[Calcium & Magnesium Episode 2] If you take calcium pills, do you get stones in your kidneys? | Dr. Esther Yeo

Dec 13, 2024Ehotyshamull Joy

Misconceptions about calcium

Calcium supports colon health

Calcium supports colon health. In a randomized clinical study, calcium reduced the incidence of polyps (small lumps in the body) in the colon, and this effect was observed up to 5 years after the withdrawal of calcium supplements.It has been reported that calcium intake of 700~800mg reduced the incidence of colorectal cancer by 40~50%. However, a randomized clinical study of more than 36,000 postmenopausal women in the United States did not show any protection against colorectal cancer. A Cochrane Review in 2008 acknowledged the potential of calcium supplementation to reduce the incidence of polyps, but found it was not effective enough to prevent colorectal cancer. If you have a lot of colon polyps, if not colon cancer, you may want to take calcium supplements.

Speaking of calcium and heart disease...

One of the most challenging aspects of calcium function is its effectiveness in preventing cardiovascular diseases such as heart disease and stroke. Originally, calcium interferes with the absorption of fat in the intestines and lowers cholesterol, which is said to be good for preventing heart disease. A study of postmenopausal women in Iowa, USA, found that calcium supplementation reduced the incidence of coronary artery disease.

The opposite result...

However, many subsequent studies have shown the opposite of calcium's protective effect on heart disease. In a study of postmenopausal women in Sweden, excessive calcium intake of more than 1,400 mg per day was associated with a higher incidence of heart disease and stroke than those who took 600~1,000 mg. Men who ate 1,000 mg of calcium per day had a 20% higher risk of stroke mortality than those who did not eat. Large clinical studies in the United States and Europe in 2011 and 2012, respectively, also showed that calcium supplementation actually increased the incidence of heart disease.

We're back to being neutral

Many were confused. This is because it was a slap in the face to people who had been taking calcium pills because they were said to help with heart disease as well as bones. However, in 2013, researchers at WHI in the United States re-analyzed the existing data by following more than 93,000 menopausal women over an eight-year period and found that there was no evidence that calcium increased the risk of heart disease and stroke. WHI is a large-scale, randomized clinical trial that began in 1993 and has involved more than 160,000 women in the United States. To sum up, it was initially said that calcium is good for heart disease, but then it changed to say that it is not good for heart disease, and now the conclusion is that it is neither good nor bad.

So to sum it up...

The controversy surrounding calcium's ability to prevent heart disease illustrates why we shouldn't be complacent about the efficacy of supplements. Once again, supplements such as calcium are foods, not drugs. Unlike medications, foods are more likely to produce jagged results. Regarding the efficacy of nutritional supplements in treating diseases, it is necessary to wait for consistent results from multiple papers over a long period of time. The conclusion so far is that calcium is necessary for the prevention of bone diseases such as osteoporosis, but it is not necessary to take it to prevent heart disease, and excessive calcium intake should be avoided.

Calcium and stones

What if you have stones in your kidneys?This is something that many people who take calcium supplements have a question about. Theoretically, calcium is likely to cause stones. The most common form of kidney stones is calcium oxalate. In fact, postmenopausal women who took 1,000 mg of calcium supplement daily with 400 IU of vitamin D were observed for 7 years and found a 17% increase in kidney stones compared to placebo.

However, when it comes to food intake, the opposite is true...

Strangely, high calcium intake from food was not associated with kidney stones. In fact, the less calcium I ate in food, the more stones I had. In a recent study of more than 78,000 women in the U.S. over an average of eight years, the top 20% of those who ate the most calcium had a 28% lower incidence of kidney stones compared to the 20% of the lowest group who ate the least. These findings can be explained by the fact that low calcium intake increases the concentration of oxalic acid in the body, which leads to the formation of stones.

Why?

So why did calcium as a supplement produce bad results? Experts note speed over quantity. Calcium is a very safe mineral. According to the most conservative estimate of calcium intake by the National Medical Association of the United States, it is 3,000mg for 9~18 years old, 2,500mg for 19~50 years old, and 2,000mg for 51 years old and older. Even if the calcium levels in the blood are quite high, it does not cause heart disease or kidney stones.

