Don’t rely on tablets for all your calcium
DEAR DR. DONOHUE: Please write about what is the right kind of calcium — citrate, carbonate or phosphate — for a 72-year-old woman. In what amounts? — J.O.
ANSWER: The recommended daily calcium intake from age 19 to 50 is 1,000 mg. For men and women older than that, it is 1,200 mg.
You don’t have to rely on tablets for all your calcium. It is in foods, too. Dairy products are the chief source. One cup of milk, whole or skim, has 300 mg. The same amount is in 1.5 ounces of cheddar cheese. Eight ounces of low-fat yogurt contains 415 mg. Eight ounces of fortified orange juice has between 100 mg and 200 mg. Half an ounce of almonds has 70 mg, and half a cup of broccoli has 89 mg.
You can pick any calcium supplement you want. What should guide you are cost and the number of tablets you have to take. Don’t take more than 500 mg of calcium at one time, because more than that overwhelms the body’s absorption capabilities.
Calcium carbonate and calcium citrate are the two most popular varieties of supplements. More calcium is in one calcium carbonate tablet than there is in a calcium citrate tablet. Calcium carbonate needs stomach acid for absorption, so it should be taken with or after meals, when acid production peaks. It’s not the best calcium variety to take if you are on medicines that suppress stomach acid. Calcium citrate is absorbed without acid and can be taken at any time. You also can get calcium lactate tablets (Cal-Lac) or calcium phosphate tablets (Posture), and a soft, chewable form of calcium carbonate is Viactiv, which comes in milk-chocolate, caramel, raspberry and chocolate-mint flavors. Some calcium carbonate brand names are Os-Cal, Caltrate and Tums. The most well-known calcium citrate brand name is Citracal.
Make sure of the calcium content of your choice. If the label lists the weight of the entire calcium prep — calcium carbonate, calcium citrate, etc. — you can be fooled. You want only the calcium weight of each tablet.
You have to take vitamin D for calcium absorption. Many recommend 800 IU to 1,000 IU of the vitamin, although the official daily allowance for someone your age is 600 IU.
DEAR DR. DONOHUE: I am 77, and the only major medical problem I have is hypertension, which is now controlled. I recently had an ultrasound (echocardiogram) of my heart and was told I have a leaky heart valve. How serious is this? When I asked what should be done, I was told that, if I was younger, surgery would be advised. I have no shortness of breath, chest pain or any other symptoms. I am very active. Your input will be appreciated. — L.O.
ANSWER: The answer depends on how great the leak is. Many people have minor leaks that cause no problems. You have no symptoms of valve malfunction. I take that to mean your leak isn’t serious. I question the remark about age. My mother had a valve replaced when she was your age, but she had major symptoms. If surgeons could fix a heart valve 35 years ago in someone your age, they can still fix it now. Ask your doctor how great is the leak.
Many people suffer from heart valve problems and have little understanding of what’s going on. The booklet on this topic explains heart valves. To obtain a copy, write: Dr. Donohue — No. 105, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I drink skim milk every day for its protein and calcium. I can’t stand the taste, so I add chocolate syrup to it. I heard that chocolate blocks calcium absorption. Is this true? — J.D.
ANSWER: Oxalate in chocolate can interfere with calcium absorption, but the amount of oxalate added to a glass of milk doesn’t significantly reduce calcium’s entry into the body.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.