Calcium + D3

[Muse]

I was in Costco today and looking over their offerings. Got into a conversation with an older Asian woman who was skeptical about what they had. She thinks the chemical supplements (e.g. Calcium + D3) are harder for the body to assimilate. She feels that they stress your organs more than natural sources. I think she mentioned the liver. She said she used to get a calcium supplement from CVS that was made from sea shells or something, i.e. a natural source but that they now have ingredients that she regards with great suspicion. She said something about an oil (her English wasn't good, I didn't find it easy to understand everything she said).

My doctor thinks I should certainly take a calcium supplement. I actually maybe don't need it as much as other folks because I buy and consume a lot of nonfat dry milk (cook with it, reconstitute, etc.). He thinks I should take a supplement anyway.

Well, I'm wondering if the cheapie Kirkland Calcium 600mg + D3 I brought home with me is a keeper or if I should return it when I return in two weeks. What do you think?

 

[Muse]

This site is making a case that it's not that big a deal, the difference between natural sourced and chemical for minerals (vitamins too), in particular for calcium, although there's some argument that for some, calcium citrate is more easily absorbed than calcium carbonate (which is what I bought today), particularly if taken between meals. I always take my supplements with a meal. I suppose I shouldn't worry about it.

That woman was somewhat agitated about it all. Her basket was filled with organics, which is fine, I usually get them too. But I think her level of information and understanding wasn't too great.

 

[turtile]

Nutrients need to be well balanced for absorption. Magnesium is vital for Calcium and Vitamin D. Most people don't get enough magnesium in their diet. Chelated(citrate, malate, amino acid) nutrients will absorb much better than non-chelated (oxides, carbonates).

Did you have a blood test that shows you are low in calcium? Taking extra calcium when you don't need it is unhealthy.

 

[mike8675309]

Calcium supplements are currently not recommend by most medical organizations. This due to randomized control studies that have shown calcium supplementation has limited benefit on bone health but increases risk for heart attack and stroke.
Thus the goal is to get your calcium from nature.

From this Video (which references many studies):
http://nutritionfacts.org/video/are-calcium-supplements-effective/

If a thousand people took calcium supplements for five years, we would expect 14 excess heart attacks, meaning 14 people would have a heart attack that would not have had a heart attack if they hadn’t started the calcium supplements. So, they were effectively going to the store and buying something that gave them a heart attack, plus ten strokes that otherwise would not have happened, and 13 deaths—people who would have been alive had they not started the supplements. But, that’s all balanced against the 26 fractures that would have been prevented.

 

[Muse]

Nutrients need to be well balanced for absorption. Magnesium is vital for Calcium and Vitamin D. Most people don't get enough magnesium in their diet. Chelated(citrate, malate, amino acid) nutrients will absorb much better than non-chelated (oxides, carbonates).

Did you have a blood test that shows you are low in calcium? Taking extra calcium when you don't need it is unhealthy.

About 2002 a blood test revealed that I had elevated calcium in my blood, 10.7 and the high norm was 10.3. Further testing revealed I had elevated parathyroid hormone (this caused calcium to be leached out of my bones which accounts for the excess calcium in my blood) and I soon had a procedure which removed one of my four parathyroid glands, the faulty one which was over-producing parathyroid hormone. I'm told that a person only needs one such gland and that removal of one is not a concern, the others soon adjust and hormone balance ensues.

At the time, the doctor who did the procedure said I should immediately start taking calcium supplementation, he recommended Citrical IIRC. I asked him how long I should take it and he said at my age (I was about 60 then), I should just keep taking it indefinitely. It wasn't that I would continue to have a calcium deficiency (the elevated parathyroid hormone had had the effect of leaching some of the calcium out of my bones, so taking calcium supplements was recommended to counteract that... presumably in 6 months or a year my bones would be OK again). Anyway, after a certain age, evidently calcium supplementation is thought to be a good idea to ensure strong bones. Indeed, I took a fall skating the other day (was distracted and didn't spot some rocks on the road) and didn't break any bones, in particular my hip! I'm sore, but nowhere near as sore as if I'd broken any bones!

