Gastrointestinal absorption of calcium from milk and calcium salts

N Engl J Med. 1987 Aug 27;317(9):532-6. doi: 10.1056/NEJM198708273170903.


Whether ingested calcium is absorbed more efficiently from freely water-soluble calcium salts than from poorly soluble salts is unclear. It is also unknown whether calcium is absorbed better from dairy products than from calcium salts. Using a method by which the net absorption of calcium can be accurately measured after a single dose, we studied eight healthy fasting subjects after they took a 500-mg dose of calcium from each of five calcium salts with various degrees of water solubility and from milk. The order of administration of the agents given was randomly determined. The mean (+/- SEM) net calcium absorption, in decreasing order of the solubility of the salts, was 32 +/- 4 percent from calcium acetate, 32 +/- 4 percent from calcium lactate, 27 +/- 3 percent from calcium gluconate, 30 +/- 3 percent from calcium citrate, and 39 +/- 3 percent from calcium carbonate. The differences in absorption were not statistically significant according to analysis of variance. On the basis of in vitro solubility experiments in acid mediums, we hypothesize that acid dissolution in the gastrointestinal tract may be responsible for the similar absorption of calcium from salts with widely different water solubilities. Calcium absorption from whole milk (31 +/- 3 percent) was similar to absorption from calcium salts. We conclude that calcium absorption from carbonate, acetate, lactate, gluconate, and citrate salts of calcium, and from whole milk, is similar in fasting healthy young subjects. Further study will be required to determine whether the results would be different in older subjects, with a higher dose of calcium, or if the calcium was ingested with food.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acetates / metabolism
  • Acetic Acid
  • Adult
  • Animals
  • Calcitriol / metabolism
  • Calcium Carbonate / metabolism
  • Calcium Gluconate / metabolism
  • Calcium, Dietary / analysis
  • Calcium, Dietary / metabolism*
  • Citrates / metabolism
  • Citric Acid
  • Gastric Mucosa / metabolism*
  • Humans
  • Intestinal Absorption*
  • Lactates / metabolism
  • Lactic Acid
  • Male
  • Milk / analysis*
  • Solubility


  • Acetates
  • Calcium, Dietary
  • Citrates
  • Lactates
  • Citric Acid
  • Lactic Acid
  • Calcitriol
  • Calcium Carbonate
  • Acetic Acid
  • Calcium Gluconate