I've read a couple of osteoporosis forums and searched online and am not finding any information on hypercalciuria causing osteoporosis and its treatment (thiazide drugs which cause your kidneys to get rid of potassium and magnesium instead of calcium). I was diagnosed with osteoporosis (in my spine) and osteopenia (in my hips) despite being very active and having worked out with weights for years. I'm 63 (I was diagnosed 1 1/2 years ago). A 24-hour urine test showed that my kidneys put out too much calcium (however blood calcium levels are normal). Testing was done to rule out parathyroid issues. The doctor called it idiopathic hypercalcemia and said it's likely genetic in origin.
After 6 months on the thiazide (hydrochlorothiazide) my atrial fibrillation, which was 100% controlled by drugs, came back. Later I learned on a functional medicine podcast that hydrochlorothiazide leaches magnesium from the body, which isn't as easily or quickly replaced as potassium which is also leached. And low magnesium is a well-known trigger for atrial fibrillation (even by the electrophysiologists who specialize in it). This drug also causes weight gain (which, if that was the only side effect, would be worth preventing more thinning of my bones).
Has anyone else been in this situation? I sure hope I'm not alone in this.
When doing some Internet research, I've heard salt consumption can also cause calcium leakage in the urine, and I have since lowered my salt intake and plan to lower it further (cutting out corn chips and peanut butter). Other dietary changes I've made since my diagnosis cutting out caffeine and soda (I made this change for my AFIb, but it's also good for bones). I wonder if these could be enough to improve my calcium leakage.
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dw98611
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I was diagnosed with hypercalciuria and osteoporosis 2 years ago.
was put on hydrochlorothiazide which brought calcium excretion under control but was not tolerable (terrible side effects on just 25mg).
replaced hydrochlorothiazide with chlorthalidone (25 mg) which didn't cause any side effect but dramatically affected electrolytes balance (primarily potassium which should be heavily supplemented) .
To supplement potassium, I used potassium citrate (about 5000 mg/day) which, in turn, further reduced calcium excretion, so chlorthalidone was cut to 12.5mg/day.
1. If potassium citrate reduces calcium excretion, would it be possible to just rely on it and stop the chlorthalidone? A while back, I thought I read somewhere that potassium citrate could be used alone to reduce calcium excretion (but don't remember the source).
2. Does chlorthalidone affect magnesium in you as well?
3. Have you reduced your salt intake as well, or considered reducing salt intake in lieu of drugs? I'm curious but am well aware a low-salt diet can be hard to follow.
I'm interested in a totally drug-free approach, as I have a condition that is aggravated by electrolyte imbalances. For me, I could either try chlorthalidone, or cut my thiazide dose in half and add potassium citrate.
I'll discuss this with both my doctors (the GP and the one I use for my other condition).
1. I experimented a bit with potassium citrate (ordering my own 24-hour calcium tests via walkinlab) and I do believe that in my case I'd be able to keep calcium around 300mg/24hour with something like 90 MeQ (roughly 10 g/day) without chlorthalidone. I will discuss that with my endo at the next visit though I expect her not be happy with such approach.
the study you probably referred to is here: ncbi.nlm.nih.gov/pmc/articles/PMC3578058/
2. I don't think so
3. My salt intake was always lower than for of an average Joe, not for any health reason - I just don't like salt
I just looked at your profile. You don’t have hypercalciuria. Assuming you consume the right amount of calcium (not less than 1000mg/day), 275mg/24hr doesn’t rise to the level of clinical condition (it’s like be pre-diabetic).
The right definition of hypercalciuria would be more than 4 mg calcium/kg body weight/24hr.
And you certainly don’t need diuretics to reduce your excretion by 25mg. Potassium citrate will do it at a pretty low dose. And maybe you don’t need even that, just go low salt.
IMO, you’ve been misdiagnosed and mistreated.
To give you a perspective, my number was 620mg/hr at the time of diagnosis
Wow, thanks for the info. I'm having definite issues with the thiazide drug, and I read up on the drug you're taking, and it would likely be much worse for me, since my blood pressure already runs low. The upper limit in the test I took was given at 250 for women. The thiazide only drops it about 50 to about 225 (I've read in a couple of places that it's best if it is closer to 120). I guess the doctor was trying to give me something for my thinning bones, but it's doing me more harm than good. I'm going to try to move to a more alkaline diet until I figure out what to do next (but won't drop the animal protein, because that's needed to protect bones as well).
But thanks for this info. It gives me something to think about.
I did some more reading last night regarding the alkaline diet to help osteoporosis (also called the acid-ash diet). Here's a couple of studies I found:
I'm still trying to make sense of this information, and figuring out how to use it for my situation. But the latter paper agrees with earlier information I've heard (that came from a reputable doctor) that people who eat no animal protein (e.g. vegans) have lower bone density and more osteoporosis than those who eat some animal protein, and also that some animal protein is good for building bone.
another benefit of potassium citrate is a very significant increase in alkalinity. My pH is consistently in 8-9 range (at or above the top of reference range)
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