Calcium Needs for People with Arthritis

Getting enough calcium is key to preventing osteoporosis, a loss of bone quantity and quality that increases risk for fractures and disability. In the United States, most people take in close to the recommended daily allowance (RDA) of calcium through diet alone. With a few dietary tweaks, most can reach daily goals without supplements.

The chronic inflammation of autoimmune diseases such as rheumatoid arthritis and psoriatic arthritis, as well as some drugs used to treat the conditions, raise osteoporosis risks.

People with osteoarthritis aren’t typically at increased risk of osteoporosis because of their joint disease but may be vulnerable to bone loss for other reasons.

Other osteoporosis risk factors include lifestyle habits people can modify, such as not getting enough weight-bearing exercise and smoking cigarettes, as well as some things that can’t be changed, such as being a woman and simply getting older. Women lose bone mineral density faster than men until age 65, when both sexes begin to lose bone at about the same rate.

It’s smart to check with your doctor about your individual needs, but most people with arthritis should meet the same RDA for calcium as healthy adults. For women 19 to 50 years old the RDA is 1000 mg; those older than 50 should get 1,200 mg a day. Men should aim for 1,000 mg a day until they are 70, and afterwards increase their intake to 1,200 mg daily.

Eating calcium-rich foods--rather than taking supplements--is the healthiest way for most people to reach their RDA for this bone-protecting mineral.

Most Americans are getting between 750 mg and 900 mg of calcium through diet alone, according to a 2011 Institute of Medicine report by the committee that sets the U.S. calcium intake recommendations. Add to those numbers by opting for healthy foods and beverages high in calcium. Dairy products are excellent sources. An 8-ounce serving of plain yogurt provides about 400 mg of calcium; an 8-ounce glass of milk, 300 mg; and a slice of cheddar cheese, 200 mg.

Dark leafy greens provide about a 100 mg of calcium per cooked cup, while 3 ounces of canned sardines or of canned salmon with bones deliver about 325 mg and 200 mg, respectively.

Calcium-fortified predicts, which include orange juice and cereals, can also deliver healthy doses of the mineral. Calcium-fortified cereals, for example, can provide anywhere from 100 to 1,000 mg per cup.

Most people can and should meet their calcium needs through diet alone. Although some individuals may have trouble getting enough calcium through food and beverages, calcium supplements should be taken only with a doctor’s okay.

“Americans love to take supplements and think, ‘Well, it can’t hurt,’” says Donald Miller, PharmD, professor in the Department of Pharmacy Practice at North Dakota State University in Fargo.

But, actually, it could, Dr. Fargo says. Excess amounts (more than 2,500 mg a day) can harm the kidneys and reduce absorption of other minerals like iron, zinc, and magnesium. And, while calcium from dietary sources protects the heart, supplements of the mineral may spell heart trouble, according to a growing number of studies that link them to cardiac events, including heart attacks.

Some researchers think the supplements may be problematic for the cardiovascular system because they spike blood calcium levels, while dietary calcium causes a gradual rise. Reena L. Pande, MD, a cardiovascular specialist at Brigham and Women’s Hospital in Boston, stresses the importance of a conversation with your doctor before stocking up on calcium supplements.

“Everyone is different,” Dr. Pande says. “For example, for a patient with osteoporosis, or with a specific condition [such as inflammatory arthritis] that might be strongly linked with the development of osteoporosis, the benefit of calcium supplementation might outweigh the potential heart risk.”
Learn more about calcium supplementation with the Arthritis Foundation Vitamin and Mineral guide .