Why You Shouldn’t Supplement Calcium

Much of the advice handed out by medical doctors is unreliable.  One reason is that the research on which that advice is based is often conducted by specialists who overlook effects beyond their scope of professional interest.

We’ve mentioned previously the example of statin research. Statin studies are generally performed by cardiologists and in the U.S., many statin studies reported only heart attacks and other cardiovascular events as endpoints, not total mortality, cancer, or infectious disease. This method of evaluating drugs would show a lethal neurotoxin to be the best cardiac treatment ever:  In the neurotoxin group not a single patient would die of a heart attack!

A similar myopia has occurred in osteoporosis research, where doctors have focused on the effect of calcium supplements on bone density or fracture rates but often do not evaluate the effect of the supplements on overall health.

But other effects have to be considered, given that:

  • Calcification of coronary arteries may be the best single indicator of heart attack risk. [1]
  • In the Nurse’s Health Study, supplementation of calcium increased the risk of calcium oxalate kidney stones by 20%. [2]
  • Calcium is a strong promoter of biofilm formation in most pathogenic bacterial species. [3] It also likely promotes formation of Candida albicans (fungal) biofilms. As a result, it can aggravate bowel disorders and infectious diseases.

Clearly, calcium in the wrong places – a problem that could be exacerbated by calcium supplementation – is a major health risk.

What causes calcium to go in the wrong places? Deficiencies of vitamin D and vitamin K2 are common reasons. Deficiencies of both are widespread. Vitamin K2 deficiency is a known cause of vascular calcification.

A few years ago, a group of New Zealand researchers conducted a randomized clinical trial that found that over five years, older women taking calcium supplements doubled their risk of heart attack compared to women taking a placebo. [4]

Now, the same group has conducted a systematic review of calcium supplementation studies which confirms the link between calcium supplementation and heart attacks. Dr. Mark Bolland of the University of Auckland, New Zealand, and colleagues report that calcium supplementation increases the risk of heart attack by 31%, the risk of stroke by 20% and the risk of death by 9%. [5]

In an accompanying editorial, Dr. John Cleland writes:

Calcium supplements, given alone, … are ineffective in reducing the risk of fractures and might even increase risk, they might increase the risk of cardiovascular events, and they do not reduce mortality. They seem to be unnecessary in adults with an adequate diet. Given the uncertain benefits of calcium supplements, any level of risk is unwarranted. [6]

We concur. A healthy diet, including dairy and green leafy vegetables, not to mention a daily multivitamin (ours contains 200 mg calcium), should provide a sufficiency of calcium as long as vitamin D levels are normal. If you’re worried about bone health, supplement with vitamins D, K2, and magnesium citrate – not calcium.

[1] Budoff MJ et al. Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol 2007;49:1860-1870. http://pmid.us/17481445

[2] Curhan GC et al. Comparison of dietary calcium with supplemental calcium and other nutrients as factors affecting the risk for kidney stones in women. Ann Intern Med. 1997 Apr 1;126(7):497-504. http://pmid.us/9092314.

[3] Kierek K, Watnick PI. The Vibrio cholerae O139 O-antigen polysaccharide is essential for Ca2+-dependent biofilm development in sea water. Proc Natl Acad Sci U S A. 2003 Nov 25;100(24):14357-62. http://pmid.us/14614140.  Geesey GG et al. Influence of calcium and other cations on surface adhesion of bacteria and diatoms: a review. Biofouling 2000; 15:195–205.

[4] Bolland MJ et al. Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial. BMJ. 2008 Feb 2;336(7638):262-6. http://pmid.us/18198394.

[5] Bolland MJ et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ. 2010 Jul 29;341:c3691. doi: 10.1136/bmj.c3691. http://pmid.us/20671013.

[6] Cleland JG et al. Calcium supplements in people with osteoporosis. BMJ. 2010 Jul 29;341:c3856. http://pmid.us/20671014.

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45 Comments.

  1. Stop taking calcium and vit. C which I’ve been taking practically since birth (a slight exaggeration), but anyway for a very long time?