Now, I emailed my PCP 3 months ago asking him about my calcium supplementation. I was wondering if I was elevating my chances of getting kidney stones. I've never had any, but the prospect is scary. He said I should continue to take Calcium.

You have me thinking I should bring back that CaCO3 to Costco and exchange it for the Calcium Citrate with magnesium, etc. when I next go there in 10 days. I gave up the Citrical long ago, figured that cheaper products were probably equivalent. I may have been wrong. Perhaps the 9.99 Calcium Citrate + other minerals at Costco is adequate. Or maybe I shouldn't take any calcium specific supplementation. I take a multi-vitamin etc. tablet daily, and I consume quite a bit of milk (nonfat dry milk). Anyway, I don't think I'm much risk for stroke (excellent blood pressure), and I think my cardiovascular fitness is pretty decent.

http://nutritionfacts.org/video/are-calcium-supplements-effective/

Interesting video. Maybe my doctor is wrong and I shouldn't take any CA supplements. Well, the doctor in 2002 who did my parathyroidectomy said I should continue to take them too. Maybe they're both wrong.

- - - -
To fear death, my friends, is only to think ourselves wise, without being wise: for it is to think that we know what we do not know. For anything that men can tell, death may be the greatest good that can happen to them: but they fear it as if they knew quite well that it was the greatest of evils. And what is this but that shameful ignorance of thinking that we know what we do not know? - Socrates

 

[Ancalagon44]

I don't feel that the current recommended daily calcium intake is really required. The reason for this, is the way that they arrived at the recommendation. They examined a few thousand people, inferred their calcium intake from their reported dairy intake, and then looked for a correlation between calcium intake and broken bones. However, I think the chance of broken bones occurring is correlated to more than just calcium - it is also correlated with vitamin D, magnesium intake, body weight and exercise level. Not all studies are conclusive about calcium in terms of its impact on bones breaking or not breaking.

Anyway, the takeaway from this is that while I agree calcium is necessary and healthy for bones, I don't think we need 1000mg of it per day. However, your case might be a little different because you have had a parathyroid organ removed.

If I were you, I'd get as much sunshine as I could in summer (for vitamin D), eat a healthy amount of dairy every day (especially aged cheese and yogurt), and be sure to eat plenty of leafy greens (for magnesium). In winter, supplement with vitamin D as needed. No difference between vitamin D3 in supplement form and what your body produces.

 

[Muse]

If I can believe what I've heard, my lacking one of four parathyroid glands (14 years on) should have no impact on my health. My most recent blood calcium level was 9.4, right in the middle of the acceptable range of 8.5 - 10.3 mg/dL, that was 2012. Maybe I'll cut back on my calcium supplementation, not daily, just a couple days/week.

- - - -
Wisdom begins in wonder. - Socrates

 

[turtile]

Most doctors don't seem to keep up with current research so you can't always trust what they say. Calcium actually is thought to lower the risk of stones since it can form with oxalic acid earlier in the process and will leave as waste.

 

[mike8675309]

Interesting video. Maybe my doctor is wrong and I shouldn't take any CA supplements. Well, the doctor in 2002 who did my parathyroidectomy said I should continue to take them too. Maybe they're both wrong.

At the video site it includes citations for the studies used in creating it. Take a look at those studies and pick one or two to talk to your doctor about. Ask them to justify the calcium supplementation in light of recent findings. If they are not willing to take a look and talk to you about it, it may be time to find a different doctor.

Here is a good one that has full text avaialble without subscription
Calcium supplements and cardiovascular risk: 5 years on
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4125316/

Calcium supplements have been widely used by older men and women. However, in little more than a decade, authoritative recommendations have changed from encouraging the widespread use of calcium supplements to stating that they should not be used for primary prevention of fractures. This substantial shift in recommendations has occurred as a result of accumulated evidence of marginal antifracture efficacy, and important adverse effects from large randomized controlled trials of calcium or coadministered calcium and vitamin D supplements. In this review, we discuss this evidence, with a particular focus on increased cardiovascular risk with calcium supplements, which we first described 5 years ago.

