What You Need to Know About Calcium Absorption

Updated: December 1, 2022

Reviewed By:
Lara Pizzorno – AlgaeCal Scientific Advisory Board Member
MDiv, MA, LMT
Best-selling author of Healthy Bones Healthy You! and Your Bones; Editor of Longevity Medicine Review, and Senior Medical Editor for Integrative Medicine Advisors.

You already know that taking calcium is critical to your bone health. In fact, 99% of the calcium in your body lies in your bones and teeth. But you also need calcium for a laundry list of other functions, like muscle contractions; regulating normal heart rhythms; blood clotting; and transmitting signals between your brain cells and your nerves.

And while you may eat plenty of calcium-rich foods and even take calcium supplements, that doesn’t mean you’ll get the full benefit of all that calcium.

In fact, just because a supplement facts label says there is 750 mg of calcium, that doesn’t mean that’s how much you end up absorbing! Same goes for healthy, calcium-rich foods like spinach and almonds.

Because as you’re about to see, there are several reasons why some of that calcium can end up wasted.

You’ll discover those reasons in a moment. But you’ll also discover some nutrients that can help you absorb more of your calcium.

Then, you’ll see a few common activities that can interfere with calcium absorption. And we’ll show you the best way to take your calcium supplement, along with the most absorbable type.

How to Increase Calcium Absorption

Let’s start with some nutrients that help you better absorb calcium. We’ll call them calcium “friends.” And then you’ll see some other ingredients that interfere with calcium absorption in your body. We’ll call those calcium “foes.” 

Calcium Friends

Vitamin D: This one isn’t a surprise. But it’s important to include, especially since a recent survey of nearly 5,000 American adults showed about 42% are vitamin D deficient.1 Even though we know we need it!

Vitamin D enables our active absorption of calcium, and that accounts for 85% of the calcium we absorb. Without the help of vitamin D, you’ll absorb only 10-15% of the calcium you consume.

happy algaecal customer

Vitamin K2: This is a crucial nutrient for calcium absorption that many people, including many doctors, aren’t aware of. Vitamin K2 activates the proteins that pull calcium into your bones, and keep it from depositing in soft tissues like arteries, kidneys, and the brain. Vitamin K2 in its MK-7 form, specifically is the best at this.

Magnesium: Magnesium and calcium work together to create strong bones. That’s because magnesium helps with calcium absorption. Magnesium is the cofactor for the enzyme in the kidneys that converts vitamin D into its ready-for-action hormonal form.

Medical research shows the “golden ratio” for calcium to magnesium intake is roughly 2:1.2,3 That’s two parts calcium for every one part of magnesium, for optimal health.

Fruits and veggies: These are great for all aspects of health. But because they’re so vitamin- and mineral-rich, they contain many helper nutrients to get calcium where you want it. Fruits and vegetables make your overall body pH more alkaline, which reduces calcium loss.4

Mineral and vitamin rich fruits and vegetables

Now on to some ingredients that block calcium from getting absorbed.

Calcium Foes

Oxalates: Otherwise known as oxalic acid. Oxalates are present in many plants. And they can bind with calcium, which blocks some of it from getting absorbed in your body.5

Now, oxalates are not harmful when consumed in normal amounts. Indeed, there are plenty of oxalate-rich foods like spinach, beets, and raspberries that you shouldn’t be without! But this is just a reminder that too much of anything is usually unwise.

That said, people with chronic kidney disease or who produce recurring calcium oxalate stones should avoid oxalate-rich foods.

Sodium: Salty foods impede calcium in a few ways. On top of sodium blocking calcium absorption, it can also cause calcium to leave your body through urine.6 And when blood levels of calcium get low, your body actively extracts calcium from bone to make up the difference!

Phosphorus: You may know that phosphorus can actually be a helpful nutrient to pair with calcium. But what you may not know is that too much phosphorus can have the opposite effect.7

Too much phosphorus can disrupt the regulation of calcium and vitamin D. One of the top culprits of excess phosphorus is cola-type sodas.8 And no, not just regular cola; diet colas contain the same amount of phosphorus, so “diet” drinks won’t do you any favors here.

