Remember the TV show Seinfeld? Jerry was the star, and the show was named after him. But the show would have been nothing without Elaine, Kramer, George and his family.
Well Calcium supplements are a lot like Jerry Seinfeld. (Except that Jerry isn’t as crucial to good health.) They just don’t work without a cast of supporting characters.
In fact, its when taken alone that calcium supplements can increase heart attack risks. So, what are the ingredients needed for safe, maximally effective calcium absorption?
Vitamin D is essential for calcium absorption in the intestines. It helps maintain the correct concentration of calcium in the blood, thereby enabling normal bone mineralization. It’s needed for bone growth and bone remodeling. It’s been shown to decrease the risk of falls, fractures and bone loss in elderly patients, to reduce the risk of hip fractures, to improve bone density and to reduce the risk of osteoporosis.
Magnesium is crucial for calcium to be utilized by the body. It stimulates the hormones that help put calcium into bones and prevent it from being deposited in soft tissue or arteries. Magnesium deficiency alters calcium metabolism and the hormones that regulate calcium. It’s been found to prevent fractures and significantly increase bone density.
Vitamin C increases calcium absorption in the intestines. It’s essential to the fomation of collagen (the connective tissue in bone) and stimulates proteins involved in bone formation. It has been shown to reduce bone loss in older men, lead to higher bone mineral density in postmenopausal women, and to protect and maintain healthy bone mass. Vitamin C deficiency has also been shown to stimulate bone loss.
Vitamin K helps calcium get from the bloodstream to bones. It’s necessary for the activation of osteocalcin, which is the protein that binds calcium to the bone matrix. It helps prevent calcium buildup in the arteries and in fact can decrease existing calcium buildup by up to 37% in as little as 6 weeks. It’s been shown to increase calcium absorption, increase bone gain and decrease bone loss. Other studies have shown it to prevent bone loss and reduce fracture risk. It sustains lumbar bone mineral density, while the lack of vitamin k has been associated with lower BMD.
Lysine may be more famous for cold sores, but studies show it has a vital effect on calcium absorption and utilization as well. It’s been shown to increase calcium absorption and decrease the amount excreted in urine, as well as increasing the speed at which calcium is absorbed. It promotes mineral absorption, increasing the amount of calcium incorporated into the bone matrix. Finally, it stimulates the cells responsible for bone formation.
Other Trace Minerals
Zinc has been the subject of conflicting reports. However, when we look past the headlines and into actual study content the picture becomes much more clear. First, when taken together zinc has been shown to interfere with calcium absorption (and vice versa) and inhibit calcium accumulation. It also significantly decreases magnesium absorption. However, these results occurred only when zinc supplementation levels were very high (about 10X the dose that has been found effective for bone health) and the calcium intake was very low.
Zinc is important for bone metabolism. It’s been shown to stimulate bone formation and mineralization. Women with osteoporosis and osteopenia were shown to have significantly lower zinc (and magnesium) concentrations than those with normal bone strength. Most importantly, zinc supplementation had no effect on calcium absorption when calcium intake was 800 MG a day or greater, and further studies have shown that calcium supplements (specifically in the form of calcium citramate) did not interfere with zinc absorption.
Therefore, our recommendation would be to take no more than 15 MG/ day of zinc along with calcium in the form of citramate.
Copper plays an important role in the constant renewal cycle of bone remodeling. It helps certain stem cells (known as MSCs) to become the cells that form bone (osteoblasts) instead of cells that become fat(adipocytes). It inhibits bone resorption or breakdown and has been shown to maintain bone mineral density in middle age women.
Manganese is important to bone mineralization and the development of cartilage. It is essential to bone metabolism. Small (but not large) amounts have been shown to increase mineralization above that of adding calcium alone. Deficiency has been shown to impair bone metabolism. One study of osteoporotic women found their blood levels of manganese to be 25% of normal.
A study published in 1993 looked at supplementation of trace minerals zinc (at 15 mg/ day), copper (2.5 mg/ day) and manganese (5 mg/ day) along with 1000 mg/ day of elemental calcium citramate. The effects of a placebo, the trace minerals alone, calcium citramate alone, and citramate together wth the trace minerals were compared on the bone mineral content of postmenopausal women. While the group taking calcium citramate alone had less bone loss than the group taking trace minerals alone, the group taking both actually saw an improvement in bone density.
Boron is important for the absorption and utilization of calcium (Kelly GS. Boron: A review of its nutritional interactions and therapeutic uses. Altern Med Rev. 1997 Jan;2(1):48-56). It’s been shown to decrease the amount of both calcium and magnesium lost in urine (and therefore increase absorption). It’s required for normal bone metabolism. It supports optimal calcium absorption even when vitamin D is deficient. Evidence suggests boron affects both functional and compositional properties of bone.
Rag-Tag Research Geek Recommendation
We have yet to find a single product with all of the above nutrients. The most complete calcium supplement available is Calciology™. It contains calcium citramate, D3, magnesium, C, K2 and lysine. In addition, we recommend separate supplements containing 15 mg/ day of zinc, 2.5 mg/ day of copper, 5 mg/ day of manganese, and no more than 3 mg/ day of boron.