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The Comprehensive Approach to Calcium
Q: Dear NEEDS Wellness Educator,
I am a 60-year-old woman that is active, playing tennis and swimming regularly. I have osteopenia (preosteoporosis) and was told to significantly increase my calcium intake by means of supplements as well as food. But, then I heard that too much calcium is dangerous and can cause atherosclerosis. I'm not sure who to listen to or what to do! I'm afraid of losing further bone density, which would impede my ability to participate in the activities I love. I'm so confused— what should I do?
A: Dear CP,
This is a timely question, especially in light of a recent New York Times article from June 1, 2016 about osteoporosis patients' uncertainties regarding the medications prescribed to them, due to the increased risk of serious bone shattering. The NEEDS newsletter reported this back in 2008, based on a letter to the editors of New England Journal of Medicine. Three physicians reported informal, patients' experience-based case studies on postmenopausal women who used bisphosphonates, such as Fosamax, on a long-term basis for osteoporosis. These doctors saw a correlation between long-term use of this type of medication, which is designed to prevent the breakdown of bone and an increased rate of a rare type of hip fracture that occurs in the absence of serious trauma. Patients who took bisphosphonates long-term also showed suppressed bone turnover in bone biopsy and fractures that did not heal well. Now eight years later, we are certain that these medications don't build strong, healthy bones, but ongoing reports of jaw bones rotting and thighbones breaking are finally deterring patients away from medication. Many are left wondering what they can do, especially if their doctor isn't familiar with dietary supplements and natural solutions.
Calcium has long been the primary recommendation for preventing osteoporosis, but we are now realizing that this approach is short-sighted. Newer studies have shown that excess calcium intake, particularly from supplements, can be deposited into arterial vessels if it isn't shuttled into bones sufficiently. This causes plaque to build up in vessel walls where the calcium is deposited and can lead to atherosclerosis. If the plaque breaks free, it can become lodged in a smaller vessel, block blood flow to a vital organ such as the heart, and cause a heart attack. Leading integrative doctors now realize that although calcium is important, it must be used in moderation and combined with other important nutrients for balance.
A better alternative to loading up on calcium is to balance calcium with vitamin D and vitamin K2, which direct calcium to the bones. You also want to take boron as well as other minerals to increase the density and hardness of bones.
Vitamin D has the important role of increasing the absorption of calcium from the GI into the blood, but we can't stop there. If we take too much calcium and vitamin D, the body could absorb more calcium than necessary and the flood of calcium in the blood could contribute to misguided vessel deposits. This is where vitamin K2 steps in. It is the essential balancing factor that directs the calcium from the blood to the bones, in order to prevent calcium deposits into arterial vessels. This is the role of K2 specifically, as K1 has a very different function—it supports healthy clotting. It's preferred to use K2 as MK4 or MK7, which have superior absorption. K2 is very safe and can be used at doses up to 500 mcg daily.
A surprising number of Americans are deficient in vitamin K2, in part because we don't eat a lot of the foods that contain it, such as fermented foods and grass fed animal products. Unlike most fat soluble nutrients, K2 is not stored in the body so we need to take it every day. It's true that vitamin K1 is converted to K2, and that K2 is synthesized in the gut, but neither of these functions provides adequate supplies of K2, so we must get it from our food or supplementation.
One product which fits the bill of being a balanced formula is Calcium Bone Maker from Doctor's Best. This formula contains 600 mg of calcium in the form of hydroxyapatite, 1800 IU of vitamin D3, 80 mcg of K2 (MK-7), 4 mg boron, and other beneficial minerals in 6 capsules. Another good option is Bone Restore from Life Extension, which offers 700 mg of bioavailable calcium, 200 mcg of MK-7, 3 mg boron, as well as other beneficial minerals in 4 capsules.
Recommending 1200 mg or more of calcium is an outdated practice, especially when other balancing nutrients are neglected. The newest approach to building healthy bone is to get a moderate dose of calcium— under 900 mg, combined with supportive nutrients to help enhance absorption into your bones and strengthen bone density. With this comprehensive approach, you should be able to maintain your active lifestyle and avoid the unwanted effects of an excessive amount of calcium. I hope this information has been beneficial and good luck in your endeavors!
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