by metformin. Diabetes Care 2000;23:1227-31.
  90. Pattanaungkul S, Riggs BL, Yergey AL, et al. Relationship of intestinal calcium absorption to 1,25-dihydroxyvitamin D [1,25(OH)2D] levels in young versus elderly women: evidence for age-related intestinal resistance to 1,25(OH)2D action. J Clin Endocrinol Metab 2000;85:4023-7.
  91. Heller HJ, Greer LG, Haynes SD, et al. Pharmacokinetic and pharmacodynamic comparison of two calcium supplements in postmenopausal women. J Clin Pharmacol 2000;40:1237-44.
  92. Bendich A. Calcium supplementation and iron status of females. Nutrition 2001;17:46-51.
  93. Lin YC, Lyle RM, McCabe LD, et al. Dairy calcium is related to changes in body composition during a two-year exercise intervention in young women. J Am Coll Nutr 2000;19:754-60.
  94. Niromanesh S, Laghaii S, Mosavi-Jarrahi A. Supplementary calcium in prevention of pre-eclampsia. Int J Gynaecol Obstet 2001;74:17-21.
  95. Ebeling PR, Wark JD, Yeung S, et al. Effects of calcitriol or calcium on bone mineral density, bone turnover, and fractures in men with primary osteoporosis: a two-year randomized, double blind, double placebo study. J Clin Endocrinol Metab 2001;86:4098-103.
  96. Zemel MB. Regulation of adiposity and obesity risk by dietary calcium: mechanisms and implications. J Am Coll Nutr 2002;21:146S-51S.
  97. Heaney RP, Davies KM, Barger-Lux MJ. Calcium and weight: clinical studies. J Am Coll Nutr 2002;21:152S-5S.
  98. Roughead ZK, Zito CA, Hunt JR. Initial uptake and absorption of nonheme iron and absorption of heme iron in humans are unaffected by the addition of calcium as cheese to a meal with high iron bioavailability. Am J Clin Nutr 2002;76:419-25.
  99. Heaney RP, Nordin BE. Calcium effects on phosphorus absorption: implications for the prevention and co-therapy of osteoporosis. J Am Coll Nutr 2002;21:239-44.
  100. Terry P, Baron JA, Bergkvist L, et al. Dietary calcium and vitamin D intake and risk of colorectal cancer: a prospective cohort study in women. Nutr Cancer 2002;43:39-46.
  101. Chapuy MC, Pamphile R, Paris E, et al. Combined calcium and vitamin D3 supplementation in elderly women: confirmation of reversal of secondary hyperparathyroidism and hip fracture risk: the Decalyos II study. Osteoporos Int 2002;13:257-64.
  102. McCarron DA, Reusser ME. Are low intakes of calcium and potassium important causes of cardiovascular disease? Am J Hypertens 2001;14:206S-12S.
  103. Krall EA, Wehler C, Garcia RI, et al. Calcium and vitamin D supplements reduce tooth loss in the elderly. Am J Med 2001;111:452-6.
  104. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academy Press, 1999. Available at: http://books.nap.edu/books/0309063507/html/index.html.
  105. Hallberg L. Does calcium interfere with iron absorption? Am J Clin Nutr 1998;68:3-4.
  106. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002. Available at: www.nap.edu/books/0309072794/html/.
  107. Dawson-Hughes B, Harris SS, Krall EA, Dallal GE. Effect of withdrawal of calcium and vitamin D supplements on bone mass in elderly men and women. Am J Clin Nutr 2000;72:745-50.
  108. Jorde R, Bonaa KH. Calcium from dairy products, vitamin D intake, and blood pressure: the Tromso study. Am J Clin Nutr 2000;71:1530-5.
  109. Wolf RL, Cauley JA, Baker CE, et al. Factors associated with calcium absorption efficiency in pre- and perimenopausal women. Am J Clin Nutr 2000;72:466-71.
  110. Castelo-Branco C, Pons F, Vicente JJ, et al. Preventing postmenopausal bone loss with ossein-hydroxyapatite compounds. Results of a two-year, prospective trial. J Reprod Med 1999;44:601-5.
  111. Vanpee D, Delgrange E, Gillet JB, Donckier J. Ingestion of antacid tablets (Rennie) and acute confusion. J Emerg Med 2000;19:169-71.
  112. Bendich A. The potential for dietary supplements to reduce premenstrual syndrome (PMS) symptoms. J Am Coll Nutrition 2000;19:3-12.