    I hope your book will layout in a “Diets for Dummies” format that assumes a very low level of knowledge what and how much of each supplement we should take?

    I take Centrum Silver which has everything you recommend except Magnesium Citrate and vit. K2. Are the dosages in the multicap high enough and what dosages to you recommend for supplements not included?

    I can only eat salmon once a week and can’t tolerate sardines at all. I’d rather take supplements than rely on my spotty diet.

    BTW – I just learned that a pretty young (50ish) fellow I know has MS. He’s not doing well, so I thought I’d ask you send him your book anonymously when it’s ready. It couldn’t hurt and he just may be amenable to trying diet since nothing else has helped.

    • Hi erp,

      Actually I take Centrum Silver too.

      Along with that I take:
      1. Vitamin D3 2500 IU on days I don’t get sunshine (ie all winter, maybe half the summer)
      2. Vitamin K2; any mix of MK-4 and MK-7 forms will do; I take this one.
      3. Vitamin C 500 mg/day or intermittent 1 g/day for 2 weeks off for 2 weeks.
      4. Magnesium citrate 200 mg/day.
      5. Copper – I eat 1/4 lb beef liver per week for this, but if I didn’t I would take 2 mg/day.
      6. Chromium picolinate 200 mcg/day.
      7. Selenium – I eat 4 Brazil nuts a day for this, but if I didn’t I would take 200 mcg/day.
      8. Iodine – 12.5 mg/day is a good dose, if you have chronic infections 50 mg/day. But work up slowly starting at 1 mg/day. possible source; food source.

      All 8 of these are important but vitamin D, K2, selenium, and iodine have the biggest mortality benefit. The magnesium/copper/chromium are important for stopping heart attacks so your husband may get a big mortality benefit from those.

      That’s basically my recommended supplement regime, along with nutritious foods: liver, seaweed, green leafy vegetables, bone broth soups, bone marrow, chicken soup, sea salt for trace elements, egg yolks.

      A few B-vitamins are probably beneficial in high doses too, notably B1 and B5. I take 100 mg B1, 100 mg B2, 500 mg B5, occasional biotin.

      Things to avoid supplementing (multivitamin is sufficient): calcium, vitamin A, vitamin E, folic acid, niacin, fish oil capsules (fish is better).

      If you don’t like fish, next best is the liquid fish oils that are kept refrigerated — they are less likely to go bad than the capsules. But if you avoid omega-6 having salmon or sardines once a week should be enough, that should provide 80% of the benefit. Keep omega-6 low by using butter and coconut oil as oils/fats and preferring red meat (beef, lamb) and seafood to chicken/pork.

      • Re your friend with MS, by all means I would love to help him. Be sure to introduce him to the site cpnhelp.org and to my earlier posts on MS: http://perfecthealthdiet.com/?p=151 and http://perfecthealthdiet.com/?p=157. I do believe that our diet, or something very close to it, is essential because these conditions are difficult to cure and you need to try to do everything right. It’s so easy to impair immune function and render these diseases incurable.

      • Hi Paul,
        You mentioned that you take vitamin C “intermittent 1 g/day for 2 weeks off for 2 weeks” why do you need to be off vitamin C for 2 weeks?

        Is it bad to supplement 1g/day for too long? Thanks

        • Hi Syl,

          I don’t recall when I said that. Normally one doesn’t need to go off it. Cancer patients should go off during chemotherapy.

          Many supplements it’s good to take intermittently, so that you can tell if you are taking too much or if you need it, but vitamin C is so safe, it’s not necessary.

          • Thank you Paul 🙂 I was worried that I needed to get off the vitamin C or something (I take 1g/day of vit C). Btw, congrats on the book! Can’t wait to get my hands on it 🙂

            Oh I got that excerpt from the comment above mine:

            Paul Jaminet August 20, 2010 at 6:33 pm
            Hi erp,
            Actually I take Centrum Silver too.
            Along with that I take:
            1. Vitamin D3 2500 IU on days I don’t get sunshine (ie all winter, maybe half the summer)
            2. Vitamin K2; any mix of MK-4 and MK-7 forms will do; I take this one.
            3. Vitamin C 500 mg/day or intermittent 1 g/day for 2 weeks off for 2 weeks.

