Calcium is an essential macro-mineral, meaning that the body requires it in large quantities (compared to trace minerals needed in micrograms). Depending upon your age, sex and whether you are pregnant or lactating, you require about 1,000 mg (1 gram) per day, ranging from 800-1500 mg. For women, even the AMA recommends an intake above the standard RDA of 800mg. They advise 1200mg. per day for the prevention of osteoporosis. About 10 million Americans, 80% female, have osteoporosis. Another 34 million Americans are considered to have the premature form of osteoporosis called osteopenia. Having either disease increases the risk of fractures in the hip, spine, wrist, pelvis and ribs and is a leading cause of death among older women. Osteoporosis was once considered an older women’s issue; now it affects children as young as 12 years old.

Here is what the Surgeon-General has to say about the necessity of adequate calcium: “Low calcium intake is recognized as a major public health problem in the United States, with more than 75 percent of Americans not meeting the current calcium recommendations for their age/gender group, putting them at risk for osteoporosis”.

The top priority of the Surgeon General is to prevent debilitation and premature mortality from all causes, including bone disease and injury. Concerns about the large toll that osteoporosis is inflicting on the nation led to release of The Surgeon General’s Report on Bone Health and Osteoporosis on October 14, 2004, which details the need for a greater public health focus on osteoporosis among all ethnic and age groups. It also discusses the issue of inadequate calcium consumption.

Calcium acts to provide much of the skeletal structure of the body as well as to participate in many enzymatic reactions as a co-factor, muscle contraction and relaxation, nerve impulse conduction, energy production and as a regulator of communication between cells. If blood levels go too high or too low, you will die. The majority of calcium is not found in the blood, however. Testing blood levels does not provide significant information about calcium balance. It is only helpful in determining pathological conditions.

The body contains about six pounds of minerals, the majority of which is calcium and phosphorus, (followed by magnesium); most of which is found in bone and soft tissues. These three minerals are closely intertwined in their absorption and regulation by parathyroid and calcitonin hormones as well as Vitamin D (which in fact is a hormone). The main factors determining balance are: intake, absorption, assimilation, utilization and the ratios of the three minerals. Too much of one decreases the others by a feedback loop involving mainly parathyroid hormone.

The optimum balance is two parts phosphorus per each part of calcium. Calcium and magnesium should have a two to one ratio. Deviations from these ratios affect the levels of parathyroid hormone and affect absorption, utilization and excretion. The main problem with long-term balance of these minerals is that the typical American diet is overloaded with phosphorus, due to high intakes of refined carbohydrates, fat, processed foods and soft drinks (to which phosphorus is added. A recent study showed that drinking one soft drink per day doubles the risk of diabetes). In addition, farming practices over the past 100 plus years have focused on utilizing phosphorus based fertilizers to increase yield. At the same time, calcium and magnesium have been depleted from the soils and not replenished.

High blood pressure affects around 50 million Americans and is very common among African Americans and older people. A study done revealed that women who take 1500-2000 mg of calcium daily reduce the risk of getting high blood pressure from pregnancy by as much as 50%.Calcium may be beneficial in prevention and treatment of: cataracts, osteoporosis, colon cancer, high blood pressure, kidney stones, premenstrual syndrome, pregnancy induced high blood pressure and inflammatory bowel disease.

How can you tell if you are calcium and/or magnesium deficient? Start with your diet. If it is high in junk food, sugar and fat, with little fresh fruits, vegetables, whole grains and dairy products, you will be deficient. If you rarely get in the sun and wear sunscreen, you will be deficient. If you are at risk for fracture you can get a bone density test (standard x-rays don’t show calcium loss from bone until at least 30% is gone- way too late for optimal treatment). Since calcium and magnesium are stored in bone and tissue, a Trace Mineral Analysis performed on hair gives an accurate picture of storage for the past two months. A simple urine test called the Sulkowitch test, tells you how much calcium is in the urine. If you have low blood levels, none spills into the urine, giving a positive test for low blood calcium.

Unless contraindicated, for the vast majority of people, taking a calcium and magnesium supplement is a good idea. For maximum absorption you should not take calcium carbonate (oyster or egg shell) as little gets absorbed. The best forms are citrate, malate or aspartate, and yes they cost a little more.