Newer research on a cross-section of over 17,000 adults even implicates soft drinks of all types. Research published in the journal Nutrients showed excessive intake of carbonated drinks and “sugar-sweetened dairy drinks” had negative effects on calcium metabolism.9

Not only did it disrupt the calcium/phosphorus balance, but it altered the acidity of participants’ bodies, leading to lower bone density and elevated risk of fractures! Those who drank soft drinks daily had over double the risk of suffering fractures.

These are all foods and compounds that can cause poor absorption of calcium. Now let’s look at several habits and activities that also interfere with calcium metabolism.

What Interferes With the Absorption of Calcium?

The following activities can take calcium out of bone:

Drinking and smoking. Smoking interferes with how your body processes vitamin D. It also lowers estrogen levels, which can make your bones weaker.

Studies even show it can greatly increase risk of fracture!10

Excess alcohol consumption (more than one drink per day for women or two for men) can also disrupt calcium balance in your body, and impede vitamin D production.11

Too much alcohol can also decrease production of osteoblasts, your bone-building cells. Plus, it can increase fat cell amount, lower estrogen levels, and destroy osteocytes, the cells that regulate bone remodeling. (All this on top of the well-documented damage to your liver!)

Lack of weight-bearing exercise. You need to move! Most importantly, you need the muscle contractions from weight-bearing exercise to add pressure to your bones. This is what activates osteocytes, those special bone cells mentioned earlier. Once activated, they initiate the bone-renewal and strengthening process that keeps your bones healthy.

You don’t have to go crazy with weights or long, arduous workouts, but you do need to engage in some form of weight-bearing activity for about an hour every day. Stay consistent so your bones receive the “reps” they need from your muscles’ force. Your musculoskeletal system directly impacts bone health, so, “Move it or lose it!”

Medications. There are plenty of medications that can impact calcium absorption. One common type are cholesterol-lowering meds, known as bile acid sequestrants.12 They can block calcium absorption and cause more calcium to leave your body through urine.

Another popular class of drugs are those that treat heartburn and GERD. Since they prevent stomach acid production, there’s no acid to release and solubilize calcium, preparing it for absorption. That means you can’t absorb calcium ions that are in your food or are still bound to their stabilizing partners (like carbonate in calcium carbonate) in your supplements.

Other common types of drugs that interfere with calcium absorption include corticosteroids and hypertension medicines.

Endocrine disruptors. These are everyday chemicals that interfere with your endocrine system. That is, the glands in your body that produce and regulate hormones.

On top of messing with hormone levels (which help control bone density), many endocrine disruptors also inhibit calcium absorption.13

Here’s just a short list of common sources of endocrine disruptors, like BPA and phthalates: The lining of metal food cans, plastic bottles, thermal paper receipts, detergents. And plenty of cosmetics, like many kinds of makeup, shampoos, hairsprays, and nail polish.

If you see the word “fragrance” or “perfume” in the ingredients list, you almost certainly have endocrine disruptors.

Now, let’s look at calcium supplements and how to maximize the calcium you absorb from them.

How to Take Calcium Supplements for Best Absorption

Taking calcium supplements

It’s best to take calcium at 350 – 500 mg at a time with a meal to ensure stomach acid production, and also to ensure you are drinking enough water to avoid constipation. Any more calcium than this, and a fair amount of it will be eliminated. If you are taking more than this amount each day, be sure to space it out for efficient absorption.

Take your calcium with food. That’s because you need stomach acid to help dissolve the calcium for best absorption. There is one exception to this, which we’ll cover in a moment. 

Don’t take calcium and iron at the same time. Be sure to space them out from one another by at least two hours.

If you’re taking any prescription medications, you should ask your doctor to ensure the proper scheduling of calcium with the medications. You can also talk to a knowledgeable Bone Health Expert to set up a personalized daily supplement (and medication, if applicable) plan.

Now, what about the one exception for taking calcium with food? Calcium citrate doesn’t require stomach acid to be absorbed, so it’s great for those taking medications that reduce stomach acid or have had gastrointestinal bypass surgery.

Note, calcium citrate has a relatively low calcium content compared to other popular types like calcium carbonate and calcium hydroxyapatite, so you’ll need to take more pills to get the same amount of calcium.

Which Form of Calcium Is Best Absorbed?

algae calcium supplement

That’s a good question. Because of its ability to be absorbed with or without stomach acid, many people consider calcium citrate the “best” absorbed calcium.

