← What's That Rash?
What's That Rash?
Should you be taking calcium supplements?
00:21:39
Our calcium needs can increase as we age, especially for women going through menopause. Most Australians aren’t getting enough calcium from their diet, so are supplements a good option Norman and Tegan discuss the conflicting evidence on calcium – in particular, could it be good for your bones, but bad for your heart? References: Calcium supplements have 'very little place' in modern medicine - the Health Report Nutrient Reference Values - Calcium Effect of age on calcium absorption in postmenopausal women Biochemical Variables in Pre- and Postmenopausal Women: Reconciling the Calcium and Estrogen Hypotheses Calcium Content of Common Foods - Healthy Bones Australia Choosing a calcium supplement: What you should know about taking calcium to boost your nutrients Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials Association Between Calcium Supplementation and the Risk of Cardiovascular Disease and Stroke: A Systematic Review and Meta-Analysi...
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- [00:01]
Podcast Host/Announcer
This episode is brought to you by Google Health. Stop chasing someone else's definition of health. What matters is what's healthy for you. Google Health offers a new kind of coach built with Gemini for effortless tracking, sleep insights and holistic coaching tailored to you. Visit googlestore.com to learn more and start a new relationship with your health. Requires Google Account, Google Health app Internet and Google Health Premium subscription. Features subject to change. Availability and results vary. Not intended for medical purposes or works independently of Gemiini apps. Check responses for accuracy.
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Podcast Promoter/Trailer Voice
ABC Listen podcasts, radio, news, music and more. From an Ipswich fish and chip shop to the epicentre of Australian politics, please
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Co-host (likely a female presenter)
explain Pauline Hart's One Nation Rise.
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Podcast Promoter/Trailer Voice
One Nation. This is the unlikely story of one nation.
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Podcast Host/Announcer
Well, I'm back.
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Podcast Promoter/Trailer Voice
Is it a passing protest vote or a permanent realignment of Australian politics?
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Co-host (likely a female presenter)
Whether you love her or hate her, truth is stranger than fiction.
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Podcast Promoter/Trailer Voice
The Making of One Nation to hear the full series, search for the Making of One Nation on abc.
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Co-host (likely a female presenter)
Listen, Norman, do you have a favourite calcium source?
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Norman (Expert/Co-host, possibly a medical professional)
You mean apart from chewing on chalk?
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Co-host (likely a female presenter)
That's your favourite way of getting calcium?
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Norman (Expert/Co-host, possibly a medical professional)
No, my favourite way of getting calcium is Greek yogurt.
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Co-host (likely a female presenter)
Oh, same. Actually, no, my favourite way of getting calcium is ice cream. But I subsist mostly on Greek yogurt in the day to day and I, yeah, big agree on that one.
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Norman (Expert/Co-host, possibly a medical professional)
Yeah, that's my biohack is Greek yogurt and I found this amazing Greek yogurt but I can't advertise it on air so we'll not talk about that.
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Co-host (likely a female presenter)
We'll have to compare brands after the show when we're not recording and see if we have the same preferred Greek yogurt vendor.
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Norman (Expert/Co-host, possibly a medical professional)
Mine isn't a brand.
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Co-host (likely a female presenter)
Do you make your own? Have you ever made your own yogurt?
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Norman (Expert/Co-host, possibly a medical professional)
I have, many, many years ago and it wasn't a big success. Tasted revolting. You know, you add the culture to milk and you get it going.
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Co-host (likely a female presenter)
I've made it before. I actually it did turn out quite well, if I do say so myself. But the cost and the effort, it wasn't much different than just going to my local grocery store and buying a kilo of Greek yoghurt from there.
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Norman (Expert/Co-host, possibly a medical professional)
I think that's right.
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Co-host (likely a female presenter)
Anyway, calcium is the topic of today's what's that rash.
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Norman (Expert/Co-host, possibly a medical professional)
The show where we answer the health questions that everybody's asking.
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Co-host (likely a female presenter)
Norman, so many people want us to talk about calcium supplementation. Seven different question askers asking about this today.
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Norman (Expert/Co-host, possibly a medical professional)
Kay Kasha to our audience, what are you going on about?
