Every great accomplishment has a supporting cast. Whether it’s enacting some social change or creating something that people enjoy, nobody acts alone. The same is true for calcium supplements. They just don’t work as well without support.
Vitamin D is essential for calcium absorption in the intestines . It helps maintain the correct concentration of calcium in the blood, thereby enabling normal bone mineralization. It’s needed for bone growth and bone remodeling. It’s been shown to decrease the risk of falls, fractures and bone loss in elderly patients , to reduce the risk of hip fractures , to improve bone density and to reduce the risk of osteoporosis .
Magnesium is crucial for calcium to be utilized by the body. It stimulates the hormones that help put calcium into bones and prevent it from being deposited in soft tissue or arteries . Magnesium deficiency alters calcium metabolism and the hormones that regulate calcium. It’s been found to prevent fractures and significantly increase bone density .
Vitamin C increases calcium absorption in the intestines . It’s essential to the fomation of collagen (the connective tissue in bone) and stimulates proteins involved in bone formation . It has been shown to reduce bone loss in older men , lead to higher bone mineral density in postmenopausal women , and to protect and maintain healthy bone mass . Vitamin C deficiency has also been shown to stimulate bone loss .
Vitamin K helps calcium get from the bloodstream to bones . It’s necessary for the activation of osteocalcin, which is the protein that binds calcium to the bone matrix . It helps prevent calcium buildup in the arteries and in fact can decrease existing calcium buildup by up to 37% in as little as 6 weeks. It’s been shown to increase calcium absorption, increase bone gain and decrease bone loss. Other studies have shown it to prevent bone loss and reduce fracture risk. It sustains lumbar bone mineral density, while the lack of vitamin k has been associated with lower BMD.
Lysine may be more famous for cold sores, but studies show it has a vital effect on calcium absorption and utilization as well. It’s been shown to increase calcium absorption and decrease the amount excreted in urine, as well as increasing the speed at which calcium is absorbed. It promotes mineral absorption, increasing the amount of calcium incorporated into the bone matrix. Finally, it stimulates the cells responsible for bone formation.
Zinc is important for bone metabolism. It’s been shown to stimulate bone formation and mineralization. Women with osteoporosis and osteopenia were shown to have significantly lower zinc (and magnesium) concentrations than those with normal bone strength. Most importantly, zinc supplementation had no effect on calcium absorption when calcium intake was 800 MG a day or greater, and further studies have shown that calcium supplements (specifically in the form of calcium citrate malate) did not interfere with zinc absorption.
Therefore, our recommendation would be to take no more than 15 MG/ day of zinc along with calcium in the form of citrate malate.
Copper plays an important role in the constant renewal cycle of bone remodeling. It helps certain stem cells (known as MSCs) to become the cells that form bone (osteoblasts) instead of cells that become fat(adipocytes). It inhibits bone resorption or breakdown and has been shown to maintain bone mineral density in middle age women.
Manganese is important to bone mineralization and the development of cartilage. It is essential to bone metabolism. Small (but not large) amounts have been shown to increase mineralization above that of adding calcium alone. Deficiency has been shown to impair bone metabolism. One study of osteoporotic women found their blood levels of manganese to be 25% of normal.
A study published in 1993 looked at supplementation of trace minerals zinc (at 15 mg/ day), copper (2.5 mg/ day) and manganese (5 mg/ day) along with 1000 mg/ day of elemental calcium citramate. The effects of a placebo, the trace minerals alone, calcium citramate alone, and citramate together wth the trace minerals were compared on the bone mineral content of postmenopausal women. While the group taking calcium citramate alone had less bone loss than the group taking trace minerals alone, the group taking both actually saw an improvement in bone density.
Boron is important for the absorption and utilization of calcium. It’s been shown to decrease the amount of both calcium and magnesium lost in urine (and therefore increase absorption).  It’s required for normal bone metabolism. It supports optimal calcium absorption even when vitamin D is deficient. Evidence suggests boron affects both functional and compositional properties of bone.
An ideal calcium supplement will consist of the following:
- Calcium in the form of Calcium Citrate Malate
- Supporting ingredients to include Magnesium, Vitamins D, C & K
- Other trace minerals
For more detailed information regarding our calcium supplement recommendation, click here.