But that doesn’t necessarily mean it’s the best form of calcium for you. Part of the importance of absorption is how the calcium interacts with your body. And that includes how easy it is on your gastrointestinal tract.14  

Calcium citrate, calcium carbonate, and nearly all other popular forms of calcium supplements are derived from rocks. Of course, your body wasn’t designed to digest rock.

Plus, rocks are devoid of the Calcium Friends you saw above. Because they lack vitamin D3 and magnesium, rock-based calcium supplements tend to cause constipation. And because they lack vitamin K2, they can increase your risk of calcium depositing in your soft tissues like arteries, kidneys, and eyes. Of course, that means there’s less calcium where you do want it — your bones!

That’s why your best source of calcium comes from plants. 

Plant-based calcium does come with many Calcium Friends. That’s because the plant has absorbed and metabolized these nutrients that help you better utilize the calcium.

If you’d like to discover more about plant-based calcium, including a unique type shown in studies to increase bone density, take a look at AlgaeCal Plus.

It naturally contains all the key trace minerals that work with calcium to build healthy bones. Plus, there are clinically-studied doses of boron, magnesium, vitamin D3, and K2 (in its most potent MK-7 form).

Takeaways

It’s important to know: What you see isn’t what you absorb when it comes to calcium. 

But the more you incorporate the Calcium Friends into your diet, and moderate the Calcium Foes, you should be in good stead.

Sometimes you can’t avoid the activities that impede calcium absorption (like taking necessary medication). But knowledge is power when it comes to your health.

No matter what type of calcium supplement you take, you’ve now got clarity on the best way to take it for optimal absorption. You also know which calcium supplements are best absorbed, best utilized, and easiest on your body! 


References

  1. Kimberly Y Z Forrest, Wendy L Stuhldreher, “Prevalence and correlates of vitamin D deficiency in US adults” Nutr Res. 2011 Jan;31(1):48-54.
  2. Rosemary DeLuccia, May Cheung, “Calcium to Magnesium Ratio Higher Than Optimal Across Age Groups (P10-100-19)” Current Developments in Nutrition. 2019 Jun;13(3)
  3. Elizabeth A. Hibler, Xiangzhu Zhu, “Pysical activity, dietary calcium to magnesium intake and mortality in the National Health and Examination Survey 1999-2006 cohort” Int J Cancer. 2019 Aug;31
  4. Bess Dawson-Hughes, Susan S. Harris, Nancy J. Palermo, Carmen Castaneda-Sceppa, Helen M. Rasmussen, Gerard E. Dallal, Treatment with Potassium Bicarbonate Lowers Calcium Excretion and Bone Resorption in Older Men and Women, The Journal of Clinical Endocrinology & Metabolism, Volume 94, Issue 1, 1 January 2009, Pages 96–102, https://doi.org/10.1210/jc.2008-1662
  5. Bsc, S.N. and (1999), Oxalate content of foods and its effect on humans. Asia Pacific Journal of Clinical Nutrition, 8: 64-74. https://doi.org/10.1046/j.1440-6047.1999.00038.x
  6. A Devine, R A Criddle, I M Dick, D A Kerr, R L Prince, A longitudinal study of the effect of sodium and calcium intakes on regional bone density in postmenopausal women, The American Journal of Clinical Nutrition, Volume 62, Issue 4, October 1995, Pages 740–745, https://doi.org/10.1093/ajcn/62.4.740
  7. Mona Schiess Calvo, Dietary Phosphorus, Calcium Metabolism and Bone, The Journal of Nutrition, Volume 123, Issue 9, September 1993, Pages 1627–1633, https://doi.org/10.1093/jn/123.9.1627
  8. Tucker, Katherine L., et al. “Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham Osteoporosis Study.” The American journal of clinical nutrition 84.4 (2006): 936-942.
  9. Li Chen, Ruiyi Liu, et al. “High Consumption of Soft Drinks Is Associated with an Increased Risk of Fracture: A 7-Year Follow-Up Study.” Nutrients 2020
  10. A K Hackshaw, “A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture: recognition of a major effect” BMJ 1997;315:841
  11. https://www.bones.nih.gov/health-info/bone/osteoporosis/conditions-behaviors/alcoholism#:~:text=The%20link%20between%20alcohol%20and%20osteoporosis,-Alcohol%20negatively%20affects&text=To%20begin%20with%2C%20excessive%20alcohol,vitamin%20essential%20for%20calcium%20absorption 
  12. Weng, MY., Lane, N.E. Medication-induced osteoporosis. Curr Osteoporos Rep 5, 139 (2007). https://doi.org/10.1007/s11914-007-0008-y
  13. Yaglova NV, Yaglov VV. Endocrine Disruptors as a New Etiologic Factor of Bone Tissue Diseases (Review). Sovrem Tekhnologii Med. 2021;13(2):84-94. doi:10.17691/stm2021.13.2.10
  14. Diaz de Barboza, G., Guizzardi, S., & Tolosa de Talamoni, N. (2015). Molecular aspects of intestinal calcium absorption. World journal of gastroenterology, 21(23), 7142–7154. https://doi.org/10.3748/wjg.v21.i23.7142