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Co-host (likely a female presenter)
Exactly. Every Single one of WhatsApp Rush's listeners is desperate to know about calcium supplementation. Kay, Kasha and Ashley are asking about calcium supplements in general. Are they helpful? What's with the different types of calcium supplements? Louise, Paula, Allison and Susan are asking about calcium supplements and the risk of calcium buildup in the arteries. So Paula shared her attempts at getting more calcium in her diet by keeping a food diary and wants to know if you can overdo calcium. Paula says, mostly I get between 600 and 900 milligrams from my diet, but on one latte fueled deadline day, I hit a whopping 3,600 milligrams from dietary intake alone. So my question is this, is too much calcium from food sources as bad for you as too much calcium from supplements? Paula says, I'm hearing a lot of conflicting advice about calcium. And I recently listened to the ice cream episode of Science Friction, and it turns out I'm not the only one utterly perplexed by dairy and calcium requirements. So, yeah, lots of calcium questions today, Norman.
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Norman (Expert/Co-host, possibly a medical professional)
There are, and it's an important issue. We need calcium.
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Co-host (likely a female presenter)
We do. I will actually add a little asterisk on the science fiction episode on Ice cream, which Paula mentions. I have to say, if you want to listen to it, it's from a 2025 series called Cooked in in the Science Friction feed. And while you are there, hit follow, because Shelby Trainor, our producer for whatsat Rash, actually has a brand new Science Friction series that's going to drop in that same feed in just a couple of weeks. And it's all about quantum computing.
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Norman (Expert/Co-host, possibly a medical professional)
Yes, don't miss that.
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Co-host (likely a female presenter)
But yeah, the people yearn for information about calcium, Norman.
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Norman (Expert/Co-host, possibly a medical professional)
They do, you know, a throwaway remark. We need calcium, so calcium's in our bones, but we actually need calcium for the, you know, healthy functioning of our nervous system and indeed our heart. And calcium in our blood needs to be finely tuned in order for that to happen efficiently and not aberrantly. And it is pretty well controlled. But the questions here are really, when you have too much calcium, does it get deposited in places where it's not meant to be?
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Co-host (likely a female presenter)
Yeah, I think the questions here are basically around how much do I need and how do I get it and what happens if I overdo it? So let's start with the first part of it. What are we meant to be aiming for? What does that even look like?
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Norman (Expert/Co-host, possibly a medical professional)
The recommendations are that if you're a young adult, say about 19, up to the age of 70, the recommendation is 1,000 milligrams a day for men and premenopausal women at menopause, interesting things happen with calcium. Mostly. Women who are menopausal tend to lose more calcium in the urine, and that's because the recycling process of calcium from the kidneys doesn't work as well. So there's normally a recycling process. You absorb calcium, goes back into the blood to conserve it, and you lose more calcium in the urine. And so the recommendation is at about 1300 milligrams a day for postmenopausal women. And as you get beyond the age of 70, you probably absorb calcium less efficiently from the gut, whether you be a man or a woman. So they say that if you're a man over 70, you should probably be on 1300 milligrams a day also.
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Co-host (likely a female presenter)
Right. Because I've heard a lot about the risk of osteopenia, so bone density loss and osteoporosis, where you're at much higher risk of fractures. I've heard about that in women before. And so what I'm hearing you say is that there's sort of like a double whammy that happens for women as they get older. They're absorbing it less efficiently and they're also losing it more rapidly. So that's why it's particularly important in that group.
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Norman (Expert/Co-host, possibly a medical professional)
Yeah. And there is a debate going on about whether or not actually the loss of estrogen is the prime cause of loss of bone mass as women get older, because there's lots of bone mass in men as well. And it may well be that the primary problem is actually in the kidneys and this loss of recycling, and therefore you lose calcium and the bone starts to provide calcium to keep it going in the blood. And therefore you get a loss of calcium from the bone, but that's secondary to the problem in the kidney. So a lot of debate about what is actually going on there. Again, just to nail this further, there's very little evidence that calcium supplementation prevents osteoporosis.
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Podcast Host/Announcer
What?
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Norman (Expert/Co-host, possibly a medical professional)
This is a controversial area, and it looks as though if you're healthy on a good diet, you are unlikely to benefit from calcium supplementation in terms of your bones. It's a different kettle of F for the elderly who might be frail, particularly if they're in residential aged care with inadequate diets and inadequate exposure to sunlight. And so the college of gps thinks that's a different game in terms of bone protection.
