Calcium and Osteoporosis

Category: Metabolic Bone Disease Published on Thursday, 21 February 2013 Written by Yong Tsai, MD


Remember when your mother told you to drink your milk and that it would make your bones strong? Well, she was right. Milk is an excellent source of calcium. And calcium is what our bones need to grow, to stay strong and to defeat osteoporosis.

The National Osteoporosis Foundation estimates that 25 million Americans, mostly women, have osteoporosis, which causes bones to become frail and more susceptible to fractures. In the United States alone, more than one million bone fractures, usually of the hip and spine, occur yearly.

There are two basic approaches to the prevention of osteoporosis. The first is to build as much bone as possible when you are young. And the second is to prevent bone loss as a mature adult. This can be done with the help of calcium and vitamin D.

Bones are formed by the production of soft protein, mostly collagen, which hardens upon the deposit of a mineral called calcium phosphate. Peak bone mass, which means the maximum density of bone that we develop is usually attained by the age of twenty. Our peak bone mass is determined by genetics, our calcium intake and our level of exercise.

To keep bones healthy and to prevent osteoporosis, adult women and men need 1000mg of calcium daily. Postmenopausal women on estrogen also need 1000mg of calcium daily, while those not taking estrogen need 1500mg daily. Children between the ages of one and ten need 800mg while young adults need 1200mg of calcium daily.

Calcium can be found in a variety of natural forms such as in milk and other dairy products. The average American diet, without dairy products, contains only about 500mg of calcium. For example, a cup of milk contains 300mg of calcium, a cup of yogurt 415mg, one ounce of cheddar cheese 200mg, three ounces of sardines 372mg and three ounces of salmon 167mg. Meat, vegetables, fruit and grains contain only small amounts of calcium. This is why the body benefits from a well-balanced diet. But, if it's simply not part of your lifestyle, there is an alternative: calcium supplements.

Many calcium supplements are available at your local pharmacy, in different doses and different forms: carbonate, phosphate, lactate, gluconate and citrate. All of these are a good source of calcium, but the actual amount of calcium they provide can be misleading.

Calcium carbonate is 40 percent elemental calcium. So, in 1000mg of calcium carbonate, there are only 400mg of actual calcium. Calcium phosphate is only 38.8 percent elemental calcium, calcium lactate 18.4 percent and calcium citrate 24.1. Also, the type of calcium you chose may have different directions. Calcium carbonate and calcium phosphate supplements should be taken with food to ensure proper absorption, while calcium citrate should be taken on an empty stomach. Therefore, when choosing a calcium supplement, it is recommended that you carefully read the label to determine the exact amount of actual calcium they contain and how to take them.

Most individuals tolerate calcium supplements very well.  However, some people develop constipation, intestinal gas or kidney stones.  Because some, but not all kidney stones contain calcium, it is reasonable to worry that if you increase your calcium intake, you may increase your risk of developing a kidney stone.  However, people mostly develop kidney stones because of infection, structural abnormalities or functional problems within the kidney.  If you have a kidney stone, your doctor can have it analyzed to see if it contains calcium.  It is important to realize that there are many causes for kidney stones and most have little or nothing to do with the amount of calcium in your diet.

To help avoid these side effects, drink a full glass of water when taking calcium supplements and take smaller doses several times a day. This will improve its absorption and reduce your chance of constipation. Never take more than 600 mg of elemental calcium at one time. And take calcium carbonate and phosphate with food to ensure its absorption and take calcium citrate on an empty stomach.

Another important vitamin is vitamin D, often called the sunshine vitamin. It is produced by our body’s cholesterol when we are exposed to at least fifteen minutes of direct sunlight. Vitamin D helps our bones stay strong by increasing the absorption of calcium in our intestine. Unfortunately, only a few foods contain natural vitamin D: liver, fish, and egg yolks. Vitamin D can also be found in fortified milk and some multivitamins.

Research has shown that vitamin D reduces the risk of hip fracture in mature adults. The recommended dietary allowance for vitamin D is 400 units for adult and 800 units for mature adults because aged skin loses some of its ability to make vitamin D from exposure to sunlight. So take your vitamin D and help your bones, but make sure to take it correctly as too much vitamin D can be dangerous and can cause nausea, vomiting and even seizures.

Help your bones stay in shape. If you can, drink enough of milk or other dairy products for their calcium and get at least fifteen minutes of sun a day for vitamin D. If not, take calcium and vitamin D supplements, the right way and right amount. It’ll do your body good!

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