Article Comments

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  1. Jackie De Jong

    November 5, 2022 , 6:42 am

    Hi Lara
    Thanks for your insights on calcium, been very informative. I have alot of issues with my body so I would love to have a chat with you of how to use AlgaeCal Plus etc to its potential. Had a bone density scan and I lost 33% of bone density in my right hip within two years. I need some help.
    Thanks
    Jackie

  2. Brianne Bovenizer

    November 6, 2022 , 9:07 am

    Hi Jackie,

    Thank you so much for commenting, and we are so sorry to hear of your recent bone scan.

    As your goal is to increase your bone mineral density, we would recommend our Bone Builder Pack, which includes both AlgaeCal Plus and Strontium Boost. It was this combination that showed an average of 3% increase in bone density over a 12 month period in our clinical research. AlgaeCal Plus alone showed 1.3%!

    AlgaeCal Plus is meant to be taken as 2 capsules twice daily with food, and Strontium Boost as 2 capsules once daily, without food, at bedtime!

    Jackie, I would encourage you to call us t 1-800-820-0184 to speak to one of our Bone Health Consultants who would be thrilled to set you up for success on our program! 🙂

    – Brianne @ AlgaeCal

  3. Mary Brown

    November 5, 2022 , 7:06 am

    I often eat a salad and wonder if it’s okay to take my supplements with salad or do I need to take them with more dense food like bread and meat.
    I have gotten Calcium stones once or twice.

  4. Brianne Bovenizer

    November 6, 2022 , 9:25 am

    Hi Mary,

    Thank you so much for commenting!

    Mary, a salad is a great, nutritious option to take your supplements with! I would suggest adding a handful of nuts for protein, and be sure to add in some healthy fat, like olive oil or avocado, which are important to absorb fat soluble nutrients like vitamin D3 and K2.

    We’re so sorry to hear you have suffered from calcium stones! The good news is that AlgaeCal won’t contribute to this as it contains important key players to calcium absorption including vitamin D3, K2, and the correct 2:1, calcium to magnesium ratio!

    Additionally, I would suggest sticking to lower oxalate greens for your salad, like kale, arugula and broccoli, if you have an increased risk for kidney stones.

    I hope this is helpful Mary, please reach out to us at 1-800-820-0184 if you have any additional questions! 🙂

    – Brianne @ AlgaeCal

  5. Urpha Hallman

    November 5, 2022 , 7:28 am

    Would you please comment on Choline Citrate for help in calcium absorption.

  6. Brianne Bovenizer

    November 6, 2022 , 9:38 am

    Hi Urpha,

    Great question! As we know, magnesium is an important factor is the absorption of calcium, and unfortunately, many individuals suffer from poor magnesium absorption, which causes lose bowel movements when they take it. Choline citrate can be an option to helps us more effectively get magnesium ions that we have released from food, or from their stabilizing partner in a supplement from the digestive tract into our bloodstream. For more information on this, see this video on our YouTube channel! Choline Citrate is mentioned around the 17:30 mark! 🙂

    I hope this helps Urpha, please call us at 1-800-820-0184 for any additional questions!

    – Brianne @ AlgaeCal

  7. Mary Ann Miller

    November 5, 2022 , 8:20 am

    Good read..

  8. Brianne Bovenizer

    November 6, 2022 , 9:55 am

    Hi Mary Ann,

    Thanks so much for your comment, we are so happy you enjoyed this article!

