Calcium is centrally important, as most people already know. Not only is it necessary for the health of bones but also for the health of the heart, nerve cells, gut microbiome, hormonal system, skin, etc and will affect such things as grip strength and fatigue. As usual, there is a lot of misinformation out there and newer information that has changed our understanding. Let me clear up the issue to the degree I can. The following represents my present understanding, based on the sources I could find.
We can store calcium when we are younger, but lose this ability as we age. On the other hand, it turns out we don’t need as much calcium as previously assumed. And too much calcium can be harmful, even deadly as can happen with hardening of arteries. In fact, the healthiest societies have lower levels of calcium. It’s not so much about the calcium itself for, as always, context matters. Calcium deficiencies typically are caused by a health condition (kidney condition, alcohol abuse, etc), rather than lack of calcium in the diet. Importantly, other nutrients determine how the body absorbs, processes, utilizes, and deposits calcium. Furthermore, nutritional imbalances involving deficiencies and excesses create a cascade of health problems.
Let me explain the interrelationship of micronutrients. There is a whole series of relationships involved in calcium processing. Vitamin B6 is necessary for absorption of magnesium; and magnesium is necessary for absorption of vitamin D3 — zinc, boron, vitamin A, bile salts, and a healthy guy microbiome are all important as well. Of course, cholesterol and sunlight are needed for the body to produce it’s own vitamin D3, which is why deficiencies in these are also problematic. Statins block cholesterol and sunscreen blocks sun; while stress will block vitamin D3 itself whereas exercise will do the opposite. Then vitamin D3 is necessary for absorption of calcium. But it doesn’t end there. Most important of all, vitamin K2 is necessary for regulating where calcium is deposited in the body, ensuring it ends up in bones and teeth rather than in joints, arteries, brain, kidneys, etc.
About on specific issue, the often cited 2-to-1 ratio of calcium and magnesium is actually on the high end indicating the maximum calcium levels you don’t want to exceed as part of your total calcium intake from both diet and supplementation. So, if you’re getting a 2-to-1 ratio in your supplements combined with high levels of calcium from food, such as a diet with plenty of dairy and/or greens, your calcium levels could be causing you harm. Speaking of magnesium deficiency is a relative assessment, as it depends on calcium levels. The body is rarely depleted of magnesium and so, on a superficial level, your body is never deficient in an absolute sense. Yet the higher your calcium levels go the greater your need of magnesium. Nutrients never act alone, such as how vitamin C requirements increase on a high-carb diet.
Here is another example of nutrient interaction. With more salt in your diet, you’ll need more potassium and magnesium to compensate. And potassium deficiency is associated with magnesium deficiency. But that isn’t to say you want to decrease sodium to increase these others, as research indicates higher salt intake is associated with greater health (Dr. James DiNicolantonio, The Salt Fix) — and I’d recommend getting a good source of salt such as Real Salt (although natural forms of salt lack iodine and so make sure to increase iodine-rich foods like seaweed, that being a good option since seaweed is extremely nutrient-dense). As an interesting side note, calcium helps your muscles contract and magnesium helps your muscles relax, which is why muscle cramps (also spasms, twitches, and restlessness) can be a sign of magnesium deficiency. Plus, excess calcium and insufficient magnesium will increase cortisol, the stress hormone, and so can interfere with sleep. There is yet another dual relationship between these two in the clotting and thinning of blood.
Macronutrients play a role as well. Higher protein ensures optimal levels of magnesium and is strongly linked to increased bone mass and density. Animal fat intake also plays a role with these minerals (B. Baggio, Fatty acids, calcium and bone metabolism; E, Bandali et al, The Higher Calcium Absorption Associated with a High Fat Diet is Not Due to Intestinal Calcium Availability; F. Nielsen, Dietary fatty acid composition alters magnesium metabolism, distribution, and marginal deficiency response in rats; R.W. Ordway et al, Arachidonic acid and other fatty acids directly activate potassium channels in smooth muscle cells; J.H. Bolivar, Multiple Binding Sites for Fatty Acids on the Potassium Channel KcsA). Certainly, fat is necessary for the absorption of fat-soluble vitamins. If you’re eating pastured (or grass-fed-and-finished) fatty animal foods, you’ll be getting both the protein and the fat-soluble vitamins (A as beta-carotene, D3, E complex, & K2). Even greater, with cultured, fermented and aged foods (whether from animals or plants), you’ll get higher levels of the much needed vitamin K2. Assuming you can stand the taste and texture of it, fermented soy in the form of natto is the highest known source of K2 as the subtype MK7 which remains in the body longer than other subtypes. By the way, some multiple vitamins contain MK7 (e.g., Garden of Life). Vitamin K2 is massively important. Weston A. Price called it Activator X because it controls so much of what the body does, specifically in relationship to other nutrients, including other fat-soluble vitamins. And all of the fat-soluble vitamins are central in relationship to mineral levels.