- ^ Wasserman, R. H. “Vitamin D and the dual processes of intestinal calcium absorption.” The Journal of nutrition 134.11 (2004): 3137-3139.
- ^ Cranney, Ann, et al. “Effectiveness and safety of vitamin D in relation to bone health.” Evid Rep Technol Assess (Full Rep) 158.1 (2007): 23-5.
- ^ Chapuy, Marie C., et al. “Vitamin D3 and calcium to prevent hip fractures in elderly women.” New England journal of medicine 327.23 (1992): 1637-1642.
- ^ Gennari, C. “Calcium and vitamin D nutrition and bone disease of the elderly.” Public health nutrition 4.2b (2001): 547-559.
- ^ Klibanski, Anne, et al. “Osteoporosis prevention, diagnosis, and therapy.” Journal of the American Medical Association 285.6 (2001): 785-795.
- ^ Fuchs, Nan Kathryn. “Magnesium: A Key to Calcium Absorption.” The Magnesium Website. November (2002).
- ^ Elisaf, M., H. Milionis, and K. C. Siamopoulos. “Hypomagnesemic hypokalemia and hypocalcemia: clinical and laboratory characteristics.” Mineral and electrolyte metabolism 23.2 (1996): 105-112.
- ^ Sojka, J. E. “Magnesium supplementation and osteoporosis.” Nutrition reviews 53.3 (1995): 71-74.
- ^ Morcos, S. R., et al. “Effect of vitamin C and carotene on the absorption of calcium from the intestine.” Zeitschrift für Ernährungswissenschaft 15.4 (1976): 387-390.
- ^ Robertson, W. van B., and Barry Schwartz. “Ascorbic acid and the formation of collagen.” J. biol. Chem 201 (1953): 689.
- ^ Franceschi, Renny T., Bhanumathi S. Iyer, and Yingqi Cui. “Effects of ascorbic acid on collagen matrix formation and osteoblast differentiation in murine MC3T3‐E1 cells.” Journal of Bone and Mineral Research 9.6 (1994): 843-854.
- ^ Sahni, Shivani, et al. “High vitamin C intake is associated with lower 4-year bone loss in elderly men.” The Journal of nutrition 138.10 (2008): 1931-1938.
- ^ Morton, Deborah J., Elizabeth L. Barrett‐Connor, and Diane L. Schneider. “Vitamin C supplement use and bone mineral density in postmenopausal women.” Journal of Bone and Mineral Research 16.1 (2001): 135-140.
- ^ New, Susan A., et al. “Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health?.” The American journal of clinical nutrition71.1 (2000): 142-151.
- ^ Hie, Mamiko, and Ikuyo Tsukamoto. “Vitamin C-deficiency stimulates osteoclastogenesis with an increase in RANK expression.” The Journal of nutritional biochemistry 22.2 (2011): 164-171
- ^ Vermeer, C., K-SG Jie, and M. H. J. Knapen. “Role of vitamin K in bone metabolism.” Annual review of nutrition 15.1 (1995): 1-21
- ^ Hauschka, PETER V., et al. “Osteocalcin and matrix Gla protein: vitamin K-dependent proteins in bone.” Physiological reviews 69.3 (1989): 990-1047.
- ^ Schurgers, Leon J., et al. “Regression of warfarin-induced medial elastocalcinosis by high intake of vitamin K in rats.” Blood 109.7 (2007): 2823-2831.
- ^ Zittermann, Armin. “Effects of vitamin K on calcium and bone metabolism.”Current Opinion in Clinical Nutrition & Metabolic Care 4.6 (2001): 483-487.
- ^ Feskanich, Diane, et al. “Vitamin K intake and hip fractures in women: a prospective study.” The American journal of clinical nutrition 69.1 (1999): 74-79.
- ^ Shiraki, Masataka, et al. “Vitamin K2 (menatetrenone) effectively prevents fractures and sustains lumbar bone mineral density in osteoporosis.” Journal of Bone and Mineral Research 15.3 (2000): 515-521.
- ^ Kanai, T., et al. “Serum vitamin K level and bone mineral density in post-menopausal women.” International Journal of Gynecology & Obstetrics 56.1 (1997): 25-30.
