Wednesday, November 20, 2013

Calcium and Bone Health

Photo detail by faria!.
I recently received a DXA scan and  found out that I have osteopenia, a level of bone density that is lower than "good" but higher than osteoporosis. For this reason, I've been reading more about bone health and talking to experts and lay people alike about the issue.

Very casually, many health care professionals and individuals state, "take a daily calcium supplement." However, I wanted to look into the issue of supplements before taking a daily pill.

If you want to read a very good source on the topic, see this page on Calcium Supplements as prepared by the Office of Dietary Supplements at the National Institutes for Health. It's detailed and comprehensive. After reading this page, I understand the value of learning more about supplements before taking them.


It turns out that the issue is complex. In fact, you should consult a health care professional to get solid information on the topic.  Nutrition is so complex and individual, it's a little silly for me to address the topic at all.  I'm not a doctor, but I'm researching this for myself, and these are some of the issues you can look at, too.  But don't commit to a plan of action--or inaction--until  you consult with a licensed professional.

The way you ingest calcium, how your body absorbs calcium and how your body excretes calcium are all variables that need to be managed.  This is true not just because it's dangerous to have low levels of calcium; it's also dangerous to have high levels of calcium.

Let's break down the above paragraph, piece by piece.

How Can I Acquire Calcium?

1. Natural Sources in Food

2. Fortified Foods

3. Supplements

4. Prescription Medications

There are a lot of forms for calcium. I started keeping a list as I researched the topic. I thought there would be just a half dozen. However, I found a pretty long list on this page. Admittedly, some of these names merely like foreign-language versions. Nevertheless, it might be easy for me to get too much calcium if I fail to read food labels.

How Many Variables Affect Absorption of Calcium?

Too many for me to list exhaustively or accurately.

I will just mention briefly that some factors include increased age, stress, medications, other supplements and the person's diet all can affect how calcium is absorbed and excreted. Again and again, I read that smaller amounts of calcium in whole foods are usually better absorbed than large amounts of calcium taken in a supplement.  Also, caffeine, diuretics and over consumption of protein can cause an increase in the excretion of calcium.   And calcium cannot be absorbed without being paired with adequate Vitamin D, magnesium, phosphorus and other vitamins and minerals.  Also, certain conditions and diseases can affect rates of calcium absorption / excretion.

Can It Be Possible to Have Too Much Calcium? 

Yes.

Many know about the dangers of too little calcium, chiefly osteoporosis. However, excessive calcium can cause problems that range from the mild inconvenience of constipation, the greater inconvenience of kidney stones to the life-threatening dangers of cardiovascular disease, which can lead to a stroke or a heart attack.

The Mayo Clinic advises people to inform their doctor about any calcium supplements taken without a prescription in order to prevent one cause of hypercalcemia (too much calcium).

Still Reading and Thinking

Well, now I know that I need to keep reading about and thinking about calcium before I just start taking daily supplements. In the mean time, I have a grocery list that includes canned salmon, canned sardines, kale, collard greens, broccoli, and tofu. I'll enjoy these foods and some weight bearing exercise (the topic of my December post on bone health) while I'm mulling things over.

Related:

What Is Osteopenia?
Exercise to Increase Bone Density



26 comments:

  1. You know that as a fitness pro, I have to support that part about doing more weight bearing activity -- ellipticals don't count, nor swimming! Walking, treadmilling (I made up that verb and kinda like it), dancing do-- well, you probably already know what's on the list. Keep us posted on how your plan goes and BEST of SUCCESS!

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    1. I could learn more about exercise and bone health, so maybe that's my next bone health topic. I'm aiming to write one post about bone health per month. Thanks for nudging me in that direction.

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  2. The best way to take care of bone is give consistent exercise to it. More importantly people should stay away from carbonated drinks and replace them with bananas and seaweeds. Those are great sources of calcium.

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  4. This reminds me that I'm due for a bone density test. My last one was very good, for which I thanked my good friends Ben & Jerry, and I'm hoping I have the same results this time.

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    1. Oh, I like the Ben & Jerry cure. I hope you get great test results (holding ground is good!)

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  5. I have Rheumatoid arthritis and I have to take calcium supplements. My problem is that I cant' stand any dairy products or the foods listed above except the broccoli, that I don't mind. Cheese, mil etc...now way
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    1. All my best to you as you manage RA and find a good calcium fit for you.

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  6. I was diagnosed several years ago with osteopenia and have tried to be conscious about incorporating extra calcium into my diet. So far my level hasn't gone up, so I'm grateful for that.

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    1. I am glad that your bones aren't getting any thinner. I hope that I am holding ground, too. I am not quite sure when I need a follow up test. I should ask my general practitioner that soon.

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  7. This is an important subject yet, as you said, it's an individualized one and people need to speak with their doctor.

    I get my calcium through the foods I consume since I form kidney stones galore and supplements are not right for me. Hopefully healthy eating and walking will do the trick.

    Best of luck to you, Karen. So happy so see that you're taking an active role in your own health. Not everyone does that!

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    1. I am glad you are getting customized advice on the topic! I'm trying to lift weights more, but I end up doing it once a week when 3x is my goal. I probably need a weight lifting buddy. That could be amusing just trying to get that set up!

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  8. Thank you for posting this! I really need to start thinking about this!

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  9. I might be due for a retest soon. My first one was fine.

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    1. Congrats on the good bone health. That's a real achievement.

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  10. Karen - I had the same results from my recent bone scan and have also been confused about calcium and the different ways it is absorbed and the best option. I probably need to explore the topic further since I gave up and just grabbed one off the shelf and figure "good enough" - probably not a got idea!

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    1. The page that NIH has on calcium supplements is excellent, but I admit it's a bit taxing. I had to have the time and mind space to read it. (And then I went back and read it twice more to confirm what I learned.) Good bone health to you.

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  11. I love, love, love how you approach this Karen. Best absorbtion from whole food with calcium -- Mother Nature does know how to deliver what we need doesn't she? I am not antisupplement, I just am anti-hype. I think the supplement industry thinks more is better and as you pointed out in this case, more can be dangerous. Another excellent, insightful, and well researched piece. I guess I better go get a bone density test, huh?

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    1. Ruth "anti-hype." That's a good way to express the need we all have to be savvy consumers. Many women I know are getting bone density tests some place between 50 and 60 in order to see how things are going in that department.

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  12. My doctor told me not to take any extra calcium, but to keep exercising.

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  13. I was just told to add more calcium to my diet and not to take any supplements. (many of them are made from shellfish and I am allergic.) I am not a fan of any dairy foods so I will be going over the food list and adding much more exercise.

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    1. I like dairy, but there are a lot of other credible sources for calcium. All my best to you for good bone health.

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  14. Hello Karen and thank you for sharing your experience and research. I too had my primary care tell me that I had osteopenia and suggested I double up on the caltrate I was taking. He also prescribed a drug called alendronate sodium, which I was supposed to take once a week. Well, I never took a second cuz the first pill made every bone, muscle and joint ache badly. Needless to say, I appreciated your article very much. I still take one caltrate, will be joining a joga class, exercise a couple times a week, and will try to eat better and looking for another doc. Thanks, Cindy K.

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    1. All my best to you as you manage the health of your bones. Thanks for stopping by the blog.

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