  113. Carey CF, Lee HH, Woeltje KF (eds). Washington Manual of Medical Therapeutics. 29th ed. New York, NY: Lippincott-Raven, 1998.
  114. Heaney RP. Lead in calcium supplements. Cause for alarm or celebration? JAMA 2000;284:1432-3.
  115. Ross EA, Szabo NJ, Tebbett IR. Lead content of calcium supplements. JAMA 2000;284:1425-29.
  116. Minne HW, Pfeifer M, Begerow B, et al. Vitamin D and calcium supplementation reduces falls in elderly women via improvement of body sway and normalization of blood pressure: a prospective, randomized, and double-blind study. Abstracts World Congress on Osteoporosis 2000.
  117. Guillemant J, Le HT, Accarie C, et al. Mineral water as a source of dietary calcium: acute effects on parathyroid function and bone resorption in young men. Am J Clin Nutr 2000;71:999-1002.
  118. Singh N, Singh PN, Hershman JM. Effect of calcium carbonate on the absorption of levothyroxine. JAMA 2000;283:2822-5.
  119. Moser LR, Smythe MA, Tisdale JE. The use of calcium salts in the prevention and management of verapamil-induced hypotension. Ann Pharmacother 2000;34:622-9.
  120. Spencer H, Kramer L, Norris C, Osis D. Effect of small doses of aluminum-containing antacids on calcium and phosphorus metabolism. Am J Clin Nutr 1982;36:32-40.
  121. Heaton KW, Lever JV, Barnard RE. Osteomalacia associated with cholestyramine therapy for post-ileectomy diarrhea. Gastroenterology 1972;62:642-6.
  122. Compston JE, Thompson RP. Intestinal absorption of 25-hydroxyvitamin D and osteomalacia in primary biliary cirrhosis. Lancet 1977;1:721-4.
  123. Compston JE, Horton LW. Oral 25-hydroxyvitamin D3 in treatment of osteomalacia associated with ileal resection and cholestyramine therapy. Gastroenterology 1978;74:900-2.
  124. Schneyer CR. Calcium carbonate and reduction of levothyroxine efficacy. JAMA 1998;279:750.
  125. Butner LE, Fulco PP, Feldman G, et al. Calcium carbonate-induced hypothyroidism. Ann Intern Med 2000:132:595.
  126. Chan JM, Giovannucci E, Andersson SO, et al. Dairy products, calcium, phosphorous, vitamin D, and risk of prostate cancer. Cancer Causes Control 1998;9:559-66.
  127. Zittermann A, Bock P, Drummer C, et al. Lactose does not enhance calcium bioavailability in lactose-tolerant, healthy adults. Am J Clin Nutr 2000;71:931-6.
  128. Cueto-Manzano AM, Konel S, Freemont AJ, et al. Effect of 1,25-dihydroxyvitamin D3 and calcium carbonate on bone loss associated with long-term renal transplantation. Am J Kidney Dis 2000;35:227-36.
  129. Iso H, Stampfer MJ, Manson JE, et al. Prospective study of calcium, potassium, and magnesium intake and risk of stroke in women. Stroke 1999;30:1772-9.
  130. Spencer H, Fuller H, Norris C, Williams D. Effect of magnesium on the intestinal absorption of calcium in man. J Am Coll Nutr 1994;15:485-92.
  131. Becker GL. The case against mineral oil. Am J Digestive Dis 1952;19:344-8.
  132. Reid IR, Ibbertson HK. Calcium supplements in the prevention of steroid-induced osteoporosis. Am J Clin Nutr 1986;44:287-90.
  133. Need AG, Philcox JC, Hartley TF, et al. Calcium metabolism and osteoporosis in corticosteroid-treated postmenopausal women. Aust N Z J Med 1986;16:341-6.
  134. Gennari C. Differential effect of glucocorticoids on calcium absorption and bone mass. Br J Rheumatol 1993;32:11-4.
  135. Lems WF, Jacobs JW, Netelenbos JC, et al. [Pharmacological prevention of osteoporosis in patients on corticosteroid medication]. Ned Tijdschr Geneeskd 1998;142:1904-8.
  136. Reid DM, Kennedy NS, Smith MA, et al. Total body calcium in rheumatoid arthritis: Effects of disease activity and corticosteroid treatment. Br Med J (Clin Res Ed) 1982;285:330-2.
