Calcium Should Not Be Supplemented Alone—Balancing With Magnesium Is Crucial

Supplemented in proper ratios, calcium and magnesium create synergistic support for the body’s heart, bone, and neuromuscular functions.

Yulia Gust/Shutterstock

Health Viewpoints

Calcium and magnesium are both essential trace elements for the human body and play a key role in maintaining health. However, many people lack sufficient understanding of the intake and balance of these two nutrients, leading to various health problems.

This article will introduce the functions of calcium and magnesium, symptoms resulting from their deficiency, recommended intake amount, food sources, and supplement choices to help people achieve a balance of calcium and magnesium and improve their health.

Functions of Calcium and Magnesium

Calcium is not only a major constituent of bones and teeth but is also involved in important biological activities such as bone health, nerve conduction, muscle contraction, and blood coagulation. Magnesium is involved in hundreds of enzyme reactions that support the body’s energy production, protein synthesis, and heart protection.

Although calcium and magnesium have distinct functions, the balance between them is especially important because the interaction between them affects their respective absorption and utilization. Proper calcium and magnesium balance will help maintain neuromuscular function, heart health, and bone stability.

Within the cell body, magnesium participates in the transmission and absorption of calcium, ensuring the normal operation of calcium within cells and maintaining the balance of cell functions. Therefore, whether it is from the diet or supplements, we need to be sure we strike a good balance between calcium and magnesium.

Symptoms of Calcium Deficiency

When the body lacks enough calcium, there will be some obvious symptoms, such as:

• Bone problems: The sensation of slight bone soreness and susceptibility to fracture. Decreased bone density (revealed by an examination).
• Muscle problems: Leg cramps, muscle twitching, spasms, weakness, and so on.
• Nervous issues: Emotional instability, anxiety, depression, and even insomnia.
• Other complications: Irregular heartbeat, hair loss, and skin and teeth problems, among others.

Ideal Calcium/Magnesium Ratio Is 2:1

Typically, most adults need 1,000 milligrams (mg) of calcium per day, with women over 51 and men over 71 needing a bit more at 1,200 mg. Babies, children, and pregnant women require even higher calcium intake to ensure bone health and normal body function.

In general, the ideal supplement ratio of calcium to magnesium is 2:1, with the daily intake of calcium being twice that of magnesium. This ratio can help maintain the best balance of neuromuscular function, and bone health support, and help alleviate any complications resulting from improper calcium and magnesium balance.

Of course, due to individual differences, some may need more calcium, while others may require more magnesium.

For example, people who are physically active and have a tendency to excrete magnesium may need to increase their magnesium intake.

In 2021, a  study published in Advances in Nutrition demonstrated that a low magnesium intake combined with a high calcium intake, that is, a high calcium-magnesium (Ca:Mg) intake ratio, increases the risk of a variety of chronic diseases, including cardiovascular disease and metabolic syndrome, as well as certain cancers (colorectal, prostate, esophageal), and overall mortality. A high dietary calcium-to-magnesium ratio (above 2.60) may negatively impact magnesium status in the body, while high magnesium intake may pose risks to individuals with an exceptionally low dietary calcium-to-magnesium ratio (below 1.70). Therefore, maintaining a calcium-to-magnesium ratio between 1.70 and 2.60 by weight is considered optimal.

The study further pointed out that National Health and Nutrition Examination Survey data have shown that since 2000, the average calcium-to-magnesium ratio consumed by American adults from food alone has exceeded 3.0. One-third of Americans take magnesium supplements daily, averaging 146 mg, while 35 percent take daily calcium supplements, averaging 479 mg.

Food Sources of Calcium and Magnesium

It is no secret that foods are the best source of calcium and magnesium because they often contain other substances that aid in the absorption and utilization of these two nutrients. Here are some foods rich in calcium and magnesium:

Foods rich in calcium include:

• Milk, yogurt, cheese, and other dairy products.
• Spinach, arugula, and other green vegetables.
• Beans such as soybeans, black beans, and white beans.
• Nuts and seeds such as almonds, peanuts, sesame seeds, and pumpkin seeds.
• Salmon, sardines, oysters, and other seafood.

Foods rich in magnesium include:

• Nuts and seeds such as almonds, cashews, sunflower seeds, and pumpkin seeds.
• Black beans, lentils, mung beans, and the like.
• Whole grain foods such as oats, brown rice, and whole wheat bread.
• Fish such as salmon and cod.

Calcium and Magnesium Supplemented With Vitamin D

When taking calcium and magnesium supplements, you also need to take note of pairing them with vitamin D, as it can enhance the absorption of both minerals.

In 2020, a research report released by the International Journal of Cancer stated that calcium and magnesium affect muscle mass and function, and vitamin D helps the absorption of both. The findings, from a cohort of 20,295 adults over 20, showed that both moderate and high physical activity were associated with a significant reduction in the risk of cancer death when magnesium intake was above recommended daily intake levels.

However, it is important to note that taking calcium and magnesium supplements along with vitamin D also carries some risks.

A 2018 study in the Journal of the American Medical Association (JAMA) stated that the U.S. Preventive Services Task Force found sufficient evidence that concurrent supplementation of vitamin D and calcium increases the incidence of kidney stones.

In 2018, another study in JAMA stated that in 11 randomized controlled trials of adults aged 50 and older, over a span of 2 to 7 years, compared with the placebo, vitamin D supplementation was found to reduce the overall bone fracture rate. However, with combined vitamin D and calcium supplementation, there was an increased incidence of kidney stones, whereas there was no such incidence increase with calcium supplementation alone.

Therefore, it’s advisable to rely on natural foods as a source of calcium unless your doctor advises otherwise.

Calcium Supplement Options

If you still prefer supplements, calcium carbonate and calcium citrate are generally better choices.

Calcium carbonate is a natural form of calcium, typically extracted from minerals, with a high calcium content, meaning you can get enough calcium in smaller doses. It is also commonly found in foods like dairy products and fish bones.

Calcium citrate provides calcium with the help of citric acid. Although its calcium content is low, citric acid can help promote calcium absorption for people with a history of poor calcium absorption in their digestive systems.

Calcium phosphate, especially tricalcium phosphate, contains 39 percent elemental calcium. Although the content is slightly lower than that of calcium carbonate, it remains higher than calcium citrate, calcium lactate, and calcium gluconate. You can use calcium phosphate only if you also have a phosphate deficiency.

The best way to choose a calcium supplement depends on the specific situation. If you need a higher dose of calcium and are sensitive to citric acid, calcium carbonate may be a better choice.

If your digestive system has trouble absorbing calcium, calcium citrate with citric acid may be better for you.

So be sure to choose a calcium supplement that suits you and use it under the guidance of professionals.

In summary, calcium and magnesium are indispensable trace elements for human health, and the balance between them is especially important. By incorporating them into our diet and using supplements, we can ensure sufficient calcium and magnesium to protect the function of our bones, heart, nerves, muscles, and more.

Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times. Epoch Health welcomes professional discussion and friendly debate. To submit an opinion piece, please follow these guidelines and submit through our form here.