How much calcium does my child need

Calcium (for Parents) - Nemours KidsHealth

What Is Calcium? 

Calcium is a mineral that builds strong bones. It helps the body in lots of other ways too. Calcium keeps the nerves and muscles working. It also plays a role in keeping the heart healthy.

Why Do Kids Need Calcium?

We only get one chance to build strong bones — when we're kids and teens. Children who get enough calcium start their adult lives with the strongest bones possible. That protects them against bone loss later in life.

Young kids and babies need calcium and vitamin D to prevent a disease called rickets. Rickets softens the bones and causes bow legs, stunted growth, and sometimes sore or weak muscles.

Where Does Calcium Come From?

Calcium is found in food. Some foods are very high in calcium. Dairy foods like these are among the best natural sources of calcium:

• milk
• yogurt
• hard cheeses, like cheddar

The percentage of fat in milk and other dairy foods doesn't affect their calcium content — nonfat, 1%, 2%, or whole all have about the same amount of calcium. Your health care provider will let you know which type of milk is right for your child.

Some kids can't eat dairy. They have to get calcium from other foods, such as:

• calcium-set tofu
• calcium-fortified soy drinks
• edamame (soybeans)
• broccoli, collard greens, kale, chard, Chinese cabbage, and other leafy greens
• almonds and sesame seeds
• white beans, red beans, and chickpeas
• oranges, figs, and prunes

Because calcium is so important, food companies often add it to cereal, bread, juice, and other kid-friendly foods.

How Much Calcium Does My Child Need?

Calcium is measured in milligrams (mg). We need different amounts at different stages of life. It's best if kids get most of their calcium from food. If that's not possible, health care providers might suggest a calcium supplement.

Babies

Babies get their calcium from breast milk or formula:

• Babies younger than 6 months old need 200 mg of calcium a day.
• Babies 6 to 11 months old need 260 mg of calcium a day.

The only types of milk babies should have are breast milk or formula. Don't give cow's milk, goat's milk, or homemade formula to babies younger than 1 year old..

Kids and Teens

Kids need more calcium as they get older to support their growing bones:

• Kids 1 to 3 years old need 700 mg of calcium a day (2–3 servings).
• Kids 4 to 8 years old need 1,000 mg of calcium a day (2–3 servings).
• Kids and teens 9 to 18 years old need 1,300 mg of calcium a day (4 servings).

How Can I Help My Child Get Enough Calcium?

Babies get all their calcium from breast milk or formula. Young kids and school-age kids who eat a healthy diet with plenty of dairy also get enough. But preteens and teens may need to add more calcium-rich foods to their diet.

Try these tips to make sure kids and teens get enough calcium:

• Make parfaits with layers of plain yogurt, fruit, and whole-grain cereal.
• Make smoothies with fresh fruit and low-fat milk or calcium-fortified soy or almond milk.
• Add fresh fruit or unsweetened apple butter to cottage cheese or yogurt.
• Add a drop of strawberry or chocolate syrup to regular milk. Avoid store-bought flavored milk drinks because they can have a lot of sugar.
• Sprinkle low-fat cheese on top of snacks and meals.
• Add white beans to favorite soups.
• Add sesame seeds to baked goods or sprinkle on vegetables.
• Serve hummus with cut-up vegetables.
• Add tofu to a stir-fry.
• Use almond butter instead of peanut butter.
• Serve edamame as a snack.
• Top salads or cereals with chickpeas and slivered almonds.
• Serve more dark green, leafy vegetables (such as broccoli, kale, collard greens, or Chinese cabbage) with meals.

Kids who can't eat dairy may not get enough calcium. If your child has lactose intolerance, a milk allergy, or eats a vegan diet, talk to your health care provider about calcium and vitamin D.

What About Vitamin D?

People need vitamin D to help the body absorb calcium. Without it, calcium can't get where it needs to go to build strong bones.

Vitamin D isn't in many foods that kids eat. So, health care providers often recommend supplements.