Another factor to consider is when nutrients are taken and in combination with what. Some minerals will compete with each other for absorption, but this probably is not an issue if you are getting small amounts throughout the day, such as adding a balanced electrolyte mix (with potassium, magnesium, etc) to your water or other drinks. Calcium and magnesium are two that compete and many advise they should be taken separately, but if you take them in smaller amounts competition is not an issue. Some research indicates calcium has a higher absorption rate in the evening, but magnesium can make you sleepy and so might also be taken in the evening — if taking a supplement, maybe take the former with dinner and the latter before bed or you could take the magnesium in the morning and see how it makes you feel. By the way, too much coffee (6 cups or more a day) will cause the body to excrete calcium and salt, and yet coffee is also a good source of potassium and magnesium. Coffee, as with tea, in moderate amounts is good for your health.
As a last thought, here is what you want to avoid for healthy calcium levels: taken with iron supplements, high levels of insoluble fiber, antacids, excessive caffeine. Also, calcium can alter the effects of medications and, in some cases, should be taken two hours apart. Keep in mind that many plant foods can be problematic because of anti-nutrients that bind minerals or interfere with absorption. This is why traditional people spent so much time preparing plant foods (soaking, sprouting, cooking, fermenting, etc) in order to eliminate these anti-nutrients and hence increase nutrient absorption. It is irrelevant the amount of nutrients in a food if you’re body can’t use them. For example, one of the highest concentrations of calcium is found in spinach, but the bioavailability is extremely low. Other foods, including other leafy greens, are a much better source and with any leafy greens always cook them.
This problem is magnified by the decreased nutrient content of most plant foods these days, as the soil itself has become depleted. Supplementation of many micronutrients is maybe necessary for almost everyone at this point, although great caution should be taken with supplementing calcium.
* * *
Sometimes I write posts about diet and health after doing research for my own purposes or simply for the sake of curiosity about a topic. But in many cases, I have family members in mind, as my own health improvements have gone hand in hand with dietary changes my parents also have made, and my brothers are health-conscious as well although with a vegetarian diet quite different than my own. This particular post was written for my mother.
Just the other day she was diagnosed with osteoporosis. She had osteopenia for decades. Now looking back, she realizes that her bone loss began when she started taking fiber and antacids, both of which block calcium. And all the years of calcium supplementation were probably doing her no good because, even to the degree she was absorbing any of the calcium, it wasn’t balanced with other needed nutrients. I gathered this information in order to help her to figure out how to improve her bone health, as her doctor was only moderately informed and her recent appointment was rushed.
This was researched and written on Mother’s Day. I guess it was my gift to my mother. But I hope it is of value to others as well.
* * *
Without Magnesium, Vitamin D Supplementation May Backfire
by Joseph Mercola
Calcium with Magnesium: Do You Need the Calcium?
from Easy Immune System Health
Expert cites risk of calcium—magnesium imbalance
from Nutritional Magnesium Association
Nutritional strategies for skeletal and cardiovascular health: hard bones, softarteries, rather than vice versa
by James H O’Keefe, Nathaniel Bergman, Pedro Carrera-Bastos, Maélan Fontes-Villalba, James J DiNicolantonio, Loren Cordain
Why You Need To Take Vitamin K With Calcium Supplements
by Stacy Facko
For Bone Health, Think Magnesium
from Harvest Market Natural Foods
Calcium Deficiency: Are Supplements the Answer?
by Jillian Levy
Calcium to Magnesium: How the Ratio Affects Your Health
from Juvenon Health Journal
How to Correct Your Calcium-to-Magnesium Ratio
by Sandra Ketcham
Calcium & Magnesium: Finding the Right Ratio for Optimal Health
by Dr. Edward Group
Magnesium, NOT Calcium, Is The Key To Healthy Bones
by Jackie Ritz
Calcium Supplements: Things to Consider before Taking One
by Chris Kresser
How to Get Enough Calcium Without Dairy
by Katie Wells
Is The Paleo Diet Deficient In Calcium?
by Michael Ofer
Paleo & Calcium | Friendly Calcium Rich Foods
by Irena Macri
Mineral Primer – The Weston A. Price Foundation
by Sally Fallon and Mary G. Enig
13 Signs Of Magnesium Deficiency + How To Finally Get Enough
by Dr. Will Cole
Top 10 Magnesium-Rich Foods
by Rachael Link
Vitamin K2, Vitamin D, and Calcium: A Winning Combo
by Joseph Mercola
Vitamin K2: Everything You Need to Know
by Joe Leech
The Ultimate Vitamin K2 Resource
by Chris Masterjohn
Vitamin K2: Are You Consuming Enough?
by Chris Kresser
Calcium: A Team Sports View of Nutrition
by Loren Cordain
How To Keep Your Bones Healthy On A Paleo Diet
by Chris Kresser