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Calcium--should we take up to 1200mg?

nathji
0 Recommendations

Almost everywhere we have been told that 1200mg of calcium is a must for all adults especially with advancing age.

However the Harvard study given below seems to indicate that people with much less intakes of calcium have been on par with those who took the large recommended doses. As a matter of fact there is less osteoporosis in regions of the world where calcium intake is low.

The fact that the Harvard School of Public Health has put across this research should surely cause us to pause and think on the subject. I give below the link, which many may already be aware of:

http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/calcium-ful l-story/index.html#bottom-line

I suppose different people will react differently to calcium intakes-- and no one will risk going below the recommended values of 1200 mg.

I wish to invite members to give their personal experiences on such a vital topic, which could even be more important than the best of research.

Explore topics in this discussion:

Exercise Cancer Surgery Forteo Alli Prostate cancer Osteopenia Hyperparathyroidism Anorexia Osteoporosis

20 replies

nathji

Dear Texastex,

Thank you so much for your kind reply. I shall be going to the sites you have mentioned and then shall come back. This is a brief note just to thank you for sending the information which will be of great use to us all.

Yours,
Priya
(nathji)

nathji

Dear Windblown,

Learning of your experience is indeed quite sad and disheartening to those of us who think we have been doing everything right all our lives -- and then find ourselves stricken by some disease which ought not to have come.

You are right there are other factors at work of which medical science is perhaps not aware as yet. Only the years ahead will tell and the future generations will know.

Thank you for the informative note, it is the truth.

Yours,
Priya

texastex20002001

Nathjii,

I have found this information from another group which I belong to. A new book which has come out recently about osteoporosis. The title is: The Whole Body Approach to Osteoporosis. Here are two websites which will give you more information. www.demccormicksblog.com
www.mccormickdc.com

I have read some parts of his blog and to me the information makes a lot of sense. Let me know what you think about it.

Josie

nathji

Dear rmchavin,

Thank you for your very learned and profound reply on calcium intake. I believe you are right-- because I recall reading that the Chinese who have a low Calcium intake of about 500 mg per day and a deficient diet had high osteoporotic fracture rates. They were given calicum supplements subsequently.

As regards calcium citrate maleate ( which is fairly nearly the same thing as calcium citrate) it is considered superior to calcium carbonate as several sites show, one of which is from the reliable source of medscape news.

http://www.medscape.com/viewarticle/412220

Thanks a lot,
Yours,
Priya

rmchavin

Dear nathji:

I'm not an expert on calcium maleate citrate and its advantages over calcium carbonate. I do know that the most trusted, successful mail order vitamin pill sellers (such as Puritan's Pride) still sell more calcium pills and calcium plus vitamin D pills as calcium carbonate than as calcium citrate, which I assume is calcium maleate citrate? (If calcium citrate and calcium maleate citrate are not the same thing, then Puritan's Pride does not sell calcium maleate citrate). I'm not even sure that forcing our blood to carry more calcium is necessarily an advantage. Anyhow, perhaps you could start a new discussion on this subject and provide one or more web addresses we can study. My real reason for replying again is that I need to modify my advice on calcium and dairy products. I said earlier, "It's a big mistake to advise people you care about to get more calcium because the vast majority of them will go out and buy dairy products and ruin their bone health. The correct advice to give to people you love is, get all your calcium from vegetables, fruits, soy, and flax and avoid dairy products completely except on very special occassions." I need to modify that slightly by saying that this advice applies only to the vast majority of people living in the U.S., Canada, Australia, Europe, Japan, and other wealthy nations. It does not apply to people who are malnourished. Malnourished people include people with anorexia nervosa or "vegetarians" living in the Third World (or in the U.S.) who don't eat enough vegetables or fruits and are so poor that they can only afford to eat grains (such as rice or wheat) and not much of anything else. Malnourished vegetarians tend to be deficient in protein and/or calcium and would benefit very greatly from swallowing one calcium pill per day, adding soy protein to their diet, eating more fruits and vegetables, or consuming dairy protein and dairy calcium. The people with the best bone health are vegetarians and almost-vegetarians who eat plenty of fruits and vegetables and are not deficient in protein or calcium. However, in the following 3 scientific studies, malnourished vegetarians/vegans had even worse bone health than excessive meat eaters! http://www.ncbi.nlm.nih.gov/pubmed/18304358 http://www.ncbi.nlm.nih.gov/pubmed/17299475 http://journals.cambridge.org/action/displayAbstract;jsessionid=C63F86284A4 79012EE716C265E423D7C.tomcat1?fromPage=online&aid=1874088 My advice to malnourished vegetarians living in the wealthy nations is to make sure that you get enough protein, calcium, and vitamin D. Swallow one calcium pill every day just in case you are not getting enough calcium from your vegetables and fruits. To make certain that you're getting enough protein, add edamame, soy milk, soy burgers, soy dogs, natto, or tempeh to your diet for the soy protein. Or go ahead and eat one egg per day or drink one cup of nonfat milk per day or eat some high-fat fish every day for the animal protein. Although well-nourished vegetarians and well-nourished almost-vegetarians have the best bone health, malnourished vegetarians deficient in protein or calcium will have even worse bone health than excessive meat eaters!