Breastfed babies need a vitamin D supplement, starting soon after birth. Baby formula has vitamin D added, so babies who drink more than 32 ounces of formula a day don't need extra vitamin D.

Ask your health care provider if your baby or child needs a vitamin D supplement. 

Reviewed by: Mary L. Gavin, MD

Date reviewed: February 2021

Calcium-Rich Foods for Kids | Everyday Health

To build strong bones that last a lifetime, children and teens need lots of calcium. Here are a dozen calcium-rich foods, and tips on preparing them for kids.

Medically Reviewed

For growing children and teens, getting enough calcium is crucial to building bone mass, which may help guard against osteoporosis and fractures later in life. But by age 12, fewer than 1 in 10 girls and 1 in 3 boys get adequate daily calcium: 700 mg for children ages 1 to 3; 1,000 mg for ages 4 to 8; and 1,300 mg — equal to about 4 cups of milk — for ages 9 to 18. Here are a dozen kid-friendly ways to get calcium into your child's daily diet.

Dairy Go-round: Milk, Cheese, and Yogurt

"Small amounts of calcium in other foods add up," says Ellie Krieger, a registered dietitian who is a mother and an Everyday Health Healthy Eating expert. "But the real dose of calcium for most of us comes from dairy foods." A cup of cow's milk has about 300 mg of calcium, about the same as 1 cup of yogurt, 1 1/2 ounces of natural cheese, or 2 ounces of processed cheese. For children age 2 and older, switch to low-fat and nonfat dairy products. And when it comes to flavors, "it's better to drink plain milk," says Krieger, "but it's better to drink flavored milk than no milk."

Soy Good: Calcium-Fortified Soymilk

What if your child can't or won't drink cow's milk? A variety of foods contain added calcium, including milk, cheese, and yogurt made from soybeans. Soymilk without added calcium contains only about 10 mg per cup, and that calcium is difficult for the body to absorb. But calcium-fortified soymilk and soy products have as much calcium as cow's milk and sometimes more. Use soy products as you would dairy products: Pour over cereal, pack in a lunch, or provide as a snack.

Get a Calcium Boost With Orange Juice

Fortified orange juice brims with calcium — as much as 500 mg is added to each cup. Calcium content varies among orange juice products, however, so read nutrition labels carefully. Keep in mind that the percentage "daily value" listed on labels is based on the needs of adults up to age 50: 1,000 mg. Children and teens need 500 to 1,300 mg daily, depending on age. While fortified orange juice is a great way to get calcium, Krieger also recommends fresh oranges, each of which naturally contains about 50 mg of calcium.

Toss in Some Tofu

Getting the most calcium out of tofu requires advanced label-reading skills. That's because tofu's calcium content depends on the way in which it was prepared. Bottom line: Tofu made with calcium sulfate contains more calcium than tofu made with magnesium chloride, or nigari. The beauty of preparing tofu for kids, Krieger says, is that "it tastes like whatever you put on it or sauté it in." Toss some into a stir-fry alone or with chicken, she advises, or cut your child's favorite flavored tofu into sticks for a fun finger food.

The Calcium Power of Fish Bones

The processing of canned salmon softens the bones, making them easy to digest — it's the bones that provide the calcium. A 3-ounce serving of pink salmon, along with the bones, provides about 180 mg of calcium — about two-thirds the amount in a cup of milk. The challenge is to make salmon bones palatable to a child. First, mash the salmon so the bones are less noticeable. Then, use canned salmon in fish cakes instead of crab, or add it to casseroles in place of tuna.

Munchable, Spreadable Calcium Source

Almonds, says Krieger, pack a surprisingly significant amount of calcium; a third of a cup, which Krieger calls a reasonable serving, contains about 110 mg of calcium, raw or roasted. Krieger suggests using almond butter in place of peanut butter in sandwiches for your kids, and including unsalted or low-salt almonds with dried fruit in trail-mix snacks. You can also toss almonds into salads, sprinkle them on breakfast oatmeal, or simply give your children a handful.

