Despite growing up with celebrities donning milk mustaches on glossy magazine pages and TV commercials, many of us don’t prioritize our calcium intake as adults as much as we should. And who can blame us? There are so many other nutrients to chase — like vitamin B12, magnesium and probiotics.
Those are important, of course, but calcium shouldn’t be neglected, either.
Calcium is a mineral that helps maintain strong bones, teeth, nails and hair. It’s also critical for many other body systems, as it helps muscles, the heart and nerves to work, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
If you aren’t getting enough, a calcium deficiency (also called hypocalcemia) can show up in sneaky ways that are sometimes hard to detect.
“Calcium isn’t just about bones; it’s essential for every cell in the body that needs to contract, signal or fire,” Dr. Damola Aje, a board-certified endocrinologist and co-director of a Bone Density Program at Berkshire Medical Center, told HuffPost. “Muscles need calcium to contract and relax. Nerves need it to transmit signals.”
If this deficiency continues, it can make your bones weaker and raise your risk of osteoporosis, a disease that makes bones brittle, according to the NIAMS.
“Beyond bone density, adequate calcium reduces the risk of osteoporosis, fractures, and has been associated with lower blood pressure,” Aje said, adding that she sees patients who haven’t addressed their calcium deficiency in decades and have lost significant bone mass because of it. “Prevention is so much easier than treatment.”
Because calcium is so vital, your body will try its best to maintain its fill of calcium any way it can. “Your body will actually pull calcium from your bones to keep blood levels normal, which is why a blood test can look fine even when your bones are being silently depleted,” Aje explained.
Calcium also affects blood clotting and normal heart function, which can lead to bleeding complications. Dr. Francesco Bajani, an emergency and internal physician and founder of CheckUP MD, told HuffPost that he sees another unique sign of calcium deficiency that can have detrimental effects.
“During massive blood transfusions, citrate contained in stored blood products can bind calcium and cause transfusion-associated hypocalcemia,” Bajani said. “This can impair blood clotting, weaken heart function and contribute to low blood pressure.”
“This highlights how essential calcium is not only for bone health but also for some of the body’s most critical life-sustaining functions,” he added.
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There are physical signs of a calcium deficiency.
Calcium is important, but since it’s difficult to detect your body’s calcium levels on a regular blood test, how do you know if you aren’t getting enough? There are many signs that could clue you in to hypocalcemia — and they’re worth a call to your doctor if you notice them.
“When it comes to deficiency, one of the more common signs I look at is muscle symptoms, such as cramps, twitching or spasms,” Stacie Stephenson, a board member of The American Nutrition Association, told HuffPost. “These often show up in the hands, legs or around the mouth and can be an early sign that calcium regulation isn’t working smoothly.”
Aje added that she also sees “tingling or numbness in the fingers and around the mouth” first.
In addition, some of the harder-to-define symptoms of a calcium deficiency include brittle nails and dry hair more prone to breaking, as well as fatigue — although these could be chalked up to many other factors, making it even more complicated to diagnose.
Changes in nails, skin, and hair “reflect longer-term nutrient insufficiency affecting tissue health,” according to Stephenson.
Some of the other physical symptoms of calcium deficiency include:
Dry skin
Dental problems, including thin, pitted, or grooved teeth
Weakness
Cardiac rhythm abnormalities
Seizures
Neurological symptoms are common, too.
It may be surprising — and it certainly wasn’t mentioned in the “Got Milk” ads — but calcium plays an important part in our nervous system, which is why we can experience neurological symptoms if we are deficient.
“Calcium plays a direct role in nerve signaling, so when levels drop, the brain feels it,” Aje noted. A drop in calcium can cause the nervous system to become “hyperexcitable,” according to Aje, which is what leads to the muscle spasms and tingling mentioned above, as well as mental symptoms.
“On the cognitive and energy side, people may experience fatigue, low stamina, or brain fog, which can feel like difficulty concentrating or mental sluggishness,” Stephenson explained. “Sometimes calcium deficiency is difficult to identify because its symptoms can closely resemble those of other imbalances in the body.”
Memory issues, mood changes,and poor sleep could also be signs of a calcium deficiency, according to Bajani. He says that confusion and neurological symptoms like seizures, psychosis and encephalopathy can occur in more severe cases.
“Persistent cognitive or mood changes should not be ignored, especially when they occur alongside muscle cramps, tingling sensations or fatigue,” he added.
Vitamin D and magnesium may be important when addressing calcium issues.
Fixing a calcium deficiency is not as easy as just taking a calcium supplement, which is why it’s important to talk to your doctor about your concerns. In fact, you may not need more calcium at all; instead, you might have to take other supplements like vitamin D and magnesium to help your body absorb calcium.
“When you look at calcium deficiency, you must consider that calcium doesn’t function properly without adequate vitamin D, since vitamin D is essential for helping the body absorb and use calcium effectively,” Stephenson said. “If vitamin D is low, calcium can look deficient even when intake seems adequate.”
Another important nutrient for healthy calcium levels is magnesium. Stephenson says magnesium “plays a key role in regulating how calcium moves in and out of cells and how muscles relax.” She added, “When magnesium is out of balance, it can contribute to symptoms that might be mistaken for a calcium deficiency alone. It’s all connected.”
Because vitamin D and magnesium are both important for calcium absorption and regulation, Stephenson recommended asking your doctor to check if the levels of these nutrients in your blood are adequate, as “calcium can’t work properly without them.”
Aje suggested seeing your doctor for a full blood workup if you have any of the symptoms mentioned above, and be sure to check vitamin D levels, parathyroid hormone, and do a 24-hour urine calcium test.
“Vitamin D is essential for calcium absorption, so you can be eating plenty of calcium and still be deficient if your vitamin D is low,” Aje added. “Dietary changes and supplementation can help, but it’s important to identify the underlying cause first.”
Here’s how to increase your calcium intake safely.
The National Institutes of Health recommends adults take 1,000 milligrams of calcium a day, and women over 50 and men over 70 take 1,200 milligrams daily. But that doesn’t mean you should just pop a calcium pill.
“What matters to me is how people get it — I prefer calcium to come mainly from whole foods, with supplements used only when there’s a clear medical need,” Stephenson explained.
She recommended adding calcium-rich foods to your diet, like leafy greens, dairy, fortified alternatives, nuts, and seeds, among others.
“Your body more readily absorbs calcium from food than it does from supplements,” Stephenson said. “The body knows what to do with calcium in food. It is absorbed along with all the other nutrients in, for example, a kale salad or a cup of yogurt.”
On the other hand, taking a calcium supplement instead might “introduce a much higher dose of calcium” than your body needs, according to Stephenson. “This can cause problems like kidney stones and constipation.”
“I would focus on getting calcium from food, support bone health with weight-bearing exercise, and only consider supplements if labs or risk factors show I truly need them,” Stephenson said.
Even if you don’t think you have a calcium deficiency, it’s important to get yearly checkups to make sure everything looks healthy before it’s too late to reverse course.
“The silent nature of calcium deficiency is what makes it dangerous,” Aje said. “Your body is remarkably good at keeping blood calcium normal by robbing your bones, so you can be significantly depleted for years before a standard blood test flags anything.”
“This is why bone density screening matters, especially for women approaching menopause,” she added.
You may not put much thought into your calcium intake on a daily basis, but if you don’t get enough, your body will tell you — and trust us, you’ll want to listen.