QUESTION: Calcium supplements and heart attacks?

QUESTION: Can taking calcium supplements make you have a heart attack?

ANSWER: A recent study published in The British Medical Journal reported that taking 500 mg or more a day of calcium increased the risk for heart attacks in healthy women by 20 to 30 percent. However, it did not increase the risk of strokes or death. The author’s theory appeared to show a rapid rise in blood levels of calcium after taking supplements that could lead to further worsening of the process that caused arterial hardening and artery plaque instability.

Too much of any good thing may itself be harmful. However, you cannot conclude that calcium supplementation in general is bad. The relationship reported in the study was a correlation rather than causation. They did not draw the conclusion that taking calcium causes heart attacks. In addition they did not control for the overall level of inflammation in the participants or the health of their coronary arteries. Nor did they differentiate between different types of calcium supplements.

It is important to understand where to begin.

Know your calcium level and know how much calcium is contained within your daily diet. As for many other vitamins and minerals, food is a much better source of minerals than supplements. Food sources are more readily absorbed into the body and their rate of absorption is slowed by the processing of the foods that contain them. If there is a choice, opt to get your nutrients through food.

When your food choices do not contain enough calcium, supplementation may be necessary. Calcium citrate tends to be the most easily absorbed calcium and should be taken with food. The amount of calcium in your diet plus your supplements should be approximately 1500 mg a day. It is best to divide this so that you take no more than 500 mg of calcium at any given time.

Calcium contributes to heart disease via its role in the creation of complex plaques in the arteries. This process arises because of the interaction of several factors including inflammation of the arteries, cholesterol that is small enough to sneak into the artery walls, and immune cells that transport and deposit the cholesterol. Calcium then gets incorporated into the plaque. Once calcium-laden plaque ruptures, platelets adhere to the rupture and form a clot along the artery wall. If the clot gets big enough, the artery is blocked and a heart attack occurs.

To summarize, it’s best to get your calcium from your diet. Supplement as necessary, but don’t over-supplement, identify and reduce your inflammation, control your cholesterol, and work to prevent plaque formation. If you are very concerned then you may chose to have your coronary calcium score quantified through a 64-slice CT of the heart. In this way, you can continue to work to enhance bone health while not worsening heart health. Remember – everything is related.

Please note: This question has been republished from the Ask the Practitioner section of the Center for Integrative Medicine website.