Tempting Treats With Calcium

A sweet potato provides about 55 mg of calcium, and a cup of cooked sweet potatoes about 76 mg. Sweet potatoes are loaded with other nutrients as well, and it's easy to enhance their calcium quotient and appeal to a child's appetite by adding cheese or yogurt. Bake a sweet potato (skin on) and top it with low-fat yogurt or grated cheddar; cut potatoes into sticks, toss in olive oil, roast in the oven, and sprinkle with Parmesan cheese; or boil and mash potatoes and toss with butter and cheese. (A note on yams: They are not as rich in calcium as sweet potatoes, containing only 19 mg per cup, so make sure you're serving the kids sweet potatoes, not yams, if you're trying to up their calcium intake. )

Calcium's Better in Beans

A cup of boiled small white beans, dried, provides about 130 mg of calcium, nearly as much as half a cup of milk. A cup of canned white beans has about 190 mg. A cup of canned chickpeas, also called garbanzo beans, contains about 80 mg. Mash, or use your food processor to blend, both types of beans into dips and spreads kids will love. With chickpeas, try traditional lemon-and-garlic-infused hummus (go light on the garlic for picky kids). Or process white beans with roasted garlic, a drizzle of olive oil, and salt and pepper and spread on toast.

Dip Broccoli Trees in Yogurt

Broccoli contains a significant amount of calcium, but you may have a hard time persuading your child to eat 2 1/4 cups of cooked broccoli or about five raw stalks to get the calcium provided by a cup of milk. Yogurt, on the other hand, contains about the same amount of calcium as milk. Double up on calcium content by pairing blanched or raw broccoli "trees" with a simple dip made from yogurt mixed with herbs (chives, cilantro), spices (curry, chili powder), or fruits and vegetables (cucumber, apple).

Green Peas, Please

Green peas contain about 45 mg of calcium per cup. But they may help improve bone health in another way: Green peas are packed with vitamin K, and some studies have shown that vitamin K supplements may increase bone mineral density and bone strength. Moreover, green peas are loaded with nutrients besides calcium. They're an excellent source of vitamins C and A and protein, and like broccoli, they can be combined with a dairy product to enhance their calcium dose. Try "creamed" peas made with low-fat milk, or toss some peas with pasta and a light, cheesy white sauce.

Added Attraction: Calcium-Fortified Cereals

Some ready-to-eat breakfast cereals are fortified with as much as 1,000 mg of calcium in each 1 1/3–cup serving. Add a cup of milk and your teen will get all the calcium he or she needs for the day. Fortified foods are a handy way to get vitamins and minerals into your child's diet, says Krieger. To add calcium to hot cereals, cook them in cow's milk or fortified soymilk instead of water.

Waffles With Calcium: An Easy Breakfast

You already use frozen waffles and your kids love them. Once again, however, it pays to study nutrition labels carefully. Not all frozen waffles are fortified, but those that contain added calcium can provide around 100 mg of the mineral in each waffle. For extra nutritional value, Krieger suggests looking for whole-grain varieties. And to up the calcium count, try topping your kids' waffles with low-fat or nonfat yogurt mixed with a dollop of jam or their favorite sliced fresh fruit.

Calcium for pregnant women - what is needed

Calcium is an important structural element. It takes an active part in the formation of bone tissue, teeth, hair, nails, is involved in muscle contraction, blood coagulation, and ensures normal permeability of the vascular wall. Calcium during pregnancy passes through the placental barrier, accumulating in the body of the baby.

For proper development, the placenta must pass 13 mg of calcium every hour. With sufficient intake of a macronutrient, a child is born with its own supply of this substance in 25 g. Bones and muscles continue to grow, they still need calcium. Deficiency threatens rickets and other malformations. nine0007

There is an important feature: being in the womb, the baby will still take its toll. He will receive calcium from the mother's body. Therefore, one can often hear complaints that during pregnancy the condition of bones worsens, teeth are destroyed, nails break. No wonder pregnancy is called "calcium stress for women." To prevent this from happening, pregnant women are prescribed calcium already in the early stages of pregnancy.

