Q: I'm a female in my 50s, and I just bought a calcium supplement at a local grocery store, but there were so many choices! This one, which was the cheapest, is oyster shell calcium carbonate 500 milligrams plus 125 IU (international units) of vitamin D3. Did I make a good choice?
HANS member, Vancouver

A: Dr. Vince Lurie of the Alta Vista Naturopathic Clinic in Vancouver (www.luriehealth.com, (604) 736-3800) and Professional HANS member, replies:
Good for you for taking charge of your health! I'm sorry to tell you that calcium carbonate is the least absorbable form of calcium and that the vitamin D3 content of your choice is too low. It also has no magnesium (which is also essential for balancing bone mineralization) and none of the trace minerals that are beneficial for enhancing the effect. This is a low-cost calcium and unfortunately, it is often true that you get what you pay for.

A calcium-magnesium (Cal/Mag) supplement is most recommended to prevent or treat osteoporosis although is useful for treating many other conditions. The type of calcium and the dosage are dependant upon the reason for taking it. It is available in a 2:1 ratio for normal use and a 1:1 ratio where higher magnesium levels are required.

The best forms of calcium (from most absorbable to least) are: microcrystalline hydroxyapatite, amino acid chelates, citrate, ascorbate and lactate. Forms such as carbonate (dolomite, oyster shell and coral) and oxides are more difficult to digest and less easily absorbed. Caution should be taken with calcium in the case of kidney stones and disease. As we need large amounts of calcium daily, a calcium-rich diet is also important. Sources include green leafy vegetables, nuts, molasses, brewer's yeast, dulse, sesame seeds, figs, oats, and prunes.

Good forms of magnesium include citrate, ascorbate and chelates, although oxide, which is less absorbable, is often used to reduce costs. Magnesium is abundant in natural whole foods.

Better formulations of calcium with magnesium often contain other nutrients to act in a synergistic manner to improve absorption and bone density. These include vitamin D3, phosphorus, copper, zinc, manganese, strontium, vitamin B1 (thiamin), vitamin C, and glucosamine HCl. Vitamin D3 is needed for calcium uptake so one should try to get at least 1,000 IU per day. Some Cal/Mags may also include boron and vitamin K2, which have been shown to be highly beneficial but are currently on the government's "hit-list," so they may not be
readily available.

So, to answer your question, a Cal/Mag citrate with high levels of vitamin D3 would be a far better choice, but you may require something even better. The best type, brand and dosage depend strongly on your bone mineral status as well as many other factors.

You may want to discuss your specific status and needs with a naturopathic doctor.

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