The problem is when there is a sudden excess of calcium

The problem is when an excess of calcium comes in suddenly, at a rapid pace. It is difficult to consume a lot of calcium from foods such as milk and spinach at once. Nutritional supplements, on the other hand, are concentrated forms, so the total amount is safe, but it can be taxing on the body in terms of speed. Calcium can only be processed by the gastrointestinal tract up to 600 mg at a time. The rest of the calcium floats in the blood and is excreted by the kidneys, where it can form stones.

But for most people, there's nothing to worry about

Currently, the calcium supplements on the market are usually about 500~1000mg per pill. The content of pure calcium is 40% for calcium carbonate and 21% for calcium citrate, so the calcium per pill is about 100~400mg. Unless you're a regular milk drinker, there's no reason to be afraid of taking calcium pills because of kidney stones. However, 8% of the population suffers from idiopathic hypercalciuria. They constitutionally produce a lot of stones in the kidneys for no reason. These people have usually been diagnosed with stones once or twice due to severe pain. If this is the case, it is safer to take calcium in food form rather than nutritional supplements.

Calcium and caffeine

It's a bit of an exaggeration to say that it's best not to take calcium supplements with caffeine from coffee or protein from meat. This is because a cup of coffee can only extract 2~3mg of calcium. It is true that protein excretes a lot of calcium from the kidneys, but in the intestine, on the contrary, it increases calcium absorption, so on the whole, calcium loss is almost nonexistent. This means that even if you take calcium supplements, you don't have to be too afraid of eating coffee or meat.

How to take calcium supplements to avoid side effects

The most common side effects of calcium supplements are constipation and gastrointestinal disorders such as gas production and abdominal distension. The more sensitive a person is, the more likely they are to feel uncomfortable when they take calcium supplements. In this case, it's better to eat it twice a day rather than all at once. The Food and Nutrition Board (FNB) of the American Medical Association recommends not taking more than 500 mg of calcium preparations at a time.

Among calcium supplements, calcium citrate is recommended. Here's why.

Calcium preparations are broadly divided into calcium carbonate preparations and calcium citrate preparations. If possible, calcium citrate preparations should be chosen. Despite the high price of calcium citrate preparations, they have a number of advantages. Calcium carbonate preparations are affected by gastric acidity when absorbed. Therefore, it is most effectively absorbed when consumed with food rather than on an empty stomach. On the other hand, calcium citrate preparations are well absorbed regardless of food, whether on an empty stomach or after meals. In low-acidity environments where stomach acid is not secreted well, such as atrophic gastritis, which is common in the elderly, inflammatory bowel diseases such as Crohn's disease, and malabsorption, calcium citrate preparations are better than calcium carbonate preparations. Gastrointestinal disorders such as gas, abdominal distension, and constipation, which are the biggest side effects of calcium preparations, are also more common with calcium carbonate. Taking calcium supplements in small portions rather than taking large amounts at once is a way to increase absorption and reduce side effects.

How much calcium am I eating per day?

In a typical Korean diet, the amount of calcium consumed by an adult after three meals and side dishes is about 400~500mg. If you're on a diet or eat a small amount of food, most people consume less than 400 mg of calcium per day. The recommended daily amount of calcium for Korean adults is 700~800mg, which means that at least 300mg needs to be supplemented separately.

The best sources of calcium are dairy products, such as milk. 1 ml of milk contains approximately 1 mg of calcium. It's easy to understand if you think that a glass of milk (200 ml() contains about 200 mg of calcium. Drinking two glasses of low-fat milk a day is the simplest. This is because 400 mg of calcium is supplemented from milk. If you don't like milk, you should supplement it with foods high in calcium, such as yogurt, bone-in fish such as anchovies and whitebait, tofu, and seaweed. If these are not possible, you will need to take calcium supplements every day.

Multivitamins also contain calcium, but the amount is small, so multivitamins alone are not enough. That is why calcium preparations are needed separately. Calcium preparations don't always contain as much calcium as you might think. When it comes to calcium carbonate, the calcium content is usually 40%, so a 500 mg tablet has 200 mg of calcium. Calcium citrate has a calcium content of 21%, so you need to eat a 1,000-gram tablet to get 210 mg of calcium. If you don't drink milk and don't eat high-calcium foods such as anchovies or seaweed, it's a good idea to take one or two calcium pills a day

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[Calcium & Magnesium Episode 2] If you take calcium pills, do you get stones in your kidneys? | Dr. Esther Yeo

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