Calcium Citrate

Calcium is an important mineral in the body that plays a role in numerous processes, including cardiovascular function, cell signaling, muscle contraction, and bone structure.

Sourced from China and Israel


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Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.


Some studies have shown that calcium supplementation can increase bone mineral density and, when combined with vitamin D supplementation, can reduce the risk of fracture in older adults.

It is recommended that men have at least 1,000–1,200 mg per day of calcium, which can come from food or supplements. Having too much or too little can be dangerous for your health.

Calcium supplements can interact with certain medications. If you have questions about the medications you are on, talk to your healthcare provider before taking calcium supplements.

What is calcium?

Calcium is one of the most important minerals in the body. While most calcium resides in the bones, calcium also flows around in the blood, exists in cells, and takes part in numerous processes around the body. Calcium is required for muscle contraction, cardiovascular function, maintaining a regular heartbeat, and cell signaling. It is very important for calcium levels to be maintained in the blood within a certain range, since having calcium that is too high or too low can be very dangerous. The body uses the bones as a way to store calcium so more can be made available when it is needed. Bones are consistently undergoing a process called remodeling and the relative rate of remodeling (whether new bone is getting formed faster or old bone is getting reabsorbed faster) helps maintain steady blood calcium levels (1).

Where does calcium come from?

Calcium can be consumed in food or in supplements. An estimated 43% of Americans take a supplement containing calcium, including nearly 70% of older women (1). In the diet, calcium is most commonly found in dairy, including milk, cheese, and yogurt. Other good sources of calcium include tofu, certain fish, and certain green vegetables like cabbage, kale, and spinach. Some foods, such as juices, are fortified with calcium. This means that calcium is added to the food in a public health effort to help make sure everybody is getting enough each day.

What are the health benefits of calcium?

Calcium plays numerous roles in the body and is essential for normal functioning. A lot of research has looked into the health benefits of calcium supplementation, in some cases yielding positive results. More research still needs to be done but in certain populations calcium may be able to improve blood pressure and improve cardiovascular health.

Calcium may also have the following health benefits, which is why it was chosen to be an ingredient in the Roman Dailies:

Bone Health

Calcium is extremely important for maintaining healthy bones. Calcium is stored in the bones and, along with phosphate, helps make up their structure. However, as people age, bone reabsorption occurs faster than bone formation. This is particularly evident in postmenopausal women due to a decrease in estrogen (in premenopausal women, estrogen helps protect against bone loss). As bone reabsorption occurs, bones become less dense. This is referred to as having decreased bone mineral density. A bone mineral density test can measure the density of the bones and gives a value called the T-score. A normal T-score is between -1 and +1. Having a T-score between -2.5 and -1 is referred to as osteopenia. Having a T-score of -2.5 or less is referred to as osteoporosis. Decreased bone mineral density increases the risk of getting a fracture because the bones are weaker. Of note, osteoporosis is different from osteomalacia, which is a disease in which the bones are soft and which is due to vitamin D deficiency (vitamin D plays an important role in maintaining calcium levels in the body).

Because calcium is such an important part of the skeleton, a lot of research has looked into calcium supplementation’s effects on bone health. One review of fifteen studies found that calcium supplementation or calcium intake in the diet had positive effects on bone mineral density in postmenopausal women (2). Another review of fifteen studies found that calcium intake from food or supplements led to small increases in bone mineral density in people over the age of 50. The review stated that this was unlikely to have a significant effect on fracture risk (3). However, a more recent review of studies from the National Osteoporosis Foundation found that supplementation with both calcium and vitamin D could reduce the risk of fracture in middle-aged and older adults (4).

How much calcium is recommended?

The Recommended Dietary Allowance (RDA) of calcium is 1,000 mg per day for men ages 19–70 and 1,200 mg per day for men 71 and older. For women, the RDA is 1,000 mg per day for ages 19–50 and 1,200 mg per day for ages 51 and older. The RDA represents the daily amount of a mineral that is considered sufficient for 97–98% of healthy individuals.

On the other end of the spectrum, the Tolerable Upper Intake Level (UL) for calcium is 2,500 mg per day for both men and women ages 19–50 and 2,000 mg per day for men and women age 51 and older. Repeated intake of amounts greater than the UL can lead to poor health outcomes (1).

What are the symptoms of having too little calcium?