  137. Lems WF, Van Veen GJ, Gerrits MI, et al. Effect of low-dose prednisolone (with calcium and calcitriol supplementation) on calcium and bone metabolism in healthy volunteers. Br J Rheumatol 1998;37:27-33.
  138. Knodel LC, Talbert RL. Adverse effects of hypolipidaemic drugs. Med Toxicol 1987;2:10-32.
  139. Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
  140. Spencer H, Menaham L. Adverse effects of aluminum-containing antacids on mineral metabolism. Gastroenterology 1979;76:603-6.
  141. Roberts DH, Knox FG. Renal phosphate handling and calcium nephrolithiasis: role of dietary phosphate and phosphate leak. Semin Nephrol 1990;10:24-30.
  142. Raman L, Rajalakshmi K, Krishnamachari KAVR, et al. Effect of calcium supplementation to undernourished mothers during pregnancy on the bone density of the neonates. Am J Clin Nutr 1978; 31:466-9.
  143. Koo WK, Walters JC, Esterlitz J, et al. Maternal calcium supplementation and fetal bone mineralization. Obstet Gynecol 1999;94:577-82.
  144. Cholst IN, Steinberg SF, Tropper PJ, et al. The influence of hypermagnesemia on serum calcium and parathyroid hormone levels in human subjects. New Engl J Med 1984;310:1221-5.
  145. Rasmussen HS, Cintin C, Aurup P, et al. The effect of intravenous magnesium therapy on serum and urine levels of potassium, calcium and sodium in patients with ischemic heart disease, with and without acute myocardial infarction. Arch Int Med 1988;148:1801-5.
  146. Ross DS. Monitoring L-thyroxine therapy: lessons from the effects of L-thyroxine on bone density (editorial). Am J Med 1991;91:1-4.
  147. Greenspan SL, Greenspan FS, Resnick NM, et al. Skeletal integrity in premenopausal and postmenopausal women receiving long-term L-thyroxine therapy. Am J Med 1991;91:5-14.
  148. Stall GM, Harris S, Sokoll LJ, Dawson-Hughes B. Accelerated bone loss in hypothyroid patients overtreated with L-thyroxine. Ann Int Med 1990;113:265-9.
  149. Paul TL, Kerrigan J, Kelly AM, et al. Long-term L-thyroxine therapy is associated with decreased hip bone density in premenopausal women. JAMA 1988;259:3137-41.
  150. Coindre JM, David JP, Riviere L, et al. Bone loss in hypothyroidism with hormone replacement: A histomorphometric study. Arch Int Med 1986;146:48-53.
  151. Perry HM. Thyroid replacement and osteoporosis (editorial). Arch Int Med 1986;146:41-2.
  152. Gough H, Goggin T, Bissessar A, et al. A comparative study of the relative influence of different anticonvulsant drugs, UV exposure and diet on vitamin D and calcium metabolism in out-patients with epilepsy. Quart J Med 1986;59:569-77.
  153. Hoogwerf BJ, Hibbard DM, Hunninghake DB. Effects of long-term cholestyramine administration on vitamin D and parathormone levels in middle-aged men with hypercholesterolaemia. J Lab Clin Med 1992;119:407-11.
  154. Heaney RP, Rafferty K. Carbonated beverages and urinary calcium excretion. Am J Clin Nutr 2001;74:343-7.
  155. Rapuri PB, Gallagher JC, Kinyamu HK, Ryschon KL. Caffeine intake increases the rate of bone loss in elderly women and interacts with vitamin D receptor genotypes. Am J Clin Nutr 2001;74:694-700.
  156. Thys-Jacobs S. Micronutrients and the premenstrual syndrome: The case for calcium. J Am Coll Nutr 2000;19:220-7.
  157. Bryant RJ, Cadogan J, Weaver CM. The new dietary reference intakes for calcium: implications for osteoporosis. J Am Coll Nutr 1999;18:406S-412S.
  158. Mackerras D, Lumley T. First- and second-year effects in trials of calcium supplementation on the loss of bone density in postmenopausal women. Bone 1997;21:527-33.
  159. Kanis JA. The use of calcium in the management of osteoporosis. Bone 1999;24:279-90.
  160. Deal C. Can calcium and vitamin D supplementation adequately treat most patients with osteoporosis? Cleve Clin J Med 2000;67:696-8.
