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Aussie Barb
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Posted: Mon Oct 31st, 2005 01:31 |
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Do I need to take a calcium supplement to prevent or treat osteopenia/ osteoporosis?
Dietary calcium helps PTH (parathyroid) homeostasis but it has little to do with bone strength. Taking too much calcium is detrimental.
Adequate calcium intake is important
Calcium supplementation is necessary if you are unable to get enough calcium in your diet.
Dr Marshall advises people with Th1 inflammatory disease to maintain an adequate calcium intake but no more than their recommended daily allowance (RDA)with a combination of both food intake and supplements (if necessary).
RDAs differ in the US, Canada and Australia.
Calcium requirements vary
Calcium requirements vary by age, gender and diagnosis. It is important to maintain adequate calcium intake (not too high or too low) to promote normal endocrine metabolism, supplementing only if needed.
This website lists Australian daily calcium requirements. Institute of Medicine -- RDAs for nutrients lists the U.S. RDAs for calcium. Calcium Requirements list the Canadian RDAs for calcium.
Those who have a history of hypercalcemia or hypercalciuria (high calcium levels) should consult their doctor regarding calcium intake.
Calcium from foods is best
Ideally, all your daily calcium should come from food but if your food calcium intake falls short, it is okay to supplement with a calcium tablet that does not contain Vitamin D. These can be found at most stores that sell vitamins.
Here is a fact sheet on calcium. Supplementation isn't necessary unless your diet is deficient. Then, be sure to take only the amount needed to equal the RDA of 1000-1500mg/day of calcium with both food and supplement combined.
Do not consume more than 500 mg of calcium at any one time (i.e., take in divided doses). When eating a meal with food containing calcium (e.g., cheese or yogurt), decrease the amount of calcium supplement you take so you do not go over 500 mg at that meal.
Here is a list of foods that are high in calcium. Keep in mind that some of them contain high levels of Vitamin D also. These are to be avoided.
Calcium and phospherus contect of selected foods
If you need a calcium supplement
This article on calcium contains information on the types of dietary calcium supplements. When you decide what form of calcium you want to take, you can do an Internet search for brandnames without vitamin D. One brand is Solgar Chelated calcium available from NEEDS (http://www.needs.com 800-634-1380) and other online sources but you may find them at health food stores.
In Australia, Blackmores make a calcium supplement called C.P.57. I had to ask at a health store as it is a practitioner dispensing only. They had it behind the counter. ~Grace
Calcium supplements may interfere with other medications
Calcium supplements may interact in various ways with many other medications, including fluorquinolones, beta blockers, calcium channel blockers, digoxin and furosemide. See this reference for details.
Do not take a calcium supplement with minocycline
Calcium can interfere with the body's ability to absorb tetracycline medications (including doxycycline, minocycline, and tetracycline) and, therefore, diminish their effectiveness. Calcium containing supplements and antacids should be taken at least two hours before or after taking these drugs.
Foods high in calcium will decrease minocycline absorption
Taking minocycline with dairy products may alter its absorption. Take this into consideration only if you need to eliminate any variable that might be affecting immunopathology. In that case, take your minocycline dose one hour before or two hours after consuming dairy products or other foods high in calcium. Otherwise, it is okay to take minocycline with food.
Remodelling bone mass takes time
The MP resolves the inflammatory process that is the cause of calcium metabolism abnormalities.
During the early phases of the MP it is unrealistic to expect that skeletal remodelling will change very much, as the immunopathology is still a major player in the body's homestasis.
Until you get the pathogen load down to healthy levels you are unlikely to see much improvement in skeletal parameters. So a stable environment (bone scan) is fine. It is once immunopathology has started to drop back, as the photosensitivity recedes, as the 1,25-D stays in a lower range, that the skeleton will get a fair chance at rebuilding itself.
The disease process causes calcium depletion
Th1 inflammation may cause calcium depletion from bones and excess circulating calcium. Thus, it is the disease process that causes a calcium deficit which results in osteopenia and osteoporosis.
"Everything in the body is controlled by the genome. The VDR transcribes the genes which are at the key of shuttling calcium through the epithelium. Thus, it is not Vitamin D which causes absorption of calcium from the gut, it is a competent VDR. In Th1 disease the two things are not synonymous." ..Trevor..
High 1,25-D causes bone loss
At levels above about 42 pg/ml, the 1,25-D (generated by Th1 inflammation) begins to stimulate bone osteoclasts (http://tinyurl.com/dp7a9), causing bone to be resorbed (dissolved) back into the bloodstream. Not only does this lead to osteporosis, but also to calcium being deposited into soft tissue of the body, including the lungs, breasts, muscle bundles (fibromyalgia) and the kidneys (where it forms kidney stones).
