Getting enough calcium is important, to keep your bones healthy. But getting too much may increase your risk for developing kidney stones or calcium toxicity or mess up your body‘s ability to absorb other minerals.

Adults should ingest no more than 2,000 to 2,500 milligrams of calcium per day, depending on age, according to a recent government-ordered report from the Institute of Medicine. That is “elemental” calcium.

When calcium is taken as a supplement, different preparations contain different amounts of calcium, and that should be noted on the label. For example, 1,000 milligrams of calcium carbonate will contain 400 milligrams of elemental calcium, and 1,000 milligrams of calcium citrate will contain 200 milligrams of elemental calcium.

In addition to supplements, you may get a significant amount of calcium from your diet, if it is full of calcium-rich foods. (Yogurt, milk, cheese, salmon, collards and black eyed peas are some examples.) And--don‘t forget--if you take over-the-counter antacids, most contain calcium as well.

Taking the maximum amount of calcium in supplements, plus antacids puts a person “at high risk for complications associated with excess calcium intake,” writes Shristi Neupane, MD, in the August issue of the journal, Public Health Nutrition. Neupane recently completed her internal medicine residency at Upstate.

She and co-author Stephen Knohl, MD, an associate professor of medicine at Upstate, point out that the Food and Drug Administration has not required an update in labeling on antacids, some of which still indicate that up to 3,000 milligrams per day is safe.

The lesson: Keep antacids in mind when you calculate your calcium intake.

Read the Calcium Conundrum abstract