      • Hi Paul,

        I’m quite shocked you take a product like “Centrum Silver”, a supplement so full of unnecessary fillers and artificial colors and flavors. It’s also used as an example of a completely ‘synthetic” vitamin on another website. Quoting:

        “These nutrients are manufactured in a lab and are different than the same nutrients found in nature. Synthetic vitamins can have the same chemical constituents, but still have a different shape (optical activity).
        This is important because some of the enzymes in the human body only work properly with a vitamin of the correct shape. When we give the body concentrated forms of synthetic nutrients, it doesn’t always appear to have an appropriate delivery system.

        Starting materials for strictly synthetic supplements can be anything from coal tar to petroleum to acetylene gas. These supplements are made in facilities via chemical manipulations with the goal of duplicating the structure of the isolated vitamin. ”

        I’d be curious to read your reply and wonder if you’ve changed to another multi, or are you still taking the same thing?

        Thank you.

      • I was wondering if you’ve revised your views on supplementing Vitamin D since this post? I’ve read and viewed Chris Masterjohn’s work on Vitamin D deficiency possibly being more a Calcium deficiency, and that the optimal levels recommended for D may be meaningless. But, then I’ve read that good studies show a benefit from D supplementation. My number is currently 28, so… just wondering if you have an opinion on Masterjohn’s ideas? Thank you!

        • I’m also curious if Paul has revised his views on “d” and also calcium. I just watched a video on youtube by Dr. Robert Heaney M.D. entitled “interactions of vitamin d and calcium”. VERY informative, and proves that they really do work together and affect each other.

          Highly recommend checking it out.

  2. Sorry here are the ingredients: Centrum Silver

  3. I want the book to come anonymously. Will you have a contact page or an insert directing readers to your website?

    Thanks so much for the heads up on vitamins. I’ll go ahead and start figuring it out.

    Am I right that you get your stuff from Amazon?

  4. Hi erp,
    The last page of the book will mention our website. We can arrange to ship the book to him, I’ll write you when the book is available.

    For vitamins, some I get from Amazon, some from cheap outlets like Swanson vitamins. I get coconut oil and iodine from Amazon.

  5. What about those of us who do not tolerate dairy or have been sold on no dairy paleo? I eat a can of sardines with bones daily and greens and nuts but greens and nuts are high in oxalates and can block calcium and cause kidney stones. I’ve recently added back grass-fed cultured butter or Kerry Gold Irish butter – both pasteurized. I realize no calcium in butter but still a good fat source and maybe k2.

    What are your thoughts on pasteurized versus non[pasteurized dairy — specifically cheese and cream and butter?

  6. Hi Annie,

    If you’re concerned then go ahead and supplement calcium, but be sure you’re getting plenty of K2 along with it. I would also not supplement the 1200 mg many doctors recommend, but half that at most.

    We generally support fatty dairy (cream, butter, sour cream, ice cream, cream cheese) and fermented dairy (yogurt, cheese) but deprecate pasteurized milk. Raw milk is easier to digest and should be better than pasteurized milk, but make sure the cows are healthy.

  7. Thanks Paul. I want to be sure I understand you. Pasteurized milk is no good and therefore even cream, butter and cheese should be raw as well?? It’s very difficult to find raw butter or cream in NYC — in fact, impossible. Only raw cheeses are available and most are imported. Some farmer’s markets do carry domestic raw milk cheeses but not raw butter or raw cream.

    I eat kimchi (cabbage/scallian) and tons of pasteurized, grassfed butter and daily greens so I think I’m ok for k2.

    As for bovine dairy in general — I take it you do not believe that there is a danger in consuming the naturally occurring IGF-1 found in dairy products or that dairy causes insulin spikes. I look forward to reading your book — you have an interesting web site here.

  8. Hi Annie,

    Well, I don’t eat raw cream, butter, or cheese – just store brands.