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Co-host (likely a female presenter)
Right. So, I mean, let's talk about diet first, because that's the primary way that we get our calcium into our Bodies. The dairy industry has done an incredible public relations job over the years of kind of owning calcium. And you and I have both talked about our love of Greek yogurt, and that will never die for me. But lots of people either want to or can't eat dairy. But that's okay because calcium is actually in a lot of different foods, even some that you might not think of.
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Norman (Expert/Co-host, possibly a medical professional)
That's right. So legumes, nuts, fortified soy beverages, breakfast cereals, bony fish. A lot of foods other than dairy that contain calcium.
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Co-host (likely a female presenter)
Quite a few vegetables are quite high in calcium. Cucumber, kale, silverbeet, and then also fruits like oranges and strawberries and kiwifruit. Calcium really is all around.
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Norman (Expert/Co-host, possibly a medical professional)
And, you know, we've calculated what a day might look like, like if you're aiming for 1300 milligrams of calcium. So it could be a glass of milk. That could be the latte that we heard about earlier. Natural yogurt, a couple of eggs sandwiched with lettuce, tomatoes, chicken and a slice of cheese. Serving of strawberries, Dinner of fish and vegetables, another natural yogurt in the evening, just for luck, some more strawberries, a kiwi fruit, and a handful of almonds. That'll get you to 1300 milligrams.
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Co-host (likely a female presenter)
I mean, for starters. It sounds delicious, and sign me up,
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Norman (Expert/Co-host, possibly a medical professional)
but, you know, it does require some thought.
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Co-host (likely a female presenter)
So let's talk about supplementation. Calcium as a mineral, as a chemical, isn't something you can take on its own. There's a couple of different forms that calcium can take in supplements. Does it make a difference which one you have?
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Norman (Expert/Co-host, possibly a medical professional)
It probably does because the different supplements have different amounts of free calcium in them, of actual calcium in them. So there's calcium carbonate supplements, which contain the Most calcium, about 40% by weight, but it requires stomach acid for absorption. You need to take them with food. And some people complain of mild constipation or feeling bloated. Taking calcium carbonate. Calcium citrate supplements are absorbed more easily than calcium carbonate. They can be taken on an empty stomach, and they're more likely to be absorbed by people who are taking acid reducing heartburn. Medications a lot of people are taking are reducing the acid in their stomach to prevent reflux, acid reflux. And that would make it difficult to absorb calcium from calcium carbonate. But calcium, citrus is only 21% calcium. And then there's also calcium gluconate, which is only 9% elemental calcium. And then there's calcium lactate, which is 13% elemental calcium. So some of these supplements don't contain a huge amount of calcium or you've got to take more, but you know that'll be on the bottle.
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Co-host (likely a female presenter)
You sort of sounded a bit dim on it before Norman. As to whether supplementation was relevant to most healthy midlife adults.
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Norman (Expert/Co-host, possibly a medical professional)
Yeah. You can go back through Old Health Reports, our sister podcast, and look at the coverage we've done of calcium over the years, particularly with Professor Ian Reid at the University of Auckland, whose studies suggested that if you take calcium supplementation, you increase your risk of a heart attack and certainly making coronary artery disease worse. There have been a lot of studies on this now and a lot of studies which have brought together the available evidence and it's confusing. It goes backwards and forwards on this. And if I were to summarize, what the evidence seems to point to is that if you're a healthy post menopausal woman, you probably are increasing your risk of a heart attack a little bit by taking calcium supplements. Not a lot, but a little bit. But equally, there are some studies which suggest calcium in vitamin D might reduce the risk of coronary artery disease. So it goes backwards and forwards. There's evidence that if you've got existing coronary heart disease, that taking calcium supplements might increase your risk of a coronary event. And the point here to be made is these are studies done on people who tend to be younger, they tend not to be frail and they tend not to be living in residential aged care homes. And so the jury's out on that group who probably would benefit. And it's an important caveat at this point in discussion is that people who are frail and at high risk and who are likely to be malnourished, all better off. In terms of the risks of calcium supplementation and vitamin D supplementation, there may well be benefits, and the Royal Australian College of General Practitioners is quite positive about calcium and vitamin D supplementation, particularly in that group. But there is a documented risk that does go to and fro in the literature.
