The Confusion and Fear About Various Calcium Forms 

“If you are taking vitamins, be sure to consider the bioavailability to the cells for if they are not being absorbed as intended, what are they doing within your body?”

The medical system has determined that adequate amounts of both calcium and magnesium are needed to remain healthy, especially for women and when aging. The determination in maintaining bone health and avoiding osteoporosis, the daily dosage from diet and supplementation is between 1,000 to 1,300 mg. The education on calcium in severely lacking, with both the professionals and the general consumers. There is still a great disconnect of education and knowledge when it comes to bone health, many are confused and scared since they do not know what to believe, they know these minerals are needed but they fear the consequences of having high blood calcium levels.

The confusion between forms

I was recently asked by naturopathic doctor’s what calcium form I thought was best, so I decided to share my findings: calcium carbonate, one of the most popular ones, calcium citrate or calcium hydroxyapatite? Each have their pluses and minuses. Calcium hydroxyapatite is sourced from bone waste from either, bovine, camels, fish and pigs. Causes for concern include the cleanness of the source e.g in case of fish farms or the improper manufacturing processes that might increase the risk of variant Creutzfeldt-Jakob disease (vCJD), also known as human mad cow disease. Because it is sourced from bones, it has been theorized that this form absorbs better but there is no clinical evidence that it is true. In fact, this source seems to be less absorbed to the bones than calcium carbonate. On the other hand, it causes less calcium plaquing within the blood.

As far as generalized calcium forms are examined, calcium hydroxyapatite is a calcium-phosphate mineral complex and would probably be as good a form as the others. As we mentioned, the daily dosage for calcium is between 1,000 to 1,300 mg but what is placed in the capsule does not mean that it will end up absorbed in the bones.

It is hypostasised that calcium is absorbed through the intestines, namely the duodenum at approximately between 70—80%, in which vitamin D facilitates the process. In addition passive absorption may occur diffused at about 20—70% at the serum 25OHD levels >10 ng/ml and does not increase with higher levels of 25OHD. The calcium intestinal absorption is referenced as intestinal calcistat and helps regulate the active Vitamin D in intestinal cells to adjust fractional calcium absorption (FCA). This suggests that it is the calcium absorptive mechanism, rather than dietary calcium intake, will decide the adequacy of calcium homeostasis.[1]

We have done extensive research in addressing this subject before producing our Opti- Cal/Mag Complex with K2 for calcium to absorb as necessary, and to have the right calcium managers, as they are equally important as the form of calcium being used.

Why is calcium orotate the best?

As mentioned before, there are several different sources of calcium yet not all of them provide the same benefits, and it is strange that calcium orotate is never included. There is a difference to what the calcium is bound to: calcium orotate can be transported through complex cell membranes, whereas other simpler calcium forms cannot, creating calcium deposits throughout the body. Orotates also liberate the liver’s calcium ion in such a way that it has been shown to have an anti-inflammatory effect. Calcium orotate protects the body from arteriosclerosis (hardening of the arteries) as well. It has also been proven to have a beneficial impact on the degenerative bone changes characteristic of osteoarthritis and in treating inflammatory and osteoporotic decalcification.[2]

A randomized double blind prospective study showed that “2 months of calcium orotate therapy in women with postmenopausal osteoporosis significantly increased serum calcium levels and reduced the symptoms of osteoporosis with no side effects. These results suggest that calcium orotate is an important therapeutic option in the treatment of women with postmenopausal osteoporosis when compared to calcium carbonate + vit D3 treatment.”[3]

Opti-Cal/Mag Complex was designed to promote bone growth by increasing the production of osteocalcin in osteoblasts, which allows calcium to anchor to bone and thus build bone. It also inhibits the production of osteoclasts, which break down bone thereby acting as an inorganic calcium scavenger for reabsorption.

Calcium content vs bioavailability

The most important aspect to supplementation is what is absorbed to the cells—this cannot be overstated. You can consider the following comparison: calcium content of calcium citrate is 21% and calcium carbonate’s is  40%. Yet, the most important is not the amount of calcium content but the bioavailability or the absorption to the cells. Here we find quite a spread between 20–49%, if 20% – 49% is absorbed to the cells, what happens to the other 80 – 51% that is not? When you compare calcium orotate, the calcium content is between 10-11%. The first thing a person would think reading a label is that is low, they could get 4 times as much from calcium carbonate. They think the value is in the amount loaded into a capsule or tablet, they do not see that bioavailability taken up by the bones and tissue is up to 500% more. It is because it is absorbed like real food, not processed, it all gets used and does not cause reside within the blood or tissues to hurt you later. “Calcium carbonate requires the absorption of stomach acid, which can cause upset stomach. Calcium orotate, on the other hand, improves absorption even without optimal stomach acid. When considering calcium orotate vs citrate, or even calcium orotate vs calcium carbonate, it’s important to note that while all these forms are effective, the orotate form tends to be more efficient in lower doses.”[4]

Form of Calcium Bioavailability Calcium Content
Calcium Orotate 90—95% 10—11%
Calcium Carbonate 20—40% 40%
Calcium Citrate 22—49%. 21%

Crazy as that sounds, sometimes I think it is better to chew on a piece of gyprock. Calcium hydroxide is primarily used in industrial applications and less bioavailable for bone health, compared to the highly absorbable calcium orotate. “Comprising between 70 to 90% of sheet drywall, gypsum has long been the mainstay of drywall products. Otherwise known as calcium sulfate, gypsum is cheap to mine, is fire-proof, and provides superior sound-deadening properties.”[5] I guess if you eat enough you will not burn so fast and have sound-deadening properties. Please, do not even consider even if it helps silence talkative in-laws.

I do believe that Life Choice provides the only multi-mineral in Canada and more than likely in the U.S.A., using only calcium orotate. The demand for USP grade calcium orotate API is difficult to obtain and it is expected to rise in coming years when people understand its potential health benefits. Calcium orotate emerges as a promising contender for promoting bone health and potentially mitigating calcium deficiency without the fear of calcium plaquing your organs, including your pineal gland that affects your sleep-wake cycle, and plaquing your blood vessels and brain. At Life Choice, when we formulate dietary supplements, we always consider product safety and efficacy, this is never compromised. As you can see, the research of using calcium orotate for specific health conditions is ongoing, many with promising results. If you are taking vitamins, be sure to consider the bioavailability to the cells for if they are not being absorbed as intended, what are they doing within your body?

Life Choice products and combos to try:

Additional Reading:

References:

[1] Garg, M K, and Mahalle, Namita. 2019.

[2] Nieper, Hans. 1969.

[3] Yasmeen, Nazia et al. 2013.

[4] WBCIL. 2024.

[5] Wallender, Lee. 2023.