LifeCare Chiropractic

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calcium supplements

Calcium Supplements and Heart Disease

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IS MY CALCIUM SUPPLEMENT GOING TO GIVE ME A HEART ATTACK??
It’s always funny the poor research that mainstream media picks up and the good stuff they don’t.
Here are a few things to consider. First, I usually don’t recommend calcium supplementation until someone becomes osteoporotic. At this point it becomes much, much more important to take calcium in order to protect the bones than worry about any additional increased risk to the heart.
Second, reading into the study, it appears that those with a higher dietary intake of calcium were at risk (my interpretation….more dairy intake), while those with lower levels of dietary intake were NOT affected by the calcium supplementation.
Further, we always have to look at the “how.” In this particular case, giving calcium without magnesium in a 2:1 ratio can cause a relative magnesium deficiency, which is NOT good for the heart….The higher quality calcium supplements all include magnesium.

Complicated Calcium Confusion: What’s the Best Source of Calcium?

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I can honestly say that I have never been a fan of calcium supplementation.  Or at least maybe not for the last decade or so.

It has truly been that long since the medical research began to change its opinion on using calcium supplements to strengthen bones.  This is not to say that I don’t recommend calcium supplements, but it is a pretty rare situation and only when someone has been diagnosed (in our office or elsewhere) with severe osteoporosis.  It has been a long, long time since I recommended calcium for anyone just to “build strong bones.”

Before we go any further, I do need to clarify something about calcium supplements for bone health.  Tums are NOT a calcium supplement.  It is a toxic product containing aluminum and artificial colors and should never, ever have been recommended to support bone health.

Any calcium supplement used for bone health should be a bone support formula, containing not only calcium, but other bone-supporting components like magnesium, boron and zinc.  And the best form of calcium is NOT calcium carbonate.  Higher quality forms like citrate are the preferred forms–especially when it matters.

Another thing that you may not realize is that your body is very selective as to how much calcium it will absorb at any given time.  This is because calcium levels are very tightly regulated in the bloodstream.  Too much or too little calcium can be fatal.  As in rigor mortis, the ultimate calcium deficiency in the bloodstream.  To keep this level constant, the gut keeps a very tight grip on how much calcium is absorbed at any given time.  If you decide to down an entire bottle of calcium supplements at a single time, the gut will actually push back, resulting in even lower amounts of calcium being absorbed.

This is why, when you are taking calcium supplements, you should take them spread out throughout the day as much as possible.

But none of this really matters because of one important fact.

Vitamin D plays a very large role in regulating the amount of calcium you gut will absorb (it’s role is much bigger, but for the purposes of this particular line of discussion, this will suffice).  With low levels of vitamin D (an all-too common problem in todays’ sun-fearing society) more calcium may not be enough to get the job done.  On the flip side, having enough vitamin D flowing through your blood will make taking a calcium supplement pointless on top of a good quality diet.

Unfortunately, for years, doctors were telling their patients to take calcium supplements (frequently in the form of Tums) and given no recommendations on vitamin D.  While that is changing, this particular study demonstrates how backwards this recommendation is.

In the study, researchers looked at 3448 men and 3812 women who were older than 50 years of age and broke them down into daily dietary calcium intakes of (1) less than 400 mg/d, (2) 400–799 mg/d, (3) 800–1199 mg/d, and (4) 1200 mg/d or greater.  Overall, the average daily calcium intake was 470 mg/d.

They then measured bone density and compared it to average daily calcium intake.  Here’s what they found:

  • Those with calcium intake less than 400 mg/d had lower bone density (specifically, femoral cortical thickness and buckling ratio).
  • In men, bone density was higher in those with calcium intakes up to 1200 mg/d.
  • Importantly, these interactions disappeared when the 25-hydroxyvitamin D level was over 30 ng/mL (men) or 20 ng/mL (women).

So, while it can be argued that calcium is important for bone health, it pales in comparison to the effect of vitamin D, so much so that adequate (not even optimal) levels of vitamin D essentially protect against low calcium.

That’s not to say that you should deliberately deprive yourself of calcium while taking vitamin D just to see if it pans out.  Rather, a solid diet with good calcium sources combined with vitamin D supplementation (starting at 2,000 IU / day) is the best way to go.  Solid sources of dietary calcium include:

  • Spinach and kale
  • Okra
  • Collards
  • Soybeans
  • White beans
  • Some fish like sardines, salmon, perch, and rainbow trout
  • And there are foods that are calcium-fortified, such as soy milk, some orange juice, oatmeal, and breakfast cereal

You might notice the suspicious lack of dairy on the list.  If you’re a regular reader of the Rantings you’ll know that I’m not a fan of dairy.  Enough so that I compiled an eBook of research demonstrating that dairy is not the health food that we think it is that can be found by clicking here.

 

Take Doctor-Recommended Calcium? This Tip May Save Your Life

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Of all the supplements that my patients take, calcium supplementation for osteoporosis prevention is one of the most popular.  Many have been told to take calcium by their doctors.

In all my years of practice, I have not routinely recommended calcium supplementation. When I do, it is only for those who, either in our office or at a bone density testing center, have been diagnosed with severe osteoporosis. I would not recommend calcium to someone with osteopenia, and certainly not to anyone else who was worried about bone health.

