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Review
. 2018 Nov 28:13:2443-2452.
doi: 10.2147/CIA.S157523. eCollection 2018.

The good, the bad, and the ugly of calcium supplementation: a review of calcium intake on human health

Kelvin Li  1 , Xia-Fang Wang  2   3 , Ding-You Li  4 , Yuan-Cheng Chen  2 , Lan-Juan Zhao  1 , Xiao-Gang Liu  5 , Yan-Fang Guo  6 , Jie Shen  2 , Xu Lin  2 , Jeffrey Deng  1 , Rou Zhou  2 , Hong-Wen Deng  1   7
Affiliations
Review

The good, the bad, and the ugly of calcium supplementation: a review of calcium intake on human health

Kelvin Li et al. Clin Interv Aging. .

Abstract

Calcium is an important integrative component of the human body and critical for human health. It has been well established that calcium intake is helpful in the prevention and treatment of osteoporosis, which has become one of the most serious public health problems across the world. However, community-dwelling adults with and without osteoporosis are rarely concerned or even not aware of the potential side effects of high or inappropriate doses of calcium intake. Some recent studies have revealed that excessive calcium intake might increase the risks of cardiovascular diseases. The purpose of this article was to review the health benefits, costs, and consequences of calcium supplementation on osteoporosis/osteoporotic fractures, cardiovascular events, kidney stones, gastrointestinal diseases, and other important diseases. In the end, we suggest that calcium supplementation should be prescribed and taken cautiously, accounting for individual patients' risks and benefits. Clearly, further studies are needed to examine the health effects of calcium supplementation to make any solid recommendations for people of different genders, ages, and ethnicities.

Keywords: calcium; cardiovascular diseases; gastrointestinal diseases; kidney stones; osteoporosis; osteoporotic fractures.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Schema of calcium metabolism and homeostasis in human body. Notes: Dietary calcium is absorbed mainly in the small intestine and mostly deposited into bones. Excessive or unabsorbed calcium is excreted in urine and feces. Plasma calcium level is mainly maintained by both PTH and calcitonin. When serum calcium level drops, PTH promotes calcium releases from the bones and stimulates reabsorption of calcium by the kidney tubules. In addition, PTH indirectly increases calcium absorption in the intestine via calcitriol. On the other hand, when serum calcium level rises, calcitonin would suppress calcium release from the bones and reduce calcium reabsorption by the kidney tubules. Abbreviation: PTH, parathyroid hormone.
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