Frequently Asked Questions (FAQ) - American Bone Hea...

American Bone Health: Osteoporosis

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Frequently Asked Questions (FAQ)


My doctor suggested a bone density test but since there is x-ray involved, I am concerned.

There is a tiny amount of X-ray involved in a bone density test - about the same amount of radiation that you would get flying from California to New York. We naturally absorb about 1 mrm of radiation per day if we are living at sea level. A bone density test gives you about 0.1mrm of radiation.

What is the best kind of calcium supplement?

Be sure you need a calcium supplement before you take one. Only take a calcium supplement If you do not get your daily requirement in your food, Put tablets where you will remember to take them with meals, or maybe a chewable can be easy to grab on your nightstand. Choose one that works with your lifestyle.

Can you take too much calcium?

Taking anything below 2,000 mg per day is generally safe for most people. An excellent study showed that 4,000 mg per day caused hypercalcemia. The 2,000 mg limit is for people with normal absorption - but may not be necessary if you are getting enough calcium from your food. People with gastrointestinal absorption defects may require more than the limit mentioned - talk with your doctor if you fall in this category.

Can taking too much calcium cause kidney stones?

Calcium-containing kidney stones are most common in people with a common congenital disorder called idiopathic hypercalciuria. In this condition, the kidney excretes excessive amounts of calcium that tends to crystallize in the urine with oxalate and form calcium oxalate stones. People generally do not form kidney stones because they take calcium supplements; however, if you have had kidney stones it would be wise to check with your doctor about what kind of calcium to take.

Should I take magnesium along with my calcium?

Magnesium is needed for good bone health; however many of our foods are rich in magnesium so supplementing it in modest quantities is not essential, but will do no harm. It is important to recognize that loop diuretics such as furosamide (Lasix) can deplete the body of magnesium, so you may need to supplement.

What treatments do you recommend?

Depending on your risk of having a fracture, there are a number of good treatments. SERMS (Evista¨and Duavee¨) may be considered, a bisphosphonate (Fosamax¨, Actonel¨, Boniva¨, Reclast¨) or for particularly fragile bones, parathyroid hormone (Forteo, TYMLOS¨) might be considered. All of these treatments require a prescription from a doctor.

Are there certain medications that create difficulty absorbing calcium supplements?

Some medications like proton pump inhibitors (PPIs) reduce stomach acids. Some of the common PPIs are Prilosec, Preacid, Nexium, and Protonix. However, these are usually prescribed because the individual's stomach acid levels are too high and the medication reduces the acids to a more normal level. You might consider calcium citrate rather than calcium carbonate if you are on these drugs.

I am taking a drug for osteoporosis; do I still need to take calcium?

All osteoporosis treatments must include calcium and vitamin D. Calcium is the mineral that is deposited in the bone as the treatment is working. Some medications are now formulated to include calcium. Check with your doctor to make sure you are getting the right amount of calcium and vitamin D.

I don't like milk and don't want to supplement, but I am concerned about my bones, so I am eating a lot of greens, especially spinach and broccoli. Is this enough?

The green leafy vegetables like spinach and broccoli are very good for you, but are not the best source of calcium. Those vegetables contain phytic and oxalic acids that bind with the calcium. This means that the body is not able to absorb the calcium that is in them. Additionally, these high fiber vegetables move through the body quickly and reduce the ability of the body to extract the calcium.

Can I get my recommended amount of vitamin D from being in the sun?

There are a number of good reasons to supplement vitamin D. Sunscreen blocks the UV rays that convert vitamin D in your skin. People with darker skin do not process vitamin D as well as those with lighter skin. In northern latitudes for much of the year, vitamin D is screened out by the atmosphere due to the low angle of the sun. And as we get older, our skin does not process vitamin D as well as it does when we are younger. Vitamin D supplements are safe at the recommended 1,000-2,000 IUs/day and not expensive.

My calcium has vitamin D in it, and I take a multi-vitamin. Is that enough?

American Bone Health recommends 1,000-2,000 IUs daily for people concerned about their bone health. Most calcium supplements do include vitamin D but multivitamins contain very little. You might ask your doctor to test your vitamin D level before you decide how much to take.

Can I take too much Vitamin D?

There are reported cases of vitamin D causing hypercalcemia and renal failure at extremely high daily doses exceeding 50,000 IUs taken for long periods of time. It is important to keep preparations of vitamin D out of the hands of children because they are dangerous if they ingest them. 1,000-2000 IUs a day are safe, and many doctors are using 50,000 IUs once a month in their patients who are deficient.

How often could/should I repeat my bone density test (DXA)?

That depends on a number of issues including your age, menopausal status, bone depleting drugs you may be on and what type of osteoporosis treatment you may have started. Generally, doctors follow-up with DXAs every two years since changes in bone density are usually slow.

Will herbal or natural supplements keep my bones strong?

Studies have not shown that herbal or natural supplements, other than calcium and vitamin D, have any effect on bone mineral density. It is also difficult to know how much of any ingredient you may be getting in many herbal or natural remedies. Studies are required to determine if there is sufficient evidence to recommend these supplements.

Full list of Frequently Asked Questions on our website

6 Replies

Hello. Yesterday a member in GB posted that a medication for osteoporosis (Strantium R.) was being reintroduced in GB.

On info pages and medical suggestions which accompany this American Bone Health venue strongly advises NOT to use this medication and notes that it was removed from GP a few years ago due to serious side effects.

I have been invited to be an ambassador for this venue, and I am considering accepting that invitation.

Thought first thing I should do while considering this, was to advise you that on our GB counterpart venue which appears to fold in with this venue, is the post yesterday which is very pleased that the medication is being reintroduced into GP.

I have replied to her post and by PM as the US and UK health systems are very different.

I think it would be beneficial if a review of the strongly negative use of this med on the American Bone Health venue be reviewed and determined how we should address questions why this venue is in the direct opposition to the post announcing the reintroduction of the Rx by a member in GB, who is very happy over this happening.

Thank you and look forward to your advice and response to this situation.

Hellloooooo......Woud you please read my reply and respond to my concern about Srantium R. below? Thanks.

kathleen_abh in reply to HearYou

Strontium ranelate has not been approved in the U.S.

The forms of strontium available over-the-counter in the U.S. or on the Internet are usually strontium citrate or strontium chloride. These forms are different from the ranelate compound and there have been no studies showing that they are safe or effective.

People who take strontium for any period of time are likely to make future bone density tests inaccurate. Strontium is like calcium and will replace calcium as the mineral in bone (Bone naturally contains calcium and phosphorus). Because strontium atoms are heavier than calcium atoms, swapping some of the calcium atoms with strontium atoms will make the bone mineral density appear to increase — this is not the same as making new bone.

Since strontium citrate and strontium chloride are not regulated, you do not know what amounts your body is getting when you take these supplements. You also do not know whether they can seriously harm you.

HearYou in reply to kathleen_abh

Thank you very much!

Mark_ABHAdministrator in reply to HearYou

Here is more from the ABH site to echo the user below ...

HearYou in reply to Mark_ABH

Thank you very much from all of us!

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