In his paper A Review-Vitamin D and Calcium in Sarcoidosis, Dr. Marshall writes, Some clinicians still administer calcium and vitamin D supplementation to their sarcoidosis patients in the vain hope that this supplementation will somehow prevent, or reverse, osteoporosis resulting from the sarcoid inflammation itself, or osteoporosis resulting from the use of corticosteroids.
But the calcium metabolism of sarcodiosis patients is not the same as that of healthy individuals[13,16]. There is no clinical evidence that supplementation has any beneficial effect on sarcoid osteoporosis[14,15], indeed, since the Vitamin D supplement often causes the 1,25-D hormone to rise to extremely high levels, supplementation can actually increase bone resorption, increasing the rate of bone-weakening[17].
"I understand the molecular mechanisms that cause osteopenia and osteoporosis in the Th1 diseases. I believe that if your 1,25-D is between 19 pg/ml and 35 pg/ml you will be building healthy bones. Unless, of course, you are taking steroids, or anything else that directly interferes with the bone metabolism." ..Trevor..
See New insights into mineral and skeletal regulation by active forms of vitamin D.
Excess calcium intake does not increase bone mass
"I have seen no properly done studies that show calicum fortification (taking too much calcium), at any age, builds better bones. Remember that the skeleton regenerates every 10 years, and a 12 month study isn't significant.
Recent studies have shown that as long as the plasma phosphatemia and the calcemia are kept in 'normal' ranges supplementation beyond that will have no effect on bone matrix."
Studies prove excess calcium does not strengthen bones
BMJ and Lancet recently published studies showing that calcium supplements (and vitamin D) do not strengthen bones:
Vitamin D and Calcium Supplements for Elderly a Waste of Time, the Lancet
Randomised controlled trial of calcium and supplementation with cholecalciferol (vitamin D3) for prevention of fractures in primary care
This study stated, "At the same time, women taking calcium plus vitamin D experienced an increased risk for kidney stones, they added." Calcium, Vitamin D Won't Protect Older Women From Fracture
Calcium supplements useless for strengthening bones: study
The aim of this study (below) is to evaluate the relative importance of vitamin D and calcium treatment on BMD and bone-related chemistry in elderly women with vitamin D insufficiency.
Randomized controlled trial of the effects of calcium with or without vitamin D on bone structure and bone-related chemistry in elderly women with vitamin D insufficiency.
This Aug 08 study concluded, "In patients with a baseline calcium intake of 1100 mg/d and vitamin D insufficiency, vitamin D(2) 1000 IU for 1 year has no extra beneficial effect on bone structure, bone formation markers, or intestinal calcium absorption over an additional 1000 mg of calcium. Vitamin D supplementation adds no extra short-term skeletal benefit to calcium citrate supplementation even in women with vitamin D insufficiency."
Calcium requirements for children
Children need calcium for growing bones. Calcium requirements vary by age. This website lists daily calcium requirements for children. Dr. Marshall advises people with Th1 inflammatory disease to get no more than their recommended daily allowance with a combination of both food intake and supplements.
Milk is an excellent source of calcium but it is problematic because all milk, whether from animals or humans, naturally has some vitamin D. The amount will vary depending on the fat content of the milk and what the animal who gave the milk was eating. As a result, any milk product will also have some level of vitamin D, although it may be low.
Drinking small amounts of milk are okay but no one can say exactly how much. It's a good idea to recheck the level of 25-D at six month intervals to make sure too much Vitamin D isn't being ingested.
Sources of Calcium without Vitamin D
A good milk substitute (although rather sweet) is the canned 'creamy vanilla' ready-to-drink high protein shake by Carb Solutions. It goes well with cereal. You can find them in six-packs at your local Kroger or Wal-mart.
Lots of foods are good sources of calcium and don't have added vitamin D or folic acid. Here are some:
Almonds
Beans - many types, including baked, limas, chickpeas, kidney
Brocolli & leafy greens
buttermilk if no D is added
cheeses (check the label for added Vitamin D)
cottage cheese (read the label)
cream - usually sold as whipping cream
half-n-half
orange (the real fruit, not the juice)
sesame seeds
sour cream
yogurt
When cooking, you can use half-n-half without D instead of milk.
Ideally, all of the daily calcium should come from food but if the food calcium intake falls short, it is okay to supplement with a calcium tablet that does not contain Vitamin D. These can be found at most stores that sell vitamins.