  161. Nieves JW, Komar L, Cosman F, Lindsay R. Calcium potentiates the effect of estrogen and calcitonin on bone mass: review and analysis. Am J Clin Nutr 1998;67:18-24.
  162. McGarry KA, Kiel DP. Postmenopausal osteoporosis. Strategies for preventing bone loss, avoiding fracture. Postgrad Med 2000;108:79-82,85-88, 91.
  163. Chiu KM. Efficacy of calcium supplements on bone mass in postmenopausal women. J Gerontol A Biol Sci Med Sci 1999;54:M275-80.
  164. Heaney RP. Calcium, dairy products and osteoporosis. J Am Coll Nutr 2000;19:83S-99S.
  165. Hammar M, Larsson L, Tegler L. Calcium treatment of leg cramps in pregnancy. Effect on clinical symptoms and total serum and ionized serum calcium concentrations. Acta Obstet Gynecol Scand 1981;60:345-7.
  166. Bell L, Halstenson CE, Halstenson CJ, et al. Cholesterol-lowering effects of calcium carbonate in patients with mild to moderate hypercholesterolemia. Arch Intern Med 1992;152:2441-4.
  167. Friedman PA, Bushinsky DA. Diuretic effects on calcium metabolism. Semin Nephrol 1999;19:551-6.
  168. Kalkwarf HJ, Harrast SD. Effects of calcium supplementation and lactation on iron status. Am J Clin Nutr 1998;67:1244-9.
  169. Sokoll LJ, Dawson-Hughes B. Calcium supplementation and plasma ferritin concentrations in premenopausal women. Am J Clin Nutr 1992;56:1045-8.
  170. Minihane AM, Fairweather-Tait SJ. Effect of calcium supplementation on daily nonheme-iron absorption and long-term iron status. Am J Clin Nutr 1998;68:96-102.
  171. Krall EA, Dawson-Hughes B. Smoking increases bone loss and decreases intestinal calcium absorption. J Bone Miner Res 1999;14:215-20.
  172. Saunders D, Sillery J, Chapman R. Effect of calcium carbonate and aluminum hydroxide on human intestinal function. Dig Dis Sci 1988;33:409-13.
  173. Clemens JD, Feinstein AR. Calcium carbonate and constipation: a historical review of medical mythopoeia. Gastroenterology 1977;72:957-61.
  174. Maton PN, Burton ME. Antacids revisited: a review of their clinical pharmacology and recommended therapeutic use. Drugs 1999;57:855-70.
  175. Heaney RP, Dowell MS, Barger-Lux MJ. Absorption of calcium as the carbonate and citrate salts, with some observations on method. Osteoporos Int 1999;9:19-23.
  176. Talbot JR, Guardo P, Seccia S, etal. Calcium bioavailability and parathyroid hormone acute changes after oral intake of dairy and nondairy products in healthy volunteers. Osteoporos Int 1999;10:137-42.
  177. Fujita T, Ohue T, Fujii Y, et al. Effect of calcium supplementation on bone density and parathyroid function in elderly subjects. Miner Electrolyte Metab 1995;21:229-31.
  178. Fujita T, Ohue T, Fujii Y, et al. Heated oyster shell-seaweed calcium (AAA Ca) on osteoporosis. Calcif Tissue Int 1996;58:226-30.
  179. Heller HJ, Stewart A, Haynes S, Pak CY. Pharmacokinetics of calcium absorption from two commercial calcium supplements. J Clin Pharmacol 1999;39:1151-4.
  180. Celotti F, Bignamini A. Dietary calcium and mineral/vitamin supplementation: a controversial problem. J Int Med Res 1999;27:1-14.
  181. Chapuy MC, Arlot ME, Duboeuf F, et al. Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med 1992;327:1637-42.
  182. Power ML, Heaney RP, Kalkwarf HJ, et al. The role of calcium in health and disease. Am J Obstet Gynecol 1999;181:1560-9.
  183. Crowther CA, Hiller JE, Pridmore B, et al. Calcium supplementation in nulliparous women for the prevention of pregnancy-induced hypertension, preeclampsia and preterm birth: an Australian randomized trial. FRACOG and the ACT Study Group. Aust N Z J Obstet Gynaecol 1999;39:12-8.
  184. Recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. American College of Rheumatology Task Force on Osteoporosis Guidelines. Arthritis Rheum 1996;39:1791-801.