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Co-host (likely a female presenter)
So you mention this is something that you've reported about on the health report for years and years now. Well, Alison, one of our question askers, said specifically, more than a decade ago, I think I stopped taking calcium supplements because Norman said on the health report that they wouldn't really help bone density and could lead to a buildup of calcium in the arteries. Alison said this was good given my coronary artery calcium score five years later reflected my family history of high cardiac risk. But my urgent question that I've emailed you in my head about all year is, can you please tell me if the current evidence still recommends against calcium supplements and if so, what the studies are. My partner is 71 and last year was told their actual arteries are okay, despite a coronary artery calcium score of over 1000. Yes, three zeros. Then she discovered that on her bone density score, she has one area which is showing signs of osteopenia. The GP blithely recommended calcium supplements. But this doesn't sound great to me. Alison says I even cheated on you and listened to a foreign podcast where
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Norman (Expert/Co-host, possibly a medical professional)
Norman said, oh, shame on you, Alison.
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Co-host (likely a female presenter)
No. Okay. I think that we are open to ethical non monogamy when it comes to podcasts, Norman, because I listen to other podcasts, too.
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Norman (Expert/Co-host, possibly a medical professional)
And what did this podcast tell her?
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Co-host (likely a female presenter)
Alison says Norman's perspective was reiterated in June of this year, but they cited no specific evidence against supplements. So we've got this sort of push and pull between Alison's experience and her partner, who has been told that their calcium score is high in their coronary arteries, but also osteopenia. Norman, please explain.
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Norman (Expert/Co-host, possibly a medical professional)
Okay, so, calcium score. The coronary calcium score is used to assess your risk of a future heart attack. It's been controversial in the past, but it seems over the last few years it's consolidated into an indicated risk of coronary heart disease. It's measured in different ways, but 1000 is certainly high. I think the upper limit of normal is 300, but you wouldn't even want to be 300. And then it requires further investigation to find out what your real risk is. And clearly, in Alison's partner, the risk was low anyway, to the point of calcium supplementation. It's been quite a sophisticated study from American and Australian researchers looking actually at the calcium inside the arteries itself using ultrasound and in various trials brought together in people usually at high risk of coronary heart disease, and relating that to whether or not they were on calcium supplements when they did the adjustment. Statistically, for all the other risk factors for coronary heart disease and having calcium in your arteries because of having atherosclerosis, the taking of supplements did increase the calcium inside arteries. What they were not able to say is whether that increase of calcium inside the arteries actually mattered in terms of whether you got coronary heart disease events afterwards, such as angina or a heart attack or what have you. But it did show an increase of calcium inside the arteries from calcium supplementation. And these were people in general at high risk of coronary heart disease, which. What we said earlier is those are people in other studies which suggest that calcium supplementation may be an unacceptable risk to add.
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Co-host (likely a female presenter)
All right, I do want to talk about dietary calcium, but I want to sort of jump in here with like a pre end of show bottom line calcium supplementation, because this is quite complicated. Bottom line, please.
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Norman (Expert/Co-host, possibly a medical professional)
So if your diet is in question and you are frail and you're elderly and you're living in residential aged care, calcium supplementation, probably with vitamin D, is a good thing to have. If you're otherwise healthy and having a good diet, it's really questionable whether you need more calcium in the form of supplementation. And for some people, there may be added risk. It's controversial, and the added risk is not massive. So it's not a question of panicking here. But if you're asking me, I don't take calcium supplementation, but, you know, I'm still young, so, you know, what the heck?
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Co-host (likely a female presenter)
Very young. Okay, let's talk about. We're not talking about supplementation anymore. We're talking about diet and basically whether it's possible to overdo calcium in your diet. Paula, of the very, very high intake day with all of the lattes, wants to know if you can basically overdose on calcium in the diet.
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Norman (Expert/Co-host, possibly a medical professional)
The real difference between diet and supplements is you've got to work really hard to overdose on calcium via diet. In fact, Shelby Trainer, our producer, has worked out what Paula's intake would have had to be to take an additional 2,700 milligrams of calcium. And that's about 12 cafe lattes. Pretty impressive.