Calcium takes part in the formation of the nervous system and heart. To help the baby develop properly, you need to maintain the level of the nutrient in the body from the first days of pregnancy ²

Why pregnant women need phosphorus

Phosphorus is no less important nutrient than calcium. Most of it is also found in bone tissue and teeth. It is phosphorus that converts the energy received from food into cellular energy. The main tasks of phosphorus ¹⁰ :

• participate in cell division and building new ones - this is very important for the proper formation of internal organs and the growth of the baby in the womb;
• regulation of acid-base balance in the stomach; nine0026
• maintenance of the work of the heart, blood vessels, endocrine system.

Phosphorus is intensively consumed from the first weeks of pregnancy. A balanced phosphorus-calcium metabolism is necessary for the formation of the baby's internal organs and skeleton. During this period, the nervous system also develops, which also needs phosphorus.

Magnesium is an active participant in energy processes. Under its influence, enzymes work, blood pressure and the functioning of the nervous system are normalized. When a macroelement enters a cell, its permeability changes, and it can actively respond to external impulses. With the participation of magnesium, energy reserves are replenished, proteins are synthesized, as well as the basis for DNA and RNA. nine0007

Two important organs of pregnancy, the placenta and uterus, are in dire need of magnesium. It performs a number of important functions:

• normalizes the tone of the uterus;

• supports the harmonious development of the fetus;

• provides the placenta with the necessary energy.

The macronutrient is also important for the mother's nervous system. It helps relieve irritation, improve mood, improve sleep and prevent convulsions (if this trouble occurs). nine0007

Magnesium is also needed by women during breastfeeding. Milk should provide the baby's needs for this macronutrient. The optimal concentration of magnesium in milk is 30-40 mg/l ⁵ .

The norms of this important trio of mineral substances during pregnancy are approved by the Order of the Ministry of Health of Ukraine and are ³ :

An important point: the absorption of calcium and phosphorus occurs with the active participation of vitamin D Also, the doctor may prescribe an increased dosage of calcium for multiple pregnancies or if there are other risk factors for the musculoskeletal system. nine0007

Calcium and magnesium should be supplemented with vitamin B ₆ . It reduces the excretion of calcium from the body. Magnesium and vitamin B ₆ are also closely related - the vitamin increases the bioavailability of the macronutrient, and magnesium increases the amount of B ₆ that penetrates the cells.

Calcium for pregnant women must be supplied in sufficient quantities. If there is not enough of it in the mother’s body, undesirable consequences are possible for both mother and child ¹¹ :

• The first signs of calcium deficiency that a mother will feel may be pain in the spine and bones of the limbs, brittle nails, dull hair, problems with teeth;

• malfunctions of the nervous system, mood changes - mainly tearfulness, fatigue;

• Long-term calcium deficiency can affect the strength of the bone tissue of the whole body - its decrease is called osteopenia and serves as a harbinger of osteoporosis - increased bone fragility

• calcium deficiency can also lead to weakness of labor, increase the risk of complications such as preeclampsia, eclampsia, postpartum hemorrhage.

For a child, calcium deficiency may be manifested by a delay in teething, late overgrowth of fontanelles; such children may suffer from the nervous system (irritability, sudden crying for no reason, muscle weakness, etc.)

If the expectant mother notices at least one alarming sign in herself, she should consult a doctor for recommendations. nine0007

Magnesium deficiency may appear already in the first trimester - an extremely undesirable phenomenon.

Lack of magnesium for the fetus is fraught with developmental disorders. In particular, protein synthesis and the formation of the baby's internal organs are disrupted. There is an opinion that magnesium deficiency may be one of the causes of sudden death of a newborn [8]. Some studies suggest that early magnesium intake reduces spontaneous miscarriage rates ⁶ .

A macronutrient plays a special role in the fight against eclampsia, a severe pathology of pregnancy. It is able to reduce the risk of its development and normalize blood flow in the "mother-placenta-fetus" system ⁷ .

Acute macronutrient deficiency leads to frequent convulsions, sudden mood swings. These symptoms only get worse with pregnancy.

