Ask The Pharmacist: Calcium supplements for bone strength

Question: I’m concerned about my bone density because I was told I have osteopenia. Are all calcium supplements the same? Do you have other recommendations? A.F., New York

Answer: Osteopenia, or lower-than-normal bone density, is frequently found in post-menopausal women but can affect men and women of all ages. Over the past few years, some questionable research suggested a connection between calcium supplements and atherosclerosis. But last November, Harvard researchers presented research showing no connection between calcium supplements and coronary artery calcification. If your doctor suggests calcium supplements for you, here’s some information:

Calcium carbonate: The least expensive form of calcium to manufacture, calcium carbonate is also called bone meal or dolomite. This requires lots of stomach acid to digest, so very little calcium goes to your bones where needed. Because it stays in the gut, you will find this compound also sold as Tums and Rolaids, two products used to neutralize acid (not for bone growth).

Calcium citrate: The easiest form of calcium to find, calcium citrate is absorbed about as well as calcium carbonate but requires less stomach acid to digest, so it can be taken with or without food. But be careful, as this type of calcium can sometimes cause headaches. There’s a bunch of brands for this.

Tricalcium Phosphate: Easy to absorb, this is a combination of calcium and phosphorous which your bones (and body) need as well. Nature Made makes adult gummies with this type of calcium.

Calcium aspartate or calcium gluconate: These intelligent forms of calcium offer your body aspartate or gluconate which is used in other metabolic pathways to produce energy. Sometimes this bioavailable form of calcium is combined with vitamin D, magnesium and/or zinc.

Calcium collagen chelate: Minerals that are ingested as chelates, or organic salts offer good absorption and that means less tummy upset. Life Extension and Swanson brands both make this.

Calcium as Microcrystalline Hydroxyapatite (MCHC): This easily absorbed form of calcium is derived from freeze-dried calf bone. This provides other bone-builders like phosphorous, magnesium, zinc, and chromium that nourish your bones. Solaray and Xymogen brands both make this.

For people who don’t drink milk, Hawaiian Spirulina tablets (a blue-green algae) may help. It actually contains 300 percent more calcium than whole milk, plus other minerals. Remember, minerals like calcium are best absorbed when taken in combination with other minerals like strontium, magnesium, and vitamin D.

Other important factors in bone health include adequate levels of vitamin K2 which is involved in clotting. And strontium. It has a two-fold effect on osteoporosis meaning it prevents bone breakdown while also stimulating new bone growth. Medications only work one side of that equation. A 2004 study in New England Journal of Medicine concluded that strontium reduces risk of non-vertebral fractures by 41 percent over three years, and increases bone mineral density by about 14 percent. Eliminated processed and refined foods is a must.

Suzy Cohen is a registered pharmacist. The information presented here is not intended to treat, cure or diagnose any condition. Always consult your physician. Visit

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