Headlines, Natural Healing and Prevention with Dr. Joseph Russo — By on December 2, 2011 10:00 AM

What is Calcium?

Calcium is the most common mineral in the human body. Almost all the calcium that we have in our bodies is found in our bones and teeth. Only about 1% of this calcium is circulating in our blood and tissues and as such, levels need to be maintained in a very narrow range for optimal health.

The recommended intake for:
an adult 19 to 50 years is 1000 mg per day
For those 51 and older it is 1200 mg per day.

For children the requirements are:
1 to 3 years 500mg per day,
4 to 8 years 800mg per day,
9 to 13 years 1300 mg per day and
14 to 18 years 1300 mg per day.

As one can see, it is important to have adequate dietary calcium as a child and adolescent.

Why do we need calcium in our bodies and why is it important?

Clearly it is important for our structure, as it is the major element in our bones and teeth. It also plays a role in constriction and relaxation of blood vessels, along with nerve transmission and muscle function. Additionally, it is important for enzymatic reactions in our body.

Calcium is also an integral player on the team of bone health. Bones continue to add mass until age 30 in most persons, creating a time called “peak bone mass.” The stronger the bones are at age 30, the less bone loss will occur as a person ages. Therefore, it is important to maximize bone growth throughout childhood, adolescence and early adulthood. This can be accomplished by consuming adequate Calcium and Vitamin D during these periods and by maximizing bone mass by partaking in weight bearing exercises such as walking, running, yoga, dancing, aerobics, skating and weight training. This will help to prevent osteoporosis(fragile bones) later in life.

The relationship between calcium and osteopenia (weakening bones) and osteoporosis (weak bones) is direct. If calcium intake is chronically low, if vitamin D intake is chronically low, if calcium is poorly absorbed or if there is excess calcium secretion, then the body resorts to breaking down the calcium in the skeleton. This action predisposes the body’s bones to Osteopenia (low bone mass). If low calcium is not corrected, then osteopenia progresses to osteoporosis. Osteoporosis is a concern because it is associated with hip and other fractures. Each year about 5 million people suffer from fractures due to osteoporosis.

How do we obtain Calcium?

In the USA, dairy products such as milk, yogurt and cheese are the major sources of calcium in our diets. Additional natural food sources such as kale, broccoli, and spinach provide calcium, but at a decreased concentration, Also, many foods are fortified with calcium such as orange juice , soy beverages and cereals.

Here are some examples of good sources of calcium in various foods:
Yogurt plain 8oz – 415 mg
Milk whole 8oz – 291 mg
Orange Juice fortified 8oz – 200 to 260mg
Spinach ½ cup cooked – 120 mg
Soy milk fortified 8oz – 80 to 500 mg
Cheddar cheese 1 ½ oz – 306 mg

Calcium can also be obtained through commercial preparations. The two main forms of supplemental calcium are calcium carbonate and calcium citrate. Calcium carbonate is the most common supplemental form. It comes in various amounts with the most common being 250mg and 500mg. It also comes in 200mg and 300mg amounts as the brand name “Tums.” There are also combination forms of calcium partnered with Vitamin D, the most popular is “Os-Cal.” This combination is a convenient way to take both calcium and Vitamin D in one shot. When taking calcium supplements, it is suggested that one take no more than 500 mg at a time, with meals, in order to maximize absorption.

Can a person take too much calcium?

As with anything, too much can be a problem. The recommended dose for an adult age 19 to 51 is 1000 mg per day and the upper limit of tolerability for an adult is considered to be 2500 mg per day. I once had a patient who decided that they had some symptoms of low calcium. Without getting a blood test or consulting a doctor,they decided to begin calcium replacement therapy. This patient also decided that if 1000mg of calcium per day was good 3000mg were better. After about one month the patient’s symptoms had gotten progressively worse, not better. Ironically, her symptoms were mainly eye muscle twitching and tingling of the arm muscles. These symptoms are in line with those of elevated blood calcium rather then low blood calcium. Ultimately the patient came to the office and, after blood work was done, it was discovered that the patient’s calcium level was too high. Discontinuing the calcium supplement relieved the symptoms and eventually the calcium level returned to normal.

What sort of variables affect Calcium absorption?

Calcium absorption declines with age, alcohol consumption, and caffeine intake. However, caffeine has a minimal effect on Calcium absorption. It is suggested that one cup of brewed coffee causes a loss of only 2 to 3 mg of calcium. a loss which can be easily offset by adding a tablespoon of milk to the coffee.

Pregnancy makes calcium absorption more efficient. Therefore, the requirements are not increased in pregnant women. Additionally, Vitamin D helps improve calcium absorption.

How does one know if they have low calcium or resultant osteopenia or osteoporosis?

You can request that your doctor perform a serum calcium and/or an ionized calcium blood test. The serum calcium test can be ordered alone and is normally part of a larger group of blood tests call a “complete metabolic panel.” Many times this larger panel will be ordered during a routine annual physical. The normal range for serum calcium is 8.8 to 10.3 mg/dl.

You can check your bone density to see if you are osteopenic or osteoportic through various bone density tests. All of these bone density tests compare your bone density to that of a 30 year old male or female of optimal bone density. The resultant score is given as a “T” value. A “T”score of -1 and above indicates a normal bone density while a score of -1 to – 2.5 indicates osteopenia. A score below -2.5 indicates osteoporosis. These lower scores mainly occur in older adults and post menopausal women.

What are some of the symptoms of low calcium?

Most people with slightly low calcium have no symptoms. However, those with a more advanced calcium deficiency can experience numbness and tingling in fingers and toes, muscle cramps, convulsions, muscle spasms, muscle weakness, muscle pain, tiredness, confusion, decreased appetite, and heart palpitations.

In conclusion, as always, if you suspect that you have symptoms of low calcium ask your primary care doctor for a blood test. Provided that you don’t have a disorder in which you cannot absorb calcium well or one that causes you to lose calcium, a well balanced diet will provide you with all the calcium you should need on a daily basis. If you are considering a supplement, calcium carbonate is fine. The dose shouldn’t be more than 500mg at a time and it should be taken with a meal.

Until next time, fly low and avoid the radar.

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