    – Brianne @ AlgaeCal

  9. Mariela

    November 5, 2022 , 10:06 am

    Hello
    I want to thank you for the interesting article on calcium absorption, very useful and complete.

    I would like to ask you a question about magnesium.
    I have heard some experts say that the ideal ratio for calcium to magnesium intake is now 1:1, and was previously thought to be 2:1.

    Could you clarify this question for me please?
    I would really appreciate it.

    Thank you very much

  10. Brianne AlgaeCal

    November 6, 2022 , 10:34 am

    Hi Mariela,

    Thank you for your question!

    In one of our referenced studies, published in “Current Developments of Nutrition” found that “a higher Ca: Mg ratio was associated with greater inflammation.” Lara Pizzorno also wrote in her book, “Healthy Bones, Healthy You”, that consuming too much magnesium over calcium (beyond the 2:1 optimal ratio) was harmful to bone, and increases fracture risk!

    We also know that in our clinical research, AlgaeCal, which is formulated at a 2:1 calcium to magnesium ratio, showed no negative side effects, and is the only calcium supplement to be clinically supported to increase bone density!

    I hope this helps Mariela!

    Please reach out to us at 1-800-820-0184 for any additional questions! 🙂

    Brianne @ AlgaeCal

  11. Penny Winton-Williams

    November 5, 2022 , 10:06 am

    Very informative wide ranging
    constructive facts to help with bone health I am 81 years & have osteoporosis due to taking inhibitors for cancer treatment so extremely helpful

  12. Brianne AlgaeCal

    November 6, 2022 , 10:37 am

    Hi Penny,

    I am so sorry to hear that you are suffering from osteoporosis, but we’re so happy to hear that you found this article helpful!

    Please don’t hesitate to reach out to us at 1-800-820-0184 if there is anything we can help with.

    – Brianne @ AlgaeCal

  13. Christine Klay

    November 5, 2022 , 1:01 pm

    Hello,
    I am taking Atrovastin generic for Lipotor, 1 a Day, due to my high Cholesterol, which I believe have inherated from my Dad.
    I eat a mixture of Fruit Daily, Vegetables or dark green Salad and take your Calcium and Strontion boost daily.
    I Exercise and do stretches daily, but have Osteoporoses which I have like Mom used to.
    Is there anything else I can do?? Sometimes your Articles are confusing with all those Medical expressions.
    Thank you for your advise. Christine

  14. Brianne AlgaeCal

    November 6, 2022 , 10:50 am

    Hi Christine,

    Thank you so much for commenting! It certainly sounds like you are doing everything you can to help your bones! 🙂

    If you haven’t already, we would also suggest working with your doctor to ensure you are getting the right amount of vitamin D3. It’s unfortunate how common this deficiency is, and if your blood levels are too low, you may need more in addition to what’s in AlgaeCal. The optimal range is between 50-80 ng/ml, so if you are below that, consider adding in an extra supplement!

    We would love to speak with you more Christine! Please call us at 1-800-820-0184, and any one of our Bone Health consultants would be thrilled to set you up for success on our program!

    – Brianne @ AlgaeCal

  15. Judy McCartt Dickson

    November 5, 2022 , 4:34 pm

    I have recently had breast cancer surgery and I’m following that with radiation. Then they want me to take some estrogen removing pills for the
    rest of my life. I currently take your algae cal regiment and have for many years
    Will these estrogen removing pills not also be taking calcium away from my bones?

  16. Brianne AlgaeCal

    November 6, 2022 , 12:12 pm

    Hi Judy,

    We’re so sorry to hear of what you are currently going through, and I hope you are getting the support you need.

    Judy, it is true that aromatase inhibitors can negatively affect our bones – that said, Lara Pizzorno has written in this article that there may be another option that you can speak to your health care provider about! In addition to this, if you are not already a member of our Facebook community, I’d encourage you to join. For more information on how, click HERE!

    I hope this helps – Please call us at 1-800-820-0184 for more information!

    – Brianne @ AlgaeCal

  17. Jennifer Roberts-King

    November 5, 2022 , 4:59 pm

    Pertinent and informative information.

