How to choose the right calcium and vitamins D3-K2 supplements?

Why do we need to take calcium supplement after 50?

As you age, your gut absorption of nutrients becomes less efficient.  A common problem is calcium deficiency, which results in low bone density.

Humans lose 1-2% of their bone density each year after age 50. This means that you may have osteoporosis without knowing it.  Unfortunately, most people only find out after suffering from a bone fracture.


How does calcium deficiency contribute to vaginal dryness?

It is well known that calcium supports bones. But it is lesser known that calcium also regulates muscle contraction and mucus gland secretion that keeps your body moist.

Vaginal dryness is caused by reduced mucus gland secretion. Glands located in the entrance of your vagina (Skene’s glands and Bartholin glands) and in the cervix secrete mucus that lubricates and protects the vaginal tissue. Secretion of these glands are regulated by calcium.

However, there are no glands inside the vaginal tract. The vaginal lubrication is not from glands but from a transudative fluid. When a woman is aroused, her blood pressure pushes fluid from the capillary blood vessels through spaces between cells to seep out. This process requires blood vessel dilation, which needs calcium.

Cervical glands.jpg

After menopause, if a woman develops osteoporosis, she is calcium deficient not only in bones but also in the blood and tissues. As a result, her gland secretion and vaginal transudative fluid reduce, showing vaginal dryness. Likewise, vaginal dryness may be an indication of osteoporosis. A bone density X-ray can confirm it.

Therefore, the most important nutrient for dietary supplement to relieve vaginal dryness is calcium.

Since vaginal atrophy and osteoporosis may occur simultaneously, it is better to manage them together. Additionally, taking vitamins D3 can promote uptake and distribution of the ingested calcium. In addition to vitamin D3vitamin K2 has recently emerged as a new player in the treatment and prevention of postmenopausal osteoporosis and reversal of wrinkles.

How much calcium do you need?

It depends on your age.

The United States Institute of Medicine recommends the following  calcium intake for the total amount of calcium from food and supplements combined.

Calcium dose.JPG

Your gut can only absorb about 500-600 mg of calcium at a time, so total calcium intake should be divided to twice or three times a day.

Calcium Supplements

Due to reduced absorption after mid-age, it may be difficult to get all the calcium needed from diet alone. A calcium supplement can help make up the difference.
Several different types of calcium are available as dietary supplements. Each contains different amounts of calcium, referred to as elemental calcium.
These are:

    - Calcium carbonate (40% elemental calcium)
    - Calcium citrate (21% elemental calcium)
    - Calcium lactate (13% elemental calcium)
    - Calcium gluconate (9% elemental calcium)

Calcium carbonate and calcium citrate are the most commonly used calcium supplements, because they contain more calcium per tablet and are less expensive than other supplements. Calcium carbonate supplies more elemental calcium than other forms and is the best value. However, it is best to take this calcium with food because stomach acid is needed to dissolve it. Calcium citrate has less elemental calcium in it, so more of it will need to be taken, but it is absorbed more easily than calcium carbonate.

Calcium Carbonate vs Calcium Citrate

Calcium Carbonate
    - The highest elemental calcium at 40%
    - Tablets are smaller
    - Should be taken with food
    - Not good for people on antacids
    - Can cause bloating or constipation
    - The least expensive

Calcium Citrate
    - The second highest elemental calcium at 21%
    - Tablets are bigger
    - Can be taken without food
    - Is good for people on antacids
    - Doesn't constipate and is better for people with digestive issues
    - A little more expensive

Briefly, if you take antacids or have constipation, you should choose calcium citrate. Otherwise, you can choose calcium carbonate, but you need to take it with meal.

Most people do not experience side effects when taking the recommended amount for calcium supplements. If you experience side effects after taking calcium carbonate, like upset stomach or constipation, you may consider changing to calcium citrate.

Too much calcium has risks

Dietary calcium is safe at the recommended amount. Excessive calcium doesn't provide extra bone protection. It may be associated with some health risks like kidney stones. Thus, it is important to take the dietary supplement according to the recommended daily amount.

Possible interference with prescription drugs

Calcium supplements can interact with some prescription drugs, including blood pressure drugs, synthetic thyroid hormones, bisphosphonates, antibiotics, and calcium channel blockers. If you take these medications, you may need to take the supplement with your meals or between meals, but at different times with your medication. Ask your doctor or pharmacist about possible interactions and which type of calcium supplement would work for you.

Quality and cost

Manufacturers are responsible for ensuring their product safety and quality. Some brands are independently tested by U.S. Pharmacopeial Convention (USP), (CL) or NSF International. These brands may have higher costs. Expensive does not mean high quality. If cost is a factor for you, you may shop around for best deals.

Which brand?

Many brands offer reasonably priced calcium pills and vitamins D3-K2. These include Bulk Supplements, Now foods, Swanson, NatureMade, Puritan, Nature's Way, Nature's Bounty, GNC, etc. When you choose calcium pills, the Supplement Fact table should say it is calcium carbonate and/or calcium citrate. When you choose vitamin D3 and K2, you can choose a product that combines the two vitamins. For K2 selection, we recommend MK7.

Bulk Supplements - Calcium Carbonate
Bulk Supplements - Calcium Citrate

About vitamin K2, should I take MK4 or MK7?

Dec 9, 2023

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