Calcium is a critical mineral that helps us maintain strong bones and keeps our heart, muscles, and nerves functioning properly. It plays a role in many bodily processes, and low levels can contribute to conditions like osteoporosis, in which bones become fragile or brittle. Unfortunately, your body offers no clue if you have a calcium deficiency.

Calcium deficiency, or hypocalcemia, often has no symptoms. Unless levels are very low — in which case you could experience muscle cramps, numbness/tingling around your lips, or fatigue — you could have a deficiency without ever realizing it. Also, calcium deficiency can be caused by a deficiency elsewhere in the body, meaning you could be eating a calcium-rich diet and still have low levels.

You may have heard of a 2008 that found a link between calcium supplement use and increased cardiovascular risk among postmenopausal women. It has been refuted — no such link has been established — but since then, there has been some confusion as to when and even if calcium supplements should be taken.

The bottom line is that calcium supplements are safe to take — but only you are unable to maintain calcium levels through diet alone. Read on to learn more about how calcium works in the body, and whether supplements are a good idea for you.

Causes of calcium deficiency

The main reasons for low calcium levels in the blood are simple: Either your body is losing calcium, your body is not properly absorbing calcium, or your body is not getting enough calcium to begin with.

The processes behind the first two scenarios are a little complex, however. Once in the body, calcium is a cooperative mineral that works in tandem with many other minerals and hormones. In other words, whether your body is getting enough calcium depends on a few other factors than calcium intake alone.

Losing calcium from your body is a rare condition most commonly caused by having too much phosphate in the body. Phosphate is a mineral important for bone health and energy, but when your body has too much, the extra phosphate keeps calcium from circulating in the blood.

For most people, this isn’t a concern. Excess phosphate can result from a number of different medical conditions, including kidney disease and hypoparathyroidism, and/or a number of different medications. If you are being treated for one of these conditions or taking one of these medications, your doctor is likely monitoring you for calcium deficiency already.

One of the most common causes of calcium deficiency is an unbalanced diet. If your diet doesn’t include dairy products and other foods containing calcium at high levels, you may be at risk. However, even if you are getting enough calcium through your diet, your body may not be absorbing it due to low levels of other nutrients and hormones.

If you do not have enough parathyroid hormone in your body (a condition known as hypoparathyroidism), your body’s signaling mechanism for calcium will be off balance. This hormone regulates your calcium levels by helping your bones mobilize the mineral into your bloodstream and preventing your kidneys from excreting it if your levels are low. Not having enough parathyroid hormone is a very rare condition, but it can mean the calcium you need isn’t released, isn’t absorbed, or leaves your body as waste.

Finally, if your body does not have enough vitamin D, then you will not be able to properly absorb calcium in your intestinal tract, even if you’re getting the recommended allowance from foods containing calcium. A low level of vitamin D is a fairly common cause of calcium deficiency.

How to get enough calcium

The first step in making sure your body has enough calcium is knowing whether it needs more. Consider getting a simple blood test from your doctor to check your calcium and vitamin D levels.

If you have calcium deficiency, your diet is the first thing to examine. Make sure you are eating foods containing calcium and vitamin D in high levels – cheese, milk, and yogurt.  Non-dairy foods that are high in calcium such as almonds, dates, sesame seeds, celery, broccoli, spinach, and oranges can be added to your diet, along with vitamin D-rich foods like milk, eggs, salmon and fortified cereal.

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If a subsequent check reveals calcium deficiency (or low vitamin D levels) persists even after eating these foods regularly, your doctor may advise you to take supplements. These are very common and available over the counter; just be sure to follow your doctor’s directions on dosage and frequency.

Above all, calcium and vitamin D needs are particular to each, unique person. Don’t let refuted studies and media hype confuse you into taking or avoiding calcium supplements without consulting your doctor.