And this one:
http://annals.org/aim/article/16558...e-services-task-force-recommendations-calcium
To Supplement or Not to Supplement: The U.S. Preventive Services Task Force Recommendations on Calcium and Vitamin D

For this group, the Task Force says that evidence is insufficient to assess the effects of daily supplementation with greater than 400 IU of vitamin D3 and greater than 1000 mg of calcium. The Task Force’s unambiguous conclusion: Supplementation at or below those levels does not prevent fractures. Because supplementation at or below 400 IU of vitamin D3 and 1000 mg of calcium seems to convey a slightly increased risk for renal stones, the USPSTF recommendation for postmenopausal women is also unambiguous: “do not supplement.”

 

[Muse]

Thanks, I'll run some info by my PCP. He seems to be a very busy guy but he's incredibly personable and smiley. Should be interesting. Meantime, I'll hold off on supplementation and return my 600mg +D3 Calcium to Costco!

 

[TheVrolok]

Thanks, I'll run some info by my PCP. He seems to be a very busy guy but he's incredibly personable and smiley. Should be interesting. Meantime, I'll hold off on supplementation and return my 600mg +D3 Calcium to Costco!

Any history of osteopenia or osteoporosis?

 

[Muse]

Any history of osteopenia or osteoporosis?

Just my hyperparathyroidism (you have obviously not read the thread), corrected by extraction of the hyper gland ~2002. Presumably a non-issue now, but I am 73 and quite active. Most concerning is that I roller-skate the streets of Berkeley, CA, and they are by and large ill-paved, and all manner of rubble and whatnot is on the streets, at least in places. It only takes one stone to throw you to the ground unceremoniously. I fell less than 3 weeks ago and am still recovering from the badly bruised buttocks/hamstring area, likely pulled the hamstring. I could easily have broken my hip in that fall if my bones weren't sufficiently stout.

Arguably a bigger concern would be my eyes. Sharper eyes pick up debris on the streets better than mine, which are compromised by cataracts. My HMO won't help with them because they aren't bad enough. I'll give them a piece of my mind next time I have an eye exam but am not confident it will change their determinations.

 

[mike8675309]

As a roller-skater you should be able to claim the cataracts are a risk for your more injuries and thus it will be likely more cheaper for them to fix your cataracts than deal with all the broken bones.

 

[Muse]

As a roller-skater you should be able to claim the cataracts are a risk for your more injuries and thus it will be likely more cheaper for them to fix your cataracts than deal with all the broken bones.

That, my friend, is exactly what I am going to say. Will it fly with Kaiser Permanente? Don't know. I'm thinking that an eye doctor may elect to stick to their parameters but my PCP is pretty personable and may have some say in the matter. I'm due to see him, just have to make an appointment. Should maybe see an ophthalmologist first.

 

[TheVrolok]

Just my hyperparathyroidism (you have obviously not read the thread), corrected by extraction of the hyper gland ~2002. Presumably a non-issue now, but I am 73 and quite active. Most concerning is that I roller-skate the streets of Berkeley, CA, and they are by and large ill-paved, and all manner of rubble and whatnot is on the streets, at least in places. It only takes one stone to throw you to the ground unceremoniously. I fell less than 3 weeks ago and am still recovering from the badly bruised buttocks/hamstring area, likely pulled the hamstring. I could easily have broken my hip in that fall if my bones weren't sufficiently stout.

Arguably a bigger concern would be my eyes. Sharper eyes pick up debris on the streets better than mine, which are compromised by cataracts. My HMO won't help with them because they aren't bad enough. I'll give them a piece of my mind next time I have an eye exam but am not confident it will change their determinations.

I certainly did, although the challenge seems bizarrely antagonistic. However, you didn't mention not having any history of such and it would alter the discussion making a potential error of omission important. Additionally, you mentioned your hyperparsthyroidism leaching calcium from your bones and I was wondering if that was qualitative based on physiology or quantitative based on imaging. Thus the question.

I take for granted that your surgical correction was successful and at that point unless you are part of a group at high risk for osteoporosis or vitamin D deficiency there would be no recommendation for either daily calcium or vitamin D supplementation.

I'd save the money.