The Calcium Controversy

Calcium is a vital mineral to the entire body, make no bones about it (er...). The musculoskeletal and nervous systems require calcium for basic functioning as do the vasculature and endocrine system for proper hormone and enzyme release. Blood calcium levels are tightly regulated by releasing calcium from the bones in order to maintain a constant concentration. Bone is constantly remodeling itself giving up calcium and redepositing it to form new bone. As we grow older, the balance of bone deposition shifts. Postmenopausal women often experience this shift more dramatically as estrogen levels decrease; bone breakdown exceeds formation resulting in bone loss, increasing the risk of osteoporosis.

Often when one thinks of bone health, calcium supplementation is suggested. This recommendation has received a lot of flak over the years due to its incomplete approach to bone health and possible risks. Indeed calcium makes up a large part of the bone matrix, but so do other minerals including potassium, boron, silica, phosphorus, and many others. Bone formation requires not only calcium but also Vitamins D and K as well as proper hormone balance. We’ve known for many years that calcium supplementation, when given alone, has been linked to an increase in the risk of heart attack.[i]

A recent study[ii] in Germany took the research even further by comparing dietary calcium and supplementation. Results suggest that dietary calcium reduces risk for heart attack by 31% while
supplementation of the mineral actually increases the risk by 86%. Taken in supplement form, calcium increases rapidly in the blood, likely causing calcification (hard deposits) of the arteries which leads to cardiovascular events like heart attack. 

This study confirms Hippocrates’ recommendation suggested by most NDs to “let food be thy medicine and medicine be thy food.” 
 
FOOD SOURCES OF CALCIUM
Food Source of Calcium    Milligrams (mg) per serving
Sardines with bones (3oz)            370
Collard greens (1c)                         360 
Wakame seaweed (25g)                325
Goat milk (1c)                                  315
Whole milk (1c)                               290
Salmon (4oz)                                    285
Mollasses (2 Tbsp)                          280
Swiss cheese (1oz)                          260
Bok choy (1c)                                   250
Spinach  (1c, cook lightly)             230
Kale (1c)                                            210
Broccoli  (1 stalk)                            160
Tofu (4oz)                                         150
Garbanzo beans (1c)                        95
Oysters (3oz)                                      90

SUPPLEMENTATION
Occasionally, however, dietary measures are just not enough. Oftentimes this is a result of suboptimal absorption of calcium in the intestines. Ideally, calcium should be delivered in a product along with other synergistic nutrients including magnesium, vitamin K and vitamin D as it is found in nature. Without magnesium, calcium may be deposited into the soft tissues and joints rather than bone. Vitamin D (calcitriol) is absolutely necessary to supplement with calcium as it signals intestinal absorption. Calcium should also be in the bioavailable form of calcium citrate or malate, preferably in a whole foods supplement for optimal absorption, and it should be spread out in smaller doses throughout the day (as it wouid be attained naturally in food). 

I prefer to supplement calcium to my patients in the form of a cell salt, which falls under homeopathy. Since homeopathics are prepared as very small amounts of a substance, this route of administration is very safe and prevents risk to the blood vessels. Cell salts are an effective modality as they stimulate the body to improve upon its own inherent wisdom, encouraging optimal absorption and utilization of the calcium through gentle stimulation.

ENHANCE ABSORPTION
  ·  Eat whole foods, avoiding processed foods. Excess sodium leaches calcium from bone
  ·  Eat foods rich in Vitamin C (broccoli, citrus fruits) as it encourages calcium absorption
  ·  Manage stress more effectively: cortisol encourages calcium excretion and bone breakdown
  ·  Avoid coffee, soda and alcohol for they interfere with calcium absorption
  ·  Spend 30 min outside every day to enhance Vitamin D production in the skin. Food sources include cod liver oil, wild salmon, egg yolks and mushrooms.
  · Weight-bearing exercise every day (walking, running, weight lifting, stairs, pushups) encourages calcium storage and bone deposition 
  ·  Lightly steam/cook foods high in oxalic acid (greens like spinach and parsley) as these compounds can bind calcium

Like many things in medicine, the topic of calcium supplementation will likely continue to be controversial until all medical providers and researchers can agree on one safe and effective decision for patients. But even then, further research may dispute another common understanding of a once-thought safe treatment. As far as naturopathic doctors can suggest, treatment is simple. Stick to food, optimize digestion for efficient absorption, and treat the cause.
 

[i] http://www.ncbi.nlm.nih.gov/pubmed/20671013
[ii] http://heart.bmj.com/content/98/12/920.full?sid=3af5715f-8a65-41e8-910c-26047a46b873


 

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