    Pasteurized milk proteins can be hard to digest, but cream and butter have less protein (and relatively more whey, which is safer, than casein, which is dangerous). Also, during fermentation bacteria break down many of the bioactive proteins, so the fermented foods are relatively less dangerous than milk.

    Still, some people will be sensitive to them and should exclude them. If you want to be very cautious, you could restrict yourself to clarified butter/ghee. Clarification removes the proteins.

    I do think that IGF-1 is dangerous – life shortening and cancer promoting. It is one of the reasons we counsel avoiding milk.

    It’s hard to draw hard and fast lines with dairy; it tastes so good and is such an inexpensive source of calories that I would hate to exclude it from the diet. But there are reasons to be concerned about it as well.

  9. Hi Paul,

    Here

    http://www.ncbi.nlm.nih.gov/pubmed/18695768

    we read that the only difference (of minerals tested) between osteoporotic postmenopausal women and those without the malady was RBC Magnesium.

    A couple of years ago I tested out-of-range low in RBC Mg – this despite having taken Solgar’s “Highly Absorbable” Mg Citrate religiously at 600mg daily for a good year.

    It wasn’t until I switched to the Glycinate (Albion) and Thorne Research’s Citrate-Malate (Citramate) at the same dose that I was able to bring my levels up to mid-range.

    Responding to an old post ~ my apologies. I followed some of your links here in my reading this morning.

    Happy Thanksgiving to you.
    Best,
    KKC

  10. Hi,

    I am just finishing the book and implementing the supplement strategy as outlined here. One question, my daily, Adult Multi for Men from Whole Foods, has 2mg of copper in it already. I noticed Centrum Silver does as well, is the recommendation still to supplement with an additional 2mg of copper daily, total of 4mg daily from the two sources?

    Similarly, my multi has 200mcg of selenium in it so I assume I do not need to supplement further.

    Thanks for the clarification and great work here!

  11. Hi K,

    We estimate the “plateau range” for copper at 2 to 5 mg per day. Most Americans get less than 1 mg per day from food. So 2 mg to 4 mg of supplements should be taken. Therefore, just the 2 mg from your multi would be fine, but 4 mg total in supplements would also be fine. I take 2 mg in addition to our multi, but Shou-Ching doesn’t.

    With selenium, we believe you should try to stay within the range 200 mcg to 400 mcg per day from all sources. Since food will have some, it would be unsafe to supplement 400 mcg; 200 mcg in the multi is sufficient.

    Best, Paul

  12. Hi Paul,

    Thanks for the speedy reply!

  13. Do you think it is plausible we would have gotten calcium from water? One bottle of mineral water will provide 32% of the rda for calcium, and I can easily drink two a day. Our ancestors’ supposed consumption of mineral water is occasionally used for justification of magnesium supplementation, but never for calcium. It also seems that calcium is not so problematic with k2.

  14. Hi Abby,

    Yes, I think water was a major source of calcium for our ancestors.

    Since calcium needs aren’t great if you’re replete with D and K, hard water could be a major source.

  15. Although I’m reasonably intelligent, I have difficulty reading nutritional research papers. Do the studies you cite to support your position of calcium take into account the level of co-factors (Mg, boron, silica, D3, K2) in study participants’ bodies? If not, how can the studies be considered valid, much less authoritative?

  16. Sorry, another question.

    I can’t tolerate cheese or butter, so I’ve had to get my calcium from supplementation (which lncludes magnesium, boron, zinc and a small amount of copper). If I don’t take it — I’ll get STRONG leg cramps which resemble tetany — and/or if I take vitamin d and k2 without taking calcium, then I get bone spurs.

    Isn’t it possible to actually have a calcium deficiency, perhaps due to long-term vitamin D deficiency?

    Thanks Paul.

    • Hi Kelly,

      We recommend getting calcium from bone soups and stews – calcium and phosphorus from the bones will leach into the water. You really shouldn’t need to supplement on top of that. We do recommend supplementing magnesium, boron, and zinc. Copper should be obtained from liver.

      If vitamin D and K2 are causing bone spurs, that suggests a deficiency of vitamin A. Liver is the best source of vitamin A.

      So I’m guessing you need to add liver and bone soups to your diet.

