Calcium Supplements for Menopausal Women

Why Do postmenopausal women need Calcium?

Everyone’s body needs calcium to build and maintain bone health. Over 99% of the calcium in the body is stored in your bones and teeth (1)

Calcium is also used to send nerve signals, help blood vessels and muscles contract and dilate, and help release hormones like insulin (1). Low Calcium intake results in the withdrawal of calcium from your skeleton and teeth to use elsewhere, weakening your bones. Since a lack of oestrogen enhances the rate of bone loss, a postmenopausal woman must take more calcium to development & protection of bones. 

Although a balanced diet aids calcium absorption, high levels of protein and sodium (salt) in the diet are thought to increase calcium excretion through the kidneys. Excessive amounts of these substances should be avoided, especially in those with low calcium intake.

Lactose intolerance also can lead to inadequate calcium intake. Those who are lactose intolerant have insufficient amounts of the enzyme lactase, which is needed to break down the lactose found in dairy products. To include dairy products in the diet, dairy foods can be taken in small quantities or treated with lactase drops, or lactase can be taken as a pill. Some milk products on the market already have been treated with lactase

General Recommendations of Calcium for women

Below are the current recommendations from the Institute of Medicine, by age (2):

  • Women 50 and younger:1,000 mg per day
  • Women over 50:1,200 mg per day

Some of Calcium -rich foods(2)

  • Milk
  • Yoghurt
  • Cheese
  • Sardines & canned salmon 
  • Bean & lentils 
  • Almonds
  • Edemame beans & tofu >
  • Seeds (e.g. poppy seeds, chia seeds) 

Calcium dietary supplements: 

It is possible for one to meet their calcium daily recommendation through food however, due to increased needs there can be a need to add a calcium supplement.

There are also recommended upper limits for calcium intake. The cap is 2,500 mg per day for adults up to age 50 and 2,000 mg per day for adults over 50 

It’s possible to get enough amounts through your diet. However, people who don’t eat enough calcium-rich foods might consider taking supplements especially postmenopausal women who have higher calcium requirements (3)

Who Should Take Calcium Supplements & what are their Benefits?

When your calcium intake is insufficient, your body will remove calcium from your bones, making them weak and brittle. This can result in osteoporosis.

Since women are at a higher risk of osteoporosis, many doctors recommend that they take calcium supplements, especially after reaching menopause.

Because of this, older women are much more likely to take calcium supplements (4). Studies of bone histomorphometry and markers of bone remodelling indicate that bone remodelling is accelerated in the perimenopausal and postmenopausal periods. The span of 5 to 10 years surrounding menopause is characterized by a decrease in oestrogen production and an increase in resorption of calcium from bone, resulting in a marked decrease in bone density (4). These changes during the postmenopausal period increases the need for calcium supplement. 

If you don’t get the recommended amount through your diet, supplements can help fill the gap.

You might also consider calcium supplements if you:

  • Follow a vegan diet.
  • Have a high-protein or high-sodium diet, which may cause your body to excrete more calcium.
  • Have a health condition that limits your body’s ability to absorb calcium, such as Crohn’s disease or inflammatory bowel disease.
  • Are being treated with corticosteroids over a long period of time.
  • Have osteoporosis.

Studies have linked taking calcium supplements with a lower risk of colon cancer and blood pressure, as well as fat loss and increases in bone density. Several studies have suggested that giving postmenopausal women calcium supplements — usually around 1,000 mg per day — may reduce bone loss by 1–2% (4)

How to take Calcium supplements?

It is very important to stick to the recommended dosage as stipulated by the manufacture of the calcium supplement.  What literature has shown is that excessive intake of Calcium supplements may increase the risk of heart disease and prostate cancer, although the link is unclear. Extremely high levels of calcium from any source may have negative health effects. It is important to take calcium supplement with or after a meal to help increase its absorption which some studies have estimated to be an increase by 20 – 30% (5)

Overview on Vitamin D

Vitamin D, a fat-soluble vitamin, occurs naturally in very few foods, with fatty fish like salmon or tuna, fish liver oil, beef liver and egg yolks serving as the best food sources. To decrease the occurrence of vitamin D deficiency syndromes such as rickets, food manufacturers fortify foods including milk, cheese, orange juice and breakfast cereals with vitamin D. Your body can also produce vitamin D when the ultraviolet rays of the sun stimulate the conversion of pre-vitamin D-3 in the skin cells into vitamin D. As women age, their skin loses the ability to produce vitamin D, making postmenopausal women a high-risk group for vitamin D deficiency (5)

Link of Vitamin D to Calcium 

The body needs vitamin D to absorb calcium.Without enough vitamin D, one can’t form enough of the hormone calcitriol (known as the “active vitamin D”). This in turn leads to insufficient calcium absorption from the diet. In this situation, the body must take calcium from its stores in the skeleton, which weakens existing bone and prevents the formation of strong, new bone. Vitamin D plays a very crucial role in the absorption of Calcium in the body (5)

Vitamin D Sources: 

You can get vitamin D in three ways: through the skin from sunlight (main source of Vitamin D)from the diet, and from supplements. Experts recommend a daily intake of 600 IU (International Units) of vitamin D up to age 70. Men and women over age 70 should increase their uptake to 800 IU daily (5)

vitamin D-rich foods (6)

  • Egg yolks
  • Saltwater fish
  • Liver
  • Fortified milk 

Conclusion: 

Calcium supplements can help people who are at risk of osteoporosis, as well as those who don’t get enough calcium in their diets. Menopausal women are the most vulnerable group with higher calcium requirements.  Vitamin D is a crucial fat soluble vitamin that is needed for the absorption of calcium 

While some research suggests a link between calcium supplements and heart disease, the link is not clear.

However, it is known that getting more than the recommended amount of calcium from any source may raise your risk of kidney stones.

Calcium supplements are fine in small doses, but the best way to get calcium is from food. Strive to incorporate a variety of calcium-rich foods in your diet, including non-dairy sources.  

Always consult with your health care profesional befor taking any dietary supplements. 

References: 

  1. https://www.ncbi.nlm.nih.gov/pubmed/21796828
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189255/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189255/
  4. Vitamin D fact sheet for health professionals [fact sheet]. (2016, February 11)
    ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
  5. Vitamin D: Safety. (2013, November 1)
    mayoclinic.org/drugs-supplements/vitamin-d/safety/hrb-20060400

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