Phosphorus deficiency in the body causes characteristic symptoms ¹⁰ :

• bone pains, their fragility;

• disorders of the nervous system - apathy, fatigue, decreased memory and performance;

• trembling and shortness of breath.

During pregnancy, phosphorus is primarily important for the formation of the skeleton of the unborn child. If a macronutrient is not enough, it threatens with improper formation of bone tissue, a violation of the laying of teeth.

Foods high in calcium, magnesium and phosphorus

Calcium in products for pregnant women is found not only in milk and cottage cheese. The diet needs to be expanded with other products.

Macronutrient foods ⁹ :

This is not a complete list of prenatal calcium, magnesium and phosphorus. Additional sources are meat and fish products, tofu, etc.

There are three ways to take calcium for pregnant women: from food, from drugs or nutritional supplements. Each of these three paths requires compliance with its own rules.

Thus, replenishing calcium from food sources, one must take care not only of the presence of foods rich in calcium in the diet. You should also additionally consume natural meat (as a source of protein) and seafood (as a source of vitamin D). nine0007

Proven fact: if you triple the protein in the diet (2.1 g per 1 kg of body weight), calcium absorption increases by 8% ¹ . You need to consume 80-90 g of protein and 10 mcg of vitamin D per day to maintain good health.

Equally important is limiting the consumption of foods that have been called "calcium thieves" due to their ability to reduce calcium absorption. These include:

• sugar, honey, wheat flour products (pasta, white bread), coffee, tea (all refined foods and caffeine interfere with calcium absorption in the intestines). nine0007

• factory-made meat products (natural meat does not interfere with the absorption of calcium).

• excess salt (sodium accelerates the excretion of calcium in the urine: just one extra teaspoon of salt per day leads to a decrease in bone mass by 1.5% per year.

• alcohol (not only strictly prohibited during pregnancy, but also one of the factors in the development of osteoporosis).

It is good if the composition of the preparation contains minerals that are allies of calcium, such as magnesium, zinc, copper, manganese, which can enhance its beneficial effect on bone tissue ⁶ .

Calcium and magnesium are best taken together. High absorption of magnesium occurs in the evening, it is good to take it before meals. Amino acids from food help absorb the macronutrient. Taking magnesium on an empty stomach can cause nausea.

Magnesium absorption is affected by high fatty foods in the diet. A macronutrient with fatty acids forms salts that are poorly soluble in water and are not absorbed by the intestines.

The best "partners" for calcium are phosphorus and vitamin D. Their balanced intake leads to high absorption of all three components, and improves phosphorus-calcium metabolism. The health of bones and teeth directly depends on this trio (Ca, P, Mg). nine0007

The combination of macronutrients must be balanced: incorrect proportions can lead to metabolic disorders. So, with an excess or lack of calcium, the body loses magnesium. And an excess of phosphorus leads to malabsorption of magnesium and calcium.

Therefore, it is better to use vitamin-mineral complexes, where the proportion of nutrients is observed.

To ensure that both mother and baby have enough calcium, magnesium and phosphorus, additional preparations can be taken. The question arises: what complex to drink during pregnancy? nine0167 Doctors prescribe two main types of preparations:

Vitamin and mineral complexes contain a number of essential vitamins and minerals for comprehensive vitamin and mineral support for a future mother and her baby.
An example of such drugs is Elevit® Pronatal - vitamins and minerals for pregnant women. It contains 125 mg of calcium, as well as vitamin D, phosphorus, magnesium and other essential nutrients. In total, Elevit® Pronatal contains 12 vitamins and 7 minerals to meet the needs of a pregnant woman in essential nutrients. nine0007

1. Kerstetter J, O'Brien K, Insogna L K. Dietary protein, calcium metabolism and skeletal homeostasis // American Journal of Clinical Nutrition, Vol. 78, no. 3, September 2003, pp. 584 - 592.

2. Grishchenko O.V., Storchak A.V., Shevchenko O.I., Grishchenko V.V. Osteopenic syndrome during pregnancy and lactation // Guidelines. Kharkov. 2004. 32p.

