Calcium Osteopenia Osteoporosis was authored by: Dr. Safaa A. Mahran (MD), consultant Physical Medicine , Rheumatology & Rehabilitation . Assiut University, Egypt.
Calcium Osteopenia Osteoporosis. Osteopenia is considered a silent
disease because bone loss can occur gradually without symptoms. However, 2 behaviors that can help in the prevention of osteoporosis are calcium intake and exercise behavior.
Bone formation and maintenance: changes throughout the lifecycle: 99% of calcium is found in teeth and bone. Only 1% is found in serum. The priorities of bone formation differ by population group. In children and young adults, emphasis is placed on strong baseline bone growth and structure. By ages 25-30, the majority of new bone formation is completed.
After this growth period, emphasis is placed on maintaining bone density and
preventing loss. After the age of 50, bone density often decreases substantially so the goal at this life cycle phase is to sustain bone mineral density and minimize bone loss. Progressive bone mineralization loss over time increases the risk of bone fracture and falling. So you have to think of your bones as a bank for calcium. If you have enough calcium intake during youth, you will be safe during your elder years.
Do you have to measure the calcium level in your blood? Serum calcium does not fluctuate with changes in dietary intake. The smallest drop in serum calcium below the normal level will trigger an immediate response. The body is ready to transfer calcium from other sources like the bones to maintain normal serum calcium levels and prevent hypocalcemia (low calcium level) usually within minutes . Thus, serum calcium is not an accurate indicator of calcium stores in the body. Normal serum calcium level is usually found even with severe osteopenia.
Calcium is lost from the bones of females who do not consume sufficient amount of calcium daily: postmenopausal women , female athletes triad (female athletes who experience the 3 following conditions: eating disorders, amenorrhea and
osteoporosis),premature (early) amenorrhea of any cause, individuals with milk allergy or lactose intolerance and other risky populations as adolescents and elderly.
Adolescents throughout the world are growing in risk due to dietary pattern changes. Many adolescents decrease calcium intake by substituting other beverages for dairy products or by decreasing their total intake of calcium.
Recommended daily requirement of calcium ranges between 700-1200 mg /day in most countries. Levels above 2500 md /day are toxic
Calcium needs the help other elements to work well in your body. the most important are phosphorus, vitamin D, and protein. Dietary protein is required transform vitamin D to an active form. vitamin D is necessary to move the calcium from the intestine to the blood.
Dairy products (milk, cheese , yoghurt, etc.)are the most familiar sources of calcium. One cup of milk (236.6 ml) contains approximately 270 gram of calcium. For people who have trouble digesting dairy products because of lactose intolerance,
lactose-free dairy products and lactase enzyme pills are also available. Most aged cheese, including cheddar, Colby and parmesan are naturally lactose-free.
Other non-dairy sources of calcium include Sardines, dark leafy greens like spinach, kale, turnips, and collard greens, fortified cereals such as Total, Raisin Bran, Corn Flakes (They have a lot of calcium in one serving.), fortified orange juice, soybeans, fortified soymilk (Not all soymilk is a good source of calcium, so it's best to check the label.) and enriched breads, grains, and waffles.
Caffeine appears to decrease calcium absorption by a small amount. Drinking more than three cups of coffee every day may be harmful to bone health. If you enjoy drinking coffee and tea, you can help to make up for any calcium loss by
getting enough calcium from other sources to meet your body’s needs.
Sometimes it is very difficult to get the proper amount of calcium through the diet, and calcium supplementation becomes an option.
There are many types of calcium compounds available to use. The most popular are Calcium carbonate and Calcium citrate. Calcium carbonate is effective and is the least expensive form of calcium. It is best absorbed with a low-iron meal (such as breakfast). Calcium carbonate may not be absorbed well in people who also take a specific medication for gastro-esophageal reflux (called a proton pump inhibitor or
H2 blocker), which blocks stomach acid.
Calcium citrate is well absorbed in the fasting state.Calcium doses above 500 mg are not well absorbed, so large amounts should be taken in divided doses (e.g., in the morning and evening).
In general, you shouldn't take supplements that you don’t need. Calcium supplements are available without a prescription in a wide range of preparations (including chewable and liquid) and in different amounts. The best supplement is the one that meets your needs based on convenience, cost and availability.
When choosing the best supplement to meet your needs, keep the following in mind Choose brand-name supplements with reliability. Look for labels that state “purified” or have the USP (United States Pharmacopeia) symbol.
The “USP Verified Mark” on the supplement label means that the USP has tested and found the calcium supplement to meet certain standards for purity and quality.
Read the product label carefully to determine the amount of elemental calcium, which is the actual amount of calcium in the supplement, as well as how many doses or pills to take. When reading the label, pay close attention to the “amount per serving” and “serving size.”
Calcium is absorbed best when taken in amounts of 500 – 600 mg or less. Calcium doses above 500 mg are not well absorbed, so large doses of supplements should be taken in divided doses (eg, in the morning and evening).
The use of vitamin D in conjunction with oral calcium supplements is more effective than calcium alone.
When starting a new calcium supplement, start with a smaller amount to better tolerate it. When switching supplements, try starting with 200-300 mg every day for a week, and drink an extra 6-8 ounces of water with it. Then gradually add more
calcium each week.
Side effects from calcium supplements, such as gas or constipation may occur. If increasing fluids in your diet does not solve the problem, try another type or brand of calcium. It may require trial and error to find the right supplement for you, but fortunately there are many choices.
Calcium supplements interfere with the absorption of iron and thyroid hormone and, therefore, these medications should be taken at different times.
There is little evidence that consuming large amounts of calcium (from foods and drinks) increases the risk of kidney stones, or that consuming small amounts of calcium decreases the risk. In fact, avoiding dairy products is likely to increase the risk of kidney stones. However, use of calcium supplements may increase the risk of kidney stones in IIIIsusceptible individuals by raising the level of calcium in the urine.
This is particularly true if the supplement is taken between meals or at bedtime. Talk with your healthcare provider or pharmacist about possible interactions between prescription or over-the-counter medications and calcium supplements.
End of article: Calcium Osteopenia Osteoporosis
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