"Bone Up on Calcium: How to Strike the Calcium Balance for Stronger Bones and Better Health"

18 Nov

Are you getting the right amount of calcium for your needs? Did you know that both low and high levels of calcium can be associated with poor health outcomes like osteoporosis and calcification of arteries? Though still common practice, popping calcium supplements might be doing more harm than good. While getting your calcium levels right is important, there are many other factors to consider when it comes to bone health.

Calcium is the most abundant mineral in our bones and plays a critical role in many vital processes throughout the body. It's required by cells, nerves, muscles, heart, bones, teeth, and even in blood clotting.

When the body doesn't get enough calcium, several things can happen:

1. Bone Health Issues

Osteopenia and Osteoporosis: Calcium is essential for bone formation and maintenance. If intake is inadequate, bones can become weaker, more brittle, and more susceptible to fractures. Over time, this can lead to conditions like osteopenia (low bone density) and osteoporosis (severe bone thinning).
Bone Pain and Weakness: Low calcium can lead to general bone pain, tenderness, or weakness.

2. Muscle and Nerve Function

Muscle Cramps or Spasms: Calcium is involved in muscle contraction and relaxation. Insufficient calcium can lead to muscle cramps, spasms, or twitching, particularly in the legs and feet.
Nerve Impairment: Calcium is also vital for transmitting nerve impulses. Low calcium can lead to symptoms like numbness, tingling (often in the fingers, toes, or around the mouth), and even more serious neurological issues in extreme cases.

3. Increased Risk of Heart Issues

Irregular Heartbeats (Arrhythmia): Calcium helps regulate heart function by contributing to the electrical signaling that controls the heart's rhythm. A deficiency can lead to arrhythmias or irregular heartbeats.
Weakened Heart Function: Prolonged calcium deficiency can affect the muscle function of the heart, potentially leading to a weaker heart over time.

4. Hypocalcemia

Low Blood Calcium Levels: When the body doesn't get enough calcium, blood levels can drop, leading to a condition called hypocalcemia. Symptoms of hypocalcemia include fatigue, irritability, depression, confusion, and in severe cases, seizures.

5. Hormonal Imbalance

Increased Parathyroid Hormone (PTH): In response to low calcium, the parathyroid glands secrete more parathyroid hormone (PTH) to try to release calcium from the bones into the bloodstream. Over time, this can weaken bones and increase the risk of fractures.
Vitamin D Deficiency: Inadequate calcium intake may also affect the metabolism of vitamin D, which is essential for calcium absorption. This can further compound calcium deficiency. Conversely, low D status can affect calcium levels.

6. Impact on Other Body Systems

Dental Problems: Just like bones, your teeth rely on calcium to remain strong. A deficiency in calcium may lead to dental issues like cavities, gum disease, and tooth decay.
Hormonal Disruptions: Long-term calcium deficiency can impact the endocrine system and disrupt the normal function of hormones in the body.

7. Calcium Homeostasis and Compensation

The body tries to maintain calcium levels within a narrow range by drawing calcium from bones if blood calcium levels drop too low. While this compensatory mechanism helps in the short term, it weakens the bones over time, making them more fragile and susceptible to fractures.

Risk Factors for Calcium Deficiency

Poor Diet: Not consuming enough calcium-rich foods
Age: Older adults, especially postmenopausal women, are at higher risk due to decreased calcium absorption and changes in hormone levels.
Vitamin D Deficiency: Vitamin D is crucial for calcium absorption in the gut, so a deficiency in vitamin D can contribute to calcium deficiency.
Certain Health Conditions: Conditions like osteoporosis, celiac disease, thyroid conditions and kidney disease can interfere with calcium absorption or increase calcium loss.
Medications: Some medications, like corticosteroids, can interfere with calcium absorption or increase calcium loss from bones.
Genetic predisposition certain populations and genetic backgrounds need more calcium
Nutrient factors: inadequate magnesium, vitamin K, b12, iron, boron and more
Absorption issues: having other minerals and products containing tannins such as tea. The former compete for absorption in the same please and the latter blocks absorption.
Heavy metals and toxins: all too common these days, heavy metals and toxins interfere with nutrient absorption and cause inflammation and oxidative stress- both linked to poor bone health.

What Affects Calcium Levels in the Body?

Your calcium levels depend on many factors:

The amount of calcium you get from your diet
The efficiency of calcium absorption in your intestines
Phosphate levels in the body
Hormonal factors (like parathyroid hormone, estrogen, and calcitonin)
Genetics
More of the factors above

When calcium in the blood drops too low, the body takes calcium from the bones to restore normal blood levels. Conversely, if blood calcium levels rise too high, the excess is stored in the bones, soft tissues, stool, or excreted through urine.

What Are Normal Blood Calcium Levels?

Blood calcium levels can be measured through a blood test (often part of a Comprehensive Metabolic Panel). According to Dr. Jim Norman from the Norman Parathyroid Center, the typical range for healthy adults is between 9.3 and 9.9 mg/dL, with 90% falling between 9.5 and 9.8 mg/dL. Levels consistently above 10 mg/dL should be examined, as they could indicate conditions like hyperparathyroidism or even certain cancers.

Why Would You Need a Urine Calcium Test?

