Constipation from Calcium Supplements

Q: I'm 50 years old and perimenopausal, so my doctor suggested taking a daily OTC calcium and magnesium supplement to help protect my bones from osteoporosis. I've been following his advice for a few months, but now I'm constantly and painfully constipated. I've tried increasing my fluid and fiber intake and being more active but it doesn't seem to help. How can I help my bones without this annoying side effect?

Dr. Donnica: First of all, you're right to be taking calcium supplements to protect your bones. Premenopausal women need a total daily calcium intake of 1,200 mg per day. If you're getting much of this from supplements rather than from your diet, my advice is to take it in divided doses, not once a day.

Not all calcium supplements are equally constipating: calcium citrate (e.g. Citra cal TM) is said to be the least constipating as it is digested more effectively, but it is more expensive than calcium carbonate. Another option is to consume calcium fortified foods and beverages, like orange juice.

For anyone with constipation, I recommend drinking 10 glasses of water per day, consuming 5 servings of fresh fruits and vegetables per day, and getting at least 20 minutes of exercise per day. If constipation prevails, it is better to add a fiber supplement or a gentle stimulant laxative than to stop taking the calcium. Daily calcium supplementation is not just good for your bones; studies have shown that it can have several other health benefits including reducing PMS, improving blood pressure and cholesterol levels, and even reducing the risk of colon cancer.

Created: 11/21/2003  -  Donnica Moore, M.D.