With the aging of the population, the incidence of osteoporosis is increasing year by year. In view of the fact that osteoporosis can cause multiple fractures and it will have a serious impact on the quality of life and survival time of patients, prevention and treatment have been paid more and more attention. For osteoporosis, calcium supplementation is the most basic treatment. However, calcium is a "prosperous family". What is the difference between family members? Let's learn together today.
Calcium Source and Chemical Composition
1. According to the Source
There are many calcium agents on the market, which can be divided into natural calcium agents and synthetic calcium agents according to their sources.
➤Natural calcium is divided into mineral-derived calcium and bio-derived calcium.For Biogenic calcium, the bones of non-polluting yak and non-polluting farmed eels are often used to make biological calcium.
➤Artificial calcium preparations are divided into inorganic calcium compounds and organic calcium compounds. Inorganic calcium has the advantage of high calcium content and generally requires the participation of gastric acid, while organic calcium generally does not require the participation of gastric acid.
Table 1 Classification of Common Calcium
Classification of Calcium | Representative Calcium | ||
Natural Calcium Agents | Mineral-derived Calcium | Ore Class | Stalactites, etc. (calcium carbonate) |
Fossil Class | Keel, dragon teeth (calcium carbonate, calcium phosphate) | ||
Bio-derived Calcium | Shellfish | Oyster shell, egg shell, mother-of-pearl (biological calcium carbonate) | |
Skeletal Class | Pork bone, bovine bone (calcium phosphate, hydroxyapatite) | ||
Synthetic Calcium Agents | Inorganic Calcium | Calcium chloride (active calcium), calcium phosphate, calcium hydrogen phosphate, synthetic calcium carbonate | |
Organic Calcium | Ionic Type | Calcium gluconate, calcium acetate, citric acid calcium, calcium citrate, calcium lactate | |
Molecular Type | Calcium L-threonate, calcium aspartate, calcium amino acid chelate |
2. According to Chemical Composition
According to chemical composition, it is mainly divided into inorganic calcium (first generation calcium), organic calcium (second and third generation calcium) and biological calcium:
➤Inorganic calcium mainly includes the first-generation calcium preparations: calcium carbonate, calcium phosphate, calcium oxide (active calcium), calcium hydroxide, calcium bicarbonate, and calcium chloride;
➤Organic calcium mainly includes citric acid calcium, calcium citrate, calcium acetate, calcium gluconate, calcium lactate in the second generation calcium preparations and the third generation calcium preparations :amino acid chelated calcium and L-aspartate calcium etc.
➤Biological calcium mainly refers to traditional Chinese medicine calcium preparation.
Biological Characteristics of Commonly Used Calcium
The classification seems a bit complicated. As an important reference for clinical selection of calcium supplements, let's directly look at the biological characteristics of different calcium supplements.
1. Characteristics of Inorganic Calcium
At present, synthetic inorganic calcium (such as calcium carbonate, calcium phosphate, etc.) is widely used in clinic. Its advantages are high calcium content, high absorption rate and low price, which are suitable for most patients with osteoporosis. But the disadvantage is that such calcium agents is low in water solubility. After entering the human body, they need to be dissociated into calcium ions by gastric acid before they can be absorbed and utilized by the human body, which affects the acid environment in the stomach. When gastric acid is lacking, the dissociation is incomplete, the bioavailability is reduced, and it is easier to cause gastrointestinal irritation.
Take calcium carbonate as an example. The preparation contains high calcium content, high absorption rate, and easily soluble in gastric acid. Common adverse reactions are epigastric discomfort and constipation. In addition, calcium carbonate can neutralize gastric acid in the body. The elderly, habitual constipation and People with decreased gastric acid secretion should avoid using it.
2. The Characteristics of Organic Calcium
The calcium content of organic calcium is relatively low, but compared with inorganic calcium, this kind of calcium has high bioavailability, good absorption, closing to neutral pH, absorption does not consume gastric acid, little gastrointestinal irritation. It is suitable for children, Middle-aged and elderly people with poor gastrointestinal function.
For example,the second-generation calcium preparations (such as citric acid calcium, calcium citrate, etc.) have high bioavailability and less gastrointestinal irritation, but its disadvantages are relatively low calcium content. Some additional effects on the body may be caused by the use of some calcium agents:
➤Citric acid calcium has low calcium content, but has good water solubility, little gastrointestinal adverse reactions, and may reduce the occurrence of kidney stones. It is suitable for patients with gastric acid deficiency and risk of kidney stones.
➤Calcium gluconate is metabolized into glucose in the body, which increases the concentration of blood glucose, so it is not suitable for diabetic calcium deficiency patients.
➤Calcium lactate is metabolized into lactic acid in the body, causing fatigue and soreness in the body, so it is not suitable for patients with weak physique.
The third-generation calcium preparations (such as L-threonate calcium and amino acid chelate calcium) combine the advantages of the first-generation and second-generation calcium and weaken their shortcomings. This type of calcium have good solubility, high absorption rate, little gastrointestinal irritation , and have a low risk of hypercalcemia due to special metabolic pathways, but the price is high.
3. The Characteristics of Biological Calcium
It is generally made from natural raw materials or shells rich in calcium by high-temperature calcination. This kind of calcium agent has a high degree of ionization and is easily absorbed and utilized by the body. However, some biological calcium preparations contain elements that are harmful to the body, such as cadmium, bismuth, lead, etc., and long-term use may cause potential heavy metal poisoning.
Precautions for Taking Calcium
1. It is recommended to use with vitamin D.
Vitamin D is beneficial to the absorption of calcium in the gastrointestinal tract. The recommended intake of vitamin D for adults is 400U (10ug)/d. People aged 65 and over often suffer from vitamin D deficiency due to lack of sunlight and impairment of intake and absorption, so the recommended intake is 600U (15ug)/D and the highest tolerable intake is 2000U (50ug) /d.
2. Avoid combining with drugs that affect calcium absorption, such as corticosteroids, isohydrazine, tetracycline or aluminum-containing acid drugs, etc.
3.Regular monitoring blood calcium and urine calcium to prevent excessive calcium supplementation to guide medication. Taking calcium in large quantities for a long time can cause adverse results such as hypercalcemia, hypercalciuria, kidney stones, ectopic calcification, atherosclerosis, etc. And it may affect the absorption of iron, zinc, magnesium and other trace elements. Therefore, avoid excessive calcium supplementation.
4. Patients with hypercalcemia and hypercalciuria are prohibited from taking any calcium. And diabetes patients are prohibited from taking calcium containing sugars.
5. If you have stomach upset, try to choose calcium preparations that are less irritating to the stomach.
6. Calcium should be taken after chewing, which is conducive to the better absorption of calcium.
7.Diets high in salt, high in oxalic acid, caffeine, smoking and alcohol are not recommended because they affect the absorption efficiency of calcium.