  18. Brianne AlgaeCal

    November 6, 2022 , 12:14 pm

    Hi Jennifer,

    We’re so happy you enjoyed this article! 🙂

    – Brianne @ AlgaeCal

  19. Judy

    November 5, 2022 , 6:33 pm

    This was a great article and so very informative. It is nice to know that I am doing everything right and eating everything right. I am looking forward to my DEXA scan in another month. This is the first scan since I started taking AlgaeCal last December 15th. Thank you AlgaeCal!

  20. Brianne AlgaeCal

    November 6, 2022 , 12:23 pm

    Hi Judy,

    Thank you so much for commenting, and we’re so happy to hear you are doing so well! Please reach out to us once you have gotten your next DEXA scan, and we can arrange for one of our specially trained Bone Health Consultants to help review this with you, and compare your new results to your previous scan!

    Of course, if you have any questions in the meantime, don’t hesitate to reach out to us at 1-800-820-0184!

    – Brianne @ AlgaeCal

  21. Ro

    November 5, 2022 , 6:49 pm

    An hour a day for weight-bearing exercise seems impossible.
    My level of energy limits me to 15mins max!
    Otherwise, the information is helpful!

  22. Brianne AlgaeCal

    November 6, 2022 , 12:26 pm

    Hi Ro,

    You’re absolutely right, one hour a day can certainly seem overwhelming if you’re just starting out! Always listen to your body, and if you need to rest, it’s best to do so. Hopefully over time, we’ll see an increase in the amount of energy you have, in order to exercise for longer periods! 🙂

    – Brianne @ AlgaeCal

  23. Anna Fochler

    November 5, 2022 , 8:27 pm

    Thank You!

  24. Brianne AlgaeCal

    November 6, 2022 , 12:27 pm

    Hi Anna,

    You are very welcome, we’re happy to help! 🙂

    – Brianne @ AlgaeCal

  25. Dorothy Roman Eldefry

    November 5, 2022 , 10:39 pm

    Great Stuff to absorb..

  26. Brianne AlgaeCal

    November 6, 2022 , 1:38 pm

    Hi Dorothy,

    Thanks for commenting! Glad you liked the article 🙂

    – Brianne @ AlgaeCal

  27. Michael Dalzell

    November 6, 2022 , 7:08 am

    Great article. Very informative. Thank you AlgaeCal

  28. Brianne AlgaeCal

    November 6, 2022 , 1:45 pm

    Hi Michael,

    Thanks so much for commenting! You are very welcome, and we’re so happy that you found this information helpful! 🙂

    – Brianne @ AlgaeCal

  29. Denise Pinkney

    November 10, 2022 , 6:20 am

    Thanks for the informative article. Do you recommend any particular makeup brands? I was told by a nurse to eat lots of beets for my gallbladder. I see beets and spinach were on the oxalate list. How much is too much? I was trying to get 2 cups of red beets a day and I would wilt about 1-2 cups of spinach a day. Thanks!

  30. Chelsea Dugas

    November 14, 2022 , 7:14 am

    Thanks for reaching out, Denise!

    We don’t have any particular makeup brands to recommend, but it is always a good choice to aim for products that have as few harmful ingredients as possible! With regards to beets and spinach and their oxalate content, it all depends on your particular health challenges. To ensure you are not eating too much of either, we recommend speaking with your primary healthcare provider. Hope this helps and please let us know if you have any more questions! 🙂

    – Chelsea @ AlgaeCal

This article features advice from our industry experts to give you the best possible info through cutting-edge research.

Prof. Didier Hans
PHD, MBA - Head of Research & Development Center of Bone Diseases, Lausanne University Hospital CHUV, Switzerland,
Lara Pizzorno
MDiv, MA, LMT - Best-selling author of Healthy Bones Healthy You! and Your Bones; Editor of Longevity Medicine Review, and Senior Medical Editor for Integrative Medicine Advisors.,
Dr. Liz Lipski
PhD, CNS, FACN, IFMP, BCHN, LDN - Professor and Director of Academic Development, Nutrition programs in Clinical Nutrition at Maryland University of Integrative Health.,
Dr. Loren Fishman
MD, B.Phil.,(oxon.) - Medical Director of Manhattan Physical Medicine & Rehabilitation and Founder of the Yoga Injury Prevention Website.,
Dr. Carole McArthur
MD, PhD - Professor of Immunology, Univ. of Missouri-Kansas City; Director of Residency Research in Pathology, Truman Medical Center.,