3. Ordinance of the Ministry of Health of Ukraine dated 03.09.2017 No. 1073 “On the approval of the Norms of physiological needs of the population of Ukraine in the main food sources and energy

4. Kazimirko V.K., Kovalenko V.N. Maltsev V.I. Osteoporosis: pathogenesis, clinic, prevention and treatment. Kyiv. Morion. 2006. 160p.

5. James M. F. M. Magnesium in obstetrics. Best Pract & Res Clin Obst & Gyn. Vol. 24, Iss. 3, 2010, p. 327–337.

6. Kosheleva N. G., Arzhanova O. N., Pluzhnikova T. A. Miscarriage: Etiopathogenesis, diagnosis, clinic and treatment, St. Petersburg, 2003, 70 p.

nine0025

James M. F. M. Magnesium in obstetrics. Best Pract & Res Clin Obst & Gyn. Vol. 24, Iss. 3, 2010, p. 327–337.

7. Polushkina E.S., Shmakov R.G. The use of magnesium in obstetrics // The attending physician. - 2010.

8. Oregon State University, Linus Pauling Institute, Micronutrient Information Center. URL: https://lpi.oregonstate.edu/mic/minerals

9. JAMES L. LEWIS, III , MD, BROOKWOOD BAPTIST HEALTH AND SAINT VINCENT'S ASCENSION HEALTH, BIRMINGHAM - OVERVIEW OF PHOSPHATE'S ROLE IN THE BODY - APR 2020

10. Shcherbavskaya E.A., Geltser B.I. Calcium-phosphorus metabolism in pregnant women and newborns - Zhurnal im. G.N. Speransky, 2003. No. 1. pp.15-19.

Calcium citrate - clinical and pharmacological activity

In the middle of the twentieth century. a kind of "boom" began: biochemists, physiologists, biophysicists, pharmacologists and clinicians began to show increased interest in studying the role of calcium in regulating the activity of organs and body systems. It has been established that calcium ions take part in the excitation and contraction of muscle cells, regulation of cell membrane permeability, intercellular interactions, blood coagulation, secretion of hormones, mediators, enzymes; perform the function of a converter of signals entering the cell, participate in the regulation of intracellular metabolism, including energy metabolism. There are 1000 times more free calcium ions on the surface of the membrane of cardiomyocytes and vessels than in the cytosol of cells. From the extracellular space, they penetrate into the cytoplasm through special calcium channels, influencing various physiological processes and functions of the cells of all organs, vascular tone, intensity of systole, diastole. nine0007

Calcium plays an important role in the formation of bone tissue and maintaining its normal structure and function. Along with special proteins, calcium ions provide bone hardness and elasticity [6, 7].

All this served as a theoretical foundation for the development and introduction into medical practice of calcium preparations based on its salts. Currently, calcium salts such as glycerophosphate, gluconate, carbonate, lactate, citrate, chloride, phosphate and many others are used in medical practice [2, 6]. nine0007

The pharmacokinetics of calcium citrate has its own characteristics. Calcium is absorbed from the intestine in a soluble ionized form. The dissolution of the drug occurs better in the acidic environment of the stomach. Dissolved ionized calcium penetrates well into all tissues, penetrates the placental barrier, enters breast milk. It is excreted from the body mainly with feces, about 20% - with urine. An important feature of Calcium citrate is its low ability to form kidney stones, which is important with long-term use of this salt. This is because the citrate salt reduces the amount of oxalates in the urine. nine0007

Bioavailability is determined by the rate and degree with which the active substance is absorbed from the dosage form, becomes available at the site of the intended therapeutic action.

