As an Orthopaedic surgeon I am often asked whether calcium tablets are good for health. I have also observed that many doctors prescribe calcium tablets for any bone or joint related problem without evaluating a case thoroughly.
In order to answer the question about whether one needs calcium supplements, one first needs to assess if your daily diet contains enough calcium. If your diet includes, milk and milk products, dark leafy vegetables and non vegetarian food, then it is very likely that your intake of calcium is more than sufficient. One of the most common arguments in favour of calcium supplements is that most people do not get enough by way of their diet since they don’t consume calcium rich food. I counter the argument by asking if they consume enough water. 90% of tap water available in India is hard water, which contains calcium carbonate. So even if you are a vegetarian as long as you eat a balanced diet it is very unlikely that you are not getting enough calcium.
Many people take calcium to prevent osteoporosis or brittle bones that happen in old age. It has however been proven through a large amount of research that taking calcium as an adult does nothing to prevent osteoporosis. There are many factors that determine a person’s predisposition towards osteoporosis and calcium intake as an adult has no role to play. In fact, it is a well established fact that calcium tablets can give you indigestion and constipation. There is also a definite concern that regular consumption of calcium supplements may cause renal stones but this is still to be clearly proven.
What is however alarming is that there is mounting evidence in many studies showing increased risk of heart attacks and strokes in adults who take regular calcium tablets. Several studies have already shown that calcium plays an important role in clot formation which is the cause of blockage that triggers heart attacks and strokes. Therefore, people who take excessive calcium will be at greater risk for these problems. Recent studies also have evidence that calcium causes dementia in older people.
I still have patients who say that they have taken calcium tablets and felt better. However nowadays in the market you hardly ever get simple calcium tablets. The calcium tablets available are invariably combined with Vitamin D. As city residents, most of my patients hardly spent much time in the sun and therefore they are all Vitamin D deficient. What makes them feel better then is the Vitamin D and not the calcium.
I would conclude that an average person’s diet usually has enough calcium content and therefore there is no need for supplements. The only patients I reserve calcium supplements for are growing children, pregnant or lactating mothers and patients with fractures or very poor diet. For most other people, calcium supplements cause more harm than good to the body and I never prescribe them. Instead, I strongly urge my patients to take Vitamin D supplements or spend half an hour daily exposing their arms and legs to direct sunlight. The afternoon is the best time for this but one needs to take precautions to avoid dehydration and heat stroke.
Inputs by Dr Swapnil Zambre, HOD-Orthopaedics, Fortis Hospital Kalyan