Related information:
Bone formation
Recommended nutritional supplements for a dietary deficiency
Osteoporosis, osteopenia and Th1 illness
Osteoporosis and Th1 illness
Calcium Fact Sheet
My 25-D is low and/or my 1,25-D is high. Should I be concerned about osteoporosis?
Please scroll down for more info and studies.........
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Barb: Dx Inflammatory Disease Endocrine Imbalance 2003| Depression| 24+ years not Dx| MP Aug04| ABC of MP| MP Search|
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Aussie Barb
Member in Phase 3
| Joined: | Thu Jul 22nd, 2004 |
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Posted: Fri Jul 14th, 2006 21:43 |
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Members' experiences with calcium supplementation
Christina wrote: That is interesting about "The Calcium Factor". I too read Bob Barefoot's book and began supplementing heavily with coral calcium with tons of vitamin D for a few years. My RA got worse and worse over that time. I also was unable to increase my bone mass (i've had osteopenia for at least four years) and the supplements did absolutely nothing to fix this. And the whole time, I thought I was going to help my body when actually I was killing myself with D supplements. Oh if only I had found MP long ago.
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Barb: Dx Inflammatory Disease Endocrine Imbalance 2003| Depression| 24+ years not Dx| MP Aug04| ABC of MP| MP Search|
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Posted: Mon Aug 14th, 2006 15:39 |
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Food Sources of Calcium
Here are some food sources of calcium. Be sure to check packaged food labels to ensure no vitamin D or folic acid has been added.
An extensive list of the calcium content of foods is available online from the U.S. Department of Agriculture.
Yogurt 1 cup = 200-415 mg
Buttermilk 1 cup = 300 mg
Cheese 1 ounce = 175-250 mg
Cottage Cheese 1/2 cup = 60-100 mg
Parmesan Cheese 1 tablespoon = 40-60 mg
Turnip greens, cooked 1 caup = 200 mg
Bok Choy, cooked 1 cup = 160 mg
Mustard greens, cooked 1 cup = 105 mg
Broccoli, cooked 1 cup = 70 mg
Broccoli, raw 1 cup = 40 mg
Molasses, blackstrap 1 tablespoon = 170 mg
Egg Substitute 1/2 cup = 130 mg
Baked beans 1 cup = 130 mg
Other beans, canned 1/2 cup = 40-60 mg
Blackeyed peas, boiled 1 cup = 211 mg
Peas, green, boiled 1 cup = 94 mg
Almonds 1 ounce (24 nuts) = 80 mg
Figs, dried 5 = 135 mg
Papaya 1 raw = 75 mg
Raisins, golden 2/3 cup = 50 mg
Orange 1 medium = 50-70 mg
Calcium information was adapted from:
Pennington, J. Bowes & Church's Food Values of Portions
Commonly Used, 17th ed., 1998
Green leafy vegetables such as broccoli, collards, kale, mustard greens, turnip greens, and bok choy or Chinese cabbage are good sources of calcium. Certain green vegetables are less effective sources of calcium. While their calcium content appears to be high, their fiber and oxalic acid content interferes with the absorption of calcium.
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Posted: Tue Sep 19th, 2006 21:07 |
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Calcium supplements useless for strengthening bones: study
(filelink)
PARIS - Calcium supplements fail to provide long-term strengthening of bones, according to a study that touches on osteoporosis, a disease commonly facing woman after the menopause.
The paper, published online by the British Medical Journal (BMJ), is a review of 19 major studies that involved nearly 2,900 healthy children aged between three and 18.
They included children who were given calcium supplements for at least three months and whose bone health was then monitored more than six months afterwards.
Children taking the supplements only had 1.7-percent better bone density in their upper limbs compared to counterparts who did not take the extra calcium.
This small benefit did persist in the upper limbs, but there was no significant effect on the rest of body, particularly at sites such as the hip and lower spine that are prone to fracture later in life.
Bone density diminishes among women after the menopause, so doctors are keen to boost bone mass early in life through diet and exercise.
"The small effect of calcium supplementation on bone mineral density in the upper limb is unlikely to reduce the risk of fracture, either in childhood or later life, to a degree of major public health importance," the paper says.
Lead author is Tania Winzenberg of Menzies Research Institute in Tasmania, Australia. - AFP
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Posted: Mon Nov 20th, 2006 04:13 |
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Severe Deficiency of 1,25-Dihydroxyvitamin D3 in Human Immunodeficiency Virus Infection: Association with Immunological Hyperactivity and Only Minor Changes in Calcium Homeostasis
Charlotte J. Haug, Pål Aukrust, Egil Haug, Lars Mørkrid, Fredrik Müller and Stig S. Frøland The Journal of Clinical Endocrinology & Metabolism Vol. 83, No. 11 3832-3838 Copyright © 1998 by The Endocrine Society
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Posted: Mon Nov 20th, 2006 04:21 |
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Epidemiological study finds a strong association between high 1,25 D levels and osteoporosis.