It is estimated that more than 50% of men over the age of 70 and more than 50% of women over the age of 50 do not consume enough calcium. Having low calcium levels in the blood is called hypocalcemia. Symptoms of hypocalcemia include:

  1. Numbness or tingling in the extremities
  2. Muscle cramps
  3. Lethargy
  4. Abnormal heart rhythm
  5. Facial twitching

Calcium levels that are too low are very dangerous and may even lead to death.

What are the symptoms of having too much calcium?

Having too much calcium can also cause symptoms and health problems. Having high calcium in the body is called hypercalcemia. It is most often caused by overactive parathyroid glands, which secrete a hormone called PTH that regulates calcium, but it can sometimes occur from taking too many calcium supplements. In fact, chronic use or overuse of calcium supplements is linked to some adverse health outcomes like increased risk of kidney stones. Symptoms of hypercalcemia include:

  1. Kidney stones
  2. Bone pain
  3. Abdominal pain
  4. Altered mental status
  5. Abnormal heart rhythm

Calcium levels that are too high are very dangerous and may even lead to death.

What to look for in a good calcium supplement:

As a supplement, calcium can come in several forms including calcium carbonate, calcium citrate, calcium gluconate, calcium lactate, and calcium phosphate. Calcium carbonate and calcium citrate are the two most commonly found forms. Calcium citrate is absorbed equally well whether or not it is taken with food and it is also less likely than calcium carbonate to cause symptoms like gas, bloating, and constipation. The percentage of calcium that is absorbed into the body is highest at doses of 500 mg or less, so larger doses should be divided and spread throughout the day for optimal absorption (1).

How does Roman offer calcium?

Roman obtains calcium from non-GMO sources in China and Israel. It is available synthetically as calcium citrate.

Roman offers calcium in the following supplements:

Bone Health

Calcium is one of ten main ingredients in Roman’s Bone Health supplement. The supplement consists of three tablets that should be taken with water. Each individual tablet contains 166.67 mg of calcium, for a total daily dose of 500 mg.

Other ingredients in the tablets include ascorbic acid, D-alpha tocopheryl succinate, magnesium citrate, silicon dioxide, boron citrate, menaquinone-4, menaquinone-7, phytonadione, cholecalciferol, microcrystalline cellulose, stearic acid, dicalcium phosphate, croscarmellose sodium, magnesium stearate, and pharmaceutical glaze (shellac, povidone).

Does calcium interact with any other drugs or medical conditions?

Calcium interacts with several other medications. If you are taking any of the following medications, it is important you talk to your healthcare provider before beginning calcium supplementation (please note that this list may not be exhaustive and other medications may also interact with calcium) (1):

Bisphosphonates: Calcium supplements can decrease the absorption of these medications. To avoid this interaction, do not take Roman’s Bone Health supplement at the same time as these medications. An example of a bisphosphonate is alendronate.

Levothyroxine: Calcium supplements can decrease the absorption of levothyroxine. To avoid this interaction, do not take Roman’s Bone Health supplement at the same time as levothyroxine.

Phenytoin: Calcium supplements can decrease the absorption of phenytoin. To avoid this interaction, do not take Roman’s Bone Health supplement at the same time as phenytoin.

Quinolone antibiotics: Calcium supplements can decrease the absorption of these medications. To avoid this interaction, do not take Roman’s Bone Health supplement at the same time as these medications. Examples of quinolone antibiotics include ciprofloxacin, levofloxacin, and moxifloxacin.

Tetracycline antibiotics: Calcium supplements can decrease the absorption of these medications. To avoid this interaction, do not take Roman’s Bone Health supplement at the same time as these medications. Examples of tetracycline antibiotics include doxycycline, minocycline, demeclocycline, and tetracycline.

In addition to these medications, other medications may affect levels of calcium in the body. These include antacids, glucocorticoids (such as prednisone), laxatives, and thiazide diuretics.


  1. Office of Dietary Supplements – Calcium. NIH Office of Dietary Supplements. Accessed November 21, 2019.
  2. Shea B, Wells G, Cranney A, Zytaruk. Calcium supplementation on bone loss in postmenopausal women. The Cochrane Database of Systematic Reviews. February 1998. doi:10.1002/14651858.cd004526.
  3. Tai V, Leung W, Grey A, Reid IR, Bolland MJ. Calcium intake and bone mineral density: systematic review and meta-analysis. Bmj. 2015. doi:10.1136/bmj.h4183.
  4. Weaver CM, Alexander DD, Boushey CJ, et al. Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporosis International. 2015;27(1):367-376. doi:10.1007/s00198-015-3386-5.