BobWallace

Alli,
I take most of the mentioned minerals in Swanson bone essentials including silica. Not mentioned was potassium citrate which has been proven to increase bone density 1% in a year. I take extra zinc, K1 and K2, vitamin D3 which I take for a heart condition as well. The beta sitosterol and ipriflavone are also supplemental..

Alli

BobWallace.. u mentioned all the good nutrients such as zinc copper etc do you take them separate or together as a bone builder. Was wondering what your opinion was on algae calcium it is quiet expensive but I am thinking it is better to go the route that you are going with snergy ... as far as i know calcium cannot build bone but needs all the rest as in what you named to help along they all work together!!

nornd

Thankyou rmchavin for your excellent summation of the calcium issue. Most people still associate the treatment of osteoporosis with drinking milk, eating dairy products, as well as taking extra calcium. I am partly vegetarian (eat fish and no meat) and keep away from dairy products. I try to eat calcium-rich vegetables, soy milk, and other foods, and supplement with about 5-600mg of extra calcium. I also take 2000iu of Vit D, plus Vit K and strontium. Here's hoping there's an improvemnt at the end of the year when I have a DEXA.

nornd

Hi wellsoul, I too take Bone Strength made by NOW, but I take less than the stated dose as I trust I am getting at least 5 or 600mg of calcium from my diet. The calcium in this supplement is calcium hydroxyapartite (MCHA), which I haven't heard about in the discussions on this site. Does anyone know anything about it?

windblown

Hi Priya: I'm like Jeffer, I started taking Calcium, D, multiple vitamins and many others from a early age because my mother was a real advocate of vitamins. Even though I've taken all of these since I was about 8-10 years old to the present it didn't prevent osteo for me. Calcium and D along with other bone vits are good, but for some and maybe many it's not the be all for bone health, but still very important. It would be really nice if it were, but I remember talking to my Dr about having been diligent in vitamin intake for over 45 years, and she said: "Well we never said that calcium and D alone will prevent osteoporosis." I was also a very active child with sports and dance which continued until I had my first back surgery so I wasn't lacking in weight bearing exercise either. I think my biggest problem is heredity and early meno and the loss of estrogen at such a young age.

Unfortunately we *can* do all the right things and still have this problem.

Good luck with your D and Calcium...

Pam

WellSoul

I'm surprised to see folks recommending calcium carbonate. I remember reading many years ago that it is an inferior form of calcium supplement. Also, in Dr. Tori Hudson's article on osteoporosis she says:

"If using calcium citrate or citrate with malate, comparable doses may be anywhere from 20 percent less to one-fourth the dose of calcium carbonate that is required. The variation may be influenced by the individual's digestion and intestinal absorption. I estimate and prescribe less calcium citrate than the recommendations for carbonate." (http://www.vitanica.com/articles_09.htm)

I began taking whole food vitamins years ago and found that I needed to take less for the same effect. I had been taking New Chapter's Calcium Magnesium until I recently switched to their new Bone Strength supplement that includes Vitamin D & K. For exercise I walk and do Pilates, yoga and qi gong. I knew that I would likely get osteoporosis as my grandmother had it and my mother who has it just suffered a severe spinal compression fracture.

Jeffer

Thanks for the links rm.

I agree Priya...I will end up with forteo or bisphosphonates along with increased Vit D.

My tests are not yet in, but I suspect that, in my case, especially since I am slender, the issue is rooted in my hormone levels (testosterone and estrogen).

nathji

Dear Jeffer,

It does become somewhat of a mystery as to why your taking large calcium, exercise possibly adequate Vit D should have got osteoporosis. Have you checked for hyperparathyroidism? This causes high calcium levels as well,-- despite low calcium intakes,-- because the calcium in the blood is being leached from the bones.

It is a tragedy though when you have done everything right and still something goes wrong. I suppose osteoporosis still has many unanswered questions and nobody knows for certain why and how it happens.

I hope high doses of Vit D solve the problem -- though I believe the doctors will absolutely insist on a biophosphonate or Forteo when they see the T score of -4.1.

I wish you all the best,
Yours,
Priya

Jeffer

Nathji,

I do walk quite frequently, especially in the last 10 years. Unfortunately, that didn't prevent my getting osteoporosis.


Rmchavin,

Thanks for the website references, which reinforce my thoughts about increasing my vitamin D intake. Also, your information about calcium from milk does make me wonder about that for myself, since in my case, at least 700-800 of my daily calcium intake is from skim milk (the rest is from supplements, vegetables, etc.). I know the milk industry has always touted the benefits of calcium from milk, but that doesn't mean they are wrong though. When I skimmed the articles you posted, I didn't see anything about avoiding dairy products. Is the somewhere else you can point me? In my case, I hate to give up skim milk (although I might cut down a bit).

nathji

Dear rmchavin,

How right you are about the Harvard article -- while they state that 1200mg is not necessary they dont tell us how much to take.