(filelink)
The Danish epidemiologist Brot studied 500 healthy women ( that is they were not drawn from a population with particular health issues) aged 42 to 58 and concluded that in this group bone density was strongly inversely proportional to 1,25 D levels ( that is low bone density was strongly associated with high 1,25 D levels) and only rather weakly directly proportional to 25 D levels. The sample was chosen randomly - and was not done to test the impact of any particular treatment programme.
Relationships between bone mineral density, serum vitamin D metabolites and calcium:phosphorus intake in healthy perimenopausal women.
Brot C, Jorgensen N, Madsen OR, Jensen LB, Sorensen OH.
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Posted: Wed Jan 10th, 2007 22:55 |
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(filelink)
1,25-D does not affect calcium level, only PTH
1,25-D Reduces Spontaneous and Hypocalcemia-Stimulated Pulsatile Component of Parathyroid Hormone Secretion
"Remarkably, the effects of 1,25-D on spontaneous PTH were observed without any difference in serum ionized calcium or serum phosphate levels at the times of investigation."
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Posted: Wed Jan 10th, 2007 23:35 |
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(filelink)
Effect of therapeutic levels of doxycycline and minocycline in the proliferation and differentiation of human bone marrow osteoblastic cells.
Arch Oral Biol. 2006 Nov 30; [Epub ahead of print]
Gomes PS, Fernandes MH. Laboratorio de Farmacologia e Biocompatibilidade Celular, Faculdade de Medicina Dentaria, Universidade do Porto, Rua Dr. Manuel Pereira da Silva, 4200-393 Porto, Portugal.
Semi-synthetic tetracyclines (TCs) have been reported to reduce pathological bone resorption through several mechanisms, although their effect over bone physiological metabolism is not yet fully understood. The present study aims at evaluate the behaviour of osteoblastic-induced human bone marrow cells regarding proliferation and functional activity, in the presence of representative therapeutic concentrations of doxycycline and minocycline. First passage human osteoblastic bone marrow cells were cultured for 35 days in conditions known to favor osteoblastic differentiation. Doxycycline (1-25mug/ml) or minocycline (1-50mug/ml) were added continuously, with the culture medium, twice a week with every medium change. Cultures were characterised at several time points for cell proliferation and function.
Present data showed that 1mug/ml of both tetracyclines, level representative of that attained in plasma and crevicular fluid with the standard therapeutic dosage, increased significantly the proliferation of human bone marrow osteoblastic cells without altering their specific phenotype and functional activity. Long-term exposure to these TCs induced a significant increase in the number of active osteoblastic cells that yielded a proportional amount of a normal mineralised matrix, suggesting a potential application in therapeutic approaches aiming to increase bone formation. The presence of higher levels of these agents led to a dose-dependent deleterious effect over cell culture, delaying cell proliferation and differentiation.
PMID: 17141175 [PubMed - as supplied by publisher]
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Posted: Sun Aug 12th, 2007 06:19 |
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filelink
Bone Formation
Bones are constantly in the process of remodeling and renewing through the work of specialized cells known as osteoclasts and osteoblasts . Osteoclasts dissolve bone, usually old bone cells. As osteoclasts work, calcium is released from dissolved bone cells into the blood supply. Normally, osteoblasts, the bone-building cells, work in near-balance with osteoclasts to lay down new bone as soon as old bone is dissolved. Factors that can upset the normal balance between bone resorption and bone formation include hormonal imbalances and lack of nutrients/minerals necessary for forming bone.
One of the things that can go wrong when folks have Th1 disease is that inflammatory cytokines and elevated hormone 1,25-dihydroxyvitamin D can throw off the balance between osteoclasts (bone dissolvers) and osteoblasts (bone builders). As osteoclasts dissolve increasing amounts of bone, calcium and other minerals are released from bone. Calcium may be deposited in soft tissue and circulating serum calcium levels may reach clinical hypercalcemia.
Once a person has managed to gain control of inflammatory cytokine levels through the therapeutic use of the Marshall Protocol, they are in a much better position to address bone health. Adequate calcium intake is important and we suggest folks get the RDA of calcium (but no more) in foods and calcium supplements when necessary.
