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How can I manage calcium deficiency?

Thursday, 13 January 2011
Answered by: Dr Raksha A. Changappa
Founder & Principal Nutritionist, NUTREWISE Project Consultant, Nutrition & Health Foods Bangalore
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Q. I am a 38 years old female suffering from calcium deficiency. I am vegetarian but eat eggs. I have had two attacks of convulsions also. I am taking Shelcal. How can I maintain calcium value of my body?

A.  I would like to point out that your calcium deficiency should be diagnosed by a doctor i.e. proven, prior to you taking any type of calcium supplement (example: in your case you have mentioned that you are on Shelcal). In case you are using Shelcal with the knowledge of your doctor then its fine, otherwise kindly consult one and find out if you are really deficient in calcium. Your incident of convulsions also needs to be elaborated, I am not sure if you are referring to epilepsy? In any case, if you are on prescription medications for your convulsions, these medications (depending on the type) may also affect your nutrient status by interfering with absorption of certain nutrients. To comment on whether this has some bearing on your calcium deficiency, I will need to know your medicine history in more detail.

The source of calcium in Shelcal is calcium carbonate. This type of calcium supplement is best absorbed, when taken along with meals (unlike calcium citrate supplements which can be taken on empty stomach too). You have not mentioned what dose of Shelcal you are on (e.g. 250 mg or 500 mg or more?) and what form (e.g. tablet, syrup?). Please note: The RDA (recommended daily allowance) of calcium for an Indian woman is 400 mg/day. You will need to consume any nutrient supplement keeping in mind the extent/severity of the nutrient deficiency. Over dosage of calcium can result in toxicity in form of hypocalcaemia, symptoms of which include, calcification of soft tissues like kidneys-this condition can be life threatening. So you must exercise caution with supplements. Since you haven’t mentioned the nature of the calcium deficiency symptoms and their severity, I cannot comment on what would be an appropriate Shelcal dosage for you.

To help maintain a good supply of calcium in your eggetarian diet, try incorporating these foods into your daily menu:
  • Consume 250 ml of milk per day . Example: as a milk shake / smoothie / flavoured milk / plain milk, with breakfast or at tea time.
  • Consume 250 ml of curd (dahi) / yoghurt per day. Example: as a snack whenever you are hungry, or, with lunch/dinner. You can also split this into two, 120 ml servings and consume once for lunch and once for dinner.
  • Incorporate readymade foods which are fortified with calcium into your daily menu. Another option is to read the nutrition label given on the food packaging and choose foods which provide 10% of the RDA for calcium per serving.
  • Put together a grilled vegetable sandwich for teatime everyday, containing at least 2 tablespoon of grated cheese.
  • Consume 200 gm of green leafy vegetables per day. Example of calcium rich greens: amaranth, fenugreek (methi), drumstick. You can consume them as a `saag' or as a saute or incorporated into rotis.
  • This apart you can try including the millet ragi (alternate names: finger millet, nachni) in your daily diet as roti, dosa, porridge etc. It is the richest source of calcium amongst all cereals grains.
Please note: since you have not mentioned your height correctly, I cannot calculate your BMI (body mass index) and ascertain if you are overweight / obese / normal weight. Dairy products are a good source of calories, if weight gain is a concern then stick to fat-free dairy products e.g. low fat milk / yoghurt / cheese.

A.  I would like to point out that your calcium deficiency should be diagnosed by a doctor i.e. proven, prior to you taking any type of calcium supplement (example: in your case you have mentioned that you are on Shelcal). In case you are using Shelcal with the knowledge of your doctor then its fine, otherwise kindly consult one and find out if you are really deficient in calcium. Your incident of convulsions also needs to be elaborated, I am not sure if you are referring to epilepsy? In any case, if you are on prescription medications for your convulsions, these medications (depending on the type) may also affect your nutrient status by interfering with absorption of certain nutrients. To comment on whether this has some bearing on your calcium deficiency, I will need to know your medicine history in more detail.

The source of calcium in Shelcal is calcium carbonate. This type of calcium supplement is best absorbed, when taken along with meals (unlike calcium citrate supplements which can be taken on empty stomach too). You have not mentioned what dose of Shelcal you are on (e.g. 250 mg or 500 mg or more?) and what form (e.g. tablet, syrup?). Please note: The RDA (recommended daily allowance) of calcium for an Indian woman is 400 mg/day. You will need to consume any nutrient supplement keeping in mind the extent/severity of the nutrient deficiency. Over dosage of calcium can result in toxicity in form of hypocalcaemia, symptoms of which include, calcification of soft tissues like kidneys-this condition can be life threatening. So you must exercise caution with supplements. Since you haven’t mentioned the nature of the calcium deficiency symptoms and their severity, I cannot comment on what would be an appropriate Shelcal dosage for you.

To help maintain a good supply of calcium in your eggetarian diet, try incorporating these foods into your daily menu:
  • Consume 250 ml of milk per day . Example: as a milk shake / smoothie / flavoured milk / plain milk, with breakfast or at tea time.
  • Consume 250 ml of curd (dahi) / yoghurt per day. Example: as a snack whenever you are hungry, or, with lunch/dinner. You can also split this into two, 120 ml servings and consume once for lunch and once for dinner.
  • Incorporate readymade foods which are fortified with calcium into your daily menu. Another option is to read the nutrition label given on the food packaging and choose foods which provide 10% of the RDA for calcium per serving.
  • Put together a grilled vegetable sandwich for teatime everyday, containing at least 2 tablespoon of grated cheese.
  • Consume 200 gm of green leafy vegetables per day. Example of calcium rich greens: amaranth, fenugreek (methi), drumstick. You can consume them as a `saag' or as a saute or incorporated into rotis.
  • This apart you can try including the millet ragi (alternate names: finger millet, nachni) in your daily diet as roti, dosa, porridge etc. It is the richest source of calcium amongst all cereals grains.
Please note: since you have not mentioned your height correctly, I cannot calculate your BMI (body mass index) and ascertain if you are overweight / obese / normal weight. Dairy products are a good source of calories, if weight gain is a concern then stick to fat-free dairy products e.g. low fat milk / yoghurt / cheese.

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