Calcium, the most abundant mineral in the human body, is best known for its important role in bone health and protection from osteoporosis. However, in addition to its key role in imparting strength to bones and teeth, calcium plays a critical role as a messenger in cell-signaling pathways throughout the body and is necessary for normal cell function, transmission of nerve signals, secretion of hormones, blood coagulation, muscle contraction, and muscle relaxation. Calcium deficiency symptoms may therefore involve any of these functions and manifest in a myriad of ways.
Causes and Signs of Calcium Deficiency
Unfortunately, most Americans don’t meet the current recommendations for adequate calcium intake through diet alone or through diet plus calcium supplements and therefore suffer symptoms of low calcium. Further, numerous factors have been found to impair calcium absorption and/or to lower calcium levels in the blood. These factors include:
- Vitamin D deficiency
- Magnesium deficiency
- High sodium intake
- High phosphorus intake (found in cola soft drinks and food additives)
- Chronic kidney disease
- Abnormal parathyroid function (due to neck/thyroid surgery or autoimmune disease)
- Bariatric surgery (gastric bypass)
- Drugs (proton pump inhibitors, chemotherapy, anti-seizure medications)
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Calcium Deficiency Symptoms
Calcium deficiency symptoms can vary widely—ranging from nonexistent or mild to severe and life-threatening. Chronic untreated calcium deficiency can cause many severe consequences, including rickets, osteopenia, and osteoporosis. However, even though calcium deficiency may not be associated with any symptoms, especially early on, metabolic alterations or potential dysfunctions have already occurred.
Low blood calcium levels and the lack of calcium may lead to the following low calcium symptoms:
- Heart failure
- Chest pains
- Numbness and tingling sensations around the mouth or in the fingers and toes
- Muscle cramps, particularly in the back and legs; may progress to muscle spasm ( tetany)
- Difficulty swallowing
- Voice changes due to spasm of the larynx
- Irritability, impaired intellectual capacity, depression, and personality changes
- Coarse hair
- Brittle nails
- Dry skin
- Chronic itching
- Tooth decay
- Numbness or tingling in the extremities
- Muscle weakness
- Osteoporosis symptoms (backache; a gradual loss of height and an accompanying stooped posture; fractures of the spine, wrist, or hip)
Calcium Deficiency Treatment and Prevention
Just how much calcium from diet and supplements is needed, and in what form, to prevent calcium deficiency symptoms? How much is required to achieve optimal health? These questions are currently the subject of much controversy and debate among researchers, doctors, and nutritionally savvy individuals alike. The Food and Nutrition Board of the Institute of Medicine concluded that there are insufficient data from which to determine the RDA for calcium. Instead, they established Adequate Intakes (AIs) for calcium, which are the amounts thought to be sufficient to maintain bone health in healthy people. The AI for adults up to age 50 is 1,000 mg of calcium per day from food and supplements combined. For adults 51 and older, it’s 1,200 mg. As mentioned above, most American adults fail to meet these requirements, even when they take supplements.
How to Increase Calcium Intake
Try to get the majority of your calcium from food sources. While dairy is a concentrated source of calcium, other components in dairy make it a poor choice for maintaining bone health. Instead, opt for foods high in calcium such as salmon and sardines canned with bones, kale, collards, broccoli, mustard greens, turnip greens, bok choy, and sesame seeds. For calcium supplements, choose calcium citrate or calcium citrate malate, and take it in at least two divided doses with meals for the best absorption.
Avoid Too Much Calcium from Supplements
Keep in mind that it is just as important to avoid getting too much calcium from supplements as it is to get enough. Excessive calcium from supplements may increase the risk of cardiovascular disease and kidney stones, so don’t overdo it. Aim for 1,000 to 1,200 mg from food and supplements combined.
How do you ensure adequate calcium intake? Share your ideas in the comments section below.
Originally published in 2014, this post has been updated.