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Posted: Wed Jan 16th, 2008 20:10 |
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[filelink]
Calcium: Heart Risk for Older Women?
Study Shows Calcium Supplements May Up Heart Attack Risk in Postmenopausal Women
By Kathleen Doheny
WebMD Medical News
Reviewed by Louise Chang, MD
Jan.15 2008 -- Calcium supplementsm generally thought to preserve both bone and heart health, may boost the risk of heart disease in healthy postmenopausal women, according to New Zealand researchers.
"Loading with high doses of calcium reduces bone loss but at a cost in heart health that is not justified," says researcher Ian Reid, MD, professor of medicine and endocrinology at the University of Auckland.
But a U.S. expert on calcium supplementation says the findings may be a fluke and at this time don't warrant any change in the recommendation to get sufficient calcium through diet and supplements.
Calcium, Heart Attack Study Details
Reid and his colleagues followed 1,471 healthy postmenopausal women, ages 55 and above, assigning half to get a daily calcium supplement of 1,000 milligrams and half to placebo pills. The average age in both groups was 74.
Calcium supplements are typically prescribed to women after menopause to preserve bone health, and some studies suggest it might also protect heart health by improving the ratio of good cholesterol to bad cholesterol.
The New Zealand researchers initially conducted the study to look at the effect of calcium on bone health, says Reid, who has received research support from calcium supplement manufacturers. This study is what is known as a secondary analysis. Researchers evaluated the women's calcium intake from diet and examined them every six months for five years, looking for reports of heart attack, stroke, or sudden death.
The women in the supplement group got 861 milligrams of calcium from diet per day, on average, boosting their total daily intake to 1,861. The placebo group averaged about 853 milligrams of calcium daily from their diet.
Calcium, Heart Attack Results
To obtain a more complete picture, the researchers also looked for events not reported at the visits by checking hospital admissions and reviewing death certificates of those who had died.
Heart attacks were more common in the calcium group, with 31 women on supplements having 36 heart attacks compared to 21 women on placebo having 22 heart attacks during the follow-up period.
The risk of a heart attack was about 1.5 times greater for those in the supplement group, but the link did not reach statistical significance.
Considered together, strokes, heart attack, or sudden death were more common in those on supplements than on placebo, but the differences -- when taken as a whole -- were statistically only of borderline significance, Reid's team found.
The researchers took into account such factors as cigarette smoking, high cholesterol, and blood pressure problems.
Calcium, Heart Attack: What's the Mechanism?
Reid cautions that the findings must be replicated and plans to do more research on the proposed link.
But he speculates that the calcium supplements may elevate blood calcium levels and possibly speed calcification in blood vessels, which is known to predict the rates of vascular problems such as heart attack.
Second Opinion: Calcium, Heart Attacks
The link between calcium supplements and heart attack suggested by the New Zealand team "seems implausible," says Robert P. Heaney, MD, John A. Creighton University professor at Creighton University in Omaha, Neb., and a long-time researcher of calcium's effect on health.
Typically, Heaney tells WebMD, "Extra calcium doesn't build up in your arteries. The body regulates the blood concentration of calcium.'' Only in people who have lost the ability to regulate calcium levels could the blood concentration of calcium increase, he says, and this condition is rare.
Calcium and Heart Health Advice
Women should keep taking the recommended amounts of calcium, Heaney says. "Postmenopausal women should be getting 1,500 milligrams [a day] through diet and supplements," he says.
The levels recommended by the Institute of Medicine are a bit lower: 1,200 milligrams of calcium for men and women ages 51 and older, and 1,000 milligrams for those 19 to 50.
"Even if it turns out this [proposed link between calcium supplements and heart attacks] is true and replicated [with further research] you have to weigh that against fracture protection," Heaney says of calcium supplements.
Reid disagrees, suggesting women over the age of 70 and some others should rethink calcium supplements.
"It is likely that this is primarily a problem for elderly women because they are more likely than younger subjects to have prevalent coronary heart disease," he tells WebMD. "Therefore it seems wise to advise against [high amounts of] calcium supplementation in those over the age of 70 years and in those known to have coronary heart disease. Aiming at a total calcium intake of approximately 1 gram [1,000 milligrams] a day [equivalent to four servings of dairy products] seems sensible in these subjects."
For instance, a woman who took in 500 milligrams of calcium from foods should take no more than 500 milligrams in supplements daily, he says.
Younger women can continue supplementing without worry, he says. "At present, there is no evidence of adverse cardiovascular effects of calcium supplementation in younger women, so the conventional use of calcium supplements seems reasonable in these subjects."
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