I am deeply impressed by your knowledge and I think I will follow the regimen of calcium intake that you have chosen. Is it all right if I substitute Calcium Maleate Citrate (CCM) elemental Ca = 250mg for calcium carbonate tablets? They say smaller doses of these are better absorbed than the calicum carbonate and that CCM is more helpful for the bones. Also they say that there is more chance of stone formation with the carbonate.

The Harvard study was against too much supplements and like in the first alternative that you gave, spoke only of getting calcium from natural sources other than milk.

It is indeed such a tragedy about milk, the more so here in India where they dont even bother to fortify it with Vit D as in the US.

The other disadvantage of milk, is the cholesterol content . I believe even fat free milk has cholesterol.

I shall be going to the websites that you have so painstakingly given.

Thanking you so much for your help. It is so nice to know that you are out there on NOF, whenever we need your expert advice.

Yours,
Priya
(nathji)

rmchavin

Dear nathji:

Thank you for that excellent article on calcium by the Harvard School of Public Health. The only criticism I have of that excellent article is that they did not courageously recommend a specific number of milligrams for daily calcium intake. Anyhow, on the difficult and controversial question of how much calcium is too much and how much calcium is not enough, I can only advise people to go by what we know for certain and not by educated guesses or theories. Here's what we know for certain: People who get 1000mg of calcium per day from vegetables, fruits, soy, and/or flax have much, much better bone health than people who get 1000mg of calcium per day from milk. Also, people who get 1000mg of calcium every day from pills(calcium carbonate) have bone health somewhere inbetween those two groups. Finally, people who get 400mg of calcium per day from vegetables plus 600mg of calcium per day from a calcium carbonate pill will have relatively good bone health but not as good as the people getting 1000mg of calcium per day from vegetables. Therefore, it's a big mistake to advise people you care about to get more calcium because the vast majority of them will go out and buy dairy products and ruin their bone health. The correct advice to give the people you love is: "Get all your calcium from vegetables, fruits, soy, and flax and avoid dairy products completely except on very special occasions." One of the biggest problems with getting calcium from a small amount (about one cup) of milk every day is that the U.S. dairy industry is evil to people who only want to drink a small amount of milk daily. The best-tasting milk comes in plastic containers and those are only provided for the one gallon(16 cup) and half-gallon(8 cup) sizes. The quart(4 cup) size and pint(2 cup) size of milk only comes in paper containers. The milk inside paper containers doesn't taste as good as the milk inside plastic containers, partly because the milk inside paper containers will spoil sooner and partly because the glue used to seal the paper containers gets into the milk to make it taste bitter. So I've decided to completely do without cow's milk and dairy products except on very special occasions. I now swallow one calcium carbonate pill every day containing 600mg of calcium. I get about 400mg of calcium every day from vegetables, fruits, soy(edamame), and flaxmeal(boiling water added). I've bookmarked the following 3 web addresses on the difficult and controversial question of calcium intake: http://jn.nutrition.org/cgi/content/full/127/9/1782 http://www.ajcn.org/cgi/content/full/77/2/504 http://lpi.oregonstate.edu/infocenter/minerals/calcium/

nathji

Dear Jeffer,

I wholeheartedly agree with you,and your decision to increase may be very wise. It appears that the calcium you took was not absorbed into the bones maybe because of Vit D deficiency, and if you took added Vit D the calcium may be better absorbed and the T scores improve.

Please see this very good site on Vit D:

http://www.vitamindcouncil.org/newsletter/2008-april.shtml

Also, I hope you had been exercising and walking a lot. It was the walking that saved me because my intake of calcium was just like yours 1200mg or more per day , but I got only osteopenia.

My Vit D was practically nothing as I sat inside the house and rarely went out in the sunshine-- all my walks were in the late evenings after work. So now I am taking Vit D supplements to help my muscle fatigue and also osteopenia. I am taking 60,000 IU per week at present-- which divides into daily doses of 60,000/7 ==9500 IU per day. I am feeling stronger but havent had any bone density tests done yet.

Best wishes,

Yours,
Priya

Jeffer

Thanks for posting this Nathji.

In my case, I have had an intake of calcium above 1200 mg (generally in the range of 1200-1300 mg/day) for the past 20 years. I am 57 now and have recently been diagnosed with a osteoporosis (-4.1 spine). My high calcium intake did not help prevent osteoporosis at all.

Given the risks (advanced prostate cancer) and the lack of impact for me (20 years), I definitely will not be increasing calcium intake. In fact, now that I am a bit more educated, I am considering lowering my daily calcium intake a little.

I will be increasing Vitamin D and Vitamin K intake though.

BobWallace

I would not take less than 1200 mg of calcium for your body will not absorb more than it can use but the obvious is that it takes more than calcium and vitamin D to built bones. I take copper, boron, magnesium, zinc manganese, soy isoflavones, ipriflavone, beta sitorsterol and particularly vitamin K1 and K2.

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