      • Thanks so much Paul. I hadn’t even considered the vitamin A aspect. Perhaps that might explain my poor (and I mean really poor) night vision?

        I tried the fermented cod liver oil w/butter oil, but couldn’t tolerate it, but will try a regular vitamin A supplement.

        How much vitamin A do you recommend per day?

        p.s. I posted a comment on your supplement page…I can’t seem to tolerate high-fat foods like egg yolks and butter, and was wondering what you think may be causing that…and/or if you’ve heard the same from other folks out there?

        Thanks again so much!

      • I’ve read a few reports of the relative lack of minerals in average homemade bone broth. Have you had your recipe tested for available minerals with standard issue bones? Grass fed bones are almost impossible to find in my area, and when I can find them, they’re more expensive than ground beef!

        What do you think of bone meal as an alternative? (KAL brand, for instance.)

      • “What do you think of bone meal as an alternative?”

        i’d be interested to know this as well (if you do not do bone broths/soups).
        bone meal contains calcium & phosphorus.

  17. Hello Paul, I stopped taking calcium and started taking vitamin D two years ago when I started low carb, primal type eating. My bone density test score went down about 10% during this time. Of course my doctor said to go back on the calcium. I have instead elected to take New Chapter Bone Strength with the calcium from algae on the recommendation of my health food store. Would this source be safer?
    Thank you!

    • Hi Jill,

      We recommend bone stock soups and stews for calcium — this gives all the components of bone, not just calcium. 1 bowl per day is plenty. That should be the safest source. I would eat seaweed too. Useful foods for bone — collagen sources, more carbs (don’t go too low carb), sulfur-rich vegetables, seaweed; useful supplements — D, K2, magnesium, boron, silicon.

      The New Chapter (http://www.newchapter.com/take-care/bone-strength-take-care#supplement-facts) has good ingredients but is rather high in calcium compared to other ingredients. I wouldn’t take more than 2 pills per day and that only if you’re not eating bone stocks.

      The problem may not be calcium related, it may be low carb or circadian rhythm related, or one of the other micronutrients.

      • Thank you for responding, Paul. I have been adding more carbs and plan to give the bone broth a try. Can you recommend specific amounts of the useful supplements you suggested?
        Again, thank you!-Jill

        • Hi Jill,

          D to serum 25OHD of 40 ng/ml — this will depend on location and lifestyle, but for a northerner it might typically be 4000 IU/day in winter, 2500 IU/day spring and fall, 0 to 1000 IU/day summer.

          K2 – 100 mcg/day of MK-7 form. Magnesium – 200 mg/day. Boron – 3 mg/wk up to 3 mg/day. Silicon – eat seaweed and you wouldn’t need this.

          There are some links to products on our supplement recommendations page.

  18. “What do you think of bone meal as an alternative?”

    i’d be interested to know this as well (if you do not do bone broths/soups).
    bone meal contains calcium & phosphorus.

    (copy of my comment above)

  19. help , what can i do about heigh blood peasure ?
    thanks

  20. It’s not the calcium you eat, but the calcium you keep that counts. The observational studies that present a scary picture of calcium supplements all fail to consider the cofactors that Paul mentions (and some important ones he omits) required for calcium mobilization and assimilation. Laura Schoenfeld did a great, in-depth post on these co-factors.

    In addition, people need to consider the (a) bioavailability of calcium from various foods and (b) the validity of the official calcium guidelines. I wrote about this in my series “The calcium you keep.

  21. Hello, Paul!

    Since I do not eat broth and dairy, but I do eat spinach and broccoli every day, should I supplement calcium?

    I’ve developed some dark stripes on my front two teeth and was wondering if it was due to calcium deficiency.

  22. Hi Paul

    Are you familiar with the topic of root canals and crowns? Do you know if root canals are harmful to your health? Are root canals a necessary procedure?

    For example, when cell phones were a new thing, there was a news segment about a woman claiming cancer from her cell phone. But it seems that many people use cells phones without getting serious illnesses… so not sure what to believe about health effects of dental procedures. Would appreciate hearing your thoughts.

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