  185. Adachi JD, Bensen WG, Bianchi F, et al. Vitamin D and calcium in the prevention of corticosteroid induced osteoporosis: a 3 year followup. J Rheumatol 1996;23:995-1000.
  186. Adachi JD, Ioannidis G. Calcium and vitamin D therapy in corticosteroid-induced bone loss: what is the evidence? Calcif Tissue Int 1999;65:332-6.
  187. Rudnicki M, Hojsted J, Petersen LJ, et al. Oral calcium effectively reduces parathyroid hormone levels in hemodialysis patients: a randomized double-blind placebo-controlled study. Nephron 1993;65:369-74.
  188. Tsukamoto Y, Moriya R, Nagaba Y, et al. Effect of administering calcium carbonate to treat secondary hyperparathyroidism in nondialyzed patients with chronic renal failure. Am J Kidney Dis 1995;25:879-86.
  189. Barsotti G, Cupisti A, Morelli E, et al. Secondary hyperparathyroidism in severe chronic renal failure is corrected by very-low dietary phosphate intake and calcium carbonate supplementation. Nephron 1998;79:137-41.
  190. Steinbach G, Lupton J, Reddy BS, et al. Effect of calcium supplementation on rectal epithelial hyperproliferation in intestinal bypass subjects. Gastroenterology 1994;106:1162-7.
  191. Thys-Jacobs S, Ceccarelli S, Bierman A, et al. Calcium supplementation in premenstrual syndrome: a randomized crossover trial. J Gen Intern Med 1989;4:183-9.
  192. Alvir JM, Thys-Jacobs S. Premenstrual and menstrual symptom clusters and response to calcium treatment. Psychopharmacol Bull 1991;27:145-8.
  193. Thys-Jacobs S, Starkey P, Bernstein D, Tian J. Calcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. Premenstrual Syndrome Study Group. Am J Obstet Gynecol 1998;179:444-52.
  194. Griffith LE, Guyatt GH, Cook RJ, et al. The influence of dietary and nondietary calcium supplementation on blood pressure: an updated meta-analysis of randomized controlled trials. Am J Hypertens 1999;12:84-92.
  195. Kawano Y, Yoshimi H, Matsuoka H, et al. Calcium supplementation in patients with essential hypertension: assessment by office, home and ambulatory blood pressure. J Hypertens 1998;16:1693-9.
  196. Bucher HC, Cook RJ, Guyatt GH, et al. Effects of dietary calcium supplementation on blood pressure. A meta-analysis of randomized controlled trials. JAMA 1996;275:1016-22.
  197. Allender PS, Cutler JA, Follmann D, et al. Dietary calcium and blood pressure: a meta-analysis of randomized clinical trials. Ann Intern Med 1996;124:825-31.
  198. Valimaki MJ, Kinnunen K, Volin L, et al. A prospective study of bone loss and turnover after allogeneic bone marrow transplantation: effect of calcium supplementation with or without calcitonin. Bone Marrow Transplant 1999;23:355-61.
  199. Hernandez-Avila M, Gonzalez-Cossio T, Hernandez-Avila JE, et al. Dietary calcium supplements to lower blood lead levels in lactating women: a randomized placebo-controlled trial. Epidemiology 2003;14:206-12.
  200. White E, Shannon JS, Patterson RE. Relationship between vitamin and calcium supplement use and colon cancer. Cancer Epidemiol Biomarkers Prev 1997;6:769-74.
  201. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.
  202. Roberts HJ. Potential toxicity due to dolomite and bonemeal. South Med J 1983;76:556-9.
  203. Whiting SJ. Safety of some calcium supplements questioned. Nutr Rev 1994;52:95-7.
  204. Gallagher JC, Riggs BL, DeLuca. Effect of estrogen on calcium absorption and serum vitamin D metabolites in postmenopausal osteoporosis. J Clin Endocrinol Metab 1980;51:1359-64.
  205. Baron JA, Tosteson TD, Wargovich MJ, et al. Calcium supplementation and rectal mucosal proliferation: a randomized controlled trial. J Natl Cancer Inst 1995;87:1303-7.
  206. Gupta SK, Gupta RC, Seth AK, Gupta A. Reversal of fluorosis in children. Acta Paediatr Jpn 1996;38:513-9.
  207. Kalkwarf HJ, Specker BL, Bianchi DC, et al. The effect of calcium supplementation on bone density during lactation and after weaning. N Engl J Med 1997;337:523-8.