At night, there is an accelerated release of mineral salts from the body (circadian acceleration of resorptive processes in the bone). Therefore, it is advisable to take calcium supplements after lunch and in the evening, which will prevent an accelerated loss of calcium in the second half of the night, especially with a reduced level (or absence) in the intestine. There is a negative dose-dependent effect of the pharmacotherapeutic activity of calcium: in low doses, this biometal is absorbed better than in high doses. In this regard, it is more rational to take the drug several times a day. For different age groups, there are different physiological norms of calcium intake (table). nine0007

Table

Recommended intake of calcium for people of different ages
(according to the Canadian Osteoporosis Society) [8]

Vitamin D, hydrochloric acid, lactose, citric acid, the presence of protein in food, phosphorus, magnesium, as well as some food products: butter, eggs, milk, fish, cod fat, cabbage, etc. contribute to the absorption of calcium ions.

Calcium absorption worsens: lack of protein in food, strict adherence to a vegetarian diet, lack of magnesium, phosphorus, foods rich in oxalic acid (sorrel, rhubarb, spinach).

Calcium absorption slows down in diseases of the digestive system (gastritis, enteritis, colitis, peptic ulcer), pancreas (diabetes mellitus, pancreatitis), pathology of other endocrine organs.

It should be emphasized that some drugs, especially glucocorticoids, hormonal contraceptives for systemic use, levothyroxine also impair the absorption of calcium ions. nine0007

According to the results of scientific studies (data from the Canadian Osteoporosis Society), there is no convincing evidence on the basis of which it is possible to recommend the additional consumption of other minerals (magnesium, zinc, copper, etc.) in order to prevent or treat osteoporosis [9].

The results of clinical studies conducted in Ukraine and other countries have confirmed the high efficiency of this drug in the treatment of many diseases [2]. Calcium citrate is also used for prophylactic purposes in various diseases. nine0007

For osteoporosis in the elderly, osteomalacia [1, 3, 4] Calcium citrate 2-6 tablets per day are prescribed, dividing the daily dose into 3-4 doses. The drug is taken before meals or 1-1.5 hours after meals, in for 3 months. Such patients should also be prescribed vitamin D ₃ at 400–800 IU per day, and also include oil, milk, fish, and eggs in the diet.

Calcium citrate is the optimal dosage form for providing calcium not only to adults, but also to children and adolescents, as it helps to increase bone mineral density, increase bone mass, strengthen dentin and tooth enamel. Children under the age of 6 months are prescribed 1/2 tablet (250 mg) (crushed, dissolved in a small amount of milk), at the age of 6-12 months - also 1/2 tablet 2 times a day, at the age of 1-10 years - 1-2 tablets, 10-18 years - 2-3 tablets per day. nine0007

Indications for calcium citrate are:

•? hypocalcemia due to bleeding of various origins, as well as during pregnancy and lactation, in case of injuries - to compensate for the increased need of the body for calcium ions;

•? calcium malabsorption in diseases of the digestive tract and an increased level of calcium excretion through the kidneys and intestines;

•? hypoparathyroidism, dehydration of the body of various origins, allergic diseases and allergic complications when taking medications, increased permeability of the vascular wall, reduced blood clotting. nine0007

Calcium citrate should be prescribed when taking glucocorticoids, oral contraceptives, levothyroxine. In the last three cases, the drug is taken 1 tablet 6 times a day after meals.

Calcium citrate is generally well tolerated, sometimes dyspeptic symptoms (constipation or diarrhea, nausea, vomiting, loss of appetite, abdominal pain), polyuria may occur.

Concomitant use is not recommended Calcium citrate with antacids containing aluminum due to a decrease in their effectiveness. It is undesirable to prescribe it simultaneously with other calcium preparations.

In conclusion, we can note the positive pharmacological properties Calcium citrate:

calcium citrate salt dissolves well and is absorbed in the digestive tract, which leads to good absorption of calcium in the body and, accordingly, the effectiveness of the drug in its prophylactic or therapeutic use, which is confirmed by the results of many clinical trials. research. nine0007

Low risk of kidney stone formation when taking the drug increases the value of Calcium citrate with long-term use.

I.S. Chekman, Head of the Department of Pharmacology with the Course of Clinical Pharmacology of the National Medical University, Corresponding Member of the National Academy of Sciences and the Academy of Medical Sciences of Ukraine, Honored Worker of Science and Technology, Professor