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Co-host (likely a female presenter)
I mean, if you're drinking 12 lattes, I think that the calcium intake is the least of your worries in terms of, like, your immediate side effects. I'm wondering how many days it was until Paula was able to go to sleep.
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Norman (Expert/Co-host, possibly a medical professional)
Yeah. And stop clinging to the wallpaper with her fingernails. Absolutely. So one day is not going to do any harm. It's a question on a regular, daily basis, if you're taking that much calcium, it's very, very hard work to take that amount of calcium in your diet day in and day out. And that's what we're talking about here. Whereas swallowing a tablet or two of calcium and you're going to a tablet of four or five, that's actually much easier to do. And therefore, that's where the risk almost certainly lies.
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Co-host (likely a female presenter)
Yeah. To reach the upper limit of what's recommended, which is 2,500 milligrams a day, you'd be drinking 10 glasses of full cream milk or 12 yoghurts a day, which probably again leads to other problems like Deficiencies in different vitamins and minerals and possibly maybe more calories than you need.
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Norman (Expert/Co-host, possibly a medical professional)
Indeed. So pretty safe on diet. Just be careful with supplements and if you decide with advice you're going to take them, there's probably a little bit of a risk there, but it's low. And if you've got coronary heart disease, I'd get some advice.
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Co-host (likely a female presenter)
Kay, Kasia, Ashley, Louise, Paula, Alison and Susan, thank you all so much for asking your questions of us. Don't forget to follow up with your doctor if you want some more specific advice to your situation, but you can always email us your general questions thatrashbc.netau
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Norman (Expert/Co-host, possibly a medical professional)
and sorry, I'm tapping my microphone out and you've had some feedback to our tapping episode.
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Co-host (likely a female presenter)
Feedback to our tapping episode. If you haven't listened to our tapping episode, it's basically a thing that you can do that promises to help you calm down or fix problems that you have. Some people were fairly skeptical on tapping as a method, and we kind of were a little bit skeptical as well. But other people have been sharing their experiences with it with some very happy customers. Stephen says at 50, despite therapy and successful management of depression with an SSRI, my panic attacks were growing to a debilitating state. My therapist suggested tapping starting with a one hour session to get to the core. I was told I would need three one and a half hour sessions. Skeptical doesn't begin to articulate my attitude. Stephen says the tapping involved direct eye contact with my therapist as we repeated lines she derived from our chat and tapped the regions without being super accurate. During the 20 minute tapping, we stopped twice while I ranted about this woo woo new age crap. Stephen says the panic attacks stopped after one treatment. 13 years later, not one attack. I've used it for three other issues. Two worked well, one not at all. Stephen finishes by saying, I think self tapping is as useful as self psychology. Not useless, but a shadow of the treatment. It's pretty hard to argue with an anecdote like that. Norman.
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Norman (Expert/Co-host, possibly a medical professional)
It is and I presume by, by a shadow of the treatment. What Stephen's saying is it shadows the treatment. In other words, you've got your core treatment and the tapping adds on.
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Co-host (likely a female presenter)
I know. I think he was saying that doing it with a therapist was what was what made it powerful and if he'd done it by himself it wouldn't have been as good.
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Norman (Expert/Co-host, possibly a medical professional)
Oh, you're much better at interpreting English than I am, so thank, thank you for that.
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Co-host (likely a female presenter)
We could both be wrong. Stephen, Send us an email. Let us know. Jill has also tried tapping Jill says I assessed my distress stress level before and while working through the technique I was able to get my anxiety from 9 out of 10 to 0 which was a fabulous relief. After several weekly sessions I prepared to return to work. My original profession as a vet and I've been fine since. Each episode of anxiety lasted about three months and without EFT which is the acronym for Emotional Freedom Techniques which we spoke about in the tapping episode Jill says I'm not sure where I'd have ended up. I can only say that for every unwell person there is hopefully a therapy or technique that can be as life changing if it can be found. So whether or not the research supports it so far I think EFT is a very effective technique for some thank
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Norman (Expert/Co-host, possibly a medical professional)
you and thank you Jill. Thank you Stephen. Really interesting stories.
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Co-host (likely a female presenter)
You can send us your stories, your questions, your feedback. Send us it all. Thatrashbc.net au we'll see you next week. See you then.