  208. Ricci TA, Chowdhury HA, Heymsfield SB, et al. Calcium supplementation suppresses bone turnover during weight reduction in postmenopausal women. J Bone Miner Res 1998;13:1045-50.
  209. Dwyer JH, Dwyer KM, Scribner RA, et al. Dietary calcium, calcium supplementation, and blood pressure in African American adolescents. Am J Clin Nutr 1998;68:648-55.
  210. Bernstein CN, Seeger LL, Anton PA, et al. A randomized, placebo-controlled trial of calcium supplementation for decreased bone density in corticosteroid-using patients with inflammatory bowel disease: a pilot study. Aliment Pharmacol Ther 1996;10:777-86.
  211. Devine A, Dick IM, Heal SJ, et al. A 4-year follow-up study of the effects of calcium supplementation on bone density in elderly postmenopausal women. Osteoporos Int 1997;7:23-8.
  212. Dawson-Hughes B, Harris SS, Krall EA, Dallal GE. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 1997;337:670-6.
  213. Riggs BL, O'Fallon WM, Muhs J, et al. Long-term effects of calcium supplementation on serum parathyroid hormone level, bone turnover, and bone loss in elderly women. J Bone Miner Res 1998;13:168-74.
  214. Baeksgaard L, Andersen KP, Hyldstrup L. Calcium and vitamin D supplementation increases spinal BMD in healthy, postmenopausal women. Osteoporos Int 1998;8:255-60.
  215. Storm D, Eslin R, Porter ES, et al. Calcium supplementation prevents seasonal bone loss and changes in biochemical markers of bone turnover in elderly New England women: a randomized, placebo-controlled trial. J Clin Endocrinol Metab 1998;83:3817-25.
  216. Weinberger MH, Wagner UL, Fineberg NS. The blood pressure effects of calcium supplementation in humans of known sodium responsiveness. Am J Hypertens 1993;6:799-805.
  217. Petersen LJ, Rudnicki M, Hojsted J. Long-term oral calcium supplementation reduces diastolic blood pressure in end stage renal disease. A randomized, double-blind, placebo-controlled study. Int J Artif Organs 1994;17:37-40.
  218. Yamamoto ME, Applegate WB. Klag MJ, et al. Lack of blood pressure effect with calcium and magnesium supplementation in adults with high-normal blood pressure. Results from phase I of the trials of hypertension prevention (TOHP). Trials of Hypertension Prev (TOHP) Collab Res Group. Ann Epidemiol 1995;5:96-107.
  219. Purwar M, Kulkarni H, Motghare V, Dhole S. Calcium supplementation and prevention of pregnancy induced hypertension. J Obstet Gynaecol Res 1996;22:425-30.
  220. Whelton PK, Kumanyika SK, Cook NR, et al. Efficacy of nonpharmacologic interventions in adults with high-normal blood pressure: results from phase 1 of the trials of hypertension prevention (TOHP). Trials of Hypertension Prev (TOHP) Collab Res Group. Am J Clin Nutr 1997;65:652S-60S.
  221. Levine RJ, Hauth JC, Curet LB, et al. Trial of calcium to prevent preeclampsia. N Engl J Med 1997;337:69-76.
  222. Baron JA, Beach M, Mandel JS, et al. Calcium supplements for the prevention of colorectal adenomas. Calcium Polyp Prev Study Group. N Engl J Med 1999;340:101-7.
  223. Shils M, Olson A, Shike M. Modern Nutrition in Health and Disease. 8th ed. Philadelphia, PA: Lea and Febiger, 1994.
  224. Young DS. Effects of Drugs on Clinical Laboratory Tests 4th ed. Washington: AACC Press, 1995.
  225. Franklyn AJ, Bettenridge J, Daykin J, et al. Long-term thyroxine treatment and bone mineral density. Lancet 1992;340:9-13.
  226. Schneider DL, Barrett-Connor EL, Morton DJ. Thyroid hormone use and bone mineral density in elderly men. Arch Intern Med 1995;155:2005-7.
  227. Kung AWC, Pun KK. Bone mineral density in premenopausal women receiving long-term physiological doses of levothyroxine. JAMA 1991;265:2688-91.
  228. McKevoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
Show more references
Show fewer references
Last reviewed - 06/19/2012




Page last updated: 27 September 2012