Recently, I have a few patients that asked about nutritional support for osteoporosis/osteopenia. Osteoporosis indicates loss of bone density below the normal range, usually based on bone density scan, and osteoporotics are more susceptible to fracture. Osteopenia is osteoporosis-lite, showing early signs of bone density deficiency that can lead to osteoporosis.
One patient has been religiously taking Fosamax, Calcium, and Vitamin D, as well as dark leafy greens (which, as I pointed out in the Kale article, contain abundant calcium that can be easily absorbed). After two years of effort, however, bone density continues to decline. This can be frustrating as the regimen she was on seems ‘perfect’. She came to me for advice.
A good example (actually, not so good) for calcium absorption is CAKE. While flour and sugar are probably the most important ingredients for making cake, you do need other ingredients like eggs and baking powder, in the right ratio, and the proper environment (temperature) to bake a cake. It is the same for calcium to deposit into bones. You’ll need:
1) Calcium that is easily absorbed (bio-available)2) Other ingredients that help deposit calcium into bones
3) Proper ratio of ingredients
4) Proper environment in the gut to allow absorption
I’ll address 2), 3), and 4) on subsequent blogs. Let’s talk about calcium absorption. When we look at the thousands of calcium supplements, the first thing we pay attention to on the label is the amount. The one that contains 1,000,000,000 mg in one pill wins. Actually, we need to focus on the QUALITY first. Minerals like calcium needs to be chemically bound to other substances to form salts, so it can be made in pill form. Once ingested, calcium separates from the bound substance (a process called ionization) in order to be absorbed in elemental form. How easily it is ionized determines its absorb-ability. So, most cheap calcium supplements you see in Walmart, or even the dollar stores (!!!), contain Calcium Carbonate. It takes 12 exhausting biochemical reactions in the body to turn calcium carbonate into elemental calcium. You’re probably better off chewing limestone. Calcium lactate is probably the closest to the ionized form, taking 2 biochemical steps before it is absorbed. Citrate is another good choice, but not as good as lactate. So the word behind calcium is one factor to pay attention to!
We will address the synergists of Calcium in my next post.