A 24-Hour Urine Calcium Test can help determine if excessive calcium is being excreted in your urine, which may indicate bone loss or other health issues. Most doctors can order this test, and it’s typically covered by insurance (check with your provider).

For the test, you’ll collect urine over a 24-hour period in a special container provided by your doctor. It's important to avoid calcium supplements, alcohol, and intense exercise for 48 hours before the test.

What’s a Normal Range for Urine Calcium?

A healthy range for calcium excretion is between 100 and 300 mg per 24 hours. For someone consuming 1,200 mg of calcium daily, your urine calcium levels should ideally be under 300 mg.

Excessive calcium in the urine (greater than 300 mg/24 hrs) can be a sign of several possible conditions:

Hyperparathyroidism: Overproduction of parathyroid hormone, often causing fatigue, bone pain, and muscle weakness.
Sarcoidosis: An inflammatory condition that affects various organs.
Excessive calcium intake: Known as Milk-alkali syndrome.
High Vitamin D levels
Certain medications (such as loop diuretics)
Chronic kidney disease or failure
Hyperthyroidism: An overactive thyroid
Renal tubular acidosis: Impaired kidney function
Malignancy or Multiple Myeloma
Testing error

High urine calcium can also signal bone loss, so it’s important to follow up with further tests if needed.

What Does Low Urine Calcium Mean?

If your 24-hour urine calcium levels are below 100-250 mg, this could indicate:

Poor absorption of nutrients
Kidney dysfunction
Hypoparathyroidism (low parathyroid hormone)
Low Vitamin D levels

Both blood and urine calcium tests are vital parts of any comprehensive health assessment. It’s crucial to discuss these results with your doctor to ensure you're taking the necessary steps for optimal health.

What should we be doing?

While blood and urine tests can be helpful, a DEXA scan or the newer technology called REMS scanner are the best ways to monitor your bone health. REMs scanners use sound waves to assess bone health without radiation. It goes beyond bone mineral density, measuring the internal structure for a more complete picture.

Exercise programme: Focus on high-impact activities like hopping, skipping rope and lunges, along with weight training. This stimulates the body to rebuild bone.

Supplements: It is best to stick with food as much as possible. Calcium supplements can help fill in the gaps if you're not getting enough from food, but it's important to take them under the guidance of a healthcare provider, as too much calcium can also cause health issues (like kidney stones, calcification in places you don’t want, exacerbation of bone issues, etc). Algae-based calcium supplements have shown to be absorbed relatively well in animal and human studies.

Vitamin D: Adequate vitamin D is necessary for calcium absorption, so making sure you get enough vitamin D (through sun exposure, foods, or supplements) is essential.

Dietary Intake: Ensuring an adequate intake of calcium-rich foods, such as dairy products (milk, cheese, yogurt), tinned small fish like sardines (with bones), leafy greens (steamed or lightly cooked can provide better absorption, but raw is ok too), legumes, sesame seeds, chia seeds, tofu, almonds, etc. A balanced diet rich in protein, vegetables, and healthy fats, as well as checking all of the nutrient boxes for minor nutrients like magnesium, vitamin K, collagen, etc is essential.

Assess Risk Factors: Carefully go through the other risk factors above and pick apart your individual bone health puzzle. This requires careful investigations. Functional nutrition sessions can help!

Calcium requirements

Age Group Calcium Requirements (mg/day)

Infants

0–6 months200 mg

7–12 months260 mg

Children

1–3 years700 mg

4–8 years1,000 mg

9–18 years (Boys & Girls)1,300 mg

Adults

19–50 years (Men & Women)1,000 mg

51–70 years (Men)1,000 mg

51–70 years (Women)1,200 mg

71+ years (Men & Women)1,200 mg

Pregnant & Breastfeeding Women

14–18 years1,300 mg

19–50 years1,000 mg

Older Adults

70+ years (Men)1,200 mg

70+ years (Women)1,200 mg

Being Proactive About Your Health

It's easy for health concerns to be overlooked, even by trusted doctors, which is why it’s important to advocate for yourself. Know which tests to request and ask the right questions. Understanding your results is key to taking appropriate action for your health.

Many people are told to simply "monitor" their condition, when in reality, more could and should be done. Navigating this on your own can be overwhelming, but you don’t have to do it alone.

Exciting new nutrigenomics testing can help identify what your unique calcium needs might be. If you would like support to assess your calcium or other nutrients needs or would like to explore nutrigenomics testing to asses your individual needs, get in touch.

In the meantime, enjoy these calcium-rich smoothie recipes. You can very lightly steam the greens for better absorption before blending, if you like.

Kale and Berry Bone Booster

Almond milk 200ml

either fortified or unfortified with a scoop of

algae-based calcium powder 240+ mg

Kale one cup. 177mg

Blueberries 50 mg 3 mg

Strawberries 50 mg 8 mg

Almond butter 1 tbsp 55mg

Dates x2 30 mg

Flaxseed 1tbsp 80 mg

593 total calcium

Sweet Greens Calcium Boost

1/2cup very lightly steamed

collard or spring greens 300mg

5 g chia seeds 90 mg

1 medium orange 80 mg

4 dried figs 55 mg

Water to taste

525 total calcium

Hannah Levine