Understanding Calcium: Supplements, Calcium Carbonate, Calcium Citrate, and More

Experts share their advice about what to consider when choosing a calcium supplement.

Are you getting enough calcium in your diet? Maybe not, especially if you're a woman or a teenage girl. Although Americans have improved at this in recent years, we're still not getting enough calcium to maintain our bone health.

How much is that? It depends on your age. According to the Institute of Medicine, the recommended daily amount of calcium to get is:

1-3 years: 700 milligrams daily4-8 years: 1,000 milligrams daily9-18 years: 1,300 milligrams daily19-50 years: 1,000 milligrams daily51-70 years: 1,200 milligrams daily for women; 1,000 milligrams daily for men71 and older: 1,200 milligrams daily

The Institute of Medicine says that most in the U.S. get enough calcium, except for girls 9 to 18 years old. Although women’s recommended calcium needs to increase with menopause, postmenopausal woman taking supplements may also be at greater risk of getting too much calcium.

"We know that peak bone mass occurs around age 30, so it's very important in childhood and adolescence to have a healthy intake of calcium early on," says Marcy B. Bolster, MD. She is a professor of medicine in the division of rheumatology and immunology at the Medical University of South Carolina and director of the MUSC Center for Osteoporosis and Bone Health.

"After age 30, we start to gradually lose bone, and that loss accelerates for women at the time of menopause. So it's very important to stave off bone loss with adequate calcium intake."

Your health care provider may recommend calcium supplements. But with so many choices of calcium supplements, where should you start? Here's what you need to know.

"I tell my patients to take the kind that they tolerate best and is least expensive," Bolster says. She says she recommends calcium carbonate because "it's inexpensive, won't cause discomfort, and is a good source of calcium."

Some people's bodies may have problems making enough stomach acid, or may be taking medications that suppress acid production. For them, says J. Edward Puzas, MD, a calcium citrate supplement might be better because it "dissolves a little better than calcium carbonate for these people." Puzas is a professor of orthopedics and director of orthopedic research at the University of Rochester Medical Center in New York.

What about other types of supplements, like calcium plus magnesium, coral calcium, and so on? Not necessary, the experts tell WebMD. But they note that supplements that combine calcium with vitamin D -- which is essential for the body to appropriately absorb calcium -- provide an added benefit.

The body can absorb only about 500 milligrams of a calcium supplement at any one time, says Puzas, so you can't just down a 1000-mg supplement first thing in the morning and call it a day.

Instead, split your dose into two or three servings a day. "The best way to take it is with a meal; calcium is absorbed better that way," Puzas says. If your daily diet includes calcium-containing foods and drinks, you may not need multiple doses.

View the original article here

Health Tip: Understanding Heel Pain

(HealthDay News) -- When your heel starts to hurt, even walking can be difficult and incredibly painful.

The American Podiatric Medical Association says possible causes of heel pain include:

Heel spurs, which are bony growths that develop on the heel.Inflammation of the fascia, known as plantar fasciitis.Excessive pronation, or inward tilt of the foot as you walk.Achilles tendinitis, in which the tendon at the back of the foot becomes inflamed.A deformity, injury or chronic disease, such as rheumatoid arthritis.

-- Diana Kohnle
Copyright © 2013 HealthDay. All rights reserved.

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The Truth About Poop: Understanding Stool Color, Shape, and Frequency

WebMD helps you answer the most common and sometimes sensitive questions about bowel movements.

We have a lot of silly names for it: BMs, caca, doo-doo, turds, and of course, poop.

We don't generally discuss it in our daily conversations.

But asking some important questions about your bowel movements might give you some insight into your gastrointestinal health. Here's the scoop on poop.

Bowel movements are the end result of your body taking the nutrients it needs from the food you eat and eliminating what's left. 

“Bowel movements are important for your health because they are the body’s natural way of excreting waste from the body,” says Eric Esrailian, MD, section head in general gastroenterology at the David Geffen School of Medicine at UCLA.

When it comes to frequency, color, shape, and size, a general rule of thumb is that normal bowel movements are defined as what’s comfortable for you. But being knowledgeable about your digestive process can help you identify when normal goes awry.

