Ellen Campbell Grizzle - Pharmacy Today CONSUMERS ARE dazzled by the vast array of calcium combinations available in pharmacies. This makes the selection of the most appropriate calcium supplement very challenging. Choices without prescription include tablets, syrups, 'fizzes', 'chewables' and herbal remedies, and the prices differ widely.
Although calcium is available in sufficient quantity from a balanced diet, some persons lose more calcium than they take in on a daily basis and end up with calcium deficiencies. This must be replaced.
Calcium is involved in regulating heartbeat, conducting nerve impulses, stimulating hormone impulses, the clotting of blood and building and maintaining of healthy bones. The body loses calcium each day through the shedding of skin, hair and nails, sweating, the passing of urine and faeces.
If your diet is deficient, calcium is leached from the bones where it is stored. A nutritionist can help you to determine any level of additional supplementation needed. There are calculated average requirements and your need is determined by the amount of calcium consumed in your daily diet.
POPULAR FORMS
Calcium exists in nature as combinations. Three popular forms used for nutritional purposes are:
Calcium carbonate -- It is insoluble and consists of 40 per cent of elemental calcium by weight. It needs gastric acid for absorption and therefore must be taken after meals.
Calcium citrate -- It contains 21 per cent of elemental calcium by weight, is more soluble, does not need gastric acid for absorption and can be taken at any time of day.
Calcium phosphate -- It is found in bone
meal or dolomite and contains eight per cent of elemental calcium.
Vitamin D (the sunshine vitamin) is needed for calcium absorption from the intestines. Usually 15 minutes of exposure to sunlight daily is adequate to produce sufficient Vitamin D. Additionally, Vitamin D is added to milk and several cereals.
Purity -- There are seals of approval on various products that are internationally accepted. This is particularly important if you are purchasing bone meal or dolomite that may be contaminated with heavy metals such as lead and cadmium.
Absorbability -- This determines the amount of the product that you will have to take every day. The amount of elemental calcium per dose must be calculated as well. You are likely to take more calcium citrate tablets to achieve required levels when compared to calcium carbonate. Calcium is best absorbed if taken in divided doses of 500mg or less.
Tolerance -- Some products cause increased flatulence and constipation. Fluid intake should be increased and dose gradually increased. It may be necessary to make a product switch.
Cost -- Products made from calcium carbonate are usually the least expensive.
Interactions interferes with iron and zinc absorption and vice versa. When it is necessary to take iron, zinc and calcium together, Vitamin C is added to the combination and calcium citrate used. Calcium inactivates the antibiotic, tetracycline. Care must also be taken with several other drugs used to treat common chronic conditions.
Pharmacists always advise that you separate calcium supplements from oral medications by more than two hours. This also applies to certain foods such as spinach, bran, fresh fruits and vegetables. Large amounts of alcohol, tobacco and caffeine containing beverages should also be avoided.
Serious adverse effects such as increased sensitivity of the eyes and skin to light, confusion, irregular or slower heart beat usually occur in a person who has taken excessive amounts of calcium for a long period, or a patient with kidney disease.
If you would like to know how calcium supplements work to keep you healthy by maintaining essential body functions, ask your pharmacist, you have the right to know!
Ellen Campbell Grizzle, President of the Caribbean Association of Pharmacists (CAP) and Director of Information & Research, National Council on Drug Abuse (NCDA), Kingston, Jamaica.
