Calcium, Kidney Stones, HCTZ, Vitamin D, stress and kinesiology!

Hi everyone,

I am 60 yrs. old, 105 lbs., just under 5’4”, on 35 mg. weekly actonel with most recent bone density results (1/08): spine -3.8, total hip -2.4 (femoral neck -2.7) and total forearm -2.1. My situation is:

1. After blood tests and 24-hr. calcium urine tests this spring, my endocrinologist reduced my calcium from 1400 to 800 mg (too much calcium in the urine) and increased Vitamin D from 600 to 1200 mg. (Vitamin D a little low).

2. Subsequent unrelated back x-rays showed “tiny calcifications… to the right of the L1-L2 level… may represent small renal calculi.” Back doctor said be careful about kidney stones.

3. Told endocrinologist who had me repeat 24-hr. calcium urine test.

4. Results show excreting more calcium now on 800 mg. per day than when I was on 1400 mg!

5. Endocrinologist is not sure if I am ingesting too much calcium or not holding it in my system. Note - I have improved my diet substantially in recent months.

6. She wants me to stay on same calcium dose and go on HCTZ to keep calcium in kidneys so it will be absorbed. She says I may be on this for a long time, and that it would help reduce chance of kidney stones (which happen when calcium is passed in urine as opposed to when it stays in the kidneys and gets absorbed) and also increase my bone density.

7. She says I need to repeat 24-hr. urine calcium test in a month as well as get a blood test to see if HCTZ is having negative effects on sodium and other levels.

8. Side note – to save money I have been taking a generic version of Caltrate 600+D (main ingredient calcium carbonate), USP tested and verified. I have a huge recently opened bottle. Previously I was taking brand name Caltrate.

Before going on HCTZ, should I:

1. Add up the average mg of calcium I intake in food each day to see if I am taking in too much? The problem is I am not sure how much of what I take in from either food or supplements actually gets absorbed.

2.Try a better grade of calcium (not generic) or a different type (not carbonate) and repeat the urine test? If so, how long should I take the new calcium before repeating test? Could I alternate taking new calcium with calcium I already have? (I don’t want to throw it out.)

Also, what is your experience with HCTZ, e.g., effectiveness, side effects, length of time on medication, associated tests to monitor, and cost? Is there a generic HCTZ?

I have a very busy, stressful life on a number of fronts and limited financial resources. I would rather not spend time and money on prescriptions, tests and appointments if I don’t have to. I also don’t want to go on another medication in addition to the actonel unless I really need to.

Thank you so much for any help you can offer.

Uma

P.S.
1. I am taking 1200 mg Vitamin D (400 mg in calcium pill, 400 mg in multi-vitamin as well as 400 mg Vitamin D3 in a separate pill). Sound OK? My endocrinologist said any kind of Vitamin D is fine.

2. Does stress affect calcium absorption from food and supplements? Does it affect bone depletion?

3. Does anyone have experience with muscle testing (kinesiology) as a way to determine which calcium to take and how much?

Thanks again. I would really appreciate hearing from you!