- ^ Civitelli, Robert, et al. “Dietary L-lysine and calcium metabolism in humans.”Nutrition (Burbank, Los Angeles County, Calif.) 8.6 (1991): 400-405.
- ^ Fürst, P. “Dietary L-lysine supplementation: a promising nutritional tool in the prophylaxis and treatment of osteoporosis.” Nutrition (Burbank, Los Angeles County, Calif.) 9.1 (1992): 71-72.
- ^ ibid
- ^ Torricelli, P., M. Fini, and G. Giavaresi. “L-Arginine and L-Lysine stimulation on cultured human osteoblasts.” Alternative Medicine Review8.1 (2003): 87-88.
- ^ Calhoun, Noah R., J. Cecil Smith Jr, and Kenneth L. Becker. “The role of zinc in bone metabolism.” Clinical orthopaedics and related research 103 (1974): 212-234.
- ^ Yamaguchi, Masayoshi. “Role of zinc in bone formation and bone resorption.” The Journal of Trace Elements in Experimental Medicine11.2‐3 (1998): 119-135.
- ^ Mutlu, M., et al. “Magnesium, zinc and copper status in osteoporotic, osteopenic and normal post-menopausal women.” Journal of International Medical Research 35.5 (2007): 692-695.
- ^ Spencer, Herta, et al. “Effect of zinc supplements on the intestinal absorption of calcium.” Journal of the American College of Nutrition 6.1 (1987): 47-51.
- ^ McKenna, Amber A., et al. “Zinc balance in adolescent females consuming a low-or high-calcium diet.” The American journal of clinical nutrition 65.5 (1997): 1460-1464.
- ^ Rodríguez, J. Pablo, Susana Rios, and Mauricio Gonzalez. “Modulation of the proliferation and differentiation of human mesenchymal stem cells by copper.” Journal of cellular biochemistry 85.1 (2002): 92-100.
- ^ Wilson, T., J. M. Katz, and D_H Gray. “Inhibition of active bone resorption by copper.” Calcified tissue international 33.1 (1981): 35-39.
- ^ Eaton-Evans, J., Mcllrath, E.M., Jackson, W.E., McCartney, H. and Strain, J.J. (1996), Copper supplementation and the maintenance of bone mineral density in middle-aged women. J. Trace Elem. Exp. Med., 9: 87–94. doi:10.1002/(SICI)1520-670X(1996)9:3<87::AID-JTRA1>3.0.CO;2-E
- ^ Saltman, Paul D., and Linda G. Strause. “The role of trace minerals in osteoporosis.” Journal of the American College of Nutrition 12.4 (1993): 384-389.
- ^ Tal, E., and K. Guggenheim. “Effect of manganese on calcification of bone.”Biochemical Journal 95.1 (1965): 94.
- ^ Strause, Linda, and Paul Saltman. “Role of manganese in bone metabolism.” 1987. 46-55.
- ^ Odabasi, Ersin, et al. “Magnesium, zinc, copper, manganese, and selenium levels in postmenopausal women with osteoporosis. Can magnesium play a key role in osteoporosis?.” Annals of the Academy of Medicine, Singapore37.7 (2008): 564-567.
- ^ Spinal Bone Loss in Postmenopausal Women Supplemented with Calcium and Trace Minerals
- ^ Kelly GS. Boron: A review of its nutritional interactions and therapeutic uses. Altern Med Rev. 1997 Jan;2(1):48-56)
- ^ Nielsen, Forrest H., et al. “Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women.” The FASEB journal1.5 (1987): 394-397.
- ^ Hunt, Curtiss D., Jo Layne Herbel, and Forrest H. Nielsen. “Metabolic responses of postmenopausal women to supplemental dietary boron and aluminum during usual and.” Am J Clin Nutr 65 (1997): 803-13.
- ^ Miggiano, G. A., and L. Gagliardi. “[Diet, nutrition and bone health].” La Clinica terapeutica 156.1-2 (2004): 47-56.
- ^ Hegsted, Maren, et al. “Effect of boron on vitamin D deficient rats.”Biological trace element research 28.3 (1991): 243-255.
- ^ McCoy, Harriett, et al. “Relation of boron to the composition and mechanical properties of bone.” Environmental health perspectives102.Suppl 7 (1994): 49.