I have however, been a strong advocate of vitamin D.  Among the many functions of vitamin D and the one that was known long before others were discovered, is to aid the absorption of calcium from the gastrointestinal tract.

Here’s the kicker.  The active form of vitamin D is the form that does all the important stuff like cancer prevention and balancing the immune system.  This is not the supplement form of vitamin D.  One of the strongest triggers for the body to convert the supplement / sunshine form of vitamin D into the active form is a dip in calcium levels in the bloodstream.

To put this in reverse, if you have plenty of dietary calcium (such as taking calcium supplements) your body has no need to produce the active, more potent form of vitamin D.  This means you may not get the best benefits from vitamin D.

Which includes the ability to protect the heart.  Which brings us to this particular study.  In it, researchers looked at 190 premenopausal and 182 postmenopausal women with cholesterol issues and gave them either 800 mg of calcium per day or a placebo for 2 years and checked them for a variety of heart disease risk factors.  Here’s what they found:

  1. Total cholesterol levels increased in the calcium supplementation group.
  2. Carotid intima media thickness, a measurement of how much plaque you have in the blood vessels of the neck, increased (not a good thing).

The research is very solid that, in someone who has a good dietary intake of calcium (not from dairy–sources like green leafy vegetables and nuts), calcium supplementation has no benefit on bone density and risk of osteoporosis.  This information is now years old, so if your doctor continues to recommend calcium supplementation and you don’t have osteoporosis, it’s time to find a new one that actually reads medical literature.

The results of this study just reaffirms that you should NOT be supplementing with calcium.  Save your money and spend it on vitamin D and broccoli instead.

 

Calcium and Heart Disease; What’s the Real Story?

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Sorry if I’m a little late on getting to this one, but I get to the studies as soon as I can.  When this study was released, there was quite a bit of hubub about calcium supplementation increasing the risk of heart disease.

In overview, this particular study found that, in men who took calcium supplements, there was a 20% increased risk of dying from cardiovascular causes. On the surface, this sounds a little scary and is vaguely reminiscent of the vitamin E and heart disease controversy, which I have reviewed in a previous blog post that can be read by clicking here.

It is likely that, as a result of this study, many doctors will tell their male (and possibly female) patients to stop taking calcium supplements. As is usually the case, this movement by physicians is likely to confuse patients and reinforce the mantra that what is “healthy” keeps changing. Here’s the problem…

We shouldn’t have been recommending calcium supplements anyway to our patients.

What?? According to the TUMS commercials, I need the extra calcium! And I need to wash down the calcium supplements with a tall glass of milk for healthy bones.

News flash: The research does NOT support the use of calcium supplements to lower your risk of fractures above and beyond what you will get from a good quality diet. This means that you probably should not have been taking calcium in the first place, making the results of this study moot. Just in case you think I’m crazy, here’s a few studies to back up this position. Note that some of these are older–this is not new information:

You get the point.

Ok. So calcium supplementation isn’t going to help your bones, but it’s not going to hurt, right? Wrong. An important transporter needed for healthy heart function requires both magnesium and calcium. With higher levels of calcium that are NOT backed up by comparable levels of magnesium (a very common mineral deficiency), heart rhythm problems may occur. Thus, the supplementation of lower quality forms of calcium that do not have good quality magnesium as well, could potentially lead to cardiac problems if the diet is magnesium deficient.

The bottom line?  Skip the calcium supplements.  Instead, opt for solid vitamin D supplementation and a good quality diet loaded with seeds and green leafies to make sure the calcium is there for your body to absorb.

ARE CALCIUM SUPPLEMENTS A WASTE?

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I have to say I have never really been a big fan of calcium supplementation.  Maybe if someone if far along the scale into osteoporosis, but almost never before this.  But this obviously flies in the face of standard recommendations for bone health.  Why?

For two reasons.  First, one of the functions of Vitamin D is to help the body absorb more calcium from the gut and our diet.  So, low calcium forces our body to active Vitamin D to its more potent form to suck up more calcium.  This will not only ensure we get the calcium we need, but will activate Vitamin D and allow us to get the best protection from this hormone.  But this means most of us need to supplement extra Vitamin D, which I DO recommend to almost everyone.  Usually starting around 2,000 iu / day and moving up from there.

Next reason.  We should be getting all the calcium we need from our diets.  This does NOT mean dairy, which is not the wonderful health food that the advertising of the dairy industry has led us to believe.  I mean really–name another mammal that contiues to drink milk after it is weaned?  And why cow’s milk?  Why not goat?  Donkey milk?  At what point did someone look at a calf nursing and say..”Hey!  That looks like it might be a good idea!”?

So, having strong Vitamin D levels coupled with a good quality diet with multiple broad sources of calcium (tofu, tahini, figs, soybeans, broccoli, kale, nuts, etc..) is the best way to go.  Funny–when you look up good sources of calcium on the net, the answers are loaded with dairy-related answers, and yet cows don’t drink milk…

This particular study finds that calcium supplementation, consistent with the above discussion, does not reduce fracture risk on top of a good quality diet unless someone had low calcium intake in the first place.  Which, of course, would not be happening in the aforementioned diet.

http://www.bmj.com/content/342/bmj.d1473.abstract