Frequency: “There is no normal when it comes to frequency of bowel movements, only averages” says Bernard Aserkoff, MD, a doctor in the GI Unit at Massachusetts General Hospital in Boston.

It’s average to go once or twice a day, he says, but many people go more, and some go less -- maybe every other day, and or as infrequently as once or twice a week.  As long as you feel comfortable, you don’t need to give your BMs much thought.

Color: “Bowel movements are generally brown in color because of bile, which is produced in the liver and important to the digestion process,” Aserkoff tells WebMD.

The food you eat typically takes three days from the time you eat it until it finishes its journey in your toilet, Aserkoff says. If it takes a shorter time, the result may be greener stool because green is one of the first colors in the rainbow of the digestive process.

Color can be a red flag when it’s a drastic change, Aserkoff says.

“If stool is black, it can mean that you are bleeding internally, possibly as a result of an ulcer or cancer,” he says.  Stool that is black due to bleeding is also "sticky" (tarry) and smells bad. However, black stools are common when taking a vitamin that contains iron or medications that contain bismuth subsalicylate.

Stool that is light in color -- like grey clay -- can also mean trouble if it’s a change from what you normally see. Although it doesn’t happen often, very light-colored stool can indicate a block in the flow of bile or liver disease.

Size and shape: “We used to believe that size was indicative of a problem if the stool was ‘pencil-thin,’” Aserkoff says. “But recent research indicates that this is actually not true.”

View the original article here

Understanding Calcium: Supplements, Calcium Carbonate, Calcium Citrate, and More

Experts share their advice about what to consider when choosing a calcium supplement.

Are you getting enough calcium in your diet? Maybe not, especially if you're a woman or a teenage girl. Although Americans have improved at this in recent years, we're still not getting enough calcium to maintain our bone health.

How much is that? It depends on your age. According to the Institute of Medicine, the recommended daily amount of calcium to get is:

1-3 years: 700 milligrams daily4-8 years: 1,000 milligrams daily9-18 years: 1,300 milligrams daily19-50 years: 1,000 milligrams daily51-70 years: 1,200 milligrams daily for women; 1,000 milligrams daily for men71 and older: 1,200 milligrams daily

The Institute of Medicine says that most in the U.S. get enough calcium, except for girls 9 to 18 years old. Although women’s recommended calcium needs to increase with menopause, postmenopausal woman taking supplements may also be at greater risk of getting too much calcium.

"We know that peak bone mass occurs around age 30, so it's very important in childhood and adolescence to have a healthy intake of calcium early on," says Marcy B. Bolster, MD. She is a professor of medicine in the division of rheumatology and immunology at the Medical University of South Carolina and director of the MUSC Center for Osteoporosis and Bone Health.

"After age 30, we start to gradually lose bone, and that loss accelerates for women at the time of menopause. So it's very important to stave off bone loss with adequate calcium intake."

Your health care provider may recommend calcium supplements. But with so many choices of calcium supplements, where should you start? Here's what you need to know.

"I tell my patients to take the kind that they tolerate best and is least expensive," Bolster says. She says she recommends calcium carbonate because "it's inexpensive, won't cause discomfort, and is a good source of calcium."

Some people's bodies may have problems making enough stomach acid, or may be taking medications that suppress acid production. For them, says J. Edward Puzas, MD, a calcium citrate supplement might be better because it "dissolves a little better than calcium carbonate for these people." Puzas is a professor of orthopedics and director of orthopedic research at the University of Rochester Medical Center in New York.

What about other types of supplements, like calcium plus magnesium, coral calcium, and so on? Not necessary, the experts tell WebMD. But they note that supplements that combine calcium with vitamin D -- which is essential for the body to appropriately absorb calcium -- provide an added benefit.

The body can absorb only about 500 milligrams of a calcium supplement at any one time, says Puzas, so you can't just down a 1000-mg supplement first thing in the morning and call it a day.

Instead, split your dose into two or three servings a day. "The best way to take it is with a meal; calcium is absorbed better that way," Puzas says. If your daily diet includes calcium-containing foods and drinks, you may not need multiple doses.

View the original article here