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Bone health isn't really all about calcium

January 25, 2018

I see many women whose doctors have prescribed huge amounts of calcium, often as much as 1500 mg a day. This is ridiculous. At least I think it’s ridiculous, and I think that it is potentially dangerous long-­‐term. This advice is often accompanied by a suggestion to take massive amounts of vitamin D, sometimes up to 10,000 iu a day or much more. This is also ridiculous.

 

So now I have to explain myself, because I am implying that the current medical

wisdom is……ridiculous. 

 

First, these amounts are suggested because too many women are extremely

stressed, don't get enough exercise or weight bearing exercise, are headed towards, or in, menopause, eat the standard American diet (SAD which is high in, sugar, coffee, soda, refined grains and meat – possibly take some kind of antacid or prescription medication for GERD) and live north of the Equator where sun exposure is not optimum on an annual basis. All these lead to calcium loss or malabsorption. Hence the prescription for massive amounts of calcium and vitamin D.

 

Calcium

Part of the problem is that it is the wrong kind of calcium persistently being prescribed. It is often calcium carbonate (chalk) which is not well absorbed, and worse, it’s rarely partnered with magnesium, a mineral which helps the body to use calcium well. Calcium is actually quite ubiquitous, so it’s not so much a lack of it that is the problem, it’s more that high adrenaline from stress, a primarily acidic diet, too much coffee, phosphoric acid in sodas, absorption blocking antacids and other medications increase its requirement or excretion, or inhibit its absorption. So the issue is much more about diet, collaborative minerals, exercise and stress management than about swallowing mountains of calcium. 

 

Team Members

Magnesium is a critical mineral for calcium absorption. It is extremely deficient in most diets and it is lost in huge amounts due to stress and many other factors. Also its absorption is greatly depleted with the use of many medications especially diuretics, antacids and GERD medications.

 

Magnesium is found in the greatest amounts in organically grown green leafy vegetables, nuts, seeds and fish, things that are sadly lacking in most people’s diets. Calcium is rarely prescribed with magnesium…..

 

Minerals like strontium (not the radioactive strontium 90), boron, silicon, zinc and other trace minerals are also notably deficient in most diets and are critical for calcium use and bone health.

 

Ironically, high calcium intake can deplete minerals like magnesium, silicon. zinc, manganese and phosphorus.

 

Vitamin D

Most of my patients have had their vitamin D tested by their PCP and it is low. As a consequence high levels of vitamin D have been recommended, sometimes north of 10,000 iu a day for several months. Yes, I think this is ridiculous. High levels might be ok short-term but it is also prescribed alone. 

 

Alone is the operative word here….because high levels of vitamin D enable calcium absorption, but not just into the bones…..also into soft tissue and the vascular system. Vitamin K3 regulates the absorption of calcium into the right places…..but these high levels of D are not being paired with K3 or vitamin A — and I predict the emergence of some real health problems in the future if this recommendation isn’t revisited.   

 

Hormones

Peri-menopause and menopause cause further problems for bone health. Prior to the hormonal changes associated with menopause there is more estrogen to protect the bones from mineral loss, and it is estrogen’s decline that often tips the bone health balance. Estrogen stimulates the liver to produce a protein that binds to certain adrenal hormones, lessening their ability to dissolve bone, so a deficiency of estrogen, coupled with stress after menopause, contributes to significant bone loss.

 

Acid Alkaline

The blood has to be maintained within a very narrow range of pH 7.4 to maintain homeostasis.  Since the average lifestyle and dietary habits conspire to tip the balance towards an acid pH, the body uses a buffer system to restore physiological equilibrium. This involves a process of feedback and regulation using sodium as a buffer.

 

The kind of sodium the body needs for this operation is not table salt or sodium chloride (which most people get too much of) but the sodium obtained from vegetables and ripe fruit. Since the arrival of 'fast foods' the average diet contains few uncooked vegetables, and those eaten are most likely to be commercially grown and contain negligible sodium in comparison to that found in organically grown vegetables. (Firman Bear Report/Rutgers University).

 

The body's need for sodium in the buffer system is greatest whenever the diet consists mainly of proteins, grains, sugar and refined foods...these leave an acid ash or have an acidifying effect on the body. When adequate sodium is not available, pH tips towards acid and, to compensate, the body is forced to use calcium as a second buffer.

 

The demand for calcium as a buffer depletes this mineral from the bones and complicates the deficiency caused by low intake and bad assimilation.

 

Stress

Stress plays a double role in calcium depletion. Not the kind of stress which gets

you to accomplish things, but (dis)stress….anxiety about something, doing too much, grief, worry, emotional stress and so on. In all these situations (including when caffeine intake is high) the body produces extreme levels of the hormone adrenalin.

 

In emergency situations a rush of adrenalin can be a life-­‐saver, but when every-day stressful situations repeatedly send adrenalin into the bloodstream, the excess plays havoc with the skeletal system, since it is capable of dissolving bone. Too much stress contributes to the body's acid over-load, and when the body is under stress its ability to utilize nutrients is reduced.

 

A better way to protect and restore bone health

As a naturopathic doctor I always look at the patient’s lifestyle as well as diet and supplementation. I also look at things like medications, endocrine disrupters and heavy metals. I recommend that women read Nancy Appleton’s, “Healthy Bones”. It is one of the most ‘sane’ books on bone health..

 

When I create a program for osteopenia or osteoporosis I take into account age, diet, digestion, stress, lifestyle, and exercise levels as well as many other factors. The supplements I recommend are highly bioavailable, balanced, and often much lower potency than most women are comfortable with, but I don’t believe that high amounts of crude calcium and vitamin D is the answer, and my clinical results with patients bear this out.

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