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When taken by mouth: Calcium is LIKELY SAFE for most people when taken by mouth and in recommended amounts (about 1000-1200 mg daily). Calcium can cause some minor side effects such as belching or gas. But calcium is POSSIBLY UNSAFE when taken by mouth in high doses. The Institute of Medicine sets the daily tolerable upper intake level (UL) for calcium at 2000 mg for adults ages 19-50 years and 2000 mg for adults 51 years and older. Taking more than this amount of calcium daily can increase the chance of having serious side effects, such as blood levels of calcium that are too high and milk-alkali syndrome, a condition that can lead to renal stones, kidney failure and death. There is also concern that supplemental calcium can increase the risk of heart attack. Some research shows that taking calcium, often in amounts over the recommended daily intake level of 1000-1300 mg per day, is linked with an increased risk of heart attack in older people. But other research suggests there is no connection between calcium supplementation and heart attack risk. It may be that some groups have an increased risk while others do not. Continue consuming adequate amounts of calcium to meet daily requirements, but avoid excessive amounts of calcium. Be sure to consider total calcium intake from both dietary and supplemental sources and try not to exceed 1000-1200 mg of calcium per day. To figure out dietary calcium, count 300 mg/day from non-dairy foods plus 300 mg/cup of milk or fortified orange juice. Also, if calcium supplements need to be taken along with dietary calcium, consider taking ones that provide calcium along with vitamin D.
When given by IV: Calcium is LIKELY SAFE for most people when given intravenously (by IV) and appropriately.
Special Precautions & Warnings:
Pregnancy and breast-feeding: Calcium is
LIKELY SAFE when taken by mouth in recommended amounts during pregnancy and breast-feeding. There is not enough information available on the safety of using calcium intravenously (by IV) during pregnancy and breastfeeding. Calcium is
POSSIBLY UNSAFE for women who are pregnant when taken by mouth in high doses. The Institute of Medicine sets the same daily tolerable upper intake level (UL) for calcium for all women based on age whether they are pregnant or not: 9-18 years, 3000 mg; 19-50 years, 2500 mg. Higher doses might cause high levels of phosphorous and low levels of parathyroid hormone in the infant during pregnancy and at birth which might increase the risk of seizures in the infant. Be sure to avoid excessive amounts of calcium during pregnancy. Be sure to consider total calcium intake from both dietary and supplemental sources of calcium including over-the-counter antacids. Try not to exceed 1000-1200 mg of calcium per day unless prescribed by your doctor. Some women may be prescribed calcium to prevent high blood pressure during pregnancy. To figure out dietary calcium, count 300 mg/day from non-dairy foods plus 300 mg/cup of milk or fortified orange juice.
Children. Calcium is
LIKELY SAFE for most children when taken by mouth in recommended amounts. The recommended amount varies based on age as follows: Age 1-3 years, 700 mg daily; 4-8 years, 1000 mg daily; 9-18 years, 1300 mg daily. But calcium is
POSSIBLY UNSAFE when taken by mouth in higher doses. Taking more than the recommended amount of calcium daily can increase the chance of having serious side effects. Children should be advised to continue consuming adequate amounts of calcium to meet daily requirements, but not excessive amounts of calcium.
Low acid levels in the stomach (achlorhydria). People with low levels of gastric acid absorb less calcium if calcium is taken on an empty stomach. However, low acid levels in the stomach do not appear to reduce calcium absorption if calcium is taken with food. Advise people with achlorhydria to take calcium supplements with meals.
High levels of phosphate in the blood (hyperphosphatemia) or low levels of phosphate in the blood (hypophosphatemia): Calcium and phosphate have to be in balance in the body. Taking too much calcium can throw this balance off and cause harm. Don't take extra calcium without your health provider's supervision.
Under-active thyroid (hypothyroidism): Calcium can interfere with thyroid hormone replacement treatment. Separate calcium and thyroid medications by at least 4 hours.
Too much calcium in the blood (as in parathyroid gland disorders and sarcoidosis): Calcium should be avoided if you have one of these conditions.
Poor kidney function: Calcium supplementation can increase the risk of having too much calcium in the blood in people with poor kidney function.
Smoking: People who smoke absorb less calcium from the stomach.
Stroke: Early research suggests that older women who have had a stroke, taking calcium supplements for 5 or more years might increase the chance of developing dementia. More research is needed to determine